On May 10, 2006, at only 6 months old, Sophie was diagnosed with Infantile Spasms...a RARE and CATASTROPHIC form of epilepsy. She continues to battle this disorder on a daily basis. Only after she had the majority of her left hemisphere of her brain removed (on May 29, 2009) has she had a relief in seizures (though she continues to show spiking in her EEG). She has shown much improvement in development since the surgery.
Friday, May 29, 2009
Thoughtful package...
Easter Pictures...
Brandon had a death grip on Sophie because the first animal they got to pet...a baby duck...she grabbed by the beak and held in the air. The lady freaked out and let go when Sophie grabbed it. Poor baby duck...probably traumatized for life. Sophie had no idea what she did. Of course, I was in charge of her at the moment. Brandon took over after that.
Elsa and Ben...they could be twins.
Update From Dr. Chugani
On a lighter note. I have received further confirmation that people in general are socially retarded. I grabbed a sandwich at Subway about an hour ago and the lady asking me what kind of cheese I wanted says, and I quote "Why so serious? Cheer up, its Friday!". Does she realize that she works in a hospital? My initial reaction was to say "Yes, big plans for the weekend. I plan on starting rehab with my daughter that is getting half her brain removed." I resisted and smiled instead.
Brandon
Still waiting...
Thank you...
The chocolate covered strawberries were delicious!
Thank you Aunts, Uncles and Cousins for the beautiful flowers, teddy bear and balloon.
They really brighten up the room.
Thank you Uncle Steve and Aunt Diane for the cards.
They were very thoughtful.
The waiting begins...
All About Poker
So, what does this have to do with Sophie and the surgery? When Dr. Asano and Dr. Chugani came into the room to give us the surgery news, I had two different reads. Dr. Chugani was displaying subtle confidence (consistent with the not terrible but not great news) but my read on Dr. Asano was much much different. As Dr. Chugani took over the description, I never took my eyes off Dr. Asano. My initial read (the one that poker players say you should stick with 90% of the time) was that there was a level of guilt or concern there. He consistently looked down to the right. As I awoke this morning, I couldn't get this image out of my head. I recalled from the show Lie to Me (predictable but also very interesting analyzing body language) that my read was probably accurate, but what about the Japanese culture. Could it have just been a sign of respect (but then why not just down...why the right also)? Am I overanalyzing? Probably... Nonetheless, I couldn't fall back to asleep, because I didn't trust my read and folded. I chickened out! I did ask the question "knowing what you know now, would you have recommended starting the surgery"; however, only Dr. Chugani answered. What would have Dr. Asano have said?
So, I searched for looking down and to the right on Google and confirmed:
"Looking down
Looking at a person can be an act of power and domination. Looking down involves not looking at the other person, which hence may be a sign of submission ('I am not a threat, really; please do not hurt me. You are so glorious I would be dazzled if I looked at you.')
Looking down can thus be a signal of submission. It can also indicate that the person is feeling guilty.
A notable way that a lower person looks down at a higher person is by tilting their head back. Even taller people may do this.
Looking down and to the left can indicate that they are talking to themselves (look for slight movement of the lips). Looking down and to the right can indicate that they are attending to internal emotions.
In many cultures where eye contact is a rude or dominant signal, people will look down when talking with others in order to show respect."
Pretty consistent with the read but I missed the attending to internal emotions. Maybe he does just take these things personally. Maybe he was feeling guilty for approving the surgery (he is the most conservative, but I hope not). Maybe he was showing respect but he wasn't talking at the time and why right??? Maybe he thought I looked glorious and was dazzled by me...probably not. Part of me wishes I didn't notice.
Okay enough of that. I will ask him in a couple hours. Won't change our course but I need to know that all of my questions were answered and that I hear directly from Dr. Asano what he is feeling...maybe I will get a few more reads :)
Speaking of poker, while talking to Elaine last night, the only analogy I could come up with is that this feels like a race...a coin flip. We have pocket 10s and the infantile spasms has AK suited... The pocket 10s are a slight favorite so maybe it is the other way around. Either way, heads we win, tails we lose. Are we prepared to flip a coin on this? Are both sides tails? If the alternative is don't flip the coin and always lose, don't you have to flip?
I guess I am back to think the worst and hope for the best philosophy. It just works better for me. Many times when facing a race, I will say "I know I am going to lose this hand". Reverse psychology...although it doesn't change a thing. The flop, turn, and river are set. The cards are on the table for everyone to see.
Thanks for reading. It may have sounded negative but it really helped me gather my thoughts. I am not usually this much of an open book. Please use whatever method works best for you: prayer (even if laodicean), thoughts, reverse psychology, positive thinking, meditation, sacrifice a lamb (okay don't do that, a little outdated)...we will take it all!
Brandon
** All words in italics and bold is poker terminology.
Thursday, May 28, 2009
What is under that wrap...
Surgery Strategy
The diagnosis:
-- Sophie's seizures are originating primarily from the left frontal cortex with a lot of spiking** in the left temporal, left parietal and left occipital cortexes.
-- There is also a lot of spiking in the left motor and sensory cortex (more on that later).
-- There is also some diffused seizure activity with no focal origination.
-- There is also some spiking over the entire right hemisphere though no seizures were noted originating from the right hemisphere (good news...though of course it would have been better not to see any spiking on the right hemisphere...more on that later).
**Spiking is considered seizure activity but not a seizure. Makes perfect sense...right?
The plan:
Step 1: Keep our composure, man this sucks!
Step 2: Repeat step 1.
Step 3: At 8am tomorrow, Sophie will be taken back into surgery for a subtotal hemispherectomy (I will pause for you to grab your medical dictionary, ready?). In other words, they will remove the left frontal cortex, left parietal cortex, left temporal cortex and left occipital cortex and LEAVE the motor and sensory cortexes.
Step 4: Immediately after the subtotal hemispherectomy, EITHER step 4a, 4b, or 4c will occur. They will keep the grids on the left motor and sensory cortex and right hemisphere for immediate observation.
- Step 4a (best case scenario): After the subtotal hemispherectomy, no or minimal spiking will be noted in the motor and sensory cortex and no further action is needed.
- Step 4b (so so scenario): The motor and sensory cortex will continue to show spiking in which they will perform a multiple subpial transection (MST). In other words, the cortex will stay but slices will be made to the horizontal nerve fibers.
- Step 4c (don't want to think about it scenario): If they continue to see a lot of spiking in the motor and sensory cortex, they will remove it. If they remove this cortex, Sophie will be weak on her right side and lose a lot of her fine motor skills in her right hand and walk with a limp. Considering the delays that she already has, this would be one more further setback to overcome.
Step 6: See Sophie in ICU at 6 or 7 pm tomorrow night...almost 12 hours later.
Step 7: Never see seizures again! Okay, maybe overly optimistic but why not change course. My philosophy ever since ACTH didn't work has been to accept the worst and hope for the best. This way you can't get crushed. But it is way too late for that now.
So, the only reason we are closer to answers is passage of time...which seems to be on slow motion. Sophie is still being strong as always. As I started typing this blog, she woke up and without prodding, she blew me two quick kisses with her lips. I think she is telling us that we are doing the right thing and she can handle it. Elaine can't wait until she can cuddle up and snuggle (Sophie's favorite pastime) this Saturday.
Brandon (with technical editing from Elaine)...because I have no idea what parietal means
Update right before posting: Sophie just sat up and started waving and saying "hi hi hi hi" to Elaine. She even said "hay hay" when we showed her the picture of her older sister. We sat her up and she drank a little.
Quick Morning Update
Brandon
Wednesday, May 27, 2009
Prepared But Still Learning
So with limited material, I offer the realization that no matter how prepared and educated on this subject you are, the most subtle question and answer can mean the exact opposite of what you thought. We come to Detroit thinking we have asked all the questions and understand the consequences of all the answers. What does it mean if the seizures are originating from the left or right? What if the motor cortex needs to be removed? Does she talk? Does she walk? Do her seizures favor one side of the body? And then the simple question, is she left handed or right handed?
I don't think we have met with Dr. Chugani a single time in the last 2 1/2 years where he didn't ask this question. In fact, the first time we met him he predicted that she would be left handed based on the results of the pet scan. Over the last 6 months, she has favored her left hand maybe 70% of the time, which is what we reported to Dr. Chugani for the second surgery conference. One of the reasons for the recommended surgery was her favoring the left hand. So, that is a good thing, right? As I spoke with Dr. Chugani this morning (he really talks to you, not down to you), he references that her being "weak" on the right side may be an indication the left motor cortex is damaged. I immediately started back-peddling..."wait, when we told you that she FAVORED her left, we didn't mean she was WEAK on the right" trying to rationalize in my head that the motor cortex will be fine...and maybe it will. We will know in less than 24 hours THE PLAN, which we know in our hearts is THE ANSWER. It is funny that we have been playing up her left-handedness as a positive and are moving it into the negative column 36 hours before the surgery.
Jason slept until noon today and will be taking most of the night shift so that Elaine and I can sleep. He also went to the grocery store and the 3 of us somehow devoured way too much food. Can't thank him enough. One of us will update you early in the morning.
Brandon
In a new room...
Up and drinking...
Morning of Day 2...
Tuesday, May 26, 2009
What is That Beeping?
As Elaine and Jason walked out, I pulled out the laptop and settled in for a relaxing movie as Sophie slept away...however, the various monitors and Sophie's roommate had other ideas. I haven't sat down since they left.
First, Sophie decided to give Dr. Asano plenty to read when he gets here in the morning. She woke up and had about 20 seizures. She was not very happy when she opened her eyes to a strange nurse rather than her favorite person in the World (her mama). However, she had to settle for the dad as she continued to say mamamamamamamamamamamamamamama. It was only 5 minutes after Elaine had left but I knew she wouldn't get any sleep if I called her every time something happened. Sorry Elaine but you and baby need rest.
Second, they gave Sophie some morphine and she fell back asleep. I immediately told them to get her seizure meds (Depakote and Dylantyn) just like Elaine gave me instructions to do. I believe it was one of the 20 instructions...the yellow line means this and should be between this and this, the green line, the blue line, the red line, the purple numbers, the ICP range, don't forget to write down the seizure activity, only let the morphine go in this tube (that one came in handy as the nurse seemed confused), etc. etc. etc.
Third, the yellow line (which I recalled was breaths per minute and should be approximately 20) went down and down and down until it was zero and the machine was beeping repeatedly. She was breathing (don't worry even though I sure did) but the morphine made her breaths shallow. This yellow line continued to crash and go off every 5 minutes while I made sure she was breathing and became obsessive of counting the breaths per minute myself.
Okay, time to relax until the kid that Sophie is sharing a room with had everything beeping. He proceeded to have 3 different IVs put in and come out within the next 2 hours. Since his parents are nowhere to be found, I became the person silencing the beeps on his machine too for the nurse (and assuring him that he would get ice cream soon...that may be the only word he knows). Even though she repeatedly thanked me, I assured her it was in my best interest to shut it up (the machine, not the kid) as well.
Back to Sophie. Fourth, around 11:30, I asked Dianne (her nurse) whether her seizure meds were here yet. She said they would only come if she had 2-3 seizures. Did I imagine those 20 seizures, which she was standing right next to me during? Evidently it wasn't as obvious to her even though I told her and asked her to get her meds...end of the shift I guess.
Around 11:45, Laura took over. Laura seems to be getting everything much more organized around the bed but that woke Sophie up. Sophie had one of the longer clusters I have seen (40 or more). More data for Dr. Asano!!! But once again mamamama was the word of choice (although she did throw in a "door", which is her favorite word when wanting to leave a room...I don't blame her) during the episode as I continued to ask WHERE WAS HER MEDS? At the end of the cluster, Sophie decided to really test my stomach by throwing up a little towards me (green which I was assured is normal).
Elaine can confirm that I don't have the strongest stomach for blood, needles, and puke so this is the fainting trifecta. But I made it through and so did Sophie. She is so brave and strong.
Back to hopelessly trying to 'interpret' the 120 different leads on Sophie's brain. Which one spiked first? No idea...will wait for Dr. Asano to fill us in tomorrow.
Time to rest...
Sophie Looks Great
Brandon
Grid Surgery - Sooner than we thought...
