Tuesday brought progress and more reason for hope that things would turn out well for Mal. The swelling in her tongue had subsided by the time that her post-op MRI was performed, so she was allowed to take out her breathing tube. As soon as the tube was out of her throat, she whispered, "Godi, Godi, Godi," to me, and I grabbed her blankets. As soon as she had a hold on the tags, she fell asleep and remained that way for most of the day.
Mal's post-op MRI looked great, as expected. There were no signs of residual tumor in any other area of her brain, and she did not suffer any bleeding on the brain or strokes during the night. The doctor did say that she was still a bit swollen in there, so she might have to keep in the ventriculostomy tube for one extra day. I thought that saying "ventriculostomy tube" was a bit cumbersome, so I started calling it her brain drain, but Rachel didn't find it quite as witty as I did.
We got a chance to talk to the surgeon, Dy Smyth, as well as Mal's oncologist, Dr. Hanson. Dr. Smyth said that the tumor was the size of a small plum or a big golf ball. He also said that he was not willing to wager on anything, but he thinks Mal's tumor was a grade 2 ependymoma. He said that a grade 2 is cancerous, but slower growing than a grade 3 and 4, so that would open up more options to delay treatment. The oncologist, Dr. Hanson, said that if it was a grade 2, he will advocate to not do radiation unless another tumor appears, because as long as we do MRIs every few months for the first few years, we will catch something before it gets really bad again. He also said that he has seen several cases where a rogue cell mutates and becomes cancerous in a toddlers developing brain. Once that cell is eliminated, as the toddler grows, the brain develops less and less, and the risk of recurrence becomes less and less likely. So, if it is a grade 2 ependymoma, and the council of doctors hearing her case agrees, we may just take a wait and see approach. We would like that very much, because aside from a periodic MRI (every 2 months or so at first) Mal would be a normal kid again, just at a risk for recurrence of brain cancer. Also, they said that since Micah and Mal are fraternal twins, Micah stands no greater risk than any other kid of having a brain tumor, so we don't need to get him checked unless he begins to present symptoms.
Speaking of Micah, he is really starting to worry about and miss his twin sister. Tuesday morning Rachel went home to shower and spend some time with him, he kept inquiring about Mal. Then, when Rachel wanted to leave to come back to see Mal, he kept saying, "Micah go to see Mall too," and "Micah sick too." We want to bring him up to see her, but not in the ICU with all the monitors and the flurry of nurses and doctors. We think he will do much better when she is in her own room, and hopefully a bit more awake and alert.
Tuesday also brought more great visitors for Mal, as my Uncle J and Aunt Claudie, as well as my mother and Rachel's parents, Chris, Jess and several other people all came to see Mal. Although she doesn't know it yet, she is quite a blessed girl, and will have a big group of people that know her and are proud of the strength she's displayed for a long time.