First of all, this peace comes from our family's disposition, one that tends to tip the optimism scale. We do our fair share of worrying, but we also believe in taking positive action when we have that capability. Helping Elizabeth find the best healthcare provider was one way we could have a positive impact on the outcome of this situation. We continue to believe that while this tumor may return, we are doing exactly as we need to do get the problem under control.
Secondly, we are surrounded by an amazing support group. Our family and friends have been a constant reminder that so many people care for us. We are fortunate to belong to a variety of communities (church, town, work, school, sororities, etc.) that connect us with multiple generations of people in all parts of the world. Knowing that so many people are praying, meditating, sending us positive energy, and taking care of our obligations while we are away, we have been able to focus all of our energy on caring for Elizabeth. That support group has provided all four of us with an amazing peace that I didn't know existed. It is a feeling I want to explore more deeply once this part of our journey is behind us; it is a feeling of inner peace onto which I want to hang.
Finally, every step of the way, Elizabeth has been surrounded by the best health care professionals in the world. From the doctors in Denmark to the doctors here at the Mayo Clinic, she has been taken care of by compassionate, intelligent, articulate, and confident people.
Today was exhausting, as Elizabeth had another MRI first thing in the morning, followed by a meeting with the surgeon later in the afternoon and a PET scan for the clinical study. The meeting with her surgeon was the pivotal moment that truly filled us all with peace to which Ghandi refers. Despite the outside circumstance of a brain tumor, we are at peace that all will be well. Elizabeth's surgeon spent a long time with us reviewing the functional MRI and reiterating the options as well as the pros and cons of each option. We could do nothing, allowing the tumor to continue to grow before addressing the problem. We could do a biopsy, hoping to get enough of a sample to give us a good picture. We could be aggressive and attack the tumor with surgery. We chose the latter.
WARNING: REST OF THIS POST DESCRIBES THE SURGERY!
Elizabeth's surgeon walked her through each step of the surgery. He began by describing the entire team of professionals that will be buzzing throughout the room, mentioning that it might be a bit overwhelming with all of the activity. He reminded her, though, that he was in charge, saying, "There will be a lot of people in the room, but I am the captain. I am the one with the SHARP instruments." She will have to lie on her back for the surgery with her head turned to the right, allowing her left side to be exposed. Once they have her head in the position they want it, they will place two rods through the skin on her forehead, touching against her skull. Two other rods will be placed on the back of her head. This will keep her from moving her head during the surgery. Fortunately, they will give her a sedative that will help her relax, and they will also numb her entire scalp.
Once she is numb and sedated, but not asleep, they will cut her scalp with a question mark incision starting in front of her ear, moving atop the ear, and up across the left side of her scalp, ending at her hairline. He assured her he will only clip her hair where he will make the incision. Once the scalp has been pulled back, he will cut the bone of her skull, removing a rather large circle using a high powered drill. Finally, he will cut through the thick membrane beneath the skull to expose her brain. Each step along the way will involve more numbing so that her entire head is numb.
Before actually removing the tumor, he will spend an hour or so mapping her brain activity showing her a slide show that requires her to identify pictures while he is probing parts of her brain using an electric stimulator. His goal is to ensure that when he begins to remove the tumor that he doesn't damage her ability to speak or understand language. At least twice throughout the surgery there will be MRIs conducted in this special operating room. After completing the mapping, they will use the functional MRI and the PET scan as a GPS of sorts as he navigates through her brain, cutting away the tumor from the healthy brain tissue.
Once they believe they have as much as they can, they will have a final MRI. If the MRI doesn't reveal any of the tumor, they will close her up (putting the bone back and using plates and titanium screws to hold things in place). If the MRI shows more of the tumor they can get, they will continue with the extraction.
The entire process is remarkable. If all goes well, she will spend the night in the ICU, move to a regular room on Saturday, and be discharged on Sunday. We will bring her back here to the hotel room for several days before we are allowed to bring her home.
Our positive thinking, our support group, and our amazing healthcare providers have given us peace. May we each find that peace within.