Day 18, Gamma Knife chat

Today was quite full and I've only just got round to blogging. This morning, Michael (and David) came by to talk to us about their impending meeting with John Fuller, neurosurgeon in charge of the Gamma Knife here. Michael told us that after more time to think and to consult with his highly respected colleague, Prof Markus Stoodley, he has come to the conclusion that the French literature he had been hoping might imply a reprieve for Rosie, is not supported and not credible.

He said that sometimes, when a surgeon gets to know a patient a little, the heart comes into the equation as well as the head and it was useful to bounce things off an impartial, respected colleague. Much as he would like to spare Rosie further treatment and correct as he was to challenge the initial diagnosis in case it was not accurate, in the end, his own thinking and research as well, convinced him that what is left in Rosie's thalamus is indeed AVM. It is quite small (1.5cm) and diffuse across the area, lacking the more usual dense nucleus, but over time would still represent significant risk to Rosie if left untreated.

Late this afternoon, John Fuller, Michael and David came to see us together. John talked about Gamma Knife, stuff we already knew and which anyone can read on the Internet but also spoke specifically about Rosie's case. He will need to find out in detail from his colleagues at Peter Mac in Melbourne - where Rosie was treated with stereotactic radiation delivered by a different machine, a linear accelerator (Linac, if you want to read about it) - as to exactly what their treatment regime entailed, especially in which direction the beams of radiation were focused and therefore which parts of the brain received how much radiation. Radiation is cumulative and although he thinks it looks as though Rosie's AVM will be able to be treated with Gamma Knife, hers is a complicated one (we already knew that part) and safety is always the first priority so he needs to carefully assess the technical feasibility of delivering further radiation. He should have the information he needs to make that assessment within a week or so.

If it is feasible, Michael and John Fuller would plan the treatment together. The art in this process is in the planning and decision-making. After that, it is fairly mechanical and is usually delivered in one visit as an outpatient. If Gamma Knife turns out to be not feasible "That would really suck!" to quote Rosie, who is after a cure, not surprisingly.

It was strange having that lengthy and sombre talk be the last time we will see Michael and David until our follow up visit in 6 weeks. We didn't really say goodbye so Rosie and I will both email him to thank him for his care and expertise. He knows it is disappointing, to say the least, to be going home with an unresolved situation which he also expected would be resolved, but he is still optimistic about a longer-term solution.

We are planning to go to Jamie Oliver's Italian restaurant in the CBD for lunch tomorrow before heading home. Rosie is a big Jamie fan.
She is valiantly working on the ridiculously huge and hard puzzle I got yesterday, as I write. We'll be able to roll it up and finish it at home, if we have the stomach for it. Merlyne, David and Yvonne, another Fijian relly, brought us dinner tonight after Sarah (Jo's daughter), Alex and later, Jo, had spent the afternoon with us, sharing our puzzle angst and playing a few other games.