I spoke with the doctor at the MNI on Monday. He had the neuroradiologist analyze the latest CT scan of my dad’s head.

There appear to be lesions on dad’s thalamus (right in the middle of the brain) that may be a lymphoma (cancer). If it’s cancer, it’s brain cancer and not a metastasis from elsewhere in the body. Brain cancers don’t show up in tumour-marker blood tests.

However, there is also a noticeable reduction of edema (swelling) from the November to the January scans. Lymphomas, being tumours, tend to grow and increase swelling. The doctor sais it’s rare that there would be a reduction in swelling with cancer. This reduced swelling is why Dad is doing so much better.

What the Freeport radiologist interpreted as calcification, the MNI doc said, may be deep vein thrombosis in the brain – vein blockages, which can induce stroke-like symptoms.

In sum, the doctor hasn’t reached a firm diagnosis, seemed doubtful that it was cancer, and is dying to get Dad into an MRI.

Dad is arriving via air ambulance tomorrow afternoon. I’ve rented a hospital bed and wheelchair, which will be moved into the rented furnished apartment tomorrow. Dad’s first appointment at the MNO is 7:50 a.m. Friday morning. I’ll be sleeping in the apartment so that I can help in the morning.

I’m kind of a one-trick pony on this blog lately, but my dad’s case is objectively fascinating.

The plan was to get my dad a new CT scan while he was sedated, so he wouldn’t move around so much. We were waiting for a bed to open at the Freeport hospital, because with the sedation, he’d need a bed. The Montreal neurosurgeon recommended we give him lorazepam (Ativan), which is safe and short-acting enough to not require that my dad be an in-patient.

While we waited, my dad continued to improve. He’s eating regular food, cut into small pieces. He is speaking better and more clearly every day and he’s gaining strength. His doctor is pleased with his progress. He asked Dad to do several different things with his hands and fingers, and my dad understood everything he was asked to do. After a few minutes, my dad started to cry. When his wife asked him if he were sad, he held up his index finger and thumb, meaning “a bit”. The doctor asked my dad if he were crying out of happiness and my dad answered yes. He is realizing that he is getting better.

He finally got the CT scans done around 8:00 p.m. last night. He entered the hospital at 2:00 p.m., but the lorazepam didn’t work; he wound up getting a dose of the heavier stuff.

The radiologist there said he didn’t see any lymphoma. He compared the November scans with last night’s and said that the darker areas have gotten lighter and smaller. I’m not sure what that means. In any event, now we wait for the neuroradiologist in Montreal to take a crack at them.

Here’s all the imagery. Feel free to send to whomever, or take a look yourself.

JFK Medical Center, West Palm Beach, July 4, 2010

Rand Memorial Hospital, Freeport, Bahamas, November 15, 2010

Rand Memorial Hospital, Freeport, Bahamas, January 10, 2010

A consultation with a neurosurgeon at the Montreal Neurological Institute (MNI) led to a neurological radiologist having a look at the the summer’s CT and MRI scans, along with the more recent CT scan. He detected a brain tumour!

That sounds bad, but as far as tumours go, there are plenty worse ones to have. The blood-brain barrier limits the damage it can do.

However, no other radiologist interprets the image to be of a tumour. They see a more prosaic periventricular demyelination, although the MNI radiologist presumably has more skill in this area.

The MNI will accept my dad as a patient – the surgeon calls him a “hot case” – so that is the short-term plan. First, however, we need a better image of my dad’s head. In Freeport, that’s limited to a CT scan, but this time the hospital will sedate him so he doesn’t wiggle. In order to sedate him, he needs to be admitted and we’re waiting for a bed.

We’re looking to buy or rent an electric hospital bed in Montreal so we have it ready when my dad arrives. Does anyone have any leads?

Bonus sarcastic site of the month:

If anyone asks you a question that can be easily answered at Google, reply with a link in the form of this URL: https://www.htsti.com/?q=xxxx where xxxx is replaced with the question. For example, if someone asks you what time it is in Newfoundland, send them this link: https://www.htsti.com/?q=time+in+newfoundland.

Unfortunately, https://www.htsti.com/?q=electric+hospital+bed+Montreal doesn’t turn up much.