A little Chiari education for the masses. If you Google Chiari, it will tell you that it’s basically common, and no big deal. Meh, I’m here to tell you that anything involving brain surgery IS a big deal. And, anytime they touch the brain, it’s considered a traumatic brain injury (TBI), you know, that thing that’s a big damn deal? It takes at least a year to heal from any TBI. So, what’s brain surgery like, and how was one different from the other?
My first surgery, in general terms, was called a decompression. In greater detail, but still generally speaking, I had the following:
My skull was cracked open to relieve the pressure that my brain’s inability fit inside was putting on itself.
This is the technically term for the bit of my skull that’s taken out
My first vertebrae (C1) was shaved down, like you might do with a cheese knife. This was to provide better access to both my skull and my spinal cord. Also, the nerves in that area were under a great deal of pressure from the hangy bits (cerebral tonsils) that had been pressing way too hard, for way too long, cutting off fluid, and causing nerve damage. This pressure is how Chiari patients get both nerve damage and become paralyzed.
Dura Graft with Host Material
When skulls have big holes in them, they need to be patched up before the surgeon closes. Surgeons have three choices: synthetic mesh (the highest complication rate), bovine pericardium (cow heart), or a piece of the patient’s own dura (harvested from the patient’s body). The dura is the thin sac-like material that your brain sits in.
I always like the term “harvested,” because it suggests that your body, knowing it will need “extra,” sets up some kind of field, growing that material. In my imagination, there’s rows and rows of dura bits, and the surgeon just plucks out what he needs. In reality, the surgeon just slices out a small bit, from further up, and pulls it down to the spot he needs.
I woke up from my first surgery, in la-la land. I was relatively comfortable, on a pain-pump, and remember virtually nothing of the first 24-48 hours. I do not remember, in fact, why I was wrapped in a turban, by the time I reached my room. I was told, that I insisted upon it, in recovery, and that I refused to leave the room without it. Apparently, I was adamant that I needed it. A turban. As I often get cold when I wake up from anesthesia, I guess it seems reasonable to assume I wanted warmth; but the turban seems a bridge too far, even for me. Although, I am crazy.
This time, generally speaking, I had the opposite procedure(s):
Instead of a big hole being cracked into my skull, I had a hole patched up. There are fancy terms that describe it better, but the gist is that a hole is fixed with my own material, or synthetic material. Since I don’t grow titanium, to be harvested from a field, or otherwise, it’s safe to say that synthetic material was used. There are fancy terms for the muscles involved and the other things, but the important part is the cranioplasty.
This time, I remember every second of the recovery room. Well, I take that back; I remember the pain. I am in and out on the remembering bit. I remember medical personal shuffling around, in a panic, shouting things like “Her heart rate! We have to get it under control!” and “It’s nearing 150!” I remember someone, actually shouting, “Ativan! Ativan! Hurry!” Apparently, 150 is too high. Who knew? Also, who knew that pain can do that to your heart rate?
I remember, literally, crying and sobbing for Bryon, and finally convincing them that he would help calm me, not hinder their efforts in caring for me. And, I was right; he did help. I don’t remember seeing him, so much as I remember feeling him there, and holding his hand. I remember that as soon as I felt his hand, I felt calmer. I was able to stop crying. Even though the pain level was the same, the terror associated with it abated.
What I don’t remember, is that, apparently, they had to give me enough pain killers to kill a small village, because my tolerance was still relatively high, even though I’d gone through withdrawal. I also don’t remember that I was incredibly high from those pain meds, which made me very entertaining to those around me.
Bryon, while very doting, as always, took the opportunity to write down my most amusing doped-out quips. He realized I was high, I guess, when I pointed at the divider curtain, and said, “Look at that, the stripe-y pattern is moving up and down, like it’s an elevator!”
While eating ice chips he was spooning to me:
I don’t know who makes this cereal, but it’s bland. But, I bet if you added milk to it, it would make good ice cream!
Awaking from a brief snooze:
I was just being chased by Teen Wolf! We had to brush our teeth!
Awaking from Another snooze…or Maybe Not...It's Impossible To Be Sure!?
Rachel: Was I just watching Yoga Hosers before I went to sleep?
Rachel: Was Jason Lee in my room?
Rachel: Was Kevin Smith?
Rachel: Phew. Good thing I asked before I told people that, because I was pretty sure it was true.
I remember none of this. I remember pain. I remember suffering. But, I also remember holding my husband’s hand, of course, his faithful and true hand. At least this time, like the turban, I was an amusement to those around me.