Before I start my 'essay' I should mention at the beginning that her admission does not mean that things are bad...please read on if you have the stamina.
The plan today was that Maria would take the bus to Woden. She would have a massage to try and relieve some of her back pain (sorry Janelle for giving up my birthday present - it was for a better cause).
Maria complained last night that her right leg was weakening. Although things hadn't improved this morning, she was determined to do the trip 'solo'. I headed off to school with the kids and then to work. While at work I chatted with Maria's sister and brother-in-law (both GPs). They had some concern about her condition, particularly the identification of a few new symptoms (which I'll omit from this entry). I contacted Maria's GP, who fitted her in at the end of her day (lunchtime today). I left work early and collected Maria after her massage. She said the masseuse was gentle with her.
After further investigation and Maria identifying some of these new symptoms, Maria's GP wanted us to head straight to hospital for a more thorough examination and imaging. She faxed a letter in advance of our arrival (we are only 10-15mins drive away). Maria was seen reasonably quickly and after an hour a bed was made available in Emergency.
The doctor who examined Maria had recently been a registrar with the Neurologist she saw a few weeks ago. He was very nice and also did a very thorough examination. To his credit, he was the first doctor to put a canula into Maria without there being an issue or any significant pain.
One consideration (which our brother-in-law was concerned about) was that perhaps there was a fracture in the back (weakening of bones from steroids) and a vertebrae could be pushing against the spinal cord. It was obviously hard for him to make any diagnosis without seeing her. After working all over her body, the doctor assessed that it was probably originating from the brain and ruled out any spinal issues including any abscesses. His rationale was that she has not suffered from any fevers or signs that would support this. We explained Maria's cerebral abscess to him (i.e. no evidence of fever) to try and put her situation into perspective (Maria was calling herself a "freak"). His mind remained open.
Maria had a CT less than 3 hours after our arrival (which is very quick in the public hospital system). We were told that Maria would be admitted and one of the neurosurgical registrars would visit to discuss further. Maria was told she could now eat and drink (she had been quite hungry and thirsty) so that was an encouraging sign. However, we were told that Maria would be put on 16mg of dexamethasone (i.e. 4mg x 4 time daily). We were extremely disappointed as we had worked Maria down to 1mg and she wasn't having any adverse effects. We said we'd discuss further with the neurosurgical team. It got us thinking whether the CT showed a lot of swelling/oedema.
One of the neurosurgical registrars (who we know well) came after a while. He said the CT didn't show anything different to her September MRI (Praise God!!). He also spent some time testing her. He wanted to do some more investigation tomorrow (was enroute to two surgeries) as he was perplexed because: she showed good reflexes and no apparent weakness in the numb leg; she could walk pretty well considering she had no sensation at all in her left leg; but now had this new weakness in the right leg. He said she was atypical, to which we responded that she has been since the beginning.
He said that a possibility was neuropathy resulting from the chemotherapy, but wanted to admit Maria so they could run an MRI tomorrow (otherwise we'd be waiting until her 11-Dec appointment) to be certain the CT didn't miss anything. The downside to this is that chemo-related neuropathy may mean ceasing the chemotherapy until things are resolved. The problem is that this may not be an option because the option are very limited after this first line of treatment. The oncological team will come through in the morning so we can discuss this further.
It was amazing to watch Maria throughout the day respond to tests on her right leg (some which hurt), yet she had no response at all in the left leg.
Maria was moved to the Neurosurgical ward around 8:30pm. She was greeted by one of the nurses who remembered her fondly and welcomed us back. Her bed was in a new room that was opened earlier that day. Unfortunately the new fancy bed did not work properly. She is in there with three other ladies (all are some years older). I headed home to grab some things for the kids (staying with dear friends). After dropping off their essentials I headed back to the hospital to supply the nurses with some of Maria's meds, which aren't available to them after hours. I also packed a suitcase for her.
I left around 10:30pm. Maria's chances of sleep may be limited given that she had just taken 4mg of steroids and one of the ladies snored (I had first-hand experience). Hopefully the ear plugs I gave her will do the trick.
It is still quite warm this late in the evening. The next few days will be hot again with the chance of some storms to cool things down.
Thanks to those of you keeping Maria and our family in your prayers.