BACK-FLIP

It's probably no surprise that my favorite roller coaster (to date) is the SUPERMAN at Six Flags... the one does the back flip around the giant superman statue. Perhaps it's appropriate that we call him "SuperBrock", because he's taken us on quite a ride the past couple days. Well, buckle up. The rollercoaster is getting ready to plummet again.

We were HOPING that the news we would get today would all be good, and we did receive some good news. For one thing, the MRI results seem to show that MOST of the areas that were effected from the meningitis were mostly just inflamed tissue that has gone back down, leaving only small areas of actual damage (which we already knew about; we just didn’t know how much was inflamed cells as opposed to damaged cells). The areas of tissue damage (without getting too technical) are several little pea-sized areas at the front of the brain, and a penny-sized area at the back right, which is an area related to vision. So it is good news that the actual damaged areas are MUCH smaller than what they could have been. That’s certainly something to rejoice about. From there on we get not-so-good news:

First of all, even the attending anesthesiologist (who does more spinal taps than anyone in the hospital) was unable to obtain cerebral-spinal fluid after several spinal tap attempts. The neurologist guessed it’s for the same reason that existed before: areas of inflammation around the meninges are still restricting fluid down to that small space where the puncture is attempted. This is a major downer because the infectious disease doctors have been wanting to see the change in cell-counts in his CSF for what seems like MONTHS (ok, so 3 weeks). We are still waiting to talk with them today, but this could mean that they will go ahead and keep him on the Ampicillin  (antibiotic he’s been on for 22 days now) for …another few days? Week? Two weeks? There ARE other ways to get spinal fluid, like attempting a puncture higher up, but then we’re talking a major increase in risks because we’re dealing closer to the brain stem (scary). I’ll add an update when we know more about that.

Second of all, the MRI revealed one of the three things I mentioned that they didn’t want to see, which is, a buildup of fluid (cerebral-spine fluid). This is probably related to the reason they can’t get spinal fluid from the lumbar puncture site: most likely there’s an area of inflammation that, in addition to not letting spinal fluid down his spine, is causing a buildup of fluid in the ventricles in the brain (like a highway pileup). The initial MRI showed us that the brain tissue was so inflamed that these ventricles in the brain (on an MRI slice you would see them as spaces of black in the middle of the brain in the shape of mirroring V’s) were very thin, like they were being pinched by the encroaching brain tissue. Well, now the brain tissue swelling seems to be going down. In addition to that, it’s likely that his actual brain is SMALLER due to the infection… like some tissue has simply “melted away,” as one of the neurosurgeons put it. Due to these things, the ventricles in the brain that hold (and drain) spinal fluid, are now significantly LARGER than normal. This is called “Hydrocephalus”- water in the brain. So, this is due to either 1) inflamed meninges not allowing the fluid to drain down properly, OR 2) the spinal fluid is simply taking up the space that the brain tissue has receded from (as it is designed to do).

When the neurologist, which is different from a neurosurgeon (you got it WRONG Grey’s Anatomy!) came in to show us the MRI results from today, he said that the neurosurgeons might recommend performing a “Ventriculoperitoneal (VP) Shunt” today- which is essentially a straw/catheter that they poke through the skull and brain tissue into the pockets of excess fluid to drain it to the appropriate pressure levels, and then gets pushed down to skin level and stays the rest of his life. This is necessary for many individuals who are at risk for constantly increasing brain pressure, which, left unchecked, leads to brain damage. As it turns out, they might NOT be doing that since they can’t PROVE (without the benefit of seeing cerebral spinal fluid that they’d get from a successful spinal tap) that the infection is totally gone. The last thing they would do is go THROUGH a potentially infected area and into the ventricles in the brain… that would be bad. Neurosurgery seems to be leaning towards just monitoring his head circumference and general demeanor (feeding habits, irritability, etc) to determine if the pressure in his brain is getting too high. They said that at the MOMENT, there’s no reason to rush into a surgery that he MIGHT NOT need and that would affect him the rest of his life, especially if it seems that pressure in his skull is not dangerously high. Here's a link that explains very easily what a VP Shunt is and how it works, etc- if you want to read it: http://www.healthline.com/health/ventriculoperitoneal-shunt?toptoctest=expand

                So here’s the basics:

-          No increased damage (currently) to the brain tissue beyond what we already knew about. In fact, MOST of the affected tissue was simply inflamed and not permanently damaged.

-          No brain abscesses were evident (according to initial reports)

-          The Lumbar Puncture failed (again, even by the best of the best)- probably due to a “dry” area caused by the number of punctures he’s had, or the inflamed meninges tissue in that area not allowing fluid to go past a certain point.

-          We are still waiting on the team to consult with the Infectious Disease team to determine what the course of action is going to be at this point.

-          It’s looking like Brock will NOT be going home this week (as of 3:39pm, anyway).

Aye-yai-yai… I told you to buckle up, right? Taryn was able to sleep a bit at home last night which is good, because I’m not sure she’ll want to leave the Hospital now. Staying up with him and not letting him take a bottle because he had to fast for 8 hours before the MRI was difficult, as you can imagine, but not as bad as it could have been. When we learned he wouldn’t be allowed to nurse or take a bottle last night I told Taryn she should go home and rest since there wasn’t any point in BOTH of us not sleeping. He is now considerably gassy, poor guy, and not feeding as well as he was earlier due to the sedation and everything. It’s also very difficult for Taryn or I to hold him very comfortably because he has to have respiratory, oxygen, heart rate, and blood pressure hook-ups for at least 24 hours after the sedation this morning. Hopefully that won’t make tonight unnecessarily difficult; although, it probably will because none of the leads stay on very well and alarms start going off every 3 minutes interrupting every conversation, ugh. So there’s a bucket of things to pray for if you’re prayer list is getting short.

Sorry this post isn’t as theological or poetic (or short) as previous ones… We are still processing all this information and still living in a currently unknown future, so we haven’t quite had time to really think through what this means. Hopefully the Infectious Disease Doctors will be by soon and, whether good news or bad news, we’ll at least know what the plan is going forward.

We continue to thank you for your tremendous love and support of Taryn and I and our girls. Laurie Frantz and Hollee Ford even stayed up here a few nights over the past couple weeks so that Taryn and I could stay together in our own bed at home, which is an exceptional gift during this time. Our sweet dog Zoe was even being spoiled at Jake Randall’s house- thank you guys! Also, my youth group went above and beyond for my family this Christmas. I had plans for a White Elephant Christmas party at the Holts' house, and when this whole thing happened, the Holts and the youth group decided to make sure that Christmas for our family didn't go down the drain with us not being able to go out and shop for each other. They bombarded Brynlee, Brielle, Brock, Taryn, and even me with presents that brought huge smiles to each one of us- even with all that's happened. Man, they sure are incredible- love them! We love you all so much, and couldn't imagine going through this with anyone other than all of YOU. God bless you. You have richly blessed us with your friendship during this time.

Grace and Peace~ Brad and Taryn