Treatment Recommendations

We haven't exactly shared our cancer plan yet, because everything was so confusing. With my brain still healing, me trying to process information, we chose to table it so that Dan and I could just breath. I wanted to be able to explain what's been happening, and make sense. 

All in all, we feel it's pretty damn good news. And who doesn't like a plot twist? 

1. The tumor areas are still remained within the same grade.

2. Dr Liau masterfully competed a gross total resection - the best possible outcome. There are still cancer cells in my brain, as my type of tumor does not grow within clean margins, instead growing little fingers, infiltrating healthy brain, but that is just to be expected.

3. There was an area where the pathologist noted "treatment effect". That was described to us as something to be seen after radiation, usually. Magically, however, as you guys know, I have not done radiation. So is causing it??? I had stopped all my treatments many months ago, and have been focusing reiki, removing negative influences, and exploring spiritually. Our radiation oncologist tells me that my brain looks I've undergone some treatment to effect the growing tumor in my brain, as if I had undergone a level of radiation - that's wild! And encouraging. It feels like hope. Do you believe in miracles? I do! I feel like I'm in the midst of a metaphysical miracle. I am on the cusp, a little speck, with so much to learn and experience. This development is profound. It's everything I've ever dreamed of! Remember how I was determined to get the MRI days before the surgery? My gut KNEW that something was different. I'm still pleased that I went through with the surgery, but the power of intuition is not lost on me. I did my MRI at a different center, that glossed over the results. It was a resurgical report that wasn't trying to measure new data, which gave me nothing to work from.

4. The Ki67, or growth rate, has actually decined. The tumor in 2012 was 7-8%, this tumor is rated at less than 5%. Things like this don't happen. Gliomas don't behave like this. I have become an anomy. It's everything I have worked for, everything I have dreamed of! Granted, my cancer has not been cured, and there is still cancer in my body, but still - do you see the significance? Something real is happening. Something tangible. Something GREAT, is happening in my body. I'm getting an immune response!! Even my gracious surgeon and radiation oncologist stated it. Just mater of fact. It's undeniable! We have it in the cells, on the microscopes. I'm not cured yet, what who knows what happens next! A tangible immune is what every patient dreams of, this is epic and I can't help but think of all your prayers, and how they elate. 

5. Some of my doctors are curious, requesting further tests, trying to see what could be going on, but I've done so many treatments, tried so many things, it's impossible to isolate the causality. Other doctors don't care, and choose to gloss over the whole mystery. 

6. Ultimately, the tumor board at UCLA, is recommending radiation and chemo, in 2-3 months. They want my brain swelling to go down. 

7. There had been three areas of tumor that they been tracking, via the MRIs. We are curious to find further info to see how the various tumors had been behaving to see what the growth patterns were. In January there was an area of increased intensity within the tumor itself, that had been lightly suggested that it was more aggressive tumor. We now know it was NOT more aggressive tumor, but seemingly treatment effect. Curious, isn't it? What if that corresponds directly with work with Maureen, my reiki master? 

I can't seem to wrap my mind around idea of starting radiation and chemo when I'm getting some really interesting, and exiting results withou actually having to go through the downsides, of those treatments. I mean, I don't know what it all means, or how it translates to my survival, but I owe it do myself to explore. Shouldn't we be celebrating, and digging into this, not sweeping it under the table? I'm not surprised, but it's sad, that I had a neuro oncologist not only pooh pooh the Ki67 changes, but he also recommended an inaccurate chemo drug (he argued with us, then we discussed with our surgeon, who confirmed we were accurate). This is not the time for auto pilot. This is my life. These choices have impacts, and coincidences.  

Thankfully, I have until May to decide on radiation and chemo, to reflect, analyze, to work on my healing, and see what is and isn't working in my life. The more I let go, and explore this journey, more I remove I negativity, stress, expectations, the more space I have for healing. It feels indulgent, and self absorbed, but I have to explore this, and give it everything I have. I have no choice, other than to choose my self. There is nothing I want more than healing.

I'm in an era of growth, of exploration. I feel like unknowing is an advantage. I don't have the answers and that feels freeing. I am learning to see the world in a whole new way. Even to look at my health in a whole new way. I am finally integrating all pieces of myself. It's science, medicine, spiritual, it's metaphysical. A few months ago, the first time of my life, I went all in. Decided that I'm open to all healing, that miracles are not finite. That we all deserve health, but we that we have to be active participants in order to receive. From that moment, it has been a snowball effect of growth and excitement. Dan comments on it all the time - we're loving this! I wish I could bottle it, even write it all down, to share all the nuances, but it's lightning speed. I can't even express myself accurately and I must be terribly confusing, but suffice to say, it all feels positive, and it's fun, and soul affirming. You must feel it in my words, in my spirit, in Dan's spirit.

I have no idea what I will find tomorrow, or the day after, I don't place things in concrete. I'm learning to let go of expectations, and learning about what "life" means to me. This the happiest I've ever felt, and yet I just had a brain surgery, I have cancer, and they want me to start treatment that will not cure me, that could cause my cancer to become more aggressive, that could kill me faster. There are no easy solutions, and if things were different, if I was different, I could easy be pretty terrified. And it's not that I'm immune to fear, but it's not my focus. I'm dumping the gunk, and I only have the energy and space for things that serve positivity, and things that heal. I want and I choose to have fun, and love on my gorgeous husband, to soak up these moments, and memories, and friendships. 

 

As far recovery goes, I have been working on this posting for days. I don't how many hours, but it has been double diggits, with spell check, guessing, and apps that predict what you're trying to say. And Dan, he's always helpful, can't discount him. I'm very fatigued, sleep, quiet are the majority of my days, but I almost aways sneak a walk in and lots of unorganized stretching. I'm working on recognizing the beauty of calm, of just being.  

I am plugging along left handed (not my regular side), my right side of my body is almost completely numb (with phantom hints of hope), and often weak. I drop things, I run into things, like it's a hobby. From the tip of my head to the bottom of my toes, I feel nothing's. The line is exactly half of my body, half my face. I drool a bit on one side but he thinks it's cute. People never know because Dan keeps me in check. My hero helps me put on a great show, taxing my limits, when I'm connecting with friends on rare occasions. They never quite see the realities. But I'm perfectly happy with that, I love the blog because people can engage as much or as little as they want. 

 

I am not safe to cook, clean, navigate most objects, handle mail, my medications, or trim a fingernail, fold anything, I still get dizzy, and dan catches me, or helps me gently so I can deep trying to gain independence. I'm crafty, though, and can disguise my deficients.  

I don't know numbers and dates, or days of the week. I can barely count, so basically it's a beautifully simple life for me, for now. Dan handles it all, and I just chill and do what I can, or laugh it off.

We have so much going on in our lives, and it will definitely be quite the transition soon when Dan gets back to work, but this past month has been one of the best times of our lives. To share this journey with the love of my life, to make such dear friends, to be completely cared for by all of you, has been one of the most beautiful things to witness. This everything I could have dreamed of, and I thank all of you from the depth of my heart. Every single one of you continue to play role in my healing, and I am deeply grateful!

On My Terms

I've been resting. I've been healing. My progress is obvious, and it's exciting!

Origenaly, while in the hospital, the speech, occupation, and physical therapists, told me that I needed to spend 2-3 weeks in acute care home where I would work 6-8 hours a day on my deficits. The worst part, I was told I would have to live on campus, alone. I remember the second their door shut and I turned to Dan. We looked at each other, and I said, "Dope." He smiled, and I whispered, "Is that okay?" 

I knew I couldn't be apart from him, not for that not during such a traumatic time. Dan and I laugh so much, we have the ability to keep things in perspective, we ground each other, and literally have fun in everything we do. There's nothing more therapeutic than my time with Dan. So I respectfully declined and said I would revisit therapy after I moved home in a month. 

I had been told from my surgeon, whom I implicitly trust, that a complete recovery was expected, but to be aware of swelling which could take sever months to recover. In my mind, her words vindicated my gut feeling, that this time should be for healing, compassion, patience, and not brow beating.

As this is my fourth brain surgery, I'm different in how I evaluate the process. I'm much more calm. I'm able to analyze what will serve me on an independent level. For me, I knew being away from Dan would dampen my soul, extinguish my light. It would actually be carmful.

So, instead of weeks working in frustration, we were cocooned with a magical beach home in Malibu. It was through a friend of a friend, but now it already feels family. We have been nurtured by everyone, even friends of friends. Each day, I get better and better, oftentimes even between naps. I started with a walker, and yesterday I walked over three miles. I no longer require assistance.

You can see in my language, in my writing, that I am fast improving. I have no fears of deficites, I have have no fear of much. Each challange is an adventure, and each opportunity is a gift. 

I have never felt so provided by the universe. From our friends, and family, holding down our home with our pets, to Dan's employers, and work buddies, the emotional support of your payers, and blog comments with pure love. All of the generous donations and gifts. We have made new friends, we have made unbelievable memories. We have found joy in the wildest circumstances, and it's because of all you! You lift us up, you nurture us, you choose to send us strength, and compassion. You are healing us. Please never underestimate your role! 

The world continues to bring surprises, and we continue to have so much fun regardless of the subject or context. Sometimes life feels like a movie, full of lessons and growth. It leaves me with hope, and recharges my soul, regardless of the ending. In those moments, as often as I can remember, I soak it up, lift my face to the heavens, with a jubilant expression, and praise God, praise the Heavens, and I thank whomever is responsible. 

Life is so damn fun!

These pictures show the milestone that is my first shower after three weeks of suture. Damn that felt good to remove and clean!!!

