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Met with the surgeon.
Feb. 19th, 2008 10:15 pmAngie, Leif and I met with one the two surgeons who will be doing the work. I s'pose it's good and bad that the co-director of the UCSF Spine Centre, Dr. Mummaneni is personally taking on the case. Good that I'll have the best possible care; Bad that I'm apparently interesting enough to warrant it.
Meeting with him was matter of fact. He talked about how he'll approach the surgery (from the back, since the placement of my aortic arch and innominant vein would make coming through the front problematic). It looks like I'll have rods and screws from T1-T6, with a cage replacing the vertebra at least at T3 and possibly at T4. People don't usually do that much movement in their thoracic back so, ongoing, his opinion was that I largely won't notice it.
In hospital-time will depend on whether or not the surgery can be done in one shot. Because of the trickiness of the area, it may not be possible to get it entirely from the back, and he'll do two surgeries rather than one if that can avoid me winding up in a wheelchair. Ideally, there's one surgery, and a week later I'm home and able to take care of myself. The way they take the tumor out in a couple pieces is known as "en bloc spondylectomy", but may not be possible with the way the spinal nerve is being pinched. He described the surgery itself, and the simple version is "remove one or two vertebra, replace them with cages, stabilize the surrounding area". Yay to the Black and Decker surgical division.
He'll be assisted by Dr. Chau for spinal cord monitoring and the rest of the surgery.
The last thing they did as I left the hospital last Saturday was a full body CT scan with contrast, and the radiologists have declared that that they see no additional tumors in the body. I'll visit with an oncologist to do some final tests, but consistently the answer is coming back that this isn't cancer, it's more likely an isolated mutation. Dr. Mummaneni doesn't feel that this is a side effect of sitting at a computer since I was 3 years old, any of the car accidents, or being hit across the back with a flute case in grade 9.
I did ask if I'll set off metal detectors at airports after this, and apparently the titanium used doesn't do that.
So, erm. What are the risks? Honestly, pretty consistently less than doing nothing. Having this thing would eventually result in paralysis anyway, and aside from the usually OMG-they're-cutting-me-open-anything-could-happen type of things that don't keep me from biking to work on a regular basis, all the other options are "And life improves from here". Informed consent means that I have statistics in my head that I'd rather not dwell on and a laundry list of things to panic about when I wake up in the middle of the night but those really are just nerves acting up and stress wanting to come out. Nothing wrong with any of that.
Surgery is booked for March 3rd. We'd hoped to go to Vancouver for Leif's birthday around then, but I've been asked not to fly. Rapid pressure changes apparently will aggravate what's there now.
I feel good about this. I'm back to pretty much 100% after the hospital time last week, and noticed that after the embolism that I'm moving a bit freer than I was before. That's enough to start the optimism going already. We've also twiddled my medicine for every 8 hours rather than 6, which will help me sleep better, and reduced it, which will help me feel better.
Having time-frames and knowing that I'm in good hands is a lovely place to be after all that.
Meeting with him was matter of fact. He talked about how he'll approach the surgery (from the back, since the placement of my aortic arch and innominant vein would make coming through the front problematic). It looks like I'll have rods and screws from T1-T6, with a cage replacing the vertebra at least at T3 and possibly at T4. People don't usually do that much movement in their thoracic back so, ongoing, his opinion was that I largely won't notice it.
In hospital-time will depend on whether or not the surgery can be done in one shot. Because of the trickiness of the area, it may not be possible to get it entirely from the back, and he'll do two surgeries rather than one if that can avoid me winding up in a wheelchair. Ideally, there's one surgery, and a week later I'm home and able to take care of myself. The way they take the tumor out in a couple pieces is known as "en bloc spondylectomy", but may not be possible with the way the spinal nerve is being pinched. He described the surgery itself, and the simple version is "remove one or two vertebra, replace them with cages, stabilize the surrounding area". Yay to the Black and Decker surgical division.
He'll be assisted by Dr. Chau for spinal cord monitoring and the rest of the surgery.
The last thing they did as I left the hospital last Saturday was a full body CT scan with contrast, and the radiologists have declared that that they see no additional tumors in the body. I'll visit with an oncologist to do some final tests, but consistently the answer is coming back that this isn't cancer, it's more likely an isolated mutation. Dr. Mummaneni doesn't feel that this is a side effect of sitting at a computer since I was 3 years old, any of the car accidents, or being hit across the back with a flute case in grade 9.
I did ask if I'll set off metal detectors at airports after this, and apparently the titanium used doesn't do that.
So, erm. What are the risks? Honestly, pretty consistently less than doing nothing. Having this thing would eventually result in paralysis anyway, and aside from the usually OMG-they're-cutting-me-open-anything-could-happen type of things that don't keep me from biking to work on a regular basis, all the other options are "And life improves from here". Informed consent means that I have statistics in my head that I'd rather not dwell on and a laundry list of things to panic about when I wake up in the middle of the night but those really are just nerves acting up and stress wanting to come out. Nothing wrong with any of that.
Surgery is booked for March 3rd. We'd hoped to go to Vancouver for Leif's birthday around then, but I've been asked not to fly. Rapid pressure changes apparently will aggravate what's there now.
I feel good about this. I'm back to pretty much 100% after the hospital time last week, and noticed that after the embolism that I'm moving a bit freer than I was before. That's enough to start the optimism going already. We've also twiddled my medicine for every 8 hours rather than 6, which will help me sleep better, and reduced it, which will help me feel better.
Having time-frames and knowing that I'm in good hands is a lovely place to be after all that.
