Eric Gisse said:
Kent Paul Dolan <[email protected]
[size of Jeanette's brain tumor]
Average brain volume is 1400 cm^3. That sucker has
a volume of about 140 cm^3.
Well, plus her head was noticably small even for a
woman, with about a US 6 7/8" hat size, and women in
general get the same work done with smaller average
sized brains than do men, so it was probably
proportionately a bit more than 10% for her.
It sure loomed scarily huge in the "before" MRI
scans I reviewed, but that was a cross-sectional
plane view, which exaggerates the comparative size,
not a volume view.
It sure left a huge fluid filled void for her brain
to recolonize, in the "after" MRI scan.
That's a lot of brain missing. I know I'd miss 140
cm^3 of grey matter, no matter where it came from.
Well, it didn't exactly "go missing", there was
nowhere for it to go. Brain tissue is soft and mushy
and soaking wet and pliable on its best days, so it
just got _displaced_ by the tumor, and got the fluid
compressed out of it so that it was starving pretty
badly for lack of room for blood to circulate
The tumor was a "benign" one, so it didn't
particularly infiltrate the existing tissue, just
grew as a compact mass in one place within it. Thus,
minus some unavoidable very thin "selvage", what was
cut away wasn't her brain, just the tumor inside it.
The damages seen may be in that cut away selvage,
but blaming the starvation and maybe some ill
effects from stretching the existing nerve tissues
as they were displaced, seems the surer conviction
Her frontal lobe ended up moved toward the top of
her skull and compressed, at least the center of it
where the tumor was did, so overall it was probably
sitting as an inverted "U", while the parts of her
brain directly behind the tumor got quite badly
compressed and starved, and the non-nerve tissues
toward the front of her head had lots of "internal
pressure" symptoms, if only we'd been smart enough
to recognize them.
Brain tissue further away from the tumor center
probably didn't fare as badly, though compression
goes through fluid and pliable tissues pretty
thoroughly, so maybe it was all equally stressed.
Trouble is, lots of the stuff that makes us human is
up front there, as is the start of the vision
processing system; she's having to relearn how to
see the same image out of both eyes, for example.
She was complaining for two years about pain and
pressure behind her eyes, but as one of the
uninsured and destitute in the US, she had no way to
pay to get that investigated, and as too mentally
ill to get herself signed up for the insurance, no
way to overcome that issue on her own, and I had no
legal standing to do that for her.
Once the hospital had her in its care and were
ringing up charges she had no hope ever of paying,
the hospital administration got her onto the local
"medical insurance plan for the indigent", so they'd
get paid by _someone_, fast enough.
The operation to remove the tumor, I'm told by one
of the nurses, involved first carefully shoving
aside everything above it by following a major blood
vessel down to it, then cutting around the tumor
repeatedly, about 1 mm deeper each time. From the
time she left her intensive care unit until she
returned to it from surgery was 11.5 hours, three
hours longer than originally planned.
I'm glad they did such a careful job on an indigent
patient, but then the hospital is a Catholic
"charity" hospital (while still one of the top
ranked neurology hospitals in North America), they
try to do that for everyone, even where payment is
impossible, not just hard.
She's having a recovery that is astonishing even her
nurses, so one concludes that this could be going
much, much worse than it is, and, if one is wise,
one practices patience and tolerance. Patience and
tolerance aren't exactly my most stand-out virtues,
though, as hundreds of thousands of Usenetters who
know me will testify, so a lot of keeping my teeth
grinding pending until after our visits end is
happening on my side.
There are still _lots_ of holes in her thinking,
behavior, motor skills, and memory [she didn't
recognize the word "annotating" last night (when I
used it to talk about adding descriptions to some
web page links for a page I just started), while I
was with her, and her with a master of fine arts
degree in teaching music where music annotation is
surely a hot topic], e.g., she called me by her
ex-husband's name off and on for a few days, but
then two days ago she sat down at a piano for the
first time in almost three years and played a very
recognizable one minute snatch of "The Entertainer",
with few errors, and from memory.
Compare her case to the other music teacher by
coincidence also in the recovery ward, now for five
months, after a car wreck, who is enduring being
taught how to survive the rest of her life as a
quadrapelegic, and you'll see just how lucky my
fiancee is to be coherent, walking, retaining some
skills, and in control of most of her faculties a
week less than a month after surgery.
Well aware that she had a good chance of coming back
to the ICU after 11.5 hours of people poking knives
into her head as some new species of vegetable, I
started and ended my want list for her after surgery
at "breathing", and only thought about extending it
when that part seemed to be secured another day
later and she began to regain awareness of her
surroundings, so most of the rest of this is pure
gravy from that starting point.
The links I was annotating: