27 July 2009

Mon 27-Jul-09 (Uncle Vic's funeral)

Today was Uncle Vic's funeral in Sydney. It was the longest I had been away from Maria (both in terms of time and distance) since the onset of her illness in February.

I woke at 5am and saw that Maria's bedroom light was on. I checked and found her awake, still experiencing periods of insomnia. She is taking it in her stride to keep sane!

I left around 5:30am and drove to Sydney, arriving at the church just after 9:00am. It was obviously a sad occasion. It was an opportunity to celebrate his life and see a lot of family from my mum's side, who I either see intermittently or haven't seen for many years. It was nice to catch up but unfortunate that it seems to be at these types of events.

After the church service, burial, and spending some time at Aunty Margaret's, I left around 3:30pm to try and beat the major peak traffic heading out of Sydney. I arrived home just after 7:00pm, taking about the same time as the trip up this morning. It has been quite a while since I've driven 7+ hours in a day.

When I arrived home, Gabi virtually crash-tackled me for a hug before I got out of the car. They had all waited patiently for me so we could have dinner together. The kids went to bed immediately after dinner, giving us a chance to chat about our days before fatigue for both of us set in. Maria was able to be driven to a morning tea for 'new' parents (for Gabi) by a dear friend and spend some time at home with her afterwards. Maria's parents also came through while travelling from Goulburn back to their home on the South Coast. It was Maria's father's 'name day' today — χρόνια πολλά μπαμπάς (pronounced "Hronia polla Babas"), which translates to "Happy name day Baba (Dad)".

What does tomorrow hold? As I may not have the energy to prepare an entry, I'll cover off on what I can recall in advance:

  • Ben has an excursion to the National Museum of Australia tomorrow to participate in a program called 'Tools of the Land" in which they'll learn about traditional Indigenous (Aboriginal) lifestyles.

  • Maria has a physio appointment for her back, which she injured while vomiting the other week (too much info??).

  • The respite cleaner will be to provide her weekly assistance (two hours).

24 July 2009

Fri 24-Jul-09 (retun to school, Gabi's excursion)

The kids returned to school yesterday (Thursday) after 2 1/2 weeks of holidays. They seemed to enjoy their first day back.

Their last day of holidays (Wednesday) involved some time at Weston Park, including a train ride, before the weather turned sour. On the way out the kids got to see a whole mob of kangaroos just sitting around in the park.
Today Gabi had her first excursion with school, going to the (NASA) Canberra Deep Space Communication Complex at Tidbinbilla as they are studying "Space'. Their visit coincided with the week marking the 40th anniversary of the first moon landing. Interestingly this complex and two other Australian facilities played a significant support role in the moon landing project. To try and summarise it (see website for more info), Australian facilities across the country provided a communication link to the astronauts and for the television coverage. Apparently the first images of the moon landing that came through to Goldstone, California were upsidedown and poor contrast because of an incorrect switch setting and poor ground-links.

"With moments to spare before Armstrong was on the surface, NASA looked to the Parkes Radio Telescope, Tidbinbilla and the Honeysuckle Creek tracking stations. Parkes didn't have a strong signal at the time due to the low position of the Moon above their horizon. Tidbinbilla was supporting the Command Module. Honeysuckle Creek was prime on the Lunar Module with the astronauts on the surface. They had a TV image and this was being transmitted through ABC studios in Sydney to TVs around Australia. NASA saw the feed coming through Honeysuckle and switched over for the international broadcast to their picture - meanwhile the sound for the international broadcast was still coming through Goldstone.

The first 8 minutes of the broadcast including Armstrong's first steps on the Moon were seen through the transmissions received at Honeysuckle Creek. Once the Moon was higher in their sky, the TV picture at Parkes' larger dish were then relayed over to Houston and the remaining 2 hours of the Moonwalk were seen through that antenna.

The Parkes radio telescope remains active today and is highly regarded as one of the world's best radio telescopes. The Honeysuckle Creek station was closed in 1981, and its antenna moved to Tidbinbilla where it continues to provide communication support to dozens of robotic spacecraft exploring the Solar System." (http://www.cdscc.nasa.gov/Pages/pg05_events.html)

22 July 2009

Wed 22-Jul-09 (Maria's struggle with sleep and fatigue)

Today is the last day of the kids' school holidays. We have had a reasonably quiet time off, especially as the kids are exhausted from having already done a full school year (their friends in Israel are now on the end of school year two months' break). With a few months of school to go for Ben and Gabi, this break was very timely.

It is a little strange to think that had Maria been well, this is the time we would have been in Australia for our "mid-term" leave break.

In recent days Maria has started to struggle with insomnia, very similar to that she experienced in Israel. It is hard to know the cause(s). Unfortunately her fatigue causes her to nap during the day, which may be creating a cycle of night sleeplessness. Maria intentionally stayed awake all day today and we put the kids into bed at 7pm with the hope of getting through to her normal bed time to see whether this would help her. Unfortunately we both fell asleep while chatting on the bed. I awoke to the 9pm medication alarm. After that we were both wide awake. I left her about 9:30pm.

It is nearly midnight now and I have been busy praying for my family with the loss of Uncle Vic (see previous entry) as well as writing a business case to work on accessing a further period of carer's leave. I hope Maria is well as truly out of it by now.

Uncle Vic's passing

Further to my blog entry the other day regarding Uncle Vic, I since learned he had been placed on life support after his heart attack, which was switched off late this afternoon. He died around 8:00pm this evening (22 July).


Please keep my Aunty Margaret, cousins Anthony and Robert, and their wider family in your prayers.

20 July 2009

Mon 20-Jul-09 (kids day out)

Maria has lately struggled with stretches of wakefulness throughout the night. Last night was no exception.

Janelle and Dom collected Ben and Gabi this morning and headed to the War Memorial for the 'dress-ups' area and to have a look around.

Afterwards they had fun at the 'fort' in the park. This gave me a chance to empty most of the remaining boxes. Although most are empty, this does not mean that we are unpacked as it is currently a matter of just getting things onto shelves temporarily to clear the boxes. Maria made morning tea and even had her first go on my recently acquired coffee machine—the sound of it puts her off.

We all lunched together. The kids played on while Maria had a nap. During this time Janelle prepared a delicious roast and we had a chance to chat a little.

My mum SMS'd to say that my Uncle Vic had suffered a heart attack and had been placed in a drug-induced coma. Please keep him, Aunty Margaret and their sons Anthony and Robert in your prayers at this time.

Tomorrow Maria has a medical appointment so we can re-stock on medication as we are no longer in the hospital system. Janelle will take Maria and I'll look after the kids as we are having a respite service provided a cleaner for a couple of hours a week over the next few weeks. This will be her first visit.

18 July 2009

Sat 18-Jul-09 (Maria completes 1st chemo cycle)

For anyone out there still following the blog, Maria finished her first cycle of chemo in Australia! Apart from feeling a little nauseas on the morning after her first dose (which could have also been attributed to an increase in her antibiotics), the rest of the week was fine. She has struggled with fatigue more than anything this week.

The kids have been enjoying their holidays. They're taking advantage of the shipping boxes that I have been slowly emptying. They have turned them into anything from an aircraft to a home, putting their imaginations to great effect. Gabi has enjoyed dressing up for the occasion, getting around in an old pair of high heels. Ben and Gabi have played beautifully together for lengthy periods, which has been a little surprising at times.

This afternoon Janelle and her son Dominic arrived in Canberra. They came over for a visit and will be around over the next few days (staying with other friends), so we plan to try and do a few things together. Ben, Gabi and Dom enjoyed each other's company today.

