Brain Surgery -- 10/27/00

It certainly wasn't easy, but she's managed to get through this one all right. It was far more difficult than we'd anticipated.

Gamma knife surgery looks a bit like something from a science fiction movie. They drill four holes in Sybil's head and screw on a large metal frame. Sybil has a picture -- she smiles through everything! Then they do some very detailed imaging of her brain. The gamma knife itself was invented in the 1960's, but it is only very recently that computer imaging has progressed to the point where it is detailed enough to do accurate cutting inside the head. After the imaging, the doctors decide on where to cut and a program is developed. Then the frame attached to Sybil's head is bolted to a large metal ring. She goes inside a machine where the gamma knife does a cut. She's removed, they readjust the machine, usually changing the ring she is bolted to, and the process is repeated. It takes an entire day.

Actually, Sybil's operation (on 10/25) takes even longer than scheduled. They must program 5 different angles to cut out three tumors in her head. Some of them are both close to each other and close to her cerebellum. This makes the surgery extremely complicated. Next, they have a very difficult time getting Sybil's frame bolted to these rings. Her neck gets twisted like a hose as three guys try to maneuver her frame into the rings. They also drop her head a few times and the frame often bangs against the metal rings. She won't feel the affects of this at first because she has a local anesthetic where they screwed the bolts in, but when this wears off she has a terrible headache. The entire torturous process goes on from 7am to 4pm.

There are a few breaks in the day while the machine is getting adjusted. Sybil is able to eat some soup brought up from the hospital cafeteria. When the surgery is over and she's brought to her room, Sybil suddenly gets very nauseous. For the next two hours she vomits about every 20-25 minutes. Any little disturbance sets her off. The phone rings and she vomits. Someone comes into the room and she vomits. Her head hurts terribly and we pack it in ice. She has nasty diarrhea, made even nastier because she has to sit in a bedpan while expelling this. She blames the cafeteria soup. They increase her steroid dose and give her anti-nausea medicine. Gradually, the vomiting stops and the head pain (the pain from the swelling of the operation, not the pain from the frame bolts) is reduced. They move her to a high surveillance floor. She gets more CAT scans and is monitored throughout the night.

She's better the next day but not well enough to go home as scheduled. In fact, she has an extremely uncomfortable day because of typical Northwestern Hospital foolishness. During the night she is given a catheter, much against her wishes, because it is a policy to do this along with one of her IV drugs. Bad enough, but the next morning they can't get the damn thing out! Four nurses arrive in succession. Each one states how unusual this is. Each one tries to deflate the balloon-like ball inside her to pull out the catheter. They all fail and go to get someone else. One finally tries cutting the hose in an attempt to deflate it. The next one in complains about the previous one cutting the hose. Several of them try to push the balloon further in, trying to get it unstuck. This only makes it more painful for Sybil, but they keep trying the same things. People from urology are called in. She has this awful thing inside her all day before someone eventually gets it out.

She's moved off the high surveillance ward to a more comfortable floor. She looks a lot better the next day, but she's run out of her chemo medicine. I bring some to her from home, figuring she can easily get the common Celebrex at the hospital. Nope, they won't give it to her because that prescription came from her oncologist, not the gamma knife surgeons. So Sybil's mother goes back to get this.

Sybil is currently getting another CAT scan and will have some PT today. We're planning on bringing her home tonight. She's back to her old self, a bit over-pepped because of the steroids, but otherwise much, much better than the day before.

Matt Donath

Mdonath@yahoo.com