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Friday, August 26, 2016

DBS - The Main event

OK. all hoops jumped through, I's dotted and T's crossed.  I was good-to-go for surgery.  I had to arrive at the hospital by 5:30am after not taking any medications the night before.  As some of you will remember from my previous posts, I don't sleep well without meds.  As expected I was up all night, so it's off I go to have brain surgery on zero sleep.
This may sound trite after the fact but I was surprised by how NICE everyone was at the hospital.  From the person that checked me in, to all the nurses (I think at last count, I was introduced to about 40 by the time I left). I've been to three different hospitals in the past two years and without a doubt, the people at Strong URMC are the best at what they do.  No comparison.  So best as I can remember here is the blow by blow.
5:40am - checked in with hospital administrator - normal questions, insurance, etc.  Then they explained to my wife how I will be assigned  a number that she could use to track me on monitors in the waiting rooms as I went through various stages.
Pre-surgical - this is where you change into your gown and the first of the 175 vitals are taken from you that day.  Also where you get the attractive bracelet used to keep track of every med they give you going forward.
From here I was brought into an area that can best be described as a symphony in chaos. Pre/Post Op.  People, surgeons, anesthesiologists, interns, nurses, patients, family are moving all over this room.  The good news was my family could be with me up until this point.  Here you meet all the people that will have a hand in your surgery that day.  Finally, the neurosurgeon walks in, looks at me says "Are you ready?"  After a quick thumbs up, it's a tearful goodbye to my wife then up to the operating room.
Operating room.  I guess you could say it was exactly as you would picture it would be for brain surgery.  Equipment everywhere.  And the people!  I lost track but there were nearly 20 people floating in and out of that room.   First up, the part I was dreading the most:  The catheter. I don't know why I stressed over this one tiny piece of the operation more than any other, but I did.  Then I got some good news.  After a numbing agent was applied (yes that was weird) I would be temporarily put out so they could do the catheter and attach the headgear. I guess I was out about 10 minutes