This evening the kids made dessert. Ben got very serious with his creations, even creatively decorating with the strawberries.

13 July 2009

Mon 13-Jul-09 (Maria "discharged", visit)

The morning commenced with the four of us heading into the hospital to meet the IDC team to discuss Maria's ongoing antibiotic treatment. We waited around for well over two hours. The kids were amazingly patient. Gabi thrashed me again at 'Uno'.

When the Registrar finally came, there appeared to be an internal mis-communication. A few minutes later the Professor turned up. It was decided that Maria could come off the IV antibiotics and one of her oral antibiotic (Ciprofloxacin) doses would be increased.

Gabi and I watched the nurse remove the line. As you can see from the photo, Maria didn't feel it at all, which is amazing as you can see it has some length to it. Ben couldn't watch the action, but he was interested in having a "sticky beak" (look) afterwards to see whether there was blood on the line. Upon examination there was very little.

Maria tried on a mask, should she need one in the future to avoid illness while on chemo. The kids and I (even the nurses) agreed it made her look like a duck!

We headed home for lunch. We also received a call from our dear friend, Elizabeth, who had arrived in Canberra with her daughter and would be visiting us later in the afternoon.

Elizabeth, her daughter, and a friend came over for afternoon tea. It was great to see Elizabeth, yet a bit strange having last seen her in Israel. The two girls had to shoot off so I took Elizabeth back to their friends' apartment later. When Elizabeth returns to Israel, she'll only be there for a further six days before returning to the US indefinitely.

Maria took her first dose of chemo for this cycle (as you can see). Although she is now on a virtual double dose (290mg/day) compared with her first regimen in Israel (150mg) because that was administered concomitantly with radiotherapy, she is taking a small number of tablets (3 compared with 5 last time). Here's praying for some positive effect, yet no/minimal side effects.

12 July 2009

Sun 12-Jul-09 (movies and week ahead)

I haven't prepared an entry since Thursday as things have been relatively quiet and we have been lazing around the house. I'm also suffering from a little exhaustion. I have to say that part of my fatigue is self-inflicted, staying up late to watch the Ashes (i.e. cricket series against England).

We took the kids to see Ice Age 3 today. They enjoyed it and Maria made it through the whole movie (much of it wearing ear plugs).

Tomorrow we meet with the Infectious Diseases Control team again to discuss Maria's antibiotics and ongoing treatment of her brain abscess.

We are expecting a visit from a dear friend, Elizabeth, who is over from the US, via Israel) to see her daughter. We are looking forward to seeing her.

Maria will commence chemotherapy on Monday evening, which is a little tricky (as already mentioned) because the chemo may drop her immunity to fight infection, yet the neuro-oncologist doesn't want to delay this cycle of treatment. We trust his judgement, having already handed this situation over to God.

Tuesday will be a busy day with our goods from Israel being delivered. I am going to try and get Maria and the kids out to someone's home for the day, allowing me work with the removalists. Otherwise the week should be eventless.

I think that my updates will slow a little, unless there is anything of interest to share.

09 July 2009

Thu 9-Jul-09 (Maria's finally home)

What a long day! Gabi decided to come into my bed to complain about feeling itchy. The only problem was that it was 2:00am, and only an hour after I'd gone to bed. We were both a little slow out of the blocks getting to Scoot.

After dropping off the kids, I had to visit the office to deliver some paperwork. I bumped into my predecessor from Tel Aviv. As he is on leave, we were able to have a good chat.

I got into the hospital around 10:30am. Maria had already met with the IDC team and it sounded like they would remove her line and send her home. As mentioned yesterday, the blood cultures were taking some time to grow and there was still no result outcome.

Maria also mentioned that her Neurosurgeon had caught up with her and was happy with the CT scan from his perspective. His summary was that there was no apparent change in this CT compared against the post-op CT. In effect this means that the tumour has done little/nothing in the 3 1/2 weeks since surgery. Praise God!

We sat around, went to the cafe, played cards, chatted, dozed and waited...and waited...and waited. Eventually I headed to a nearby shopping centre/mall to do a little shopping. As I was about to head off to collect the kids from their respective play-dates, Maria called to say they would be proceeding with her release "shortly". At this stage it was just after 3:30pm.

Anyway, at 5:00pm we finally left after a HITH (Hospital in the Home) nurse hooked Maria back up to her regular IV antibiotic. The PIC line remains in for now. The only change in her medication is that one of the oral antibiotics (Metronidazole aka 'Flagyl') has been removed. Maria said to the nurse that it would have been strange had IDC removed her PIC line because that would have meant she was officially discharged and therefore no longer in need of HITH visiting us at home.

We have been asked to go in on Monday morning to meet the IDC Head to review Maria's situation, particularly the duration of IV antibiotics. Hopefully we'll have the blood results by then also!

The kids had a ball at their play-dates. Tomorrow is their last day at Scoot. It appears they have enjoyed it so far.

08 July 2009

Wed 8-Jul-09 (Maria still in hospital)

I received a call from Maria first thing this morning. She told me that she had a bad night with some vomiting and rigors. After packing a few things in anticipation of a longer stay I headed into the hospital. I called the kids, who were having a ball with their friends.

Upon arrival on the floor, Maria was being wheeled to X-ray for a chest x-ray. She was otherwise quite well (this continued throughout the day). We waited around for the IDC team to come through to discuss any infection issues. After a lengthy wait we decided to head to the cafe for a break. Just as we were on our way back up, the nurse called me to say the team had arrived. The summary of that conversation was:
  • Basically nothing could be found from the CT or chest x-ray that raised any particular concern. However, the bloods would take a little while to culture and this may solve the mystery.
  • Maria may be suffering a reaction to one of the oral antibiotics, which they intend to remove. She was very happy as she finds it terrible to ingest.
  • The PIC line could be introducing infection. If this is the case, they will remove it.
  • Further to the previous point, they may introduce another antibiotic intravenously (Vancomycin Hydrochloride). This is used for the treatment of potentially life threatening infections that cannot be treated with another, less toxic antibiotic. Maria received this after surgery, which may have helped, but appeared to be the cause of all the problems she had with her veins, making the insertion of canulas almost impossible. They are therefore not sure how they will manage this. Perhaps another PIC line, but in the other arm?
  • Because Maria has a bout of rigors earlier that morning and the bloods taking a while to culture, they decided she should stay in for another day. I'm feeling déjà vu coming on!
Our brother-in-law Brian was in the hospital for the day at a workshop. He visited Maria before he and I had lunch together.

After spending some further time with Maria, I collected the kids (a huge thanks to Gill) and re-introduced myself to them. We collected McDonalds for a special dinner to take to the hospital to have with mummy. It was also to celebrate their end of term reports. They both did very well. In fact (a turn of the tables) Ben's report was outstanding! They put cheese on my burger, so Maria ended up enjoying two burgers and I had (not enjoyed) her hospital meal.

The kids crashed out pretty soon after we arrived home. This has given me more time to get my final loads of washing and basic cleaning done as well as take a few minutes out to punch out this update.

Here's praying for Maria's return home tomorrow. The only blessing in her being in hospital tomorrow is that we have some appointments there anyway.

07 July 2009

Tue 7-Jul-09 (Maria hospitalised)

Last night I collapsed into bed at 8:30pm after being up most of Sunday night watching tennis. I even missed a call an hour later even though it was on my bedside table.

