August 28-7 Days After Surgery

Emotional Recovery is as important as physical recovery. Reasons for Jocelyn's good emotional
recovery: 1) Being told initially she had a benign brain tumor by Dr. Mike Armstrong, 2) Having
Bernie's Daughter in Richmond,VA and Googling her diagnoses, 3)Listening to the diagnosis over from Jocelyn's IPhone and hearing from the doctor tumor is BENIGN, 4)Having a Godlike
Surgeon, Dr. Sahni, and a friend, Janet Goode, who knew Dr. Sahni well and use to work for
him for 7 years as a RN, 5)Friends, Best Friends, praying, supporting and knowing they really
care for me and feel the pain I am going through emotionally.

Jocelyn's Brain Tumor Prognosis Information

Meningiomas make up about 20 percent of all brain tumors. A meningioma is a type of tumor that develops in the meninges, the protective membranes that cover the brain and the spinal cord. Most meningiomas are non-aggressive, or benign, although up to 5 percent are aggressive, or malignant. Benign meningiomas are slow-growing and do not invade surrounding tissue or spread to other parts of the body, but they often require surgery, because they compress adjacent brain tissue as they grow.


Prognosis
Meningiomas fortunately carry an excellent prognosis--complete recovery usually occurs within a few months.

Initial symptoms

indicating the growth of a frontal lobe brain tumor can be difficult to notice. However, over time noticeable symptoms such as seizures and frequent urination will begin to develop. It is important to stay vigilant if someone you know displays these outward symptoms or others, such as personality change and mood swings, as they may not be readily acknowledged by the person

Discharged, 3:55PM

Jocelyn is on her way home. She was discharged from the hospital at 3:55PM today.

Bernie with his Sweetie, Sunday Night Post

Television remote in his hand, his Sweetie by his side and he gets to sleep in a
recliner all night. He's happy. Hopefully, last night at the hospital.

Hospital Stay, Day 7, Sunday Evening

Jocelyn woke up at 4AM to have blood work done since she is on steroids, anti-seizure, analgesics, saline, docusate sodium, etc. Celeste left this AM because she has to work in Indiana for the next two days. Bernie arrived at 7AM to relieve Celeste. Jocelyn decided to visit Carrington who is in this hospital. He is on 5th floor. She had on regular sweatpants and was excited about this. However, after the visit and seeing Carrington's scar due to his knee replacement, Jocelyn felt woozie. Bernie and Jocelyn went back to her room, about 3 rooms from her room, Jocelyn's felt like she was falling. Many nurses came to the rescue. Her blood pressure was so low it didn't register and her sugar was high due to Dexamethasone(steroid) use. They put her back to bed and she started feeling better a few hours later. The prune juice and stool softener worked for the first time since surgery. Jocelyn walked again this afternoon and did good. She had a good dinner while Bernie was eating Subway at the hospital. Jocelyn should get her first bath in her own room later tonight. The basics of life are the things she is yearning now. Since I am blogging, Bernie said he felt left out so I'll add that he just tinkled. Bernie added that he tinkled and tinkled. He is watching 60 minutes now and he is sporting a fancy fashionista sweater. Tomorrow we aren't sure about now because she has to be released by her neurosurgeon, then physical therapy needs to see if she can walk 30 steps. Can you imagine Jocelyn wondering if she can safely walk 30 steps? So, we are waiting to see how tomorrow goes. Bernie is staying the night in a recliner next to Jocelyn's bed. We hope she will be released, but we will update you, as soon as we know.

Hospital Stay, Out Of ICU, PM Post

Good news. Jocelyn was moved out of the ICU today. The hospital was full all week, so they kept her in the ICU. Celeste was told today, Jocelyn will be going home Monday. She is in a regular hospital room now. Jocelyn is doing good. She continues to go to bed at 8:30PM and she is sleeping through the night. Good night everyone! (Oh, Celeste continues to spend the night with her Mom. Jocelyn is being taken good care of by Celeste and Bernie.)

Hospital Stay, PM Picture, August 23, 2012

This picture was taken post surgery. Jocelyn said it was okay to post. Picture was
taken at 9:00 PM or so. I stopped in to see if  I could help and update the blog, as
I was instructed to do by Jocelyn during this process. I think she looks great. Her
hair is growing in nice and thick. She'll be looking like herself shortly.

Hospital Stay, Day 4

I have new information that is more accurate. Jocelyn's tumor was the size of an orange, not an egg. She walked again today. Some flowers were sent to the hospital, but the ICU doesn't allow because of infection control. Celeste took the flowers home to keep them until Jocelyn moves out of the ICU. In the way of news, Jocelyn has been very tired. This is something they are watching; however, she didn't move out of ICU today because of availability of regular hospital rooms. Celeste is sleeping in Jocelyn's room each night to watch over her special Mom. They are sharing moments which will be remembered for a lifetime. Bernie has been taking the day shift with Jocelyn. Jocelyn told me Bernie was anxiety ridden during her surgery. A physician who was visiting his family member spoke with Bernie on Tuesday in the cafeteria. Later in the day, Jocelyn remembers an unfamiliar physician stopping by to check on Bernie because he was so worried about his wife!

Day 3, Hospital Stay, PM Post-August 22, 2012

It's 10:30 PM and I just spoke to Jocelyn's RN,Amy, for an update. Jocelyn is still very sleepy. Jocelyn is off IV fluids now. She is on oral Meds. She walked around hospital hall twice today. Nothing more to report. She still has her head wrapped and a drainage tube, but not much fluid coming off. With this information, the tube will be removed tomorrow. I understand Bernie has been at the hospital most of the time. He and Celeste have been excellent supporters during this stressful time in Jocelyn's life. I know Jocelyn loves everyone who cares about her and she appreciates everyone following her progress during this journey.

Wednesday, Day 3 Hospital Stay-August 22, 2012

Celeste asked me to add the following comments: Jocelyn is doing well. She is happy and thankful to have the surgery over. The doctor came in and checked on her and said she will need to get up after lunch and walk around a little bit to avoid blood clots. Doctor said she is doing well and that the tumor has probably been there at least for 10 years. Jocelyn was finally able to eat and she ate her favorite thing, frozen yogurt from Sweet Frog. Celeste went and made a special trip to the yogurt shop for HER SPECIAL MOM. (I am adding these comments at 12:30 PM and I plan on updating this blog as I get more definitive data. I am Jocelyn's blogging trainee, Terry. Thank you for your patience with this blog process.)

Hospital, Day 2, PM Post

I called the hospital a few times during the afternoon and they said Jocelyn was still in surgery. Finally, at 8:30 PM, I reached Bernie at the hospital to get an update. They were just bringing Jocelyn back from recovery room. She now rests in the Neuro ICU. Bernie stated that she was in pain. Instructions from Bernie-NO VISITORS UNTIL SHE GETS HOME. What I know: tumor had been there a long time. Tumor was calcified and the tenicals were deeply embedded in the scalp. In order to get all the tenicals, the neurosurgeon spent 4 hours using laser. Then he needed to reconstruct scraped area for cosmetic reasons. The tumor was high between the scalp and forehead. Any indentations would show on her forehead; thus, detail to surgery matters. Surgery was said to be a success. Celeste is staying in the room with Jocelyn at the hospital tonight, at this point. As I get updated, I will post the details. Jocelyn should be in ICU for 48 hours. Then, she could be in a hospital room additional 4 days. This could change based on physician orders.

Hospital Stay, Day 1, PM Post

Jocelyn & Bernie left home at 7 AM. Karen, their neighbor, took them to Johnston Willis Hospital. Bernie promised Jocelyn he would not drive to the hospital which is 10 miles away on curved  roads. At the hospital, prep began. Radiology was the first stop. Prep for OR began for cerebral angiogram. In OR, table was very cold. Room was like a meat locker because of infectious disease control (aka-mersa.) Next stop, lines were placed in neck and Jocelyn was slightly sedated. She cried inside until she remembered what Bernie had told her..."you must be brave." Two hours later, surgery over. Surgeon gave very positive results. Doctor said embolization not necessary due to calcification of tumor. Meaning tumor had been there awhile and blood supply to tumor was very minimum. So, this is very good. Next stop, Neuro ICU unit. The next 6 hours...NO movement. Finally, food was given, but Jocelyn refused because of the meat diet offered. But, at dinner, vegetarian meal was brought. Yeah! Next...nurse practitioner came into room to put GPS tags on skull. Jocelyn's head was shaved. She looks simply marvelous with her fashionista style going on. The GPS tags/probes help guide the surgeon on surgical boundaries for Tuesday 8 AM surgery.

START READING Monday August 20 THEN Sat, May, 5 thru Wed, Aug. 15, 2012

May 5, 2012

My husband Bernie and I were at our condo in Vero Beach, Florida and had just returned home from a Republican Women’s Kentucky Derby fundraiser party.  Within the last two years, I had noticed a reoccurring rash on my ring finger that frequently made me take my engagement ring off.  After the party, I was certain I took my ring off and placed it on the dresser.  Little did I know it wouldn’t be there the next time I went to put it on.  Lost in my vacation activities, I am still unsure how many days later I went to look for my ring, but I do know that when I did; it wasn’t there.  While my husband was taking a nap, I frantically looked for it.  It wasn’t on the dresser, behind the dresser, under the dresser, the bed; it was gone and I had no idea how or when I was going to explain this one to my husband.