We Are Not Stuck

Sometimes I wonder why my lift continues to be so magical. I am so full of happiness? Why do I get to feel this way? How us it possible to me this happy? Shouldnt I be scared? Or angers?

During the lead up in LA, presurgert, I was waiting for a doctor, and while sitting in a room, I heard gurgoral sobbing, then wretch screams that could not be calmed. After a few minutes I got up, and walked over to the nurse to see if there was anything I could do. 

I was gently told that a patient had been notified of a tumor recurrence. I asked she was going to be okay, if she needed help, and the nurse reassured me that she went back and hugered her and she was with our doctor. I thanked her for sharing that hug, and hugged her too. Life is a circle of comcassion, and sometimes that's all you can do.

By the time the doctor got her settled, the office was running falf an hour late, and my rushed physician, mussled in worried I word be mad at him. I let out a laugh so loud that I even stunned myself. 

I shrinked and said, "Hey, that's life!"

We got settled it, and we got to checking in. We had never met as it was he was there to assess the safty of my surgery. To see my risks, and conduct extra blood work - things like that. 

As we reviewed my years of surgeries, the lenthly treatments, and touched on my scheduled brain surgery, only a day or some away, he stopped me and asked in awe, how I can handle this with smiles and laughter. He said wants to research people like me to learn and figure out more so help for other patients. He is aways fascinated by the differet perspectives of people, and how they analyze there situations. I told him I feel the same too! It's wild, really, wow different people see things.

He ashed it he could me some pointed questions about my attitude, and I askered him best I could. I told hi am in absoute awe that I get to be alive. And that means all of it - not just the good stuff. I choose to be happy. Because it really is a decision. I am easy to laugh, because it makes me feel good. I work hard to give people grace. And I'm easy distracted. I love making people laugh, and smile. Those two tings are my favorite things to give. And that I try to limit negativity.

I was very clear that I'm no master, but these are my goals. This is how I try to life my life. And damn if it isn't fun! 

 

World is a very special place, full of choices. Don't like your attitude? Change it. Don't like how that person treats you? Stop spending so much time with them. Feel scared? Start saying aloud, everything you're grateful for. Feeling down? Pick people that lift you up! 

I probably sound simpistic, but you just start little by little. And it requires analyzing your environment, your feelings. We are not stuck, unless we chose to be. 

I choose to be happy, and I do it because it is saving my life. That might sound confusing, but regardless of my cancer, I feel deep joy in my soul, and THAT is what I mean about healing. I can feel healed every day, in my own attiute. It's viseral, palpable, it is with intention and it's my choice.

We are alive as much we want to be. We are present as we want to be.

Rad Apt

Its some time past three am. The world peppered with dozer eager crickets gently gossiping.

We met with a raduatiopn oncolocgest yesterdar, and have been digestinging her opinion everever sence.

I opted away from radiation atleast 3 times onthis these 7 years. I am aware there are risked. I'm aware of possible humatiotations, of secondary melyglancies. If short and long term effects.   

The radiatiotion oncology doctor was a gem, though. A werd way to describe her, I'm sure, but what a wonderful woman. She was the perfect combo of information, science, reality, humor, humility, and respect.  

She feel strong that that we need to act on now while tumor murdan is low - from the surgery. The trick there is still no baruntee that it would sow tumor growth, and there will be now side effects, and later effects, and it not possible to say how severe the damage would be. Her argeue is that our tumors clearly keep protesting, aways grow back so we need to act. For me, I don't string those that too clothether. Radiation not a simple choice, nor the only, or even the most promesting.

I hear what she is saying, and I'm not ruling out, but we are meeting with our oncolog Friday, and will discuss chemo, some possible medical deivises, off-label drugs and lord only what. Maybe we would do all. Maybe we will do none. Most likely combo. 

I no idea what we will decide, but I'm in no rush. I have minimal stress about treatment. I feel in my soul a depth that I can't explain. I'm living my live with no regrets, analyzing my options, listening to my inner voice. This is my rescission to make. I can't phone this in, or copy some else's notes. I need to look at all my options, even outlandish ones, longshots, exporemtal ideas, and of corse revisit the convential combos. The answers will come, I know, so there is no need to be scared, or stress. I feel free, and content. I am alive in this moment, so I soak up each moment. 

I am still mimin 3 hour of pills, but I snooze day and night, sneaking whenever I can. I relish when I awake and I relish my naps. I love it all. That helps it when I find myself tapping away, sharing with you how I feel, analyzing my life and where I want do.

It's wild to live in a moment, or environment, where I not competely capable of major decisions, yet I have to push thro. I am heal daily, but I don't trust my mind. Thank god for Dan yet again. We discuss, he explains, we discuss, I nap, then we try again. A lot in invain. I will make dense agang, and with his patience, I feel calm, and safe. The harder this is, the more he steps up.