And about 10 minutes ago, Dr. Sood came in to say they were DONE!!! ALREADY!!! Everything went well. She will be in recovery for about an hour before she goes to ICU. We won't be able to see her until she is in ICU.
Grid Surgery - Meet the doctors...
Grid Surgery update...
Our trip, so far, in pictures...
Sleeping beauty.
Waiting room.
Pre-op...in the most comfy hospital gown I have ever seen.
Hootie...deserves a post on its own to explain his significance.
Included in the bag is a note from NaNaw (Grandma Debbie).
This bag went with Sophie during surgery to watch over her.
Grid Surgery has started...
Grid Surgery Pre-op...
The rest of our trip...
Monday, May 25, 2009
On our way...
Thursday, May 21, 2009
"THE" call...
I was in planning mode. Not trying to think about the actual surgery. Just trying to get all the details worked out...who was going to watch Elsa and the new baby, making housing accommodations in Detroit, trying to get a neuropsych evaluation appointment (which took me almost 3 weeks to get and I got the call this morning with the appointment date of June 1st), etc.
So here I am now. In just a mere 5 days, Sophie will be scheduled to have Part 1 of the surgery. All my prior planning is out the door. Useless. Now I need to focus on both planning and surgery. I am in shock. I can't believe it. I am scared!!! Scared is an understatement!!!
But I am happy?!?! Can't think of quite the right word to explain how I feel. I knew Sophie was going to have surgery. So better now than later. Of course, I wish she didn't. I wish her seizures would have just stopped on their own. But I am hopeful that surgery is the answer. But it is hard to be hopeful when so many things have failed in the past. But I can't think about that. I can't think about the "what ifs". I HAVE to put all my hope into this. That by the end of next week I will be able to say...I HAVE NOT SEEN ANY SEIZURES TODAY!!!
Baby feet...
I love baby feet. Love them. Love them. Love them. A bit obsessed. They are just too darn cute. So here are a few extra pics...
Saturday, May 16, 2009
Practicing to be a contortionist...
California Residents...
Friends of Gwendolyn, Vote NO on CA Prop 1D
To Our Dear California Resident Friends:California Proposition 1D will be on a special statewide election ballot on May 19, 2009. We are asking you to please VOTE NO ON PROPOSITION 1D and tell your family, friends, colleagues, and neighbors to do the same.
If passed, the proposition will have a material NEGATIVE impact on Gwendolyn's services and would eliminate "First Five", an important early childhood development program dedicated to improving the lives of California’s young children and their families through a comprehensive system of education, health services, childcare, and other crucial programs. "First Five" was created as a result of the passage of Proposition 10 by California voters in 1998.
Please VOTE NO ON PROPOSITION 1D. This is important to the well-being of our family and families just like ours.
Friday, May 15, 2009
City Museum...
It had a bunch of ramps and such that you could slide down and swing across.
The girls had fun climbing and sliding around.
We found Haley and headed outside to Monstro City.
Not a place to go if you have a fear of heights.
There are all these wire things suspended from the outside of the building that you can climb around. Sophie and I decided to watch as the rest of them explored.

Wednesday, May 06, 2009
Med Update...
On the other hand, Sophie's seizures have been a little scary lately. She mostly has tonic seizures (quick seizures in which her head will drop and her arms will fly out...each seizure only last a second but they come in clusters). But lately she has been having more atonic seizures (head will slightly decrease and arms will fly out but she freezes in this position for 5 to 10 seconds while her body slightly shakes). Usually, she will only have one of these at a time. But on 2 separate occassions, she had 4 atonic seizures in a row. Completely wiped her out. She will immediately cuddle up in my arms and fall asleep for 15 to 30 minutes. Breaks my heart.
So is this because of the weaning of the Banzel or increasing of the Felbatol? She always has withdrawal seizures. Even if the med did absolutely nothing for her seizures!!! ABSOLUTELY SUCKS!!! How can a med that does absolutely nothing for seizures cause them to get worse during the wean??? Luckily, her seizures eventually stabilize.
So for Felbatol...we are currently at 2.5ml/day (1ml in AM, .5ml at 2pm, 1ml in PM).