So that is the story of my ring.  The real story and purpose of this blog.  My lost ring was never found but is the reason I found I had a benign brain tumor.   

June 6, 2012

At some point, I had to tell Bernie.  I was afraid to because he always told me not to take it off because I would lose it.  The good thing is the ring was insured, but I did not tell him for two weeks after I had torn the condo in Vero Beach apart.  He kept asking me where was the engagement ring and why was I not wearing it.  He wanted to take it to a jewelry store where we had taken the ring before and have them put another anti nickel metal protection plate on the inside of the ring.  Finally, at dinner one night after I had given him 2 Bourbons and a large glass of wine for dinner I broke the news.  Of course, I heard," I told you so".  But, he did not get mad at me because I was so upset and he hates to see me cry.

He knew that it was insured and told me that we would look for another one when we got back home to Richmond.  I was so glad I had told him and that weight could be lifted off my shoulders and heart.  Phew.

Wednesday, July 11, 2012

We met with a State Farm agent to file a claim on the engagement ring.  Our personal property agent Myra Howard looked at my finger and said I could see why you took off the ring.

Wednesday, July 11, 2012

Bernie and I met with Adolph, Bernie’s longtime friend and owner of a well-known jewelry store, Adolph’s Jewelers.  They made my original ring.  After explaining the irritation I continued to have and the whole reason I took it off, Adolph said, “What are you allergic too”?  Well, I did not know. So, I made an appointment with Dr. Mike Armstrong an Ear, Nose, Throat and Allergy doctor in Richmond, VA.

Friday, July 13, 2012

I chose Dr. Mike Armstrong because I’ve known him personally for10 years.  I coached him in an Adult Masters Swim Program at the Tuckahoe YMCA. My appointment with Mike was 2-fold.  After a Rhinoplasty I had in 1975, I have had a problem with drainage from my left nasal passage and blockage.  It has been annoying me for many years, but because I needed to find out what my metal allergy was, I figured I could finally ask someone about what I could do to fix this nasal problem. 

Monday, July 16, 2012

My appointment with Mike came up with two diagnoses. One, I had noticeable blockage in my left nasal passage caused by scar tissue from the rhinoplasty 35 years ago. Two, Mike was going to send me for a C- Scan to see how bad the blockage was. Then, I was to meet back with him the following week to determine if I needed surgery to remove the blockage.  As far as the allergy and the main reason for my doctor’s visit, he was not sure if I was allergic to a particular metal but suggested I choose a platinum or 18-carat gold ring to prevent future painful rashes on my ring finger.

Monday, July 23, 2012

I scheduled my Cranial CT scan at Henrico Doctors Hospital.  Bernie and I went to the appointment together.    I found the staff in this hospital left me with a calm feeling. It helped because I was really nervous. What is a Cranial CT scan anyway?  Prior to going in for my appointment, I researched it and this is one of the answers I found... 

(CAT) scan, is an X-ray procedure that combines many X-ray images with the aid of a computer to generate cross-sectional views of a certain area.  Computerized tomography is more commonly known by its abbreviated names, CT scan or CAT scan. A CT scan is used to define normal and abnormal structures in the body.  For me it was a Cranial Ct scan to find the extent of the scar tissue blockage in my left nasal cavity.

I was asked to lie on a narrow table that slid into the center of the CT scanner.

Once inside the scanner, the machine's x-ray beam rotated around me.  The modern "spiral" scanner performed the exam without stopping. I was told that a computer creates separate images of the brain area, called slices. These images can be stored, viewed on a monitor, or printed on film. I was asked to be really still during the exam, because movement can cause blurred images. I was also asked to hold my breath for short periods of time. The good thing was the completed scans took only a few minutes and it was basically painless except for the cold table. I asked for a heated blanket but the guy doing the scan just laughed. I wasn’t kidding, but I didn’t ask again.  The bad part was I read in the Consumer Reports magazine that the radiation from CT scans- are equivalent to 100 to 500 chest X-rays-which might contribute to an estimated 29,000 future cancers a year, a 2009 study suggests. Oh, great!  Now I can worry about cancer.  Before leaving, Bernie wanted to know how much the C-scan cost. You have to know Bernie.

After we were completely done with the treatment, I was given a DVD of the results and was told to take the DVD back to my appointment with Dr. Armstrong the following Monday.