Unfortunately the timing of my deep wasn't great. About 7:15am I went to check on Maria to find her unwell. She said that she woke around 5am and vomited. She called out, but as I am in a different room (and no doubt in that "deep sleep"), I didn't hear her. Unfortunately while sick she coughed and put her back out as well. As we knew the nurse would be arriving in a little while we decided to go ahead with the routine of me taking the kids to 'Scoot' as I'd only be out of the house for about 30mins and she was confident of looking after herself for that period.

When I returned our favourite nurse was already there. She made a call to the hospital and spoke with the neurosurgical registrar. It was decided I'd monitor Maria and should there be any change or additional vomiting, we'd contact the hospital for further advice. As Maria had come off her dexamethasone (steroids) completely the day before (she was only on 1mg before ceasing) I felt one possibility was another case of withdrawal, which is what she had experienced post-surgery.

Maria had a short (pre-arranged) visit from our dear friend Sue who arrived as we were farewelling the nurse. Afterwards Maria went off to sleep.

I collected the kids and after returning let Maria sleep a little longer. I checked on her around 2pm as she was due some meds and found her very tired and with significant head pain. When I helped her up, she commenced having rigors. At this time I received a call from the nurse saying she had followed up with the neuro-oncologist who was keen for her to come in if I was concerned for Maria. The timing of her call was impeccible. We got moving and arrived at the hospital within half an hour of that call.

After some assessment, it was decided that Maria would have a CT brain scan and blood/urine/etc. cultures. In the meantime I was able to get through to another dear friend who came and collected the kids from the hospital. That's where they now are, having their first sleepover since returning to Oz. They are excited but obviously concerned that their mummy is hospitalised again.

Maria was given 2mg of dexamethasone around 4:30m. By the time I left, she seemed a whole lot better. Before I left we bumped into one of the neurosurgical registrars, who said Maria looked great and he felt it may be steroid withdrawal also. Obviously we can't still rule out infection issues yet.

The feedback we received before I headed home was that: (a) the neurosurgical team was happy with the CT from their perspective; (b) the Infectious Disease Control (IDC) team wanted Maria to undergo a chest x-ray later in the evening; (c) another antibiotic would be introduced temporarily until they resolved the issue; and (d) IDC wanted her to stay in so they could assess all scans and cultures in the morning.

Hopefully even if it is infection, she can come home and they can introduce another antibiotic through her line. Maria is very frustrated to be back in hospital (same Acute Care Unit room) as she believes she is too well (and bored) to be occupying a bed. She also knows the night ahead means constant observations, which will break-up whatever sleep she is able to get.

Prayer points
  • Reasonable rest for Maria.
  • Resolution of the issue tomorrow and a return home.
  • Peace for the kids.
  • Maria's PIC line has a kink in it, which has been blistering her skin. The nurses are doing an admirable job trying to move it to another spot on the skin and avoiding any other infection. However, it is also challenging as you can only move it sideways so far because it is running through a small hole into a large vein.
  • Effectiveness and minimal side effects from the chemotherapy, when it commences (could now be as early as Thursday). This is a little tricky as the oncologist is balancing the risk of her immuno-suppression against the need to actively fighting this aggressive tumour as quickly as possible.
  • Some respite for the four of us. There seems to have been something each week since returning that has challenged us and kept us from doing family stuff.

Mon 6-Jul-09 (Hospital and Scoot)

The kids spent their first day at 'Scoot', a kids program run at one of the churches in Canberra. They both seemed to have had a lot of fun and were well and truly exhausted by bedtime.

After 'Scoot' the kids went home with a dear friend (thanks Mel), which worked really well as we were at the hospital for the neuro-oncologist's appointment and spent some time in the HITH office (which was manic). Unfortunately when I went through the bag of many meds I collected, I missed one, which meant another trip for me little later that afternoon.

Chemotherapy (which was put off due to Maria's surgery) will commence on Monday evening. Grateful prayers over that.

06 July 2009

What I didn't mention

What I forgot to mention was that yesterday (Saturday) we had a visit from my brother Mark, his wife Cass and our very cute nephews, Magnus and Luka. It was the first time we had seen them in two years and the first time we got to meet Luka. The kids all got on really well and had fun playing together.

I thought I should add a couple of photos.

Sun 5-Jul-09 (general update)

It's actually after 1:00am on Monday but thought I'd take a few minutes while watching the Wimbeldon Men's Final to give a brief update as I haven't written since Wednesday. This is probably because we haven't been up to much apart from trying to relax and have quality time and fun with the kids.

Ben and Gabi are now on three weeks holidays. They will spend this next week going to a kids' church program (3hrs each day) at which a number of their friends will also be attending.

Maria suffers head pain usually in the morning and evening (with a little throughout the day), but her current medication keeps it well under control. Otherwise she is quite active—perhaps too much at times—which over the last couple of afternoons has caused her to feel exhausted and in need of a good rest. This is not concerning when you consider her level of activity (again, comparing it with how she fared after the last surgery) and that she is still recovering from this surgery.

We see the neuro-oncologist later this morning (10am) so we'll find out the specifics about Maria's next round of chemotherapy, which may start as soon as next week.

I'll sign off with Roger (Federer) having just taked the third set in a close tie-break. Here's praying that he can become the first male tennis player to win 15 Grand Slams to cement his place as "Tennis' best ever".

01 July 2009

Wed 1-Jul-09 (suture removal)

I'm going to keep this brief as I can barely stay awake and am not sure if it is the onset of illness or exhaustion, but wanted to put something up as I know a lot of you had covered Maria in prayer today.

We got into the hospital just before 10am. One of the nurses who has been visiting Maria at home, and was supposed to be on a day off was working today because they are short-staffed. This was the first blessing as both she and Maria have developed a great rapport and she is highly professional at her job. She and I noticed a lump on Maria's head just below where the titanium plate was inserted. This was a result of an accidental head-clash she had with Gabi in the morning just before school.

After the nurse organised the neurosurgical registrar and infectious disease control (IDC) dept doctors to see Maria, she removed the sutures without any incident. A real answer to prayer. Thanks to those out there who held her up at this time.

The neurosurgical registrar was happy with the healing of Maria's wound and overall condition. We have now dropped from 2mg to 1mg of dexamethasone, with the aim to cease it completely in 5 days time. At this same stage after the initial surgery, Maria was somewhere around the 24mg mark!

IDC doctors are still to commit to the duration of Maria's intravenous antibiotics, but it may be around six weeks in total, followed by oral antibiotics for an indefinite period. The registrar that saw us will meet with the dept 'head' so there will be more for us to discuss at Maria's next review on Thursday week (9th). The good news is that the results of a blood test taken yesterday show that in terms of infection indicators her 'levels' are in the normal range, which may suggest a positive response to the antibiotics.

We have a meeting with the neuro-oncologist on Monday, at which we'll be able to discuss a range of issues, including Maria's treatment regimen (e.g. next round of chemo).

One last look before the sutures come out

Maria's head sutures will be removed in a few hours time (planned for 10am on 1-Jul), providing the neurosurgery registrar is happy with her healing. That said, the nurses visiting each day believe the wound is healing well. Maria has been happy to walk around without any head covering (apart from when it has been far too cold to do so) and show them to whoever is willing and able to stomach it. As you can see, it's not really that bad.

For those of you familiar with the first surgery, you'll notice there is an additional incision coming out onto the forehead. That said, as you can see from the subsequent shots, the neurosurgeon didn't come all the way down on the left and didn't have to make any incision on the right. The original scar is fading somewhat. Unfortunately there is no real hair growth in the areas that were irradiated. As mentioned before, there may be future growth, but there may not.

