Reassurance

I wanted to share the following emails between me and Jacob's neurologist...


Good morning Dr. B.  I don't know if you have had any correspondence with 
Boston, but we did get a call that they will move forward with his surgery.  We 
are supposed to get another call this week to schedule a date.  If you can 
believe it, I am more anxious than ever before.  I'm having a hard time letting 
go of his brains because my understanding of the brain is so limited.  So I have 
a few last questions for you and if you prefer, I'll schedule an appointment to 
discuss... again.  I'm also going to meet with Dr. M again to talk about 
the particulars of the surgery and recovery process.  

Given the extent of damage to Jacob's left hemisphere, how do you explain his 
progress?  
 
We think that he is normal even better than normal in terms of his social, 
emotional, cognitive, and receptive communication skills.  We only see deficits 
in his motor and expressive communication skills but he is improving in these 
areas.  Would disconnecting the left hemisphere stop his progress in these 
areas?  I read his EEG reports and recall our office visits and have the 
impression that most of his seizure activity was coming from the front and the 
back.  Does the middle strip of tissue remaining contain motor and speech 
functions?  Can the right hemisphere assume expressive communication functions 
including written language?  Would he plateau at some point anyways even if we 
left that tissue to function?  During Constraint Therapy this time, Jacob has 
been able to move his index finger independently although very slightly.  How is 
this possible?



Lots of questions...

His progress is reassuring. You need to remember that it is occurring in spite
of his brain malformation.

Freedom  from seizures will only accelerate the developmental gains you have
seen.

The malfunctioning brain tissue is not contributing one bit to his development.

children who have entire hemispheres removed are capable of considerable
positive development, due to the normally functioning other half. that includes
the non-dominant hemisphere assuming functions normally delegated to the
dominant half.

remember that the front and back portions of the seizing hemisphere are the only
portions "visible" to the EEG. there is no brain tissue in the middle.

I understand your anxiety. I would never have suggested moving forward with this
had i though for a moment it would not help or worse, would hurt.

He is in good hands.