2nd surgery

Dear friends,
On 4th feb, norman's brain scan showed a malingnant tumor measuring 3 x 3.5cm. I was devastated! I feel like I have fallen through a trap door into total darkness and i felt numb to the bones! Nothing felt the same after that bad news. Nothing is the same and nothing will ever be the same. I see the despair in Norman's eyes and I feel so helpless! I do not know, honestly, how I will weather all the grief, the emotional stress and the deep agony in my soul. God have mercy on me! I will breath deeply through every bout of anxiety and fears and pain!
After several visit to several hospital and several doctors, we decided on surgery.
On 16th feb, surgery was done at sunway medical center.5 glaidel wafers was implanted. Norman recovery was excellent. Praise God. The price?? Its too traumatic to tell. Leave it alone ok! We are discharged on the 19th feb.
Below are some pre and post op photos.

Family Support Is Of Utmost Importance

ECG before operation

Tumour mapping on the night before op

In ICU - 6 Hours After operation

Waiting To Remove clips - 8 days post op

Glialdel wafer for glioblastoma

Treatment Options for Glioblastoma Multiforme
The Role of GLIADEL Wafers in Glioblastoma Multiforme
GLIADEL Wafer (polifeprosan 20 with carmustine implant) is a small wafer containing the cytotoxic agent BCNU (carmustine) in a biodegradable polyanhydride copolymer. GLIADEL Wafer is a localized drug delivery system that allows high concentrations of BCNU to be delivered to the tumor cavity, thereby, overcoming the adverse side-effects associated with conventional systemic administration of BCNU.

GLIADEL Wafer is biodegradable, meaning that it dissolves slowly over time and releases high concentrations of BCNU in a sustained fashion over an extended time interval.

The GLIADEL wafers are implanted into the tumor bed following surgical removal of the brain tumor. Up to 8 GLIADEL wafers are implanted into the surgical cavity after the tumor has been removed and, as the wafers dissolve, they release high concentrations of BCNU at the tumor site to destroy residual tumor cells that have not been removed by the surgery. More than 70% of the polyanhydride copolymer degrades by three weeks after implantation although "wafer remnants" can be detected even several months after implantation.

In February 2003, the United States Food and Drug Administration (FDA) approved GLIADEL Wafer for use in newly diagnosed patients with high-grade malignant gliomas as an adjunct to surgery and radiation therapy. Prior to the FDA approval for use in newly diagnosed patients, GLIADEL Wafer was used only for those patients who suffered recurrence of glioblastoma multiforme and required a second surgery to remove the tumor.

The results of clinical trials have shown that GLIADEL Wafer significantly prolonged survival in both newly diagnosed patients and patients with recurrent glioblastoma multiforme when used as adjunctive therapy to surgery and/or radiation therapy.

The most common side-effects of GLIADEL Wafer that were observed during clinical trials included:

seizures
brain edema
wound healing problems
intracranial infections

Medical History

14th nov 2007
-Had a seizure of the right face lasting 1-2 mins
-had numbness of the right side
-unable to spell words
-very slow in speech

!6th nov 2007
MRI done. reports show a tumor on the left frontal lobe measuring 4 x 4.5 cm
Diagnosis- glioblastoma multiforme

21st nov2007
craniotomy and excision of tumor done at sunway medical center by Dr Lee Foo Chiang
Biosy report:
The tumor is compose of high grade glial cells exhibitig marked pleormorphism, many tumor giant cells and endocapillary vascular proliferation. Necrosis is seen.
The cells are strongly positive for GFAP and EGFR. MIB-1 activity is seen in about 35% of cells; P-53 mutant protein is seen in more than75% of cells.

17 dec2007-1st feb 2008
30 fractions of radiation therapy completed

march-july 2008
6 cycles of temodar chemo therapy completed

Brain Scan (MRI and MRS)
3rd may 2008- small lesion about 1 x 1.5 cm seen. suggestive of radiation nercrosis
13th sept 2008-lesion now 1.4 x 1.5 x 2.1 cm. still suggestive of necrosis
30th dec 2008- lesion now 2.2 x 2.1 x 3.4 cm. still suggestive of necrosis

3rd feb 2009
Had 2 facial seizure lasting 1-2 min. No loss of consiousness. Admitted to hospital
Put on epillim 200mg 3x/day for fits
Put on steriod 2mg 3x/day for brain edema

4th feb 2009
Brain scan shows enhancing mass of 3 x 3.3cm with cerebal edema. Its a recurrent glioma.It is malignant.

The neurosurgeon suggest craniotomy with insertion of gliadel wafer.

Dear friends, we thank you for your support and prayers at this very trying times. I will update you all on the surgery date. Norman needs to rest more now. Even though depress and worn out, he is putting up a brave front. We will fight this bitter war till the end. God will be with us.