Maria has never sought to wear a wig and it has been helpful for Ben and Gabi's peers to see Maria "as she is" on the few occasions she has been able to visit the school.

Here's praying that the suture removal will be a little less stressful than when Effie did it after the first surgery!

30 June 2009

Tue 30-Jun-09 (first visit to work)

After taking the kids to school, I headed into work for the first time since leaving Australia for Israel in August 2007. It was strange to be there, yet I didn't feel out of place with so many familiar and welcoming faces. Everyone I got to speak with was very warm and supportive.

I met with my HR manager to discuss "where to from here" with time off. Work has been a huge blessing and this support has continued with their receptivity to any requests I make for leave (including duration). The length of time I'll be off work will depend significantly on how Maria responds to upcoming therapy as well as a few other factors. For now I'll be off for the foreseeable future.

Apart from brief chats with a few former colleagues, I had a coffee and long discussion with a friend who happens to also be one of our staff counsellors (thanks Julie). I also got to meet briefly with my Tel Aviv successor. We hope to meet again on Thursday morning for a more detailed briefing and chat about life in Israel before she launches into her final training. I finished my 4+ hours in the building over another coffee, this time with our "sister" Trish. It was strange to be sitting and chatting in a "Canberra" cafe after having worked closely with her in Tel Aviv throughout our time there (we actually departed Israel only a day apart).

29 June 2009

Mon 29-Jun-09 (still some pain, kids adjusting well @ school)

As there was only one nurse on today, we didn't see her until just before lunchtime. It is difficult to make any plans. Most of the day we both (mostly Maria) went through cartons of files and did some serious culling. It was hard work and wore her out. I think from our recent experience with culling in Israel we have both lost a degree of sentimentality.

Maria joined me collecting the kids. They were both very excited. Maria met with Gabi's teacher briefly and commented how she (Maria) feels quite "out of the loop". It must be difficult, considering her role up until she fell ill involved so much time involved in the kids' schooling, etc. I have to say that I'm still struggling to meet parents from Ben and Gabi's respective classes so I can connect them to children (whose names I'm still trying to get across).

We read the kids' diaries and discovered that Ben brought his maths tests home. We looked at them and were in awe of his results. Gabi has gone up a couple more levels in reading competency (after starting off at a very high level). We are very proud of both, as any parent would be, but for us it feels like more of an achievement given the circumstances and distractions they have encountered since our return. We're not ones to focus on their level of academic excellence (although we'll accept these bonuses). We just want to be able to encourage and praise them in trying their hardest. So far there has been a lot to praise!

The kids found a couple of very old skateboards in our shed. Since the weekend they have been keen to try and ride them and have been having a heap of fun doing so. They have been spending a bit of time kicking the (Aussie Rules) football together, with Ben teaching Gabi. It's nice to see those moments when they get on so well. I'm praying for more!

Maria was struggling a bit with head pain again later into the afternoon and evening, but she hasn't rated herself too high on the scale. I put it down to the effort she put into sorting today. She went to sleep a little early. This made it difficult for me to wake her for her final dose of medication @ 9pm, but unfortunately there is no luxury in skipping or delaying.

Sun 28-Jun-09 (some pain)

The nurse came in the morning and Maria complained of some head pain, but was feeling better. The nurse emphasised that as they are accessible 24/7, we shouldn't hesitate to call if she really finds it difficult to manage.

Mid-morning Ben and I headed off for a birthday party. I left Ben at the Go-Karting party, while I had to do a little shopping. Maria and Gabi hung out together for some girls time.

When we got home later in the afternoon, Maria reported that she had struggled again with some head pain and for a period both her and Gabi just stayed together in Maria's bed. She eventually managed it, but it was a little on-and-off during the afternoon into the evening.

27 June 2009

Sat 27-Jun-09 (another quiet day)

Another reasonably quiet day. Apart from the nurse's visit, we went to see our niece Maggie play soccer—her team was in Canberra today.


Later in the afternoon we made some cookies.

In the evening Maria decided to go through some old files. I got to do the shredding while watching the Wallabies (Australian Rugby Team) comfortably defeat the French. A good result considering the French just came off a win against the All Blacks in New Zealand.


Maria is suffering some head pain now and then, but overall she is way ahead of where she was last time around (forgive me for sounding like a cracked record on this issue).

26 June 2009

Fri 26-Jun-09 (quiet day)

Not much to write about today. The nurse's visit in the morning was uneventful. Afterwards, Maria and I did some tidying up around the house.

In the afternoon a couple of dear friends came to visit Maria.
We had our usual Friday "family night". Tonight it was making our own pizzas, which we ate while watching a DVD in front of the fire.

The only frustration for the short-term is that we'll be restricted from venturing off too far because of the daily nurse visits. I should qualify that statement by saying we don't have anything against the nurses.

25 June 2009

Thu 25-Jun-09 (4 months since first surgery)

Today is four months from the date of Maria's first surgery. Wow! looking back on it, it has been long and exhausting, yet nothing has slowed!

Today I was blessed to have read through three separate messages eminating from Australia and Israel where dear friends have passed our blog on to others they know (both directly and indirectly) who are going through the journey of battling GBM. We don't begin to pretend we have the monopoly or copyright on how to cope in this situation, but pray there may be something in there that may be an encouragement for them. To summarise the four months (to save them reading pages of blog entries), we are simply sustained by our faith in the Lord Jesus. It not only gets us through each day, but allows us have a different perspective on what people would call "suffering". In this time it can also be very simple to become self-centred. We have tried to use our situation to reach out to others. Have I lost you?

Maria had her first visit from the nurse this morning. Maria was so energised (far better progress than after first surgery) that she decided to accompany me on the grocery shopping trip. An hour and a half later we left the supermarket, exhausted. It is the first time Maria has been shopping since we returned to Australia, and quite a while since doing it at all. She did amazingly.

We got home in time to quickly have a late lunch and for me to head off and collect the kids while she slept.

Apart from the daily nurse visits, our next busy day will be next Wednesday, when Maria has her sutures removed, meets the Neurosurgeon and Infectious Diseases team (weekly appt - infection mgt).

I hope to visit work early next week as circumstances since returning has made it impossible to do so until now. This will give me the opportunity to discuss and negotiate my future leave arrangements.

I checked my current monthly mobile phone bill (only half-way through) to be completely horrified by the current cost. I contacted the company and after examining the bill, I was confident I had identified a serious anomaly (i.e. multiple SMSs sent to a number over a few seconds). After some investigation it was revealed that an SMS is charged per 160 characters. When given this information, I immediately realised that some of my daily updates from hospital were quite lengthy (as was the list of recipients). I admitted my naivety expecting that would be the end of it and I would have to honour the bill, regardless. To my pleasant surprise, they said they would will help to resolve this issue. I am very grateful.

Prayer point — This evening I spoke with my brother Mark. His father-in-law, Max, is in that tough stage of his own battle with cancer. Amongst all the difficulty, they have all had quality time together on-and-off in recent months. It is always hard to know what to say, except that we love them. After the call, Maria and I took some time to pray for Max and his immediate and extended family. While there were quite a few very personal prayer points I am not willing to share, I'd ask those of you out there joining us in prayer for Max and family that you please uphold them "as the Spirit leads you".

24 June 2009

Wed 24-Jun-09 (Maria is home)

I'm sitting here in front of the TV (something I have not watched for a long time), watching the 2nd State of Origin (for my overseas friends it is a rugby league rivalry between two of our states NSW -v- Qld). I am also working through all her new medication to ensure both that I'm familiar with it and it is correctly organised in her dispenser.

