2/14/2003
Subject: AVS status
From: Brian Bulkowski
To: Dr Larson

Hello Dr Larson -

No need to reply. Yesterday was tough for all of us.

Pain has greatly decreased over the last 24 hours. She can now turn / sleep on her side, support her own head, sit up with assistance (without pain). Some skin pain sensations in the arms - perhaps nerves coming alive? I would suspect that it's treatment based edema decreasing. Swallowing problems about the same, but a great visit by a visiting nurse / speech therapist yesterday showing us coping strategies.

Her mind seems foggy now in a way I haven't seen. Yesterday her denial reflex was very, very strong (I can get up and walk around, why won't you let me) - today she seems both sad and silly, and DEFINATLY not giving up. She can hold a conversation fine, but gets a little confused, sometimes mistakes things for similar things (reclining chair becomes a couch, coffee becomes tea, two years ago becomes two days ago, "Send a call" instead of "send a letter or make a call"). We're on 50ug/hr of the fentanyl, haven't needed the oral morphine for a few days. Not sure if the confusion is a long term effect of the morphine, or problems related to the brain tumor that may have expanded without treatment in the last few weeks.

I am contacting that fellow you recommended today. We have an appointment with Dr Prados set up for tuesday.

FYI - My band Rosin Coven has dedicated its next album, which it has been recording over the last two weeks (without me) to Ann and myself. I'll get you a copy when it's done (probably not for quite a few months)

FYI2 - Ann gave a poetry reading last saturday. There's a video on the web from the following page: http://www.hypertwins.org/tigger/

Thanks again.
-brianb