Once at Moffitt we got called back to meet with one of the Jennifers, his usual radiation oncology nurse. He has two Jennifers in medical oncology as well. I wrote down the three things I wanted to remember: MM needs to have oxygen by nasal cannula during radiation, what is the plan regarding steroids, and a baseline neurological assessment has not been performed this time as it was performed before and after both prior stereotactic radiation surgeries. The oxygen issue was easy. The steroid issue complicated with radiation oncologist recommending one approach and medical oncologist recommending another. A different radiation oncologist was sent in to do the neuro assessment, likely because the radiation oncologist assigned to MM for today's procedure is really a prostate guy, not a central nervous system guy, and probably hadn't done a neuro exam in 15+ years.
It is confirmed there are three, not two tumors, one very close to the brain stem. Jennifer says Yes I can go to work tomorrow, but do watch MM for seizures, severe headache, confusion, slurred speech etc.
Thursday I go to work. it is a decent day. Before work I counsel MM: "keep your phone on, respond to my texts and emails promptly today. I am making sure you are ok." He agrees. Later in the evening he reports a few episodes of stabbing pain in the right temple and then twitching on the right side of his face, but now resolved.
Friday morning I am getting ready for work. He is frowning, sitting on the sofa waiting for me to give him his Fragmin injection. "What's going on ?" I ask.
"I'm worried. I have a headache in the same spot as yesterday's pain. I feel disoriented."
I inquire whether the disorientation is a balance/ dizziness phenomena or a thinking problem. He says it's thinking, the thinking is slower, finding words is hard. The finding words was hard on the drive home from Moffitt too, with him using he word "snack"instead of "snake", "speed dial" in place of "cruise control."
I bend down in front of him and tell him it's ok to be worried. It is ok to talk to me about the worries. It is even ok to talk to his medical team about them. He decides against ibuprofen for now. I am off to work.
By 10 am he reports the headache is gone. He is feeling better. Friday night I administer his Zemaira infusion and we are done with all things medical for the day.