good thoughts

Dr. Akins (mom’s doctor) came by today (Wednesday, July 30, 2008), to give us an update on mom’s condition. So, here it goes. From a neurological standpoint she is the same to slightly better than yesterday. She is doing some communication with her eyes and is moving her left arm. At this point we still do not know the outcome but he did say that anything is possible. However, he said that if there were no hope that they would not continue working so hard to save her.

They are going to continue with the angiogram steroid treatments daily. Yesterday, (the 29th of July) they applied treatment to all three arties and are planning to do the same today. Dr. Akins did say that at some point the blood and vessels will calm down and stop spaziming, until then they will continue this treatment. We were told that the average patient has this spaziming anywhere from 4 to 14 days but that she is “NOT the average patient”.

Also, blood brings oxygen to the brain and she is a little anemic so they are going to start giving her a transfusion of a couple pints of blood. They want to keep as much oxygen as possible in the brain so they will watch closely and make sure she is getting enough but not too much blood.

I waited long enough to post this that I now have a report for today. Dr. Amar did the steroid treatment today (July 30, 2008) and she is now back in the room and doing fine. He pointed out that today is 9 days since her last and largest bleed (it happened Monday, July 21st) and that typically they have 12 days (again they noted that she is not a typical patient) where the vessels are actively spaziming. So, the good news is that her arteries have not gotten worse and are actually looking a little better in some areas, still not in others, but overall she is looking a little better internally. They will do the procedure again tomorrow and will keep treating her as she is slowly healing. The road will still be long and bumpy but when you look at it as 9 days, versus day by day, she is really doing so much better.

Please know that we do appreciate all that you are doing to pray for her and our family. Your love and acknowledgement means so much to all of us. Also, if you have any photos that you would like me to add to her book please e-mail them to me christienoelle@yahoo.com or you can mail them to my home address- if you e-mail me then I will give you my address. (Notes or cards are welcome too)

Note: She still has the breathing tube which is placed between her vocal chords therefore she can not talk at this time. This does not mean that she will be unable to speak; we still don’t know that. Also, she is still in the critical care unit and is still critical. These daily milestones are some indication of improvement but she is not out of the woods yet.

The Tammy Larson Fund

Today mom had another procedure to apply the medicine directly to her arteries. I gave misinformation yesterday when I said that they only needed to apply it to one artery. They said that one of her arteries is still doing well but that they had to tend to the other two. Tomorrow they will do the same procedure, actually they will do it daily until it becomes more stable.

Also, I won't be able to post all that often for a few days as I am on Mom duty and don't have internet access at the hospital. I will get to a computer as soon as possible with any changes in her condition. Until then, think good thoughts and keep her in your prayers.

Finally, a fund has been established for my mom- The Tammy Larson Fund. We have been asked how people can help and if there is a place for donations so now there is. You can go into any Wells Fargo Branch and let them know you would like to donate to the Tammy Larson Fund, no account number needed they can look it up. I will try to find out about posting a way to donate directly online and will get a form if you would like to mail it instead.

Again, thank you for all of your love, support and constant prayers. We do appreciate everything and are praying for you too.

Thank you for your outpouring of love and support!

Our entire family really loves hearing all of your well wishes, thank you! We haven't been able to read all of them to my mom yet but I am excited for her feeling a little better so we can do so. Thanks again! Keep them coming, I am creating a book for her so any notes will be nice to include.

Okay, for her progress report: Yesterday she fought through yet another invasive procedure. Before explaining what I know of her current condition let me explain further what they have done previously. I found this image online and obviously don’t know what I am talking about but I will explain to the best of my knowledge.

There are four main arteries that carry blood into the brain (fig a), Vertebral Arteries and Carotid Arteries; in whole the arteries of the brain are called cerebral arteries. Last week one of the procedures that were performed was where they went in and inserted two coils to shut down flow from the right vertebral artery. It was done in order to keep her from having an aneurysm at that location. Looking at the angiogram it was visible that this was one particular point that could be fixed. (fig b)

Currently, the MRI showed that the other arteries were spaziming, in order to keep them from closing and cutting off blood circulation to the brain they needed to do an angioplasty however, her vessels and arties are just too weak to do that. So, in order to help calm the spaziming arteries they insert a catheter (angiogram- fig c) and apply some steroid medicine to the affected spot. They were planning on doing this to the three other arteries, however, when they got inside they only ended up doing it to the other vertebral artery. The medicine only lasts for a few hours so this procedure will occur everyday until spaziming stops. The procedure has major risks (and is life threatening) every time they do it, however if the spaziming results in more strokes, another aneurysm or a hemorrhage then it can be fatal.