I wish didn't have to ask to ask him of this mich, but he never companes. He's full of graces, and compasson. The reality of what we go throug is often indescribable, but his love is never escaping me. I don't have a lot that I can take of, I need to relian dan, but I can live him grace, gratitude, smiles, and laughter. And gratefuly he is trilled with these small gifts. 

Jess Offcial Post

It's jess nere, and I am so happy to try my first post I am pecking away left finger, my right sisde is no good. My whol right body is messed up, to the pont thap oor Dan must take care of my potty. And all needs do most all. We just laught, these days, and I smile in haditude. 

Dan approved ny plan for a new post so that I could connect. Ok I need to rest, and I do, but I am a connecter. I ty to try with friends but not allmakes sensebse, I'm hoping you will understand me, and we can hulp me grow and love and live. Becasuse your comments make me feel so loved, soroted, and cared for. You encourage me, and espires me.

Just right now I ecstatic to be trying this right now!

I feel my brain grow, my soul expand. In ripe now I hear a deecate owl, so gentle, just a house rear.

I have so many insighteests, so many feelings. I feel rure joy and raditude, every second. I laugh nobsop, and oooo at my husband, ahat he has no lomit on what he will do for me. And my love and respect to him shaters expectations. I never krew I could love him more, bit I can, and I am now. 

Dan makes me feel powerful, capable, funny, sexy - and ge sill has to hive me sasppotores, for consetation, so this no small feat.  

I thank god ever moment for each moment, I scuggle softly bed, and coress his mack while he purrs med app benween meds. Be probably doesnt even know as he is easy to snooze cause he's fitred.     

Im dedicated to his happiest life. I live to make him smile, and feel my love. This time together is a dream, and gift, and is completely evolve our bond. We are our own habitat, our own rare species. 

We don't yet biw the treatment reatment, or all the things to expect - my status, what my life will look, but I have dan with me, and for now, that's all I need to know. We always choose happy, even when life is scary and uncertain. All life is unsertan, it's a so fang fun. We choose joy. And gratitude. And laughter.

I share in the blog because I can, because it's real. I don't know this is why is nine to live, but it's beautiful, and I am so happy to ne here! 

Tens of times a day I choose choices to cloose happy or be cranky. Or be sad, or bitter or elated. By I see no joy in being wasting time. Even in sadness. Sometimes I have to stop and say to dan sorry for being short, when trying to do small things I used to able to do.  And he smiles, and he hugs me, and we kiss. Life really is basic. We try to give grace, hug, thank all the time, no thing is too small. This journey is clearly dufty, but I love it too. The challenge, the exploration, and the beauty. 

I am so happy to be here on Earth. Thank for helping me facilitate this dream, of life. I am loving you.

Snake Charmer

This is Dan,

We decided to venture away from the beach today and went the opposite direction into the hills for a quick hike. It was about a 20 minute drive, which is enough of a challenge for Jess in itself, then we proceeded to walk for another 30-45 minutes. We were on our way to a lookout point, when our hike was abruptly cut short by the familiar, but still terrifying, rattle of a rattlesnake. We both have had encounters with rattlesnakes before which helped us determine what was going quickly. It was sunbathing on the side of the trail and did not appreciate the intrusion. Luckily it gave us plenty of warning and we were more then happy to simply turn around and proceed back the way we came. Jess was walking in the front (to show her independence) and did a good job of recognizing what was happening by standing still, but did not have the dexterity to walk backwards or to turn around abruptly. I picked her up (probably rougher then i intended) and pointed her in the direction we had just came from. We continued for rest of our hike without any more excitement, but did appreciate the change of scenery and the challenge of walking off road. Between the driving, hiking and the excitement of the snake, Jess was pretty drained when we got back and shortly took a nap. I think if anything, the snake was simply reminding Jess that she should not overdue things and should probably head home to rest up. If only Jess listened to me as intently as she does a snake.

 

Is This Your Brain On Drugs?

This is Dan,

During these past few days of recovery Jess has experienced some strange phenomena. She felt it necessary to describe to people what was going on even though she did not really understand it herself. Often during the night Jess has manifestations of things occurring that are not actually happening. She will have lengthy conversations with people who are not there. She will believe she had conversations with people who are there (me). She will often have the sensation of being back in the hospital. One particular time she was awaiting a blood draw and kept asking when the nurse was going to come in. Regardless of how many times I explained that she was not in the hospital anymore her questions and concerns lingered. Only once I told her that the nurse said there was not going to be any blood work tonight did she relax and fall asleep. It would appear that the trauma of being in the hospital is still very much with Jess. Getting her Blood drawn was always a source of apprehension due to the fact that she had categorically difficult veins to puncture. Because of this she would experience a tremendous amount of pain while the technician maneuvered the needle in her arm attempting to hit a vein.

