Wednesday, January 28, 2015

Brain surgery, take two!

Ok, here’s the good news! (and the story behind it)
My view from my room in St Vincents Hospital

I had radiation therapy in October to get rid of the last of the tumour (or at least arrest it’s renewed growth). That went perfect. I went to the Radiologist last Wednesday (Jan 21) for a three month check-up. He asked all the usual questions. All good. Then he said, “Anything else to report?” I told him there was a little leakage from the wound over the past month. He had a look and was truly surprised. “That’s not good, Dave. I’m not going to lie to you. It’s clear. Could be CSF (Cerebrospinal Fluid) and that is not good.” Leaking CSF can cause meningitis… often a death sentence. He wrote an Email to the Surgeon right then and asked me to watch. He was very serious. I love Mike Daly. Google him, you will too!
The next day was my first day back at school as Chaplain at Sunbury Downs College. At about 10AM I received a call from Jane, my Neurosurgeon’s Personal Assistant. “Dave, I have an email here from Mike. Not good! I need you to have a CT Scan tomorrow and come in to see Paul (Neurosurgeon) next Tuesday when he is back in the office." So, I did.
Dr Smith was befuddled. “Never seen anything like it, Dave. Two years after the surgery the wound opens and leaks? I saw the wound a year ago and it was perfect! First time I’ve even heard of such a thing!” I said, “Well, I do love to be first! Maybe you can write a paper about it and be famous!” He laughed and then sent me to get an MRI.
Then straight into hospital. I mean right then. MRI 45 mins after my neurosurgeon saw the wound. Admitted that afternoon. That was yesterday.
Yesterday’s MRI revealed no leak.
Neither did the CT Scan from last Friday.
But the fluid and hole in the scar were very evident.
They slotted me in for surgery today. They said they would open the scar, find the leak with a microscope, seal the leak, patch the wound with muscle and tissue from my leg and close up the wound. If necessary, they would move jaw muscles to assist in strengthening the area. An ENT came in yesterday afternoon and walked me through the possibilities of major reconstruction if they needed invade the aural canal. Jin, the assisting Neurosurgeon came in last night and ran me through the possibilities – Including death. Such is surgery when you are going fully under for awhile.
At 11:50AM they drove my bed (It’s a Rolls-Royce convertible! Remote control seat—back and feet, drop down rails on all four sides, powered-adjustable height suspension, built in TV [when parked in my room] and… It has wheels!) to the surgery ward. I met the anaesthesiologist, Andrew. He was really nice guy but was a vicious wrist squeezer (mine not his). Then there was the nurse who was prepping me. I wish I could remember his name! He was cracking me up. I hadn’t had any meds yet, he was just very funny. He turned the three tone beep of one machine into a song. He said it was a hymn to make me feel at home.
They wheeled my Rolls into the surgery room. The previous time I was completely out by the time I reached this room. Interestingly, I recognised the lights on the ceiling. Two huge spotlights on long arms. I told the doctors and they said, “This was the same room you were in last time.” In the days after my brain surgery (two years ago) I had memories of a moment in the surgery room. I had wondered if those memories were invented, or true somehow. I must have had a sentient moment!
They pushed my Rolls (sideways drive, even!) against the operating table and helped me change to a new bed. The two Neurosurgeons checked my head/neck mobility and allowed me to stay on my back and turn my head sideways for the surgery. SO MUCH BETTER than last time when they put me on my side for the nine hour surgery. I had a bone-bruised hip for weeks afterward – couldn’t walk for two days!
Once I was on the operating table, they put an oxygen mask on and started the drip. Bye Bye, Davy!
Soon, I heard my name (well the Australian version which sounds like ‘Dye-vud’) off in the distance. I was back in my Rolls! And new people were looking in through the open roof. They wanted Dye-vud to open his eyes. They really wanted that. The kept calling him. Finally I decided to help. He couldn’t be that far away with them all looking for him in my Rolls.
Compared to last time, coming too was soooo much better. No vomiting. No chipmunk voice (I had a speech therapist on call last time and the warning that my voice may never be the way it was before the surgery) from the breathing tube. I’m only a little hoarse this time (like a Shetland vs a Clydesdale). I’m still speaking in bass range. No teasing from my three teenagers! Sorry guys.
Once I was able to help the nurses with their chronic disorientation (they are always asking for their current location and the present date–maybe calendar and map skills should be in their training…”OK Google”) I flexed my leg muscles to see if I could feel where the doctors took muscle and tissue from. I could not. I lifted my sheet and saw a new tattoo on my leg. It was a cross. I smiled, “Funny-man nurse strikes again!” Then I realised what the tattoo meant. They had prepped a spot for removal of flesh and then not taken any. I asked why. They said, “It was quick and easy. All good. A doctor will come and explain everything once you’re back in your room.”  
After I helped a nurse with the time – 4:30PM – I asked how long the surgery had been. “Just about an hour. We’ve been having a tough time waking you up.” Perhaps if they had an American on staff to yell “DAY-VID” I may have come down the dark alleyway toward the voice with the suspiciously friendly tone. In all seriousness, they had to give me an extra dose of wakey wakey juice. And then it still took some time. Oh, well, it’s all the same to me – I got my Rolls back.  
Back in my room, I got to see my lovely wife again. She is my strength and the most beautiful thing in my life! She is so supportive and compassionate. She watched me nap. She rubbed my feet. She kissed my cheek. She went down two elevators to the vending machine in the basement carpark and bought me Iced Coffee. Love that lady!
A few hours later, Jin the Neurosurgeon, came in and explained things:
He told me it was not CSF and there is no leak.
He said, there was dead tissue between my skull and the scar. The tissue had been breaking down into fluid and looking for way out. So, it made a way through the scar. The dead tissue-become-fluid was most likely tissue killed by the radiation in October, slowly desolving.* They removed all the dead tissue, moved a bit of muscle in my head to strengthen the wound and sewed me up. They sent a sample of the fluid to the lab to have it analysed. And so, when the lab results come back in, they will tell me all about it.
He said my leg was still intact because they didn’t need to use it.
For now, the news is, I no longer have fluid behind the wound, I have a renewed scar and Endone every three hours. Can we say, “Ahhhh, Endone!”
Oh, and a random staple in my forehead… forgot to ask about that. (Funny-man nurse again?)

Thanks for your prayers, Peeps. You rock my world!


*The primary Neurosurgeon Paul Smith saw me on Saturday and explained the fluid was actually dissolving bone from the reconstructed area. He said they removed all foreign matter (titanium plates, bone concrete) and replaced it with muscle tissue from my neck. They concluded that my body was rejecting the foreign substances. So, now, it's only me in my head!

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