As you know we saw all of Corey’s doctors prior to our Thanksgiving trip. The preemptive checkups were needed to clear Corey for her first flight. We returned home to a mountain of mail and several phone messages which included a generic voice mail from her neurosurgeon, Dr. Yalamanchelli. (Not that we weren’t excited to hear from him, but I had a feeling he wasn’t calling to wish us a Happy Holiday) He took a second look at Corey’s CAT scan, saw something on the film and wanted a closer look.
The MRI confirmed a growth on her pituitary gland. The pituitary gland is at the base of the brain. The blood work ordered shows the hormone levels controlled by the gland.
Corey’s blood results are inconclusive in order to diagnose if the growth is benign or malignant. This type of tumor will continue to grow either way. If the growth is found to be benign, it will eventually affect the Optic nerve. We are also wondering if it is affecting the vision issues she currently has. If it’s malignant, it could spread to the rest of her brain. Most tumors on the pituitary gland are usually benign. Regardless of its classification it will eventually need to be removed.
Dr. Yalamanchelli is referring us to an Endocrinologist at Christiana. Corey will have more blood work taken to analyze her levels in depth. If the tumor is found to be benign, Dr. Y will most likely order repeat MRI’s to watch the size and speed of the tumors growth ~ he does not want to put Corey through surgery at this stage of her recovery if he doesn’t have to.
I asked their impression of the current MRI in comparison to her prior films. I jokingly added the last time I asked for their opinion Shakira looked at me panicked because I obviously was clueless in understanding the diagnosis. I assured them I have graduated from my freshman status in Parent Pre-Med moving onto Neurology, Psychology and multi-discipline therapy 201. I wanted to know what differences they saw in the films and if it has a direct correlation to the level of therapy for Corey’s recovery.
Like any photograph, an MRI and CAT scan capture an image of the brain at that moment in time. It is used for clinical diagnosis only. Dr. Y explained from a neurosurgeons perspective, the film definitely shows a patient with a traumatic brain injury, but it also shows the difference in healing and development of new tissue.
I pressed them further, “if you didn’t physically see Corey prior to reading the films, what would it tell you? Do the films reflect the acute level of rehabilitation she’s received?” He explained, ‘the films show a significant improvement in how the brain has healed but at this stage, 2 years post injury, we rely on the physical exam to truly evaluate the progress a patient makes’. ‘Corey’s physical exam exceeded anything we could have interpreted on the films; that does reflect her therapy’.
Today, Bryn Mawr agreed to do a patient story on Corey’s recovery including a video of her using the Lokomat. I shared with Dr. Yalamanchelli and Shakira that I’m hoping to use the article and footage to validate the need for extended length of stay at the acute inpatient level, the need for full coverage to maintain the acute level of post rehabilitation (at home or in a sub acute facility) as well as not capping the Out Patient therapy coverage for TBI patients whether they are injured at the mild, moderate or severe levels.
Dr. Yalamanchelli stated that if we could get Corey’s story heard, ALL neurosurgeons would support it. They are like the lead runners in a relay race. They save the patient then pass the baton to the rehabilitation hospitals. Once a patient moves on, they can only hope they get the maximum coverage for services…unfortunately, the baton is often dropped and the patient is the one that loses the race. This is the very reason Dr. Y spoke on Corey’s behalf to Fox National News. The battle to have the baton passed is why Corey and I continue to advocate for “all” TBI patients…they all deserve to run the race for as long as it takes them to reach “their” finish line…not the line set by insurance companies! We’re goin’ for GOLD, xoxo