Saturday, May 28, 2011

The Surgery: Chopping up my man & more

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[[WARNING If you're squeamish, you  might want to skip this post. It's not graphic per se, but its very specific in defining brain surgery. I had a hard time writing it, so it might be hard to read it.]] 

While I have time, let me tell what they did my husband. I have a hard time thinking about it because its gives me the heebie-jeebies (did spell that correctly?). It's also absolutely amazing. Who thinks up this stuff? I thank god that they do, but it still blows my mind (and it's blowing my husband's mind literally!).

This is the sum of all parts, to the best of my knowledge. None of this has been easy to understand. The medical dictionary has been my friend the past two months. I've done so much reading, questioning and explaining that I could probably start work as a doctor tomorrow-- except I don't like people meat. Blood is fine, not an issue for me at all, but get below the skin and I can't tolerate it (I make my husband tell me "when it's over" when we watch anything that has any sorta "gore"... I shut my eyes and cover my face.):

First, they had to dissect the muscles at the base of the skull to the C1 vertebrate. Apparently that in itself takes a lot of work as that area of the body contains a lot of muscle. I jokingly asked the surgeon if I could still whap the husband upside the head (or in that area), to which the surgeon replied a hearty yes- I could hit him there as much as I liked because the muscles give adequate cushioning.

The doctors then shave the bone at the base of the skull until its the thickness of an egg shell. They carefully take out that thinned back portion of the skull. My husbands says it feels like they took four inches off his skull, but my guess is its less than that-- it just feels that way to him. That part of the operation I think is called a suboccipital decompressive craniectomy. Now that's a name to chew on.

Either before or after the above, a temporary shunt was put in my husband to drain away all of his spinal fluid and maybe cerebral fluid (I'm not sure). This allows room for everything messed with, including the brain, to go through the inflammation that occurs during the healing process. Without this part, his head would implode after surgery and his brain would be literally crushed or the brain stem... not something to mess with, but it's part of why he's had the world's worst headache for the past two weeks. 

The surgeons then doa C1 laminectomy, where they basically do that bone shaving thing to the outer bone of the C1 vertebrate. This just allows more room for my husband's big brain. And probably helps its juices all go in the right places. I don't know for sure. 

Next came the duraplasty. I think that's where they opened up the covering of the brain. The rockstar doctor said he'd peak at the brain at this time to remove any adhesions (any area of brain matter that was damaged from rubbing against the skull). Whether they did or not, I have no clue because we care-takers never laid eyes on the doctors in the sixteen hours my man was in the hospital after the surgery. And of course, I went bananas, so I probably would have forgotten to ask anyway.

The final step (besides putting my husband back together) was taking a piece of pericardium (basically the sac that holds your heart) that was donated by some wonderful person after they died, to help hold his brain in place. If it were not for this unidentified organ donor, none of this would be possible. I believe they used to use a Kevlar like mesh for this, but the cutting edge technology guys and gals figured out that the pericardium makes for a better long-term outcome.

Naturally, they closed him all up and stapled his skin together. They put surgical tape (that's still stuck on-- sticky sh*t!!!) over the incision site--which isn't that big, by the way-- it was supposed to eight to ten inches, but ended up about four to six inches long. Of course, the incision in the muscle and other parts may be much longer than the superficial one.

It's cutting edge stuff, but its heavy and deep. The recovery is hell. I now know why the doctors would only say that my husband would have the worst headache of his life and feel "crumby for awhile". You'll "probably get a strain of meningitis (not the spinal one that kills everyone) which will make you feel worse and intensify the headache". Good lord, I hope we paid for someone's summer home in France.

No definitive descriptions of anything when I asked questions about recovery-- very vague and no concrete answers. They say: "Everyone is different. Every responds differently. There are lots of complications and we aren't perfect. We screw up sometimes" (of course the law makes them say that--informed consent). That was the only clear picture we got-- that no one knows for sure how your body will react to all this mess and doctors aren't gods, but that this surgery is the only way you won't be dead by Christmas.

If they told you what really happens-- what you really go through during the recovery process--  nobody would ever willingly go through this sorta surgery. My poor husband wishes he didn't do this, wishes that the pain would just let up and thinks that death might have been an okay option in hindsight. The headache could last up to six weeks-- I couldn't effing imagine a six week long "migraine times a thousand" (how my hubby describes it). Nope, I'll just enjoy the last days of my life, thanks, buh-bye now.

The sad thing is that he was prescribed 5/325 of Oxycodone and told to take 1 to 2 every four hours. Well, a Tylenol gives him more relief than the narcotic. I'm sure there is a good reason for the pain meds prescribed after this surgery, but I'd like to know it. Maybe its more for the muscle pain? His pills certainly wouldn't help me with a headache, so what purpose do they serve besides the 325mg of Tylenol its has in it.

And because this surgery was such a big deal, full of such huge unknowns, its probably a large part of my meltdown. Okay, let him out of the hospital about 16 hours after surgery (practically an outpatient procedure span of time) so I can take him home and kill him. You need to at least be a nurse to care for him-- and thank god I helped a girl get through nursing school,  read as much as I could about the procedures and the aftercare or he would have been dead by now.


We've already been to the ER once. He probably does have a strain of meningitis-- starting the day before the ER trip-- and some dehydration because he wasn't eating at all nor drinking much. I pretty much thought he was going to die in our bed. (It's part of why I can't sleep-- too busy checking vitals. The other half is imagining what they've done to him *shudder*.)

At the ER, we had to explain his condition and the corrective surgery he underwent. I brought the discharge papers for reference, but even still we had to explain to doctors and nurses what it all meant-- the surgeon's PA eventually called, explained it to the ER doctor and then told him what check and to do. It's a little scary when the ER doesn't know what to do with you and to see them look at you quizzically.  

"You had what done for what?!?!" Look mom, no hands!!!  Or skull!! 


That's it-- everything in a nutshell, tied up with a bow. I'm gonna stop now because I would like to stop thinking about this and get some sleep.  Or not. I'm going to try to not to envision how much he's suffering, how little I can do and the magnitude of what he's had done to his head. It's like hitting your computer with a sledgehammer and putting it back together again to make it work better.

A size 12 brain in a size 10 skull...

1 comment:

Pamela said...


I can only imagine the pain John is going through and how worried you must be. I'm surprised they didn't issue a home health nurse to come make daily visits. When I had my gastric bypass and all the complications in 2001, the doctor issued me in home care for the first couple of weeks. It also helped that my mom stayed with us and was a tremendous help, while I recovered.

Hang in there, things will get better!! I hope John gets some relief soon.