Friday, July 27, 2012

I received a call from Dr. Armstrong’s Assistant. I wondered why his office was calling me.  I had a follow up appointment on Monday, today was Friday.  I did not know Dr. Armstrong’s office had already received an email of my C-scan results. It was late in the afternoon and Bernie’s daughter, Jane was in town so I decided not to call them back.  It could wait, I thought.

Monday, July 30, 2012

Today was my follow up appointment with Dr. Armstrong.

Dr. Armstrong told me the C-scan found a meningiomas Benign Brian Tumor of the frontal lobe.  He went on to say that I needed a MRI and also needed a neurosurgeon.  I only came if for a blocked nasal cavity and was shocked to here such a foreign diagnosis.   I asked him to repeat the information and I videoed it on my iphone.  Not knowing any neurosurgeons’ I asked him, “If your Mother needed brain surgery whom would you have operate on her?”  Right away he answered, Dr. K. Singh Sahni at the Neuro Center at Johnston Willis Hospital in Richmond, VA.  I asked why and he said that his mom actually did have surgery by him.  Maybe this is more common than I realized.  With the help of his staff, I scheduled an MRI and was told that someone in Dr. Sahni’s office would call me to set up an appointment with him.  This was all happening so fast. 

Wednesday, August 1, 2012

Today was my MRI.  The technician asked me repeatedly if I was claustrophobic.  Over and over, I answered no. Okay, so maybe I was wrong.  I was told to remove my watch and all other jewelry and place it in a locker. No thank you. I would give the jewelry to my husband.  Bernie was there with me waiting in a 10x10 box of a waiting room. The only pleasant thing about the small waiting room was a large ivy plant flowing over onto the floor.  God bless the Kindle so Bernie could read his books while he waited.  I gave the jewelry to him.  Next time, I will not take any jewelry. 

The next thing I knew the technicians were putting a space like helmet over my head with bars in front that cradled my cranium.  I could barely breathe or see.  I was guided into a dark, tunnel-like tube, a kind of medical solitary confinement where I spend the next 30 to 40 minutes.  My ears were stuffed with plugs, covered by sound-cancelling headphones.  Good thing since there were on and off LOUD sounds for over 40 minutes.  Was this really happening all because I took my engagement ring off and it disappeared?

Friday, August 3, 2012

I was now at my first appointment with Dr. Sahni.  I met with his assistant and filled out a medical history form that took me thirty minutes to complete.  It seemed like they wanted to know everything about me that had ever happened.  Bernie was not with me because he had another doctor appointment for himself.  Geez, don’t we sound exciting!  I was lucky that Dr. Sahni office had called me and said they had a cancelation and I could come in earlier than my original appointment.  I was worried and the sooner that I could have an idea of what I was about to go through, the better.

Dr. Sahni showed me the MRI.  And, he explained it was a Meninoga Benign Brain Tumor on the left frontal lobe and the size of an egg. He explained the tumor was benign, but it was large enough that it needed to be surgically removed. If it was smaller he could zap it with a gamma knife laser, but of course, I had to have a large one. 

He asked if I had headaches, and I said no.  I did in the past, but not now.  He knew I exercised everyday from the paper work I had filled out and said adrenalin helps the frontal lobe function and that is probably why working out helps me feel better.  

Always thinking I had ADD I read that People with ADD or ADHD often have depressed moods and anxiety. They have those feelings because their frontal lobe, their CEO, can't manage the busy activity of the mid brain.   Could it be possible I do not have ADD and it was the tumor pressing on my frontal lobe and making me think I had ADD?  Dr. Sahni said it was highly possible!

Here is an overview from my understanding thus far about a meningioma:

A meningioma is a type of tumor that grows from the protective membranes, called meninges, which surround the brain and spinal cord. Most meningiomas are benign (not cancerous) and slow growing; the reason they think mine is benign is because of the calcified mineral deposits C-scan found.

Symptoms are typically gradual because these are slow growing tumors and mostly affect women between the ages of 40 to 60.  Meningiomas tend to grow inward and due to the size of mine, the tumor had to be removed s that it could relieve the compression it was placing on my brain.

What were my symptoms?

Frontal lobe tumors can cause behavioral and emotional changes.  Over the last few years I have had memory loss issues, speech problems (difficulty finding the right word), and vision problems.  I had surgery for acute angle closure two years ago.  This is the stage right before glaucoma.  And, if the tumor was not found early enough I could have had seizures.  I could not be more thankful for having a metal allergy and losing my ring!

Wednesday, August 8, 2012

Dr. Sahni ordered for me to have a Cerebral Angiogram a day before my brain surgery.  So, Bernie and I met with Dr. Spinos who would perform this surgery.