On a happier note, she is communicating a little more with her eyes today than in the past few days and moved her left arm and leg. This is really great!!!! It’s the small things in life that keep us going and give us the strength to endure.

Fig. A Fig. B

Fig. C

Figure A
http://www.stanfordhospital.com/clinicsmedServices/COE/neuro/stroke/patientEducation/whatIsStroke.html

Figure B

http://www.highlighthealth.com/health-news/chiropractic-adjustments-and-artery-dissection-is-your-neck-in-safe-hands/
· Carotid artery: a principle artery located in the front of the neck that carries blood from the heart to the brain. There are two carotid arteries — the right and left common carotid arteries — on each side of the neck.
· Vertebral artery: a principle artery located in the back of the neck that carries blood from the heart to the brain. There are two vertebral arteries that ascend on each side of the body through the spinal column. The path is largely parallel to, but distinct from, the route of the carotid artery ascending through the neck. Inside the skull, the two vertebral arteries join to form the basilar artery.

Figure C
http://www.vascularweb.org/patients/NorthPoint/Angiogram.html

Why Chemo?

First, to clarify, the type of chemotherapy that is being administered to my mom is not because of cancer and is not the same type that cancer patients use. She is getting Cyclophosphamide, also called Cytoxan, and is classified as a “cytotoxic agent”, because it has a toxic effect on many types of cells “good” cells as well as “bad”. Cytoxan is used in conjunction with high doses of steroids in order to stabilize and strengthen the blood vessels in her brain; it will also help with the inflammation. I have read that "for some forms of Vasculitis that do not respond to steroids (prednisone) alone, cyclophosphamide may be a life–saving medicine." It works by slowing or stopping cell growth. Not a lot of info, but the doctor says that because of how rapid the vessels were being attacked that this would help to stop that. It takes her immune system completely down in order to rebuild it- hopefully without the virus or what the body was interpreting as a virus.

Still Sleeping

Just a quick update, I know everyone is wondering what is happening. Mom started the chemo and has basically been sleeping every since. She wakes up occasionally but gets excited easily so they are keeping her pain meds up on a regular basis. She is communicating with her eyes during the few minutes that she is awake. Also, she is breathing on her own now but still has the breathing tube because they are worried that with her sleeping so much that she won't be able to protect her airway when the need arises. More to come later...

My mom is very ill

My Mom is battling for her life; please keep her in your thoughts and prayers...

Last week was the beginning of a nightmare for our entire family. It all started on Saturday, July 12th when I took my mom into the ER in Santa Rosa where she stayed for five days. During this time she had a blood transfusion; many multiple tests ran on her and even spent her birthday in this hospital. Finally, on Friday July 18th she was told that they could not find what was wrong with her and sent her home! She came home even sicker than when she had originally been admitted.
At 4 in the morning on Saturday, July 19th I again rushed her to the ER this time in Terra Linda hoping for some better results. Much to my dismay I was told that all that was happening to my mom was psychological! I was like, are you kidding me!!!! The way that it was explained however did make sense but it just didn’t settle well in my stomach so I fought for a second opinion. Finally, an amazing doctor ran a new CT scan and found out what was happening to my poor mom. She was then set up for ambulatory transfer to Kaiser’s top neurological hospital in Sacramento. He informed me that she had a large bleed in her brain that was likely vasculitis and it was inoperable.
Mom was transferred to Sacramento around noon on the 19th where they immediately ran more tests and scans on her. We learned that in actuality she had two bleeds that were very rare because there was one on each side of the brain, the larger being on the left. I am not going to go into every detail of her trauma but I will give some of the major events that have led us to where we are now. On Monday the 21st, this nightmare became even worse when she started having continuous seizures and strokes which caused more bleeds in her brain. She's made it through 3 life threatening brain surgeries in less than 24 hours. The pressures in her brain keeps going up which is also a major problem. She has now been diagnosed with a rare disease called PACNS - Primary Angiitis (Vasculitis) of the Central Nervous System. She's currently in critical condition and is on life support but as of 3pm on Thursday we haven't had any major setbacks. She made it through another night which is more than the doctors expected. She's in a coma so at this point we have no idea how much of the brain damage will be permanent, all we can do is hope for the best.
She has started a special Chemotherapy so her immune system is completely weakened so we can’t have visitors or flowers. However, I wanted to inform you and update you about her condition. If you would like to send her any notes you can do so to her e-mail tammylarson@yahoo.com and we will print them and read them to her.

Thank you for your thoughts and prayers, I will try to update my blog as often as possible with any addition information.

Amie and Jason are finally married...

Jason and Amie Dyer
July 5, 2008

http://opiefoto.com/