A Change of Plan

The medical team has spent the last few days trying to assess their next steps in Paul’s treatment. Earlier in the week, after careful consideration, they elected not to proceed with Paul’s planned surgery to stem a leak which leads to the loss of cerebral fluid. They decided to conduct a series of additional tests to make sure the appropriate decisions could be made.

They undertook a lumbar puncture yesterday (Wednesday 20/05) with fluorescent dye and two nasal endoscopies in an attempt to narrow down the location of the fluid loss. There is now a clear view that this is not an ENT problem. After further consultation amongst the team of neurologists, ENT specialists and others responsible for his care following this battery of tests, they have now elected to proceed with another lumbar puncture and a drain for a week. This drain should reduce cerebral pressures and hopefully permit the leak to heal on its own. One’s sense is that the doctors are reluctant to see Paul undergo further surgery if other options are still to hand. Medicine is an iterative process. This is just one example.

All of this is very hard for Paul. He has been slightly unsettled by the events of the week and the cancellation of the intended surgery has not been easy for him, and of course this has been equally difficult for Penny who bears a large part of the burden with the medical team in helping Paul to understand next steps. This has been a tough few days for her.

Paul, of course, was transferred to the Feldkirch hospital on Monday and they plan to keep him under observation in their neurological ward for the next two weeks. This is best place for him at this time, given where we are. They really need to resolve this problem. Only then will they be able to start to consider and reflect on the next and appropriate rehabilitation steps and of course, the location for this next phase in his recovery.

William has his Harrow Speech Day this Saturday and Penny has flown out of Zurich to return to London today. I will be joining her for part of the proceedings before she heads home with William for the half term break. They plan to head to Mull which will be a welcome diversion. Charlotte has been in London and is busy planning a trip to the Far East which will be a welcome distraction as her gap year starts to draw to a close. University beckons in September/October.

As ever, Charles 21 May, 2009