Update on Seizure Surgery; Does He Or Doesn’t He?

Quinn and Carmella face to face

Tuesday was a nail-biter with lots of buzz about collecting data and analyzing it with a fine-toothed comb. 5 or 6 Doctors and technicians filed into Quinn’s hospital room. Since the day before the mood was  guarded, as the big concern was that during brain mapping that they’d find the area with the D-Net too close to the speech center of the brain and if that turned out to be the case it would be deemed too risky to attempt with the possibility that they could accidentally wipe out his ability to speak (and/or possibly to comprehend others’ speech).

Doctors in rounds

Some were already scaling back their hopes, including his step-grandmother who has been a little leery about the whole idea of his going under the knife (well, laser, actually) from the beginning although she managed to keep that thinly veiled from Quinn, just dropping subtle and some not-so-subtle hints that she thought he should accept something less than a full cure. Just the day before some of the doctors began talking about other options and I could tell that it was swaying my son’s confidence. They discussed a neural pacemaker (which as it turned out would require alot of maintenence including uploading data regularly), and a few other possibilities which would involve some further monitoring to get an even more precise idea of all the tumor’s parameters.

The one big unanswered question was how deep the lesion goes, and there were not sufficient electrodes implanted to check it from all angles, but that would not be possible to arranage during this hospitalization and it could take several months to a year before they could even get to the point that they could determine the exact dimensions and how the brain-matter in the very close vicinity functions.

Epilepsy electrical activity

My son has been losing further brain function the longer his seizures are left to their own devices, and it’s no longer just a matter of inconvenience to him such as in his being unsafe to drive, but in recent years he has actually suffered increasing problems in certain cognitive areas. He just doesn’t think as well nor is he as equipped to care for himself as the average guy his same age, and often seems a little lost when trying to describe something to another person, and it can sometimes blunt his emotional reaction as well.

I knew that at this stage that medications aren’t stopping the damage to his brain nor are they adequately reducing the number of seizures enough so that the damage would not progress, so this has to work in order for him to have a chance out there in everyday life. The atmosphere yesterday morning before the mapping was thick with tension and uncertainty and though nobody came right out and said it, it was more what they didn’t say that made me uneasy. He’d already discussed other options with his doctors previously and none really gave much hope of adequate seizure control, so he came in here hoping for the new technique which would have the best success rate and the most permanent and safe results. Despite the deflated mood that was developing amongst the others I remained resolute that where there’s a will there’s a way.

Inspired Woman

As soon as he’d told me this new technique was available I felt that he could benefit from this and that the right doctor could make it a big success and I have never waivered from that philosophy. Dr. G. (according to Quinn’s general Neurologist) is one of the top Neurosurgeons in the world, and the minute I met him I felt confident he could do the job and do it right.

Doctor who looks like Dr. Gross

Success in treatment is a winning combination of factors on the doctor’s part; the skill, the will, and the ability to think creatively, and I knew that this guy had it. Sometimes you can just tell. Then the other half is the body’s ability to surprise us all. I encouraged Quinn not to give up hope yet. There was still the brain mapping. Nobody but his own brain at this point knew the outcome that was about to reveal itself.

Around 1:57 PM Tuesday several doctors and EEG Techs entered his room and introduced themselves.

Happy Doctors

They seemed a bit more upbeat than the group who had been in the previous day, and one of them (whom I am pretty sure was an Aspie and had a movement disorder) seemed to know what I was dealing with as his mother more than the rest.

The team began the mapping, testing one electrode at a time with a process involving delivery anywhere from 1-8 millihertz of electricity to a specific area of the brain. If he were to be deemed a candidate for the surgery there would be no or little interference with his speech as he was directed to identify objects  and famous people and to read short sentences. If on the otherhand they discovered that stimulation of certain areas caused speech or comprehension to cease entirely then that would be of concern, indicating that these vital areas would be considered too close to the tumor which needed to be removed for surgery to be safely performed.

All waited with baited breath as the young blonde woman with her hair in a poneytail and what appeared to be about 1 Ct. diamond earrings (or CZs; I’m not sure) had her finger on the red button attached to a black box which delivereed pulsed electricity to a designated electrode. It made a ticking noise when pressed and Quinn was asked to repeat the sequence of instructions over and over as each electrode was tested.

Doctors using digital tablet in meeting

Communication between the members of the team consisted of a number of fingers held up and and coordinates denoting particular electrodes and voltage. At first my son felt nothing or mild to moderate euphoria, but as time went on and they tested other parts of the brain he became violently nauseated and threw up several times. That was enough to send doctors and techs scattering, but after a few minutes he collected himself and resumed the procedure. It is quite possible that they hit something that tripped off his Autonomic Nervous System. It was nothing dangerous at that low a voltage, but it was scary nonetheless seeing him react so suddenly. The Vancomycin they’ve been giving him to prevent infection makes him nauseated as it is on and off, but there was no doubt that one of the stimulations triggered it this time…and very strongly!

A few other areas that were tested made him light-headed. The team paused in order to let his brain settle down and resumed where they left off.

