Surgery Follow Up

Well, another one is in the books. Judi had surgery Wednesday afternoon and we had to remove the bone flap that was created during the craniotomy procedure last year. I can't describe how disappointed I am that we had to do this, but it is what it is and we'll move on.

When Judi's bone flap was re-inserted, there were three areas where some bone loss occurred. This is not uncommon. The most pronounced spot was just about in the top middle of her head and was about the size of a quarter. We had noticed that the skin in these areas pulled inward over time as opposed to growing across these areas which is what normally occurs. Her neurosurgeon could not explain why this was happening and had not seen it before (good old Wilkerson luck at work again). We had been watching these areas for quite some time to monitor for any indication of skin breakdown since this was essentially the only barrier between the outside world and the dura matter which surrounds the brain. The area on the top of her head was the culprit.

The surgery was very successful and it appears that we caught it right at the start. All of the dura matter was still intact and showed no signs of degradation or infection. Several samples were taken to determine what type of infection (if any) was present in the areas surrounding the brain. So far everything has been negative which is excellent news. This is not only important for the right side of her head, but also indicates that there is likely no infection that would get to her shunt (installed on the left side) which would require removal/replacement. The fact that there is also no indication of infection in her blood stream alleviates the concern over the hardware that is in her back becoming infected as well. If it gets infected, it could require removal/replacement as well. So if you wondered why this is such an emergency for Judi, this should give you a good picture of why.

The neurosurgeon did identify a very thick layer of scar tissue under her bone flap when he removed it. It is typical to have some, but this was much more than normal. Some of you may know that Judi's brain had never returned to the normal position on the right side after all of the surgeries were done. There is a possibility that this was the cause. So if there was any silver lining, this was probably it. The surgeon also identified what caused the skin to appear "pulled in" across these areas. For some reason, her skin adhered to the edges and cracks where the bone flap and existing skull mated up up. It was just a matter of time before the skin pulled apart in one of these areas.

Sooooo, where are we today. The bandage was changed this AM and the incision looked great. She is very tired and comes and goes pretty frequently from sleeping to awake. She is moving everything she moved before she had the surgery (very good news - last time it was a couple weeks before it came back). I also got her to smile and laugh today so I know she is getting better. I think the key difference for her this time is that her awareness level is VERY high. I can't say this any other way - this time she was VERY scared. I could see it in her eyes and I did everything I could think of to re-assure her (including not letting her know I was scared too). If no infection surfaces, she will be able to go home Mon/Tues time frame. She'll be able to go back to outpatient therapy, but will have to wear the dreaded helmet again. She'll get IV antibiotics for 4-6 weeks as a precaution and if all goes well, we'll be back in 3-6 months to have the prosthesis installed (yep, another surgery). Not sure yet how this will impact her ability to get neurofeedback therapy.

Thanx to everyone for the support and prayers as we have gone through this latest bump in the road. Judi had a lot of momentum going before this last surgery and I pray that she will be able to continue improving when we get her back home. We could sure use your prayers to keep the healing and recovery process moving in a positive direction. I'll try and do a better job of keeping the blog up to date, but time has become a difficult commodity to come by these days. I had been working on a new entry for a couple of weeks before all of this happened. I usually don't have time to sit down at the computer until the very last thing of the day and often wake up in the same place I started (must be gettin' old).

Steve