This morning we went to visit the neurosurgeon. There's little "neural" for him to do here, but these are the guys who are good at going through people's skulls, so they're the ones you want to work there. He agrees that it shouldn't be too hard to take this little bump off. I was hoping for him to only have to deal with the outer layer of skull bone, but it doesn't seem to work that way. He'll have to remove a whole section of skull, maybe 2cm x 3cm in area. He called this surgery a craniotomy. For a brain surgeon, this is just the beginning of his usual routine, which is to work on the actual brain itself. In my case, it should be the end as well, as this kind of tumor almost always respects the dura (the brain's covering) and stays only in the skull bone.
In the morning (Wednesday morning) I'll head over to the hospital for pre-surgical stuff (blood test, etc.) Then on Friday morning I'll get up early, have an MRI done of the site, and get marked as to where they want to cut. The surgeon was just used to doing it this way, even though he can see the bump with his eyes. Much of the time his target is invisible underneat the skull, and they use a little wand to precisely locate the incision in 3-D space.
Friday afternoon at 12:30 is "tee-time". I can't imagine that the procedure will take very long. It won't seem long to me! He said I'll be under an general anesthetic, though for some brain surgery they do it with just a little local numbing. He will take out the little oval of bone, and then lay in a titanium mesh "plate" to protect the brain. I explained that I do a lot of work at height, caving, climbing, and such and inquired about the strength of the patch. There is an optional bit of stuff he can add that will make the patch even stronger. (Bondo brand body repair filler!) It's similar to dental cement. He said there's a slightly increased risk of infection with such an addition, and that with my lower-than-usual white blood cell count we might not want to take that extra risk. He's thinking about it now.
After one night, or perhaps two, in Erlanger's own special neural Intensive Care Unit I should be back in action and good to go.
My oncologist has me scheduled to begin chemo treatment again (hopefully just the last two doses that he "owes" me) in mid-September. We still don't know what else to expect. Among the options are these:
- change chemo blend and start a new regimen to target whatever caused this skull bump
- call this a "one-off" and just finish the last two doses of the old regimen
- take a dose or two of radiation to ensure that the brain bump is gone and doesn't come back
- or just skip the radiation because they were able to get all the stuff and a little margin around it and now there's nothing left to irradiate
And maybe more things to consider. I'm pretty eager to talk with the oncologist again and find out all these details.
That's about it, then. I don't expect to have any significant news from tomorrow's tests, but if I do you'll be the first to know. (Outside of my FaceBook friends.)
Cheers,
Clem
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