Tuesday, March 18, 2003

Dad’s Surgery: tumour removed

I arrive in Toronto, off to the hotel to meet up with Mom after Dad’s surgery to remove the tumour. My mother was quite upset. She said that Dad has bruising around his face and kept falling out of bed. He has always gotten up in the night to go to the bathroom. He refuses, or cannot remember, to call for a nurse for help, nature calling him rather loudly, and falls, Mom tells me. His face is terribly bruised. It breaks my heart to look at him. I wonder why he will not be restrained or have a bedpan. Both cheeks were black and blue. He has these huge staples in a large U shape on the leave side of his brain. I feel sick to my stomach. I feel such agony knowing that I cannot prevent his pain. I find out, after some pain and crying, that the bruising was due to the surgery and not his falling. At the time it was a horrible thing to think about. I wish someone had told me. I still feel sick to my stomach thinking about it.

Dad cannot talk at all. It makes visits frustrating. We write things down on a piece of paper for him. It takes a lot of time. Jesse, 20 years old and my middle child, visits the 2nd day. Jesse was living in Toronto and attending York University, which is not too far away. He is brave to visit. I find it rather excruciating. Dad is disoriented and asking the same questions several times. He never buzzes for help from the care staff, and we are worried he will fall if he gets up. He has to go to the bathroom several times while we are there and leaps up out of bed, flashing his equipment to us, desperate to get to the bathroom. This was like an inoculation and prepared me for all that happens later.

His voice is scratchy. All of the hair above his ear is gone. He is talking gibberish. Mom and Dad do not always remember what the doctors say to them. It was the beginning of my frustration that they will not allow me to be part of this process. I should have insisted. Doctors think Dad will have radiation, but they are not sure. This is whether the tumour is benign or not. He can walk, at least, but his arthritis is worse.

I went out to the bookstore, while buying dinner for Mom who was back in the hotel room. Mom wanted chicken from a well-known fast food place, even though it usually upsets her stomach; I bought myself sushi to take back to the room. I have forgotten how great it is living in the middle of a city. I bought the book, Talk, Talk, Talk, by Jay Ingram. I know it explained some of the quirks of the brain and language. I read some of the parts out loud to Mom. It helps to understand a bit of what was going on in Dad’s brain regarding language. By now Dad can put together smaller sentences, but is unable to retrieve nouns. He can describe “those animals with black rings around their eyes. They eat garbage.” The word raccoon was somewhere in his brain cells but will not come to the surface. As irretrievable as his old life.

Thursday, March 6, 2003

Diagnosis: Broca's Area

Dad had to go to Toronto for his pre-operative visit. Another long day - driving, sitting, waiting and returning home. Today the situation is reversed from our last visit. Brian and I travel to Toronto to help Mom and Dad prepare for Dad’s surgery to remove what they decided, through the MRI, was a brain tumour. It is located in the prefrontal cortex, Broca's area, in the left frontal lobe above the basal forebrain.

They know that his language will be affected, as the tumour is in Broca's area, and his surgeon tells us not to worry about that when that happens. It is ‘normal’, they say. They are sure which language skills will be affected but thought that gradually some or all of his language skills will come back. I find out later that the prefrontal cortex affects a great deal of cognitive functioning, as well as language. Dad has trouble retrieving nouns. This proved to be a clue later in 2006 for me. Brian takes time off work. He flew to Toronto to be with my parents for Dad’s preoperative visit. Dad has to have some tests. I am ill with bronchitis and cannot go. Dad has blood taken and other tests are done to prepare for his surgery.

With dad's diagnosis of a brain tumour dad was given an information book published by the Brain Tumour Foundation of Canada. It provides information about the cell and how cells function. I had done a great deal of work on teaching and the brain and how it functions in order to better understand the minds of my students. Dad's tumour was in the prefrontal cortex which plays an important role in memory, intelligence, concentration, temper and personality. This is a sophisticated part of our brain that facilitates the setting of goals, the ability to make plans and judge priorities. It guides our eye and head movements and sense of orientation.

Dad's cancer is said to below grade hemispheric astrocytoma. He had mixed gliomas classified into oligo-astrocytoma. Treatment usually involves surgery, depending upon the characteristics and numbers of astrocytic cells present.