Appt w/ Dr. Spetzler and Dr. Fiorella

Hi again!

Well, today was the day that we got to meet with the doctors. Unfortunately, we left feeling a little less confident in the potential outcome. Of course it is necessary for the doctors to point out all the possible scenarios, both positive and negative, but we were hoping for just a little more long term confidence.

Because of the size of the thrombosis (swelling/clotting) around the aneurysm, which happens to be roughly the size of a golf ball, I guess we should be pleased that his symptoms aren't even worse. The hope is that removal of the blood flow through the aneurysm by applying a clip or coil will eventually cause the body to absorb the material and, therefore, the thrombosis would decrease over time and release the pressure on the brain stem. When I asked how long that process would take ... weeks, months, years ... both doctors confirmed that there was no way of knowing and that, although this was "theoretically" supposed to happen, there was no guarrantee. Of course, our hope was that a successful surgery would make his symptoms go away and that he would feel better and be able to get back to doing the things he liked to do, but we won't know if that will be the case. There is the chance of them being able to do another surgery down the road to actually remove the thrombosis, but it didn't sound like they were too excited about going that route. So, once we get through the surgery, remember to add to your prayer requests that the thrombosis will dissolve and ultimately shrink as he progresses through his recovery.

In discussing all the possible surgery options, we found that they were considering doing a coil, which can be done through the artery, versus doing a clip, which is done through open surgery. The basic plan is this: They will do the balloon angiogram on Thursday through an artery in his groin. He will be awake for this procedure (ouch!) as they will be talking to him and asking for his response to commands during the test to see how he tolerates the balloon. Although this will be more unpleasant than being knocked out, it is comforting to have them see how his faculties are reacting. This will take up to twenty minutes, if he does well. At that time, they will insert another catheter into the other side of his groin (more ouch!) and inject the dye to watch the blood flow - that will take another ten minutes. If they are happy with the results, they could decide to put him to sleep at that time and insert a permanent coil into the artery, and he would be done. The downside of this procedure is that there could be invisible blood flow around the balloon (they are a little concerned that their biggest balloon won't be a tight enough fit because of the size of the artery/aneurysm) which could create some complications after the coil is in place. The coil also carries a little higher risk of stroke than a clip, but open surgery is riskier than arterial, so that is what they will be weighing when they make their decision. The biggest downfall is if the balloon angio doesn't look good. Then they will definitely have to do open surgery on Friday. That gets a lot more complicated as they will need to do another bypass, this time from the left side of his head. They will again take an artery from his forehead and use that to create a bypass, and then they will do a full clip below the aneurysm. Jim was kind of bummed that they might have to mess up the "pretty" side of his head! All in all, we still know that this is a very major and risky procedure, no matter what they decide to do; we just are going to have to be even more patient to see how the results pan out over time. We are still hopeful that this will be the last time that we need to go through this, and that he will get better and be able to live the kind of quality of life that he so badly wants.

So, please keep the prayers coming! Now you know a little more about what to pray for specifically -- that the balloon angio looks good, that the doctors pick the best procedure (coil or clip), that if they need to do a bypass, that it will go as well as the last, that he won't stroke (now or in the future), and that the thrombosis will disappear over time as he heals. That's all!!!

Well, I hope I haven't sounded too discouraging. Obviously, we are terrified, but we also know that there is no other option than to give this a try. Jim can't and won't live much longer with things the way that they are. The rate of his deterioration has been terrifying in and of itself these past couple of weeks. We are still optimistic as we have the very best doctors, and we still have our faith that God will get us through. It's a miracle that Jim is alive, and there's no reason not to expect another miracle this time. God has already blessed our family, and will protect and guide us always. Dr. Spetzler promised that he would take care of Jim as he would one of his own -- we can't ask or expect more than that.

Tomorrow, Jim will have his pre-op, and they have also added in another CT angiogram to get some more pictures. Thursday continues to be a very big day, so please follow along. Love and blessing to all of you and yours -- I sometimes forget that there is a whole other world going on out there -- and we still hope to be returning home soon with a much healthier Jimmy!

Love to you all!
Krissy