As the heading says, Maria is home. However, she has not been not discharged yet. Maria is now part of the Home in the Hospital (HITH) system, where she is technically still an inpatient of the hospital, but treated at home. When a nurse coming onto shift asked if Maria was being discharged, I answered that she is being transferred to a private hospital, which happens to be our home. The advantage of this is that should there be any issues, then she is immediately given a bed in hospital (but we are not expecting any such issues).

Maria had her PIC line inserted this morning with a double lumen attached (tubes - one usually to administer the antibiotic and the other to take blood), after some difficulty. She was away for four hours in total. They weren't able to push it right through the vein on the left arm (preferred) so fortunately the anaethetist, who was in charge of Maria in her surgery (and has visited her a couple of times since) turned up and put it through via the right arm. Maria was sedated, which I think helped the whole experience.

She is now hooked up to a portable machine that she has to carry everywhere in a small bag, which administers one of her antibiotics in two half-hour doses, twelve hours apart. A nurse will visit us every day to change the bag.

While Maria was out, the Social Worker and I had a long chat, which was nice. Maria and I have enjoyed our time with her. She has been extremely helpful and was also able to organise one of the onology social workers to visit us also.

It was time to head home. One of Maria's neighbours is a young guy who had a double dislocation of his neck in a rugby match last weekend. We got to know him and his parents a bit over the last week and a half. He had surgery yesterday and all seemed to go well. It is interesting when you feel a little sad moving on from neighbouring patients and staff, while at the same time looking so forward to leaving the hospital itself.

The kids were very excited to see their mummy. They were able to show off their individual "Welcome Home" masterpieces. We had takeaway for dinner to celebrate. Let's hope Maria can get some sleep without the usual hospital disturbances, while adjusting to the idea of having something attached to her for the foreseeable future (especially if she gets up in the middle of the night to use the bathroom!).

23 June 2009

Tue 23-Jun-09 (still in hospital, much revealed, VIP visit to kids' school)

What an interesting day. There is a lot to write, but I feel a little drained to devote the time needed. I will do my best to get out as much as possible in 30mins of typing.

The day started off with an early arrival so I could see the kids' work to date in their respective classrooms (called "learning journeys"). As they have only recently started there was not much to see, but it's about ensuring they don't feel neglected. It was nice to see what they had actually done in the three or so weeks since returning to Australia.

I was planning to head to the hospital, but as I was walking to the car park, I bumped into a friend who we happened to see at the hospital on 5-Jun when we were about to hop into the lift to see the Neurosurgeon, completely oblivious to the fact we were then about to receive the dreaded news about Maria's tumour regrowth. During our discussion I learned that the day she was at the hospital she was visiting her mother, who lives in a town about 1+ hrs from Canberra and that Maria's sister Effie was her mother's referring doctor! The world seems to shrink more and more.

As I was driving from the car park, a dear friend called and asked me to join her and her husband for a coffee nearby. Another mum happened to be walking by and joined us. That was an additional blessing as unexpectedly led to a conversation that affirmed God having us meet at that time.

Just when you thought the encounters were about to finish...When I got to the hospital, Maria and I decided to go to the Cafe before they hooked up the next antibiotic drip. Enroute to the lift we came across another dear friend and her daughter emerging from the bathrooms. We were able to go and hang out for a coffee.

We were just finishing up when I received a call from the nurse to say the Infectious Diseases team had arrived. We made our way back up, but not before bumping into another dear friend we hadn't seen since before we left for Israel in 2007.

They finally were able to narrow down the bugs. The slow growing (and therefore slow to identify) is in fact a Propionibacterium acne (p acne) bacteria, which we all have on our skin. In this case it developed inside Maria's brain. We had to absorb quite a bit of information about the plan and management of her treatment. The key thing for everyone out to know is that she will hopefully be home tomorrow after undergoing a procedure to have a PIC line inserted (under sedation). Maria also continues to defy statistics, on this occasion being in the 1-2% range of people developing infection in this case. I told her that she should buy a lottery ticket as most of the statistical categories she has fallen into have ranged from 1-2/100 down to as little as 5/100,000.

On the way out to collect the kids and return for a visit I bumped into the Neurosurgeon. We had our first one-on-one since the surgery. It was a helpful 10mins and in some ways a little shocking. All I can say is that Maria is firstly MEGA-BLESSED to have had the surgery that day, and secondly MEGA-MEGA-BLESSED to have come through it as she has. I was appreciative that he was willing to take measured risks. In addition to our case, I was also able to share some independent feedback along the same lines after speaking with the parent of someone who he had just operated on. In this case, he performed an extremely complex (yet successful) spinal surgery that at least one other neurosurgeon had avoided.

Gabi was again very disappointed, but was less emotional today. The kids and I came back for an "afternoon at the Cafe" visit. The kids were excited to report that the Prime Minister (PM) had visited the school (we actually already had inside knowledge of this from a "source"). Gabi was disappointed as the PM spent a lot of time in the other Year 1 classroom, but none in theirs. He dropped by Ben's classroom briefly. Ben says he remembered Mr Rudd's face from when I had spoken with him at Sydney Airport before we left for Israel (we were on the same flight from Canberra to Sydney and I had worked closely with one of his key advisers). At that stage he was the Leader of the Opposition. I joked to the kids that perhaps his popularity rose after he was seen speaking with me (for the record that couldn't be further from the truth).

We had the mum of Maria's neighbour take a shot of us before we headed home.
We had a quiet night at home, trying to catch any glimpses of the kids on the evening news, but without success.

22 June 2009

Church

Friends from the church we attended before leaving Australia as well as other friends through school (who attend other churches) have been kind enough to invite back/to their congregations when "we are up to it". At the moment this has been a topic far from our mind...please read on to appreciate why.

Since returning to Australia we have not been able to jump off our personal rollercoaster for a real break. We went from surgery to radio/chemo, then packing to return to Australia while having 11th-hour meetings to ensure Maria's fitness to travel. When we got back we were straight back into appointments and scans. Our hope was that when Maria was to commence her 6mths of chemo, the four of us could have what is our priority as a family: quality/precious time together. Unfortunately we find ourselves reliving events of four months ago.

These circumstances naturally dictate each of our decisions, which I should add we carefully think through. Albeit we really enjoy fellowship with other believers and listening to solid bible-based teaching, we certainly don't feel any further from God because of this decision. If anything, the last four months has brought us even closer to Him.

As I mentioned in a blog some time back, my plan will be to focus on doing more church at home, with the kids perhaps "very occasionally" visiting their friends' respective churches to hang out together at Sunday School and get some independent teaching.

One thing I was struck by when overseas was that the many passages of the Bible emphasising the unity of believers under Christ was actually realised, albeit at a micro level (approx 50 of us). For me it was a huge sense of freedom.

It is interesting to hear responses when I write "Christian" in answer to 'religion' on an official document. I'm usually asked to be more specific (i.e. denomination), but there is nothing more specific. Sadly over the centuries the enemy's successful division of the church has led to where we are today. I'll hop off my soapbox for now.

Mon 22-Jun-09 (still in hospital, taking its toll)

I called the hospital early to discover Maria had a good night.

On the way to school in the car the kids were praying for Maria, with the major emphasis on identification of the remaining bacteria, which would lead to Maria's discharge.

After a quick drop-off and running a few errands, I got in to see Maria. Not long after I got there, she was a very popular person, having the physio, pathology and a doctor wanting a bit of her time. All three meetings went well (although Maria continues to have problems around the canula entry areas (I continue to rotate her two pairs of pyjamas each day, washing the bloodstains out of one set while she wears the other), but is tolerating it to avoid another vein. We were told the veins are struggling in part because of one of the antibiotics she is on, which is quite potent.

