Yesterday we took my brother to UW Medical Center for an MRI and consultation. The MRI took about 40 minutes and we then went upstairs to Neuro-Surgery and checked in. After reviewing the new MRI and the CT from japan, the Chief Resident on Neuro-Surgery there came in to talk to us. Dr. Patrik Gabikian who seems to be about the same age as me has a good smile and started off asking my brother about his seizure, about any other symptoms (which turned out to be Aura’s that he’d been having for a couple months) and then asked about all sorts of random things. The serious of questions were purposely designed to establish how his brain was working and establish right/left dominance.
Dr. Gabikian explained that there is an “abnormality” which appears to be a tumor, in the right frontal lobe. The good news is that my brother is left-brain dominant so language and cognitive functions are fairly safe but it could still affect motor function. The mass is about 55mm (just over 2 inches) in size and it concentrated but irregularly shaped.
He gave my brother 3 options,
1.) Do nothing and let it go, check it in a few months.
2.) Perform a biopsy to get a diagnosis from pathology, then come back for further treatment.
3.) Skip the biopsy and have surgery to remove as much of the mass as possible and give it to pathology for a diagnosis.
Obviously the doctors recommended option 3 because it means only a single operation, and better chance for diagnosis. Risk of complication seems about the same and it accelerates the treatment.
After that discussion, we met Cynthia, the Case Nurse/Patient Coordinator that I’d been talking with on the phone to get the appointment and she introduced us to Dr. Daniel Silbergeld, the Attending doctor and head of Neuro-Surgery at UW. He showed us the MRI and went over the options again, and some details about the surgery itself. He explained that he only works on Brain tumors, has been doing it for 25 years and said there is no way to know what kind of tumor it is without the pathology tests and as such will not make any guesses about it until pathology results come back approximately 5 days after the surgery.
I got the sense that these 3 people are a VERY good team. Dr.Silbergeld has extensive experience–apparently he trained the Nuero-Surgeons at Swedish. He has worked with Cynthia for close to 20 years and Dr. Gabikian seems highly intelligent. All three have very comforting “bedside manner” but are also very direct.
So my brother has pre-operation appointments totaling 4 hours on Friday 1/2/09, then the actual surgery is scheduled for Tuesday 1/6/09. UWTV has video available online about a patient who went through this whole process.
It’s definitely an advantage to be living so close to UW and Fred Hutchinson
Somewhat related – I found an interesting article about Tumor Paint from Fred Hutchinson, and apparently Dr. Gabikian was one of the researchers who found a technique for illuminating small pieces of cancer cells that the MRI can’t see.