29 November 2011 - Neurosciences Outpatients Department, New QE

Three months since the last post and Deb is still doing really well. Visited the new Queen Elizabeth Outpatients department today for an appointment with Dr Sanghera to review Deb's progress and get results of the last MRI scan. Outpatients at the new hospital is like an airport. You check in electronically on a touch screen and report to the first waiting room. You wait for your name to come up on another screen and you then move forward to a second waiting room where you sit until called to see the doctor. It seemed to work well even though I forgot my passport.


1) MRI Scan


Deb had her MRI scan (18th since RT) on 21 November. The scan results were excellent. There was no discernible sign of tumour growth. The tumour has now been stable since Deb stopped taking PCV chemotherapy at the end of May. In fact the tumour seems to have been stable with no signs of growth since Deb started the PCV at the beginning of the year. This is great news. I again asked Dr Sanghera why this had happened given that we could still see bright active areas on the scan. (these are areas with developed blood supplies to feed active tumour cells). He said we are not always sure what we are looking at on the scan: the bright areas could be due to some failure of blood vessels caused by radiotherapy or chemotherapy and perhaps were not all active tumour. He also explained that although Deb had been classified with a Glioblastoma Multiforme Grade IV, this classification covered a mixture of cell mutations. A typical GBM would stop responding to treatment after a short while but some (like Deb's) seem to respond better because of the cell type within the tumour. 


2) Seizures


Since we last saw Dr Sanghera Deb has had four 'fainting episodes'. Two on the 24 September (while we were at Patrick and Liz's wedding) and two in mid October. The last episode was more of a fit that a faint and occurred after Deb had started to reduce her anti-convulsant medication (phenytoin). These episodes were discussed at length and Dr Sanghera agreed that Deb should maintain her phenytoin dose at 300mg. He also arranged for Deb to have a blood test to monitor her phenytoin levels. 


3) Steroids


Although Deb has tolerated her steroid (dexamethazone) well. Dr S thought it appropriate for her to be referred to an endocrinologist for a Short Synacthen Test - a test to check the amount of cortisol (cortisol is a steroid hormone vital for good health) in your body. For more information see: http://www.patient.co.uk/health/Synacthen-Test.htm 


4) Next appointment


Next appointment  is set for Tuesday 28 February. MRI scan will take place before the appointment. We all feel we can now relax and enjoy a good Christmas.