The doctor from the infectious diseases department spent some time with us asking Maria a lot of questions about her history from the first surgery to try and better understand the abscess/infection. As she said about the infection, although it probably originated from the first surgery, that could have occurred anywhere. There is one final bug they are trying to identify, but it is so slow-growing that it is making it difficult to finalise their results. The turnaround is usually 3-4 days, so a week is not usual for this (many things throughout Maria's experience have been atypical from the onset in February). Maria may also have to be on antibiotics indefinitely, firstly to clear the infection, then to prevent any future incident. We are praying that if this is the case then appropriate oral antibiotics will be available.

The doctor said she'd return later in the day with a senior doctor with hopefully some more news. Maria and I continue to learn patience and to focus on the opportunities these delays present. It's certainly been a good opportunity to get to know the young man and woman neighbouring Maria with different ailments.

When I got to school to collect the kids Gabi came up to me excited, asking where her "mummy" was. When I told her that she would be in hospital this evening, she broke down. It is starting to take its toll. Ben was also disappointed, but acknowledged the situation.

On the way home Gabi asked some good questions like, “Why would God keep her mummy in hospital when we want her to be home?”, and, “Can’t God just have the bug grow quickly so they can send her home?” After some discussion she reluctantly accepted that perhaps there is someone God wants mummy to meet and their interaction may be important for that person's future.

Because all of the play-dates and having different carers around over the last week, we had a relaxed afternoon and evening at home. They worked on some "Welcome Home" posters after homework and I set them up on the futon sofa bed in the dining room (which I converted to a cubby over the weekend). Gabi was still highly emotional and sought prayer to help her sleep. They both drifted off quite quickly. As you can see from one of the photos below, they are exhausted, yet peaceful. It's been a long road, which we'll be on for a while to come.


21 June 2009

Addition to Sat 20-Jun-09

I can't believe I forgot to write about Effie leaving yesterday morning. I have re-posted th 20-Jun-09 entry to include a new first paragraph.

Sun 21-Jun-09 (uneventful day, however still in hospital)

Maria had some good patches of sleep. When she woke in the morning she had some brief head pain and nausea, but that passed. Her parents visited her for a while before their long drive home.

I have to say at this point that in my view Maria is comparatively doing much better than at this same stage after her first surgery. I re-read the 3-March entry to refresh my memory. Back then she had more facial swelling, was struggling with sleep (no doubt due to being on 4-times the dose of steroids than this time around - which was required then), and was not able to independently shower herself.

On the flip side, because of the need to have IV antibiotics, she has a canula inserted but has had a horror run with them not lasting for a long time. She has been a serious pin cushion [I'm not even addressing the additional daily blood tests (x2) and stomach injections (x2)]. Although she is in some pain and discomfort, she is certainly overcoming her needle phobia.

The Neurosurgeon saw Maria this afternoon while I was out doing playdate pick-ups. He told her that all but one of the nasty bugs had been identified and hopefully this would be resolved "soon" so she can be discharged. Maria feels guilty for occupying a bed that someone else "in greater need" could have, but the reality is that the onus is on the hospital to resolve this so she can be discharged with everything in order.

During my late afternoon/evening visit, I collected the kids and took them up for a quick visit. They are praying hard for Maria to be home ASAP.

Apart from family visits, Reverend Ron and Sue came through as did Denis from BTAA. All brought yummy snacks, especially for the kids.

I have ceased SMS updates today and will just continue with blog entries, unless there is a significant issue arising that requires some timely prayer coverage.

Hopefully tomorrow's entry is typed with Maria back in the house.

20 June 2009

Sat 20-Jun-09 (another good day)

Effie left before 6:45am (I woke to farewell her and she was already on the road). she has been a huge blessing over the past week. We really appreciate all she has done (again), and to Brian and the kids for releasing her to us. I'm sure she'll enjoy being back home (as will the rest of her beautiful family).

I called the hospital at 8am to see how Maria's night was. She was having breakfast and able to speak with me. She said the evening was quieter and she had some good patches of sleep.

Maria's mum went and spent some hours with her, while her Dad kept himself busy doing jobs around our home. I had some good play time with the kids before dropping them off on their respective play dates. That gave me a chance to get up to the hospital around 4pm. Maria and I walked down to the cafe for a milkshake and coffee. Unfortunately Maria has been having blood taken from her a couple of times a day and it is becoming more difficult for them to get a good vein.

Our dear friend Mel dropped the kids and a taco dinner off to us at the hospital before she took off for her own family dinner date.

Gabi was a bit nervous seeing Maria as she now is without her bandage and therefore her wound, stitches and pulsating soft spot (where titanium was placed) are exposed. I had to take a photo and show Gabi before she went in. She was fine from thereon in.

We were able to have our dinner in the Patients' Waiting Room while the kids watched a Spider-Man video. Got home around 8:30pm. Kids exhausted. They have some recovery time before launching into further playdates tomorrow.

19 June 2009

Histology

Many have been curious to know whether what the surgeons had removed in surgery was in fact mostly infection and perhaps the tumour itself had not progressed as much as seen on the MRI (as it is not possible for them to differentiate between the cancer and infection until they get to the site as was the case on Monday).

The histology showed a combination of infection and GBM (her cancer). While I cannot quantify the amount of GBM present, it was not insignificant.

Fri 19-Jun-09 (a much better day)

Maria had a restful night (apart from the hourly checks). As much as we adore the staff of the Acute Care Unit, she is looking forward to being moved for the sake of catching up on sleep.

Denis from BTAA (mentioned in yesterday's blog) visited. After the three of us had a chat, Denis and I spent some time alone over a coffee. It was nice to catch up with him.

Maria was keen to stretch her legs, so we went for a walk from the ward (Level 9) to the shop next to the cafe on Level 2 (a lift was used for the levels) to gather some essentials (chocolate, chips).

Maria's face was swelling a little more, but I still think she is looking much better than at this stage after her initial surgery. She is certainly a lot of active, talkative, less sensitive to sound, and able to read some literature.

We met with the Neurosurgeon, who is happy with her progress. He would be happy to discharge her but unfortunately the Infectious Diseases Unit staff have a big say as they are finalising all the pathology. They have identified some of the bugs, but are waiting for some final results. They will play a significant role in Maria's discharge. If Maria's antibiotics continue to be administered intravenously, they will insert a "peripherally inserted central catheter" (PICC or PIC) line. This will allow her to go home and come under a Hospital in the Home (HITH) situation, i.e. nurse visiting as required to administer the medication.

The Head Radio-oncologist came to see us. Like Maria's Neurosurgeon and Neuro-oncologist, she was young and really nice. We (Maria and I) had an instant connection with her. She confirmed our understanding that further regular radiotherapy would not be possible as she has already received what one would consider a maximum dose. As we have been praying for doors to open and close, this was another door closed. We were not upset by this at all. In fact, Maria is looking forward in the near future to have a break from all the medical attention so we can just chill-out as a family, which has not been possible very much since February.

They expected Maria to be in for 6 nights (discharged Sunday), but as we are now commencing the weekend, infection pathology won't be finalised before at least Monday.

The Social Worker came to speak with us at one stage. Maria was quite chatty and even joking around.

The kids came up in the afternoon for a visit with Effie and Maria's parents. Gabi was a little freaked by "seeing mummy with a puffy face", so taking photos of Maria and showing her before entering helped as it did in Israel. they are really missing Maria and want her home ASAP.