Dizziness

As the mapping continued I could sense the exitement in the room growing and the clouds of doubt lifting.

Looking Up After Fainting

One tall young man with dark wavy hair who was watchig the brainwaves on the monitor burst out at one point and exclaimed “This is incredible!” There was alot of nodding and thumbs up all around and I was pretty sure that meant it was a go! The team could barely conceal their excitement. Things were proceeding much better than predicted.

Group thumbs up

Next they tested an area that ventured into the visual area (I believe the visual cortex?) He noticed just a small area of vision that was fuzzy like an old fashioned TV going on the fritz, but it was a very small area restricted to the top of his visual field.

At the end one of the main doctors in charge of the mapping, a neatly choiffed and quick-whitted guy with GQ good looks asking him the questions explained to us that Quinn did very well and that it was encouraging that they ran into no problems with the area involved in speech or comprehension.

GQ Type Doctor

There were only one or two instances in which he had to search for a word, but other than that he zipped through it without hesitation. Thankfully the surgery was still on the table!

After this team left, the main Neurosurgeon Dr. G. came in wearing street clothes and in a very down-to-earth and personable way sat in a chair beside Quinn’s bed and began duscussing with us that he though Quinn would be right for the surgery. I could tell he wanted to make a way for this to happen and with the new data from the mapping his confidence had returned.

He recommended ablation with higher electrical current (possibly in addition to laser, but would think over the logistics that night when he got home). It was clear that the wheels were turning again and faith was renewed. Dr. G. was a man inspired to change lives for the better.

surgeon

His fondness of Quinn was evident and it renewed my own faith that there are still some doctors out there who really do care and won’t leave you holding the bag when challenges present themselves, doctors who want treatment for the patient as much as the patient does. This is how all doctors should be and the right reason to work in the field of medicine. Quinn and I looked at each other and there really was no question that he should go for it.

Tonight (Wednesday, August 31st) at about 6: 10 PM when I had to leave because my transportation had been prearranged he waited in the que in pre-op for about 2 hours and then went into surgery around 8:00 PM after. I hated not being able to be there both before and after and had hoped to get a live report from the doctor when the surgery was completed. His step-Grandmother was able to go over there after I left, but Quinn and I have a special bond, even greater than many parents and children because he was sick as a baby and I saw him through several surgeries on similar tissue in his trachea.

For that first year he needed lots of special care and we were pretty much attached at the hip. He went everywhere with me and I rarely hired a babysitter because I didn’t feel comfortable leaving him with anyone else even for short periods of time.

mother holding baby's hand

I have always known when something’s happened to him such as an injury or accident or when he’s had a particularly bad seizure day intuitively even when he’s been geographically miles away.

Luckily it didn’t take long tonight to be picked up and the handicap transport vehicle got me home pretty quickly. I prepared some crispy hashbrowns and ate those with ketchup and while they were frying the phone rang. It was Quinn’s step Grandmother to say he’d just gone into surgery. She was waiting in the same waitingroom we’d waited in the first day when he’d had the electrodes implanted.

Apparently they are going to put him in another room when he’s out of surgery, so she had to take all his belongings out of there and keep them with her until they know where they’re going to put him.

He may get to go home tomorrow but I can’t imagine he would feel up to it that soon even though this surgery is less invasive than the open craniotomy style that they used to do most often. Judging by how much pain he’s had I really think that a discharge the day after would be overly optimistic.

Road

It will be exciting to see the outcome; whether the surgery stops his seizures entirely. I know he really wants to be able to drive again without risking an accident. He’s had several in the past that completely totalled his cars and since then has been greatly limited in his ability to go where he needs to go, as the bus system in Athens is not great and most buses run no more than once an hour. His girlfriend’s car was having numerous problems and then hit a deer and was completely destroyed. She has not obtained another one since.

Service between Athens and Atlanta is not accessible by public transportation so when nobody can give him a ride he has had to take a commercial bus which operates regionally (sort of like Greyhound) which is more expensive than public transportation would be had it been connected.

Last year he wasn’t able to get here around the holidays or at any other time. The only exception was when he had the external seizure monitoring earlier that year and I came out to see him for that during the few days he was in the hospital.

surgery

I hope this surgery opens up many doors for him and that he will be able to drive again. It is likely to be at least 6 months before we know for sure if it’s done the trick, but there is a very good chance he may be seizure-free, and if it doesn’t rectify all of it then he has the option to come back and have it refined. I know that if he had not had this surgery chances are that he would continue to decline cognitively which would add to the limitations he already has. It came through just in time. He called me around 1:30 AM once the surgery was finished and except for some soreness in the areas where the electrodes were he’s feeling pretty good. So far it looks as though no collateral damage resulted. Time will tell whether all the seizures are gone forever. Thanks to all the dedicated men and women who made this a reality!

This is for you, Quinn, here’s to a bright future. I just know great times are ahead. 🙂 I’m proud of you for hanging in there even during the times you were in pain, persisting despite the nausea, in spite of the fear of the unknown to see this through.