Two nights ago, I woke to find her awake in bed. We spoke for a few moments and I could tell that she was not exactly 100% in the here and now, with her believing she was at the hospital again. She calmly asked me a question that quickly cleared the fog from my head and woke me up. "Are they going to hang me?" she asked. I assured her that no one wanted to hang her and she responded with another equally calm question "Am I going to hang myself?" she asked slightly confused. Again I assured her that she did not want to hang herself and that nobody else wanted to hang her either. "Then why is there a noose?' she said to me as she pointed to an area somewhere above the foot of the bed. Again, I assured her that there would be no hanging of any kind, which seemed to satisfy her, and she went back to sleep. This is the conversation I remember the most because of the strange topic, but there are many perceived conversations that she has during these odd hours on the fringe of sleep. She can remember them in the morning but needs some prompting to recall the details. Whether it is the vast amount of drugs she is taking or some new addition to her life caused by the brain surgery we are not yet sure. She is confused and fascinated by this new development. I think it stems from her curiosity. How can the brain create such vivid actions without one being aware of it?

On to a new topic..

Jess is continually getting better and better. As we expected, some things are coming much quicker then others. Her walking has improved drastically, to the point where there is hardly a noticeable mis-step or awkward stride. Uneven terrain can cause some apprehension, and the stamina of her healing brain cannot keep up with her legs, but overall it has, and continues, to improve dramatically. Her vocabulary continues to become more elaborate and her word finding problem is decreasing steadily. We are working on dexterity activities for her right hand and although improving, Jess is still operating strictly left handed. Some words and letters are slowly coming back, but they are hit or miss with no logical pattern that I can decipher. In all, Jess is taking it in stride and with a tremendous amount of grace. She is not attempting to constantly break through these barriers, but rather letting skills come back naturally as her healing progresses. This was something we had difficulty with after the previous surgeries. She felt that if she worked hard enough things would come back to her. We realized that if the brain was not ready for a particular skill it did not matter how hard you tried to learn it. It is the equivalent of breaking your leg and trying to run before the bone is healed.

Starting on Monday we begin our follow up appointments at UCLA. We will be meeting with radiologists, neurosurgeons, neurosurgeon assistants, oncologist and many more. We should hopefully get more information on the pathology of Jess's tumor. Up to this point it has been wonderful to solely be focused on Jess getting better without any other distractions or major questions looming over our heads. We always appreciate more information to help us make our decisions, but it was nice to have some time to breath. Anyway, next week we will have more information to provide you with as to what direction we will be heading from here.

As always, we appreciate everybody's support and Jess wants everyone to know that she can "feel everybody's love and prayers, and it carries me"


It does not feel like rehab when you get this as your walking path, but between walking in the sand and traversing over rocks it is a great exercise for her to get her coordination back.



 


   

A beautiful way to recover

This is Dan,

We are so fortunate to be recovering in such an amazing place. Motivated by amazing scenery and gorgeous beaches Jess has been persistent with her multiple daily walks. Her coordination is ever increasing and she is getting faster and faster. To a passerby, she would probably appear as a normal person casually taking a slow stroll. What you would not see is her focus and determination to go just slightly farther then she did the day before. The home that we were so gracefully allowed to occupy feels like something created by Jess herself. It exudes happiness and surrounds us in a calm demeanor. Jess's speech is slowly improving through normal conversation, and at times surprises me with complex ideas or elaborate vocabulary. On the same hand, once her stamina runs out, and she starts to fatigue, her words and pronunciation quickly deteriorate. Her ability to identify written words or letters is still her biggest deficit. She is taking it in stride because she knows some things take longer then others, but still has frustration at her inability to write her own name. On our morning walk we were discussing the differences between the last two brain surgeries. The most recent surgery left her with a better handle on verbal communication, compared to written communication. The previous surgery left her with a better ability to write then to speak. She used the blog as a way to express herself, because her verbal communication was lacking. Its interesting to contemplate the brain and how stress or trauma in different areas can affect someone so differently. 

Thanks to the kindness of our surgeons assistant, all our Dr appointments are scheduled for next week. It is odd to wait so long to hear any information or to have a Dr evaluate Jess, but it is a relief to have an entire week to allow Jess to heal and get her bearings. As always, she is eager to push herself and to accomplish the next task. I am finding myself in the familiar position of continually pulling her reins in. I do have to admit that she has a better understanding of pacing herself then she has ever had before, but still, it is Jess we are talking about. Just this morning she asked me to look into some hikes that are close by. I told her I would but reminded her that pushing it too hard always comes back to haunt us later. Push too far in the morning and it is back to bed for most of the remaining day, push too hard at lunch and it is a bad headache when she's trying to sleep. It is a difficult balance between moving forward and getting better and over-doing it.

