How to pick a booger

Okay, so now that we're all up-to-speed and know what Sylvia is, let's talk treatment and prognosis. Or as my doctor so epically put it, let's pick that booger.

Thank you for trying to help demonstrate, Ted, but that's not quite what I've got in mind.

The treatment moving forward is more brain surgery. Very similar to what they already did, in fact. Cut two holes, one to relieve intracranial pressure, and one to do the surgery. Take an endoscope - a camera - and go in, find the tumor, and chop it up and suck it out. Simple enough.

But, well, maybe not quite that simple. And I acknowledge that, and accept the treatment.

Before, they just went in with a simple tool designed to grab a piece for biopsy. Now, we have to use this super-special device designed to pull apart and suck out Sylvia. As was told to me, this is a custom-designed, single-use tool. And as we all sit around doing our taxes, just know that you contributed to the $3,000 to be spent on this device. Thank you.

There are some questions about Sylvia that still remain. When the doc was in the first time, he said she appeared to be very avascular. Not vascular. So, as she grew, she's got some blood vessels, to be fair. I mean, she has to have some blood vessels. But not a lot. This is good thing #1 - less blood means less likelihood of complications or stroke or anything like that.

The other question is a total unknown right now - just how connected is she? Is she a lump, a blob pushing up against the rest of the brain? Or are they connected? Did fibrous tissue intermingle with the rest of my normally-functioning brain? Even the MRI can't see that detailed. The only way to know is to poke.

Apparently it takes a couple of days to get a $3,000 disposable rotorooter, so we're back to waiting. On Sunday, my parents are going to drive up again, and we're going to have our own family Super Bowl Party at the house. Monday, we're going to take them to Base and get them a Base ID so they can pick up Teddy, if necessary. And Monday evening, just after dinner, I'm going to be admitted to the SICU again.

Tuesday around 4am I'm going to get another MRI, just to create a final map of my brain. Oh, another thing they're going to do this time around is to have a "brain GPS" (as was described) so they know at all times EXACTLY where they are. Then around noon, next Tuesday, they go in.

The other part is, and the doctor was very forthright about this, I will likely need multiple surgeries. He's going in with an endoscope, and he can only cut so long as he can see. And he was very honest that it might not last. Because although Sylvia isn't highly vascular, again - she does have SOME blood. So as they cut and suck her out, she may bleed. They'll try to control it with irrigation. The tool will also be able to cauterize. But there may eventually just be too much blood to see and he'll have to stop.

In that (likely) case, they'll finish what they can, pull out, leave the CSF drain in place, and let me rest. After three or four days of stabilizing, they go back in to continue.

I'm not naive here; based on what the doctor said, I expect there to be maybe 3 or 4 surgeries. One would be awesome, but I'm not holding my breath.

The doc performing the surgery is one of the best. He is *the* top guy at Walter Reed for endoscopic neurosurgery. He is incredibly experienced and I have all the faith and trust in him. Everything about him exudes confidence and the self-assurity that he is the right man for the job.

There are possible complications. One thing I didn't get a chance to ask, but will before the first surgery, is: if they have to do multiple surgeries, do they get to reuse the old channel? Or are they going to be drilling multiple holes in my head? Secondly, there is the possibility they may not get all of Sylvia. If she's fibrous and too intertwined, pieces of her may be left behind. That can happen. It's real, I acknowledge it. In the case that happens, the normal recourse is to follow-up with targeted radiation therapy.

But, that's all down the road. One day at a time. I get the weekend to hang out with friends and family, and then I go in Monday evening. Personally, I expect to be in the hospital for 2-3 weeks. That's what I foresee.

Sylvia ain't nothing. I got this.