I joined the others for dinner at the Hellenic Club as Maria was happy to stay alone.

18 June 2009

Thu 18-Jun-09 (up and down pain day)

The morning started with a school drop-off, followed by a visit to the post office to collect a package. As I entered the post office the young lady commented that we had the same model phone. When I handed her the slip, she told me she lived in the same street (there are only a handful of houses in our street and we know some of our neighbours). It happens that she is two doors from us. She commented that the painting of the exterior of our house looks great. I haven't had a good chance to check it yet, with the early departures and late arrivals home.

The first two things I noticed about Maria when arriving at the hospital were: (a) that she was looking and feeling much better compared with yesterday. She had eaten breakfast without any problem; and (b) swelling starting setting in around the left eye (see photo).

This was similar to first surgery in terms of timings, but not on both sides this time round (so far). It appears the reintroduction of dex (steroids) had the desired effect. She took a walk with the Physio to the gym nearby and did some general exercise and testing of her balance.

A little while later one of the radio-oncologists came through to obtain some background on Maria. I explained that only five weeks ago she finished six weeks of radiotherapy (concomitantly with chemo), receiving the maximum dose of 60Gy. We were told in Israel that she would have to wait about 2-3 years before receiving such a dose again. He agreed, but was to check with his 'boss' so we may/may not have much further involvement with that team. There was a blessing revealed in this conversation. When I mentioned that in Israel they commenced regular radiotherapy but because of the tumour's proximity to her optic nerve they moved IMRT (far more targeted) to avoid long-term damage, he said that Canberra did not have those facilities at present.

I also got to meet with the Neuro-oncologist. We had a long worthwhile discussion. One thing that came out of the conversation (another blessing for the day) was that he said had Maria commenced the next phase of chemo (which would have happened had the MRI been deferred), there is a likelihood she would have gone septic.

Canberra is a small city and known for its "one degree of separation" as the example from earlier in the morning testifies to this fact. Well, to put the matter to rest we discovered through chatting with the nurse caring for Maria during the day shift that she grew up around one of the areas we lived in and to bring it closer to home, her husband is one of the primary/elementary school teachers at the kids' school!

About 1:30pm Maria started to experience severe head pain and after an hour of other pain relief, she was not better. She was asked to rate her pain on a scale from 1-10 (10 being worst). She rated herself as a '10'. When you appreciate what she's been through over the past four months and I have never heard her rate herself over 8, I could only imagine how severe it must have been! They gave her a morphine injection. Her temperature was checked @ 2:00pm and was deemed high (38.4). The doctor took further blood (had some taken earlier) for 'culturing'. She said that perhaps a post-op chest infection was setting in, albeit Maria's chest sounded fine. I told that about our dear friend who after a number of weeks in a critical condition in Israel was medivac-ed to the US. She suffered from at least one infection that took a while to identify as it was from the Middle East. After this mentionand the fact that the Neurosurgeon believed the infection was possibly introduced during the original surgery, she said she'd have the infectious diseases staff speak with us.

At 4:30pm Maria had a chest X-ray. Funnily enough, I completely forgot to chase up the result. the nurse who cares for Maria is quite good at explaining things in advance. As there has been no changes to her medicine regime, I can only assume they didn't identify anything.

Eventually her pain subsided a little. She felt she would manage without further morphine for now. Her temperature @ 7:00pm had come down to 37.7. She was still feeling a little hot and cheeks a little rosy. I kept ice packs on her head most of the day for the swelling and the pain. On my last look before Maria feel asleep, the swelling was still increasing mostly around the left.

After about a couple of hours of sleep, I decided to sneak off and probably call in at some stage later to check on how things were going.

To my friends in Israel - due to the frequency and number of people I'm SMS'ing updates to on a daily basis, my phone bill is increasing at a frenetic rate. My plan now is to give a single update each day (still after 8am your time), unless there is a significant issue that requires immediate prayer coverage. Thanks for your understanding.

After sending this entry, I plan to sit down and look through the MRI and MRI Stealth (pre-op) as well as Tuesday's post-op CT. I am going to have a copy of yesterday's MRI burnt for me tomorrow, which will be interesting to see.

I established email and SMS contact with the Brain Tumour Alliance Australia (BTAA), the only national brain tumour patient and caregiver organisation in the country. One of the key members will be coming into the hospital tomorrow for some meetings, so we are both hopeful of a time of a meet/greet and coffee. In addition to the hyperlink, I've added BTAA to my 'web links' on the side bar of this blog.

Finally, I need to mention Maria's sister Effie, who has been doing a great job caring for the kids to free me up for the hospital. She has come into a role she is all too familiar with, having done the same thing travelling to Israel after Maria's initial surgery. On that occasion she stayed three weeks. She will probably leave Saturday morning. It has been a huge blessing for us to have her (and Brian and their kids to share her) for this time.

17 June 2009

Wed 17-Jun-09 (a rough patch)

It's 7:30pm and I'm sitting by Maria as she sleeps. She had been out for an hour now. She really needs sleep. You'll appreciate why as you read on.

About 8:30am I called the hospital to learn that Maria had a rough night with a lot of vomiting. Doctors saw her this morning and changed her anti-emetic drug.

I went to see Gabi's class host assembly(they did an awesome job. Gabi read her bit fluently, I was very proud) followed by morning tea. I got into the hospital about mid-morning. Maria was very unwell and agitated. She wasn't even up to seeing her mum.

Further changes were made to her medications to see whether they could determine why she was feeling so nausea. She was quite agitated, probably because of the inability to rest due to the nausea, pain and lack of sleep.

She had an MRI @ 4:30pm (2hrs later than planned). This scan is not related to how she is currently feeling (i.e. planned prior to surgery).

About 5.45pm the Neurosurgeon saw Maria. He immediately put her symptoms of vomiting, nausea, headache and dizzy spells down to her complete withdrawal from steroids. They wanted to be careful reintroducing it while awaiting the final infection pathology, but have decided now to introduce a low dose. Although the infection pathology is to come, he said the initial indication was that they were very nasty bugs. He is happy how she is currently responding against the infection.

He said from looking at the MRI he estimates he removed the bulk of the tumour and infection. The residual tumour was glued in by infection around the main arteries. When starting to clear those masses, Maria's speech started slurring and she was feeling faint (she doesn't recall that). Making a judgement call (a sound one), he didn't proceed any further because of the increased risk of stroke or paralysis.

16 June 2009

My lack of responses to SMSs and emails

Due to the current situation, overwhelming support for Maria, and continuation of SMS and blog updates, I have chosen to conserve my energy by not responding to the many SMS and email replies. It doesn't mean I'm ignoring you. In fact it is nice to sit in my quiet time and sometimes catch up on reading those messages. I know you all understand. Thanks.

Tue 16-Jun-09 (out of ICU)

Maria had some vomiting during the night (anaesthetic-related) and was very tired by the morning because of the busyness and noise in ICU. In the morning Maria had all her lines removed (apart from a single canula). She had breakfast, slowly got into her pyjamas and by 9:30am was ready to go for a walk to the bathroom. She did it under the watchful eye of the physio. They wheeled away the bed and replaced it with a recliner. As they were happy for her to head to the Ward, we were hoping to hear good news from the morning meeting about 15mins later. Unfortunately there was no space in the Neurosurgery ward but anticipated there may be space as the day continues. The ICU staff were amazed by her level of activity and general appearance.

Most of the morning was spent hanging around, chatting with Maria and in-between spending time in the ICU waiting room with a couple of families I've come to know who have seriously ill family members.

Maria had very brief visits from her parents, "Doudou" (i.e. Maria's aunty Ralou), my parents, Effie & Brian. We then received news around 12:15pm that Maria could go to the Ward after a CT scan, which had been confirmed for 1:00pm. That all went smoothly, as did her transition to the Neurosurgery Ward. I have to say I was very impressed with the ICU nurses, who apart from doing a great job were really genuine and caring.

Maria was looking forward to the change of scenery, which may be more conducive to sleep. She is currently in an Acute Care room (like a High Dependency/ICU) of four with a couple of guys. She will need to remain there at least 24hrs, then a determination will be made when to move her (which is also dependent on bed space).

Maria slept a little while I hung out in the waiting room. The Social Worker came and saw me and we had a great chat, during which she was interested in our faith and journey. Another awesome opportunity to share, which I did not hesitate to do in a humble way.

Maria's blood pressure was tested and as it was quite low, it was double-checked by the nurse using an older, more traditional device. A doctor came and went through the same process, asking a number of questions. As she otherwise seems fine, a decision was made to put a drip in and the increase in fluids may help alleviate this issue.

Our very dear friend, pastor Ron, came by to visit briefly. It was great to see him after nearly two years. This was followed by the Anesthetist who was popping in, in her own time. She is so lovely. She couldn't believe how Maria looks and that the three types of antibiotics she is taking need only be orally administered (she ssid that was a great sign). She described how nasty the abscess was (she has her own photos, which I hope to see in the future), yet in awe that Maria smiled all the way through the awake portion of the surgery! Focusing on the underlined text, as her smiles were not anesthesia-related, let me ask you where do you think that came from, considering the awake sections of surgery was her single fear? Well, I believe it was the "peace surpassing all understanding" that came from the Lord through your prayer.

Maria sent me on my way around 6:00pm. She is exhausted and is hoping for some sleep. As I left they were planning to change her canula as there was a problem. I'm praying for minimal pain. I'll find out till later in the morning as Gabi's class is hosting Junior School assembly tomorrow as she is involved.

I spoke with the painter who had planned to paint our house, but I had put off upon return as we were otherwise distracted. Because of our change in circumstances with Maria is hospital I contacted him at short notice to see whether he was able to arrange to have the house done this week. It was a blessing to learn he has moved other jobs around to accommodate us and had three guys here today to work on it. The first coat looks great.

Back to Maria—medical staff continue to be amazed at her progress from this surgery, considering how quickly she is up and about and looking so well. In fact, in one conversation with one doctor today, they used the word "miracle". I'm not jumping ahead of ourselves in terms of her overall healing, but given all the complications (e.g. the mess to clean up, and had the abscess burst at any stage prior to surgery she would have had a rapid decline) and when you see how she is 24 hours later, I proclaim this a miracle in its own right.
As Jesus said to one (of many) he healed, "Return home and tell how much God has done for you." So the man went away and told all over town how much Jesus had done for him." (Luke 8:39)

15 June 2009

Mon 15-Jun-09 (Surgery #2, non-graphic photos of Maria included)

It has taken me over 45mins to even get this entry started as my laptop has decided to commence the end of its useful life.

I set up a mass email group in 'gmail' from the computer last night but unfortunately I have since learned that it does not work when accessed from mobiles. I then resorted to SMSs.

The day started with Maria and I departing home @ 5:30am, but not before bidding farewell to the kids. It was cold and the fog quite heavy. While waiting to be admitted, Janelle arrived.

Maria wanted me to take a shot of her in her designer outfit. When you see her, it is hard to imagine what has actually been happening inside of her head! She was wheeled off at 7:40am.
Janelle and I took over a section of the ICU waiting room for the anticipated arrivals. We then found the cafe for my first of what would be a few coffees for the day. For my Israeli friends, have to say I prefer 'Aroma'.

Effie arrived after having taken the kids to school. Maria's parents and Aunty came a while later, followed by my parents. It was then a long waiting game. It was good opportunity to immerse in the scripture, lean on His promises and have prayer time(s).

The Neurosurgeon met with me and Maria's parents about 2:45pm. He explained that Maria was amazingly tough, calm and relaxed (the prayer coverage). They had her awake in two sessions, of which she only recalls the second. She was awake for up to four hours of the operation. His summary was something like this:

  • When they "opened her up", they found a significant infection.
  • He is fairly certain the infection was introduced during the first surgery and then "sealed" in by the radiotherapy.
  • The infection caused the whole area to almost glue together. This caused its own challenges when working through removal of the puss, tumour while moving around the major arteries.
  • They had the infection tested immediately and the lab found it to contain a whole range of nasty micro-organisms.
  • As the flap of skull from the first craniotomy was infected (possible initial point of introduction of infection) he replaced it with a piece of titanium.
  • She was on large doses of antibiotics to control the infection, but as they planned to wake her shortly, that was the critical time. If she was having trouble, they would have to insert a shunt for drainage, which was not ideal because it is introducing a foreign body to her system.
  • Given the circumstances her was happy with the amount of tumour and oedema he was able to remove. He only needed a smaller incision on the left. Another praise point (and they keep coming) was that there was no need to enter through the right (preserving that side of the brain).
  • Neurologically she was consistently fine throughout until towards the end when she was slurring her speech. An increase in fluids and a position change seemed to help.
  • As he films his surgeries, he is going to show it to me so I get a better appreciation of the extent of the infection.

As you can imagine Maria's parents were overcome with emotion, although we weren't "out of the woods" by any stretch. I was at complete peace because as with the first surgery, I always had a sense she'd come out of the surgery.

A little while later (some time before 4pm) the Anaesthetist came to me and said Maria was asking to see me in recovery before going into ICU. She said they made a special dispensation for me and I was able to see Maria briefly. Maria was lucid, looking so well and introducing me to all the nurses by name. They were amazed at her initial recovery. The Anaesthetist was also amazingly impressed with Maria throughout the surgery. It has been great to then use that and witness to those practitioners.

About 6:30pm I was able to sit in ICU with Maria. She was laughing, joking and praising God for the way she has come out of this critical surgery, especially when you consider the amount of infection present. She was eating a sandwich and was happy to see Janelle (who had to head back to the Blue Mtns) and the kids a little later, but was obviously exhausted.
During the late afternoon and evening I got to chat with some of the other families in the waiting room and have developed a rapport with them. Their family members have a range of issues, with some far more critical than others.

The kids came in with Effie around 7pm. They were a bit nervous, but relaxed some when seeing Maria. As anticipated, Ben was interested in all the instruments and nurses carrying big needles, while Gabi was focused on how she could get close to Maria without hurting her. The nurses allowed me to take a couple of photos.

At school today, Gabi won a football by answering a correct answer. I'm still not clear on the detail, but a footballer gave her the ball and a photo was taken of them. I don't know whether or not it was in any way connected with Maria's surgery. I suspect not, as Ben didn't have the same success in his sports lesson.

Maria kicked me out @ 9:30pm, wanting to get some sleep. ICU is quite noisy, certainly not the place for rest. The ICU nurses (like everyone else to date) have been very professional and helpful.
Maria mentioned to me that they were unable to implant the Gliadel wafers because of the infection. That is a closed door for now. Tomorrow an MRI will be done to see how successful the surgery was as it was quite a mess.
Thanks to all of you out there (and there are many) for your prayers to God for our immediate and extended family, but most importantly for Maria. Maria also asked me to pass on her deepest gratitude. We both pass onto HIM the glory and praise for where we are at right now. It could have been so much worse!