Sorry it has taken a little while to post. It took a few days to get into our routine and get everything squared away. Jess is on a large regiment of pills to help her heal from the surgery. She is taking 66 pills a day with no break between pills longer then three hours. The pharmacist essentially just went over what pill did what, then handed us a bag full of 14 different bottles. Some are every three hours, some every eight, others twice daily, some need to be taken with breakfast or dinner, others are not scheduled and only need to be taken as needed...ect. We have created a daily regiment that seems to be working as best as it could. Jess has recently been finding herself awake and alert at night for a few hours but we have yet to determine what is causing that and if there would even be anything we could do about it. I feel that as long as she is getting enough rest overall then it is not terribly detrimental. When you mix this regiment of pills with rehabilitation then add a normal days activities, time can get away from you pretty quick. I will attempt to keep everyone up to date from here on out.

Took advantage of some morning mist to escape to the beach.

Warning!!    Warning!!    Warning!!     Warning!!    Warning!!    Warning!!    Warning!!    Warning!!

Some People have asked to see Jessica's scar from the operation, if you do not want to see the scar then do not scroll down any further 😀

Home Sweet Home, Temporarily..

This is Dan,

We finally made it out of the hospital about five hours after they thought we would, but at least we made it out. It was a stressful day for Jess. She had multiple appointments with different doctors discussing our upcoming appointments and our regiment of medications for post hospital life. She meet with physical and speech therapists about continuing therapy after discharge. She meet with pharmacists to discuss what each and every medication was and how it would be administered. Once each meeting was over, she would look at me with the expression that I had become familiar with. It was an expression of "do you understand what he just said, because I sure as hell don't". It usually was followed by a look of frustration for not being able to understand things that were simple to her eleven days ago. Any papers, handouts or business cards were quickly passed along to me. Even the basic alphabet eludes her now, and most of the words written on her prescriptions were tough for me to say.

She also meet with Fred, but more about that later.

We packed up our belongings and Jess got wheeled down stairs. We had to stop and put on sunglasses for the bright lights, ear plugs for the extra noise and had to get the transit nurse operating the wheel chair to downshift from 5th to 1st gear. We knew the trip would be stressful but did not think it would be so tough on her just to get to the lobby of the building. We got a car to transport us to our temporary home and had to give the driver specific instructions about driving with over-emphasized caution and as little quick movement as possible. The Driver was very conscientious and drove as best he could but it still took its toll on Jess. She toughed it out as she always does, but I was happy to see the drive come to an end. The difficulties of our transportation were quickly pushed to the back of our mind once we arrived at our new temporary home. Tami and David are two incredible people who have offered us their home for the duration of our stay. They only briefly meet us but were gracious enough to help us in such a extreme manor. Their home is wonderful, and I could see Jess's shoulders drop about 100lbs as soon as we walked in. We could not have picked a more perfect situation for Jess to heal in, and there are not adequate words to describe my level of appreciation to them. Thank you.

We know that we still have a tremendous amount of work to do from here on out, but leaving the hospital and being allowed to live almost as normal people, is going to have an insurmountable effect on our lives. Jess will begin the long process of rehab tomorrow and hopefully you guys will be reading her words in the near future. Until then, please remember she has extreme difficulty with the written language and cannot read text or email from anybody at this time. Hopefully everyone understands and does not take her silence as an insult.

It was not all bad getting delayed a few hours at the hospital, Jess did get to meet a new man in her life. This is Fred, he is a patient canine connection dog. He was by far the best part of the hospital stay and Jess nearly lost it!!

Jess was looking good when she left the hospital thanks to a wonderful gift from our friends Stacy and Guy. Thank you.

The Time Has Come

This is Dan,

The day has finally come, apparently... It appears that we will be getting discharged today!!! Jess's new pain management protocol was started yesterday afternoon and has been successful throughout. We still need to meet with the pain management team but it looks like today will be the day. Jess is extremely excited to get out of the hospital and regain some sense of normalcy in her life. As she so eloquently puts it "I'm BORED". I know that getting out of the hospital will be a wonderful thing but there is a slight knot of fear in my stomach to leave the cocoon of nurses, Drs', and most importantly pain killers. The protocol we are on has proven itself to keep her pain tolerable, and I think things will be much calmer and more relaxing once we get out of the hospital. If anything changes I will let you know but around 11:00ish envision Jess driving along the beach with the wind blowing her hair because that is going to be how she feels. The reality of the situation will be her strapped in tight with oversized sunglasses and her head wrapped, but who cares about that reality.

Jess got to 'wash' her hair today. This is a hospital shower cap, which has shampoo on the inside and does not need to be rinsed. Not exactly a spa day, but pretty close.

