Tuesday, June 9, 2009

Mom in recovery room

Mom is out of the operating room and in the recovery room. We can't see her until she's moved back-- yet again-- to the ICU. She'll spend the night there, then undergo plastic surgery in the morning to resolve the skin tension problems.

In case I haven't been clear about why plastic surgery is necessary: when Mom came in for her second surgery, it was determined that a large portion of the skin bordering the scalp incision site had become heavily infected. A lot of this skin was unsalvageable, and had to be cut away. Closing the incision therefore required pulling the skin of the scalp rather taut, because the wound had been widened. This tautness posed a problem for the long term, especially for when Mom's new synthetic bone flap has to be put in weeks or months from now.

Mr. Mirali, the plastic surgeon, came out to the surgical waiting room around 4:10M with consent forms for Dad to sign. He re-explained what tomorrow's surgery will involve, and noted that, because Mom has already gone through two sessions of radiotherapy, there is some concern over whether the incised skin will heal properly. He puts the odds at 65% to 35% that healing will occur.

The operation will be the Plan B discussed yesterday; I imagine that Dr. Mirali came to this conclusion when he was in the OR today to watch Mom's cranial surgery. You'll recall that Plan B involves rotating the entire scalp forward to allow the skin atop her head some slack. Because this involves unmooring the scalp from the bottom rear of Mom's skull, a skin graft-- probably from one of Mom's legs-- will be used to cover the exposed skin.

The operation is slated to take 3-4 hours.

Before Dr. Mirali's arrival, Dr. Leiphart came out around 3:05 to tell us (including Pastor Jeri, who was with us all day) about Mom's operation. She came through it more or less all right; pus and "cheesy" buildup was removed, infected brain tissue was excised, and the mass close to the blood vessels leading to Mom's legs was removed. Tissue samples have been sent for biopsy.

Mom has to deal with a lot of swelling before we can know more about her cognitive state, but Dr. Leiphart seemed optimistic. He said that Mom was awake and looking around after the operation; she was extubated quickly (i.e., the anesthesia hadn't left her too weak to breathe on her own, so the breathing tube was taken out), and her legs show no signs of paralysis.

So: Leiphart at 3:05 with good news, and Mirali at 4:10 with news about tomorrow's surgery. Mom will obviously have to remain in hospital for a while, as her healing needs to be closely monitored.

We're not out of the woods yet, so no one can breathe a sigh of relief. Surgery on the scalp can involve massive bleeding, so tomorrow's procedure carries its own risks. (Along with bleeding, there's the aforementioned concern about irradiated skin's inability to heal.) Dr. Mirali did note, however, that all those blood vessels in the scalp also promote quicker healing. One reason why the infected bone had to be removed was that it didn't have any blood vessels to aid in conveying immune system material and flushing away infection. We're hoping that Mom's scalp, which was irradiated only twice, will heal the way it's supposed to.

Next step this evening: see Mom. We're awaiting word on when we can do this. Mom is, as of 4:50PM, still in the recovery area and awaiting a berth in the Neuroscience ICU-- a ward with which we have all become intimately familiar.

UPDATE, 5:40PM: Mom's been moved to the Neuroscience ICU. We have to wait until the staffers page us.



Becky said...

That's a lot of scary stuff, Kevin. You guys seem like a close-knit family that will support each other well through this. Courage and strength, friend. Hang in there. A lot has already passed...let's look forward to a positive future.

augusta said...

Kevin, you and your family must be exhausted....physically and emotionally....