Thursday, August 9, 2012

I was back for my second visit with Dr. Sahni.  He met with Bernie and my friend Janet Goode who is a nurse. I found out later she worked for Dr. Sahni for 7 years at Johnston Willis Hospital in the neuro ICU.  Small world.   Bernie agreed that if Janet liked him and thought so highly of him, he was the doctor for me.  He also said that I would be the only patient he would have for the entire day of surgery.  A good thing to know.

Tuesday, August 14, 2012

Dr. Sahni sent me to Dr. Ed Peck at Neurophyschological Services of Virginia for  pre-neurophyschological testing.  This would demonstrate my cognitive abilities pre and post-surgery.

Wednesday, August 15, 2012

I went back to the testing center for 3 hours of cognitive testing.  I got every question wrong on one memory test.  Apparently, my short  term memory is non-existent.  I can’t wait to re-take it after the tumor has been removed.  Maybe I really am a genius!  Well, even if I am not, at least I know why I have had these memory and cognitive issues for all of these years. 

Wednesday, August 15, 2012

I left the testing center and drove to pick up Bernie.  We went for my pre-op at the Johnston Willis Hospital Surgery center.

Sunday, August 19, 2012

What began as a nervous talk to tell my husband about losing my engagement ring turned into an unplanned four weeks outcome that would make me understand the importance of family, fate, and being truly thankful for being one of the 20% of those who can be told they have a benign brain tumor one that will most likely not take my life. This blog below tells my story of finding, learning more about,  (and later about) living through, and the processes it takes to move beyond a benign brain tumor. 

Monday, August 20, 2012

Monday, August 20, 2012

I am admitted to the hospital tomorrow  for a Cerebral Angiogram.  I will stay in the ICU over night at Johnston Willis Hospital.

  

Cerebral Angiogram

Introduction:

Cerebral angiograms provide a roadmap of the blood vessels of the brain.  Physicians use this blood vessel roadmap to determine how a particular patient’s brain is supplied with blood and how to best proceed with the course of treatment.

Procedure:

Cerebral Angiogram– The procedure for a cerebral   angiogram requires that a small tubed catheter, similar to a long piece of spaghetti, be placed in an artery in the groin area. Prior to catheter placement, patients can be given local anesthesia with sedation medication to keep them comfortable. After anesthesia has been taken care of and the catheter is inside the artery; the catheter is navigated under image guidance up to the vessels of the head and neck. Once the catheter has been stabilized then contrast dye is allowed to flow through the catheter for a short period. While the dye is moving through the blood vessels a special x-ray camera or   fluoroscope takes pictures of the blood vessels.

What is Embolization?

Tumor embolization is a procedure that can be performed prior to a planned   surgical resection. Embolization shuts down the blood supply to a tumor reducing   blood loss during surgical resection. A secondary benefit from embolization can be that tumor margins are more easily identified and a tumor can be removed more completely and with less effort.  Meningioma Tumors (what I have) are   embolized and have relatively large blood vessels supplying the tumor.

Procedures frequently take 2 to 3 hours and the time necessary is often not predictable before the procedure begins.

After the procedure, I will need to remain still and avoid bending the hip where the puncture occurred for at least 6-8 hours. This means lying flat and is often the portion of the entire experience that is most uncomfortable. This period of rest is very important because it allows the small puncture hole in the artery to heal.

I will remain in the hospital overnight following the     embolization procedure, until the tumor is surgically removed tomorrow.

I will spend the night in the neurological intensive care unit for close monitoring. 

Tuesday, August 21, 2012_Benign Brain Tumor Surgery

I woke up very early by the night nurse preparing for surgery.
At 7:30am, pre-op began. The nurse assigned Jocelyn a place
between two other day patient surgeries. Celeste was out of town in Chicago on business and Bernie was arriving at hospital later
in day due to length of events on this day. Rhonda, Jocelyn's RN,
took vitals, history again and asked if Jocelyn had family outside
and if she'd like to see them. Jocelyn said no. Hair already shaved, so Jocelyn was ready. Nurse said "your daughter is on the phone."
It was early for Celeste since Celeste was in Chicago. This is one of the conveniences of the cell phone age.

Celeste and Jocelyn prayed over the phone. Celeste was scared for her Mom and scared for herself. Celeste was working and flying
on Tuesday and said she would be there at 8:30pm. Dr. Sihni was
cool and it was just another day at the 'office.' The doctor's bedside
manor was unusually good. The nurse thought Jocelyn had a really
good attitude for a person with a brain tumor and a patient facing
surgery. The doctor came in and introduced everyone and one of the assistant asked about taking phone numbers of family members. Jocelyn said "great" and gave out a few numbers.