Neurologist Input

I took Satomi to see her Neurolgist friend yesterday.  He took a complete history and reviewed te MRI from early July in detail.  It was quite informative.

He confirmed that the tumor had signs of shrinking which agreeed with the Neurosurgeon and Oncologist opinions.  He also noted that the MRI showed only some relatively minor of edema (swelling)-This was a surprise.  We had though all this time that swelling was the primary cause of Satomi’s dizziness.  The culprit seems to be scar tissue around the tumor area.  The scar tissue is basically dead tumor and surrounding brain cells.  This tissue is slowly removed over time by being re-absorbed in the body via the macrophage system.  Based on the small amount of swelling, the overall effectiveness of the Dechadron would be minimal.  That explains a lot but doesn’t help Satomi in the short term.  She is going to be dizzy for what could be a long time.  No one can say for sure but the macrophage system is vey slow so it could be many weeks or months before the scar tissue shrinks.  We’ll have to see how it progresses.

Now Satomi’s goal is to get off the Decadron.  That’s not so easy.  Decadron supresses adrenal and pituitary function so the dosage must be reduced over a relatively long period of time.  According to the Neurologist, aggresive dosage reduction may also have unexpected Neurological effects.  I didn’t ask him to expand upon “neurological effects” but it doesn’ sound good.  On her own Satomi had reduced her Decadron from 12 mg daily to 8mg daily.  The Neurologist agreed and instructed us to maintain the present dose for a week.  The following (2) weeks would maintain the dosage level but skip a day between dosages (i.e. Instead of 8mg daily for 2 days, she is to take 16mg on day #1 and none on day #2).  That seemed a bit weird but I would ask our Radiation Oncologist about it for clarification.

For these past 2 weeks, Satomi has been almost continuously fatigued and dizzy.  The diuretics helped with some swelling in her right hand and foot but didn’t make much difference in her weight.  The diuretic did make a distinct change in Satomi’s blood pressure-Now it’s just about normal even when she’s exerting herself.

Her emotional state changes but is mostly good.  Now that she has a plan, she’s moving forward and that seems to give her strength.