The Slow Road Through The Hospital

This is Dan,

It is incredible to think that it has only been five days since Jess had her surgery. Time loses its meaning when you are lost in the hospital cycle of nurse visits every few hours, days bleeding into one another, sunrises bleeding into sunsets, living in three hour increments between administration of drugs. Sometimes it seems like it has been months since the surgery and other times it seems like it has been seconds. There is ever present fear and elation. There are actually times when the two can occur simultaneously. Elation that Jess can stand up on her own, and fear that her wobbly legs will not sustain her trip. Elation that her right hand can now almost fully open, and fear that it will not regain its sensation or dexterity (although Jess says its nice because she can use her numb side for getting shots from the Dr's, and she is getting really good at doing stuff with her left hand). The most significant journey while in this hospital has been attempting to get a handle on Jess's pain management. Jess's pain management has been our most frustrating aspect of our stay at the hospital and remains our largest hurdle to being discharged. In order for Jess to leave the hospital she needs her pain managed by oral medication only, as that is all we can administer on our own. Right now Jess has a regiment of oral medication, and a self-administered limited dosing of medication through her IV. As to date the pain management team working with Jess have yet to make any significant strides in an attempt to limit Jess's need for her IV dosage. We are not willing to leave the hospital until it has been demonstrated to us that their particular drug protocol has a longterm effect on managing Jess's pain.

Its hard to gauge what is working and what isn't because Jess's level of activity has been steadily increasing. She has recently began eating more solid food, going on walks around her floor, walking to the bathroom with minimal assistance. With this increase in activity Jess becomes strained and worn down, often needing a nap after traveling to the bathroom, or meeting with a Dr. It appears to me that it is simply exhausting for jess to be awake. Her body is working so hard on healing itself that there is little energy for other things. Deficits will come and go or vary in degree depending on the severity of Jess exhaustion, or severity of inflammation and healing. Jess needs a nap pretty much after any activity. In similar fashion to life before her most recent surgery, Jess insists she does not need a nap right up until the point she falls asleep.

All and all, Jess is her normal resilient self. Always seeing the best in things, talking with all the nurses, and continually making her parents and I laugh. She really appreciates all the support she has been getting. It has become somewhat of a ritual for me to read her your comments on Facebook and her blog. As of right now, Jess cannot interpret written language. This gives me the pleasure of reading all of your comments to her, and quite frankly I often need to take breaks to allow the lump in my thought to subside. She really wants me to express the fact that she is not in a state where she can respond to anyone but does want to thank you all for the kind words of encouragement.

Prior to Jess being able to walk on her own, we took her around the floor in a wheel chair, because she's Jess and she can't just stay put!!!!

In Jess's Words

This is Dan,

One of Jess's more severe deficits is her inability to distinguish between letters. Its 1:26am and I found her working on her first attempt at writing since the surgery. She asked if I would post it, and of course I gladly obliged. I hoped this would illustrate to everyone why Jess is unable to responded to your messages. I save reading her your comments until things are really tough, it is the extra motivation she needs to pull through. Thank you all for your continued support.

 

Jess's next step

This is Dan,

Last night Jess was moved from the ICU to a neurological step down room. This was an expected step and is a step that every patient who undergoes head trauma at UCLA goes through. It was something that had been approved since yesterday morning but we had to wait for a room to become available. This has been a mostly a good move, with some slight hesitation and concern. On the positive side, the move means that Jess is progressing accordingly in her healing and that she will be in a room that is much more calming and private. The nurses do not come by as often and her regiment of medications has lessened. For the first time since coming out of the surgery Jess was able to sleep for more then a few minutes at a time. The room is bigger then the ICU and allows for me and her parents to all have a comfortable seat and room enough not to step on each others toes. The room also has a window, which although just shows surrounding buildings, allows sight to the outside world and natural light.

On the negative side, is STRESS. Jess had to endure a fair amount of pain during the travel 200ft down the hall to the corresponding wing. Any movement is tough on Jess and this was a big one in her present world. The same freedom that allows Jess to sleep also causes her significant stress. She is haunted by the memory of the surgery at UW and the need for a second surgery. She worries that she will begin to deteriorate and no one will know. This is in spite of the fact that between me and her parents, she is never left alone, she is hooked up to every monitor available to the facility and is periodically checked on by her nurse. The memory of the pain and exhaustive rehabilitation caused by her emergency brain surgery at UW is so prevalent that every time she cannot control her right hand or cannot find a answer she fears she is slipping backwards again. She easily forgets that it has been less then 24 hours since her surgery was completed and she still has a vast amount of recovery to do. The nurses and caregivers here are wonderful and Jess has quickly found her favorites and made each of them laugh. It is rare to have a nurse leave her room without a smile on their face. Her deficits are severe, but we see small changes daily and even hourly that are encouraging to us. We also see negative changes when she gets over worked or exhausted. My personal opinion on these changes is overall positive. I feel that if we see changes, good or bad, then it means that particular aspect is not permanent. If this aspect is not permanent, it is possibly fixable. When dealing in this realm, possibilities are always positive.

