Pre-op appointment

This is really happening

I had my pre-op appointment at the hospital today. It really wasn't as big of a deal as I thought it would be since I have had so much testing recently. I was told to fast for the day until the testing was done. When I asked why, they said that there wasn't a need for me to fast that the Dr's office just tells everyone that to be safe. Wow, I could have had a nice breakfast and lunch after all. I guess it didn't hurt me to go without a couple meals. They wanted to know why x-rays and other testing wasn't requested by Dr. Tyagi and all I could say was, "you'd have to ask the Dr., I really don't know". Turns out that after contacting my primary physician they had all the records and clearance they needed for surgery. Two different people had to take my blood to double check everything. When I asked why two they said it was so they could cross check that I am who I say I am and they could check my antibodies and blood type since Robert Wood Johnson Hospital doesn't have info on me in their database. Then I just had to review everything with the anesthesiologist. Turns out they will need to give me a high dose of anti nausea medication since I had a reaction to anesthesia in the past. They don't want the nausea (vomiting) to cause trauma to the incision site. I don't like taking medicine, but I don't like being nauseous and vomiting even more. Dr. Tyagi says that I will be rather sick during my hospital stay; I'll be in ICU for at least one day and then 3-4 days in the step down unit.

Makes it all so real; just over a week away until surgery. Now I am thinking about what I need to do to be prepared. Maybe some yard work and bringing my plants in off the deck...I don't think I'll be outside doing work for awhile after surgery. What do I want or need to do that I won't be able to do for awhile?

Oh What a Year Brings

I sure didn't expect to be having brain surgery

Last September I began experiencing some very unusual symptoms. My face was swollen and constantly felt as if I had been injected with Novocain. This numb feeling would sometimes extend to my left ear and the back of my head. I was very unsteady on my feet and My Doctor sent me for a brain MRI, which revealed that I have a Chiari 1 Malformation. Of course I had never heard of this and took some research to understand what it was and if this was what could be causing my symptoms.

My doctor then referred me to a neurologist. Before I was able to make that appointment I began having crushing pain in the back of my neck at the base of my skull, which radiated into my left shoulder and down my arm. I had this before, but never this excruciating. I also was having double vision and slurred speech, as well as trouble with word finding at times. I was quite off balance and felt as if I could pass out at any moment. One night I woke Bob the middle of the night to take me to the hospital because I was in so much pain. I brought my MRI results along with me to the E.R. The doctors in the E.R. Suspected that I had Multiple Sclerosis or a carcinoid tumor based on how my symptoms presented. They did additional MRIs and several teams of doctors saw me. At this time they could find no reason for my symptoms and did not think that they were related to the Chiari 1 malformation. All they could say was that they believed I was having some sort of hormonal change; I guess because of my age….hmmm! I went home from the hospital a bit discouraged, feeling the same and not knowing how I was going to find a doctor that could figure out what was going on with me.

I pretty much went through the year with the same symptoms that would sometimes be very mild, but always present, and other times flare up and be quite unbearable. This spring I decided to just start making appointments, seeing several specialists and ruling out many possibilities. I did even see a chiropractor, which made me much, much worse. Finally when I went back to my primary doctor she said I should have seen a Neurosurgeon when she first gave me the Chiari diagnosis. I found out that I should never be having chiropractic manipulation on my neck and that this could be very dangerous for me. I think there was a misunderstanding, last fall when I saw one of the other doctors to get the MRI results because my Dr. was out of the office. This Dr. said I needed to see a neurologist. That’s when I had a really bad flare up and went to the hospital. At the hospital I did see a neurologist who said that my symptoms were not neurologically based. Therefore I thought I had done what my Dr. was recommending. My primary Dr. was so surprised when she heard my whole story and said, “oh no, you shouldn’t have seen a neurologist, you need to see a neurosurgeon!” Who knew that they were so different? Wow! All these months later it seemed I was finally on the right track now.

The neurosurgeon I decided to see is Dr. Ranchana Tyagi (Tea-ah-gee) at Robert Wood Johnson University Hospital in New Brunswick. She is the assistant professor of the department of surgery and director of the pediatric neurosurgery program. I chose her because of her interest and specialty working with Chiari Malformation. On my first visit I was amazed at the amount of time Dr. Tyagi spent with me hearing me out and reviewing my history and records. She referred me for more MRIs ruling out a syrinx, which was good news. This could have been much worse than it already is. I was quite surprised when on my next visit she offered surgery and said that there was an 80% chance that my symptoms would be alleviated and that it would stop the progression of my symptoms. I think my jaw dropped to the floor; it was an emotional moment. Just the thought of there being an answer and the possibility that I don't have to live with these symptoms for the rest of my life was so encouraging.

The surgery is called a posterior fossa decompression and duraplasty. Even though I knew that I had a Chiari 1 malformation and had researched what that could mean for me I never expected to get to the point of surgery. I was surprised and also relieved that someone believed me and that I now hopefully had the answer to these unusual symptoms. Dr. Tyagi doesn't even have the answers as to whether my symptoms are all caused by the Chiari. Seeing what changes after surgery may answer that, but the symptoms are not always reversed since they are caused by compression of the nerves. In making the decision about whether to have surgery or not I did a great deal of research and Bob and I returned for a consult with Dr. Tyagi so he could hear 1^st hand from her and help me to decide. Dr. Tyagi spent an hour and a half with us explaining the procedure and answering all our questions.