Jess In The ICU

I am very sorry for the delay in getting information out to you guys, I realize I left you out on ledge with no answers. Again, sorry about that. Jess is recovering in the ICU, and by all accounts is doing as good as can be expected today. Almost immediately after writing my the last blog we got a call in the waiting room saying that one of us could go and see Jessica. Bonnie and Bob were gracious enough to ease my eagerness to see her and allowed me to go first. Or maybe I just left...When I arrived at her room, my heart sank. I found her screaming in pain, nearly hyperventilating, with tears streaking down her face.

Jess has an incredible tolerance to pain medications. It has been an issue with every single brain surgery. We thought we took steps to eliminate this prior to the surgery by informing anyone and everyone who would listen, and showing documentation the on her charts, but it did not help. Either the information never made it across departments or no one can fathom that Jess needs the same amount of painkillers as a women literally twice her weight. After entering Jess's room I quickly relayed all the information that we had already told so many people and after 45 excruciating minutes she started to feel the effects of the painkillers and began to level off. The nurse stated that she did not think anyone in the room would still be conscious after taking the amount of painkiller they administered to Jess. Needless to say this was extremely difficult and not what I was expecting. This experience started the cycle of me not leaving Jess until this exact moment. This is why I was not able to write an update blog and give everyone the information they were seeking.

Once Jess got her proper dosing in order, things have been going. The staff has been incredible (besides the obvious) and Jess is quickly becoming friends with every single person who enters the room. It is important to explain what 'good' means in terms of a craniotomy recovery. First off, I will say that she seems to be doing better then the previous surgeries relative to the same time frame. unfortunately what this looks like for Jess is; occasionally slurred speech and word finding issues, blurry vision, loss of motor skills and decrease in cognitive abilities. Lots of tears. Lots of stress. Lots of worry. Some of these deficits are an expected byproduct of surgery, but none are guaranteed to diminish. We all hope they will, but nothing is certain. There is an tremendous amount of healing that still needs to take place. There are going to be hard days in her future, but if there is one thing I know, it is that she has done it before and she can do it again. Amongst all this pain and worry Jess still manages to be polite and caring to everyone. After the tears comes one of those smiles, the type that somehow reassures everybody in the room. Just as quickly as she gets sad from not accomplishing something, she is elated at one of her tasks conquered and puts both hands up in the air as if she won the ICU rehab championship.

I only mention her deficits to ask everyone to be cognizant of her healing and remember that the work will continue long after we leave California. Please continue to send your love and prayers her way, she is very moved by the amount of support she is receiving. Thank you all so much.

Here is the girl..

2nd update

This is Dan,

Just got an update stating that the tumor removal is over and that they are closing her up right now. Dr Liau will be coming down and speaking with us shortly and I will let you know what she says. Thanks for all your support.

First update

This is Dan,

About 45 minutes ago Jess was taken from the pre-op area to the surgery room. She was in as good of spirits as can be expected. Her tracking status still has her in the operating room, but they have yet to actually start the procedure. My understanding is that she is getting her anesthesia and more IVs. Im sure its no surprise but she quickly made friends with her entire surgical team. She was restless last night and, although I refused to let her respond to any, we went through the comments of support she has received from everyone and it quickly settled her down and filled her heart with happiness. Adding a couple cat videos after quickly had her asleep. Thank you for all of your support and encouragement. We will try to keep updating the blog and allow everyone to follow along with her progress. Once we are able, we will be sharing your comments with her, so if you are debating writing something please go forward and say whatever you feeling. It makes a big impact on her and means so much. Thank you,

Surgery Final Details

This is Dan,

I have removed Jess from her phone and laptop in an attempt to minimize the vast amount of stress she is dealing with. She had a few Dr appointments today, along with finalizing everything necessary for her surgery tomorrow, took their toll on her. The stress that she is under is tremendous and even before todays activities it has effected her greatly. Her body temperature was a full degree below the normal range, which the Dr says can happen when people are in high stress situations. One of her eye lashes actually turned white over night. These are just a couple of examples to illustrate the reasons I have chosen to remove Jess from the outside world and allow her to focus on herself, as much as is possible anyway. We have been overwhelmed with support and love sent our way, and I wanted everyone to know that any lack of response from Jess is because of my wishes of her. Thank you for your understanding.

Tomorrow Jess is scheduled to begin the surgical process about 7:15 with the actual surgery scheduled to begin at 7:30. If everything goes accordingly, Jess should be finishing up with the surgery around 1:30pm and we will get an update (and hopefully get to see her) an hour or two after that. She asked me to let you know so that if you wished to send her your thoughts, prayers, love (or any form of support) this might be a good of a time as any. We truly appreciate all the support everyone has given us, thank you.


The blog will be update periodically by either myself or Jess's parents. We will attempt to keep everyone informed as best as possible but priority one is taking care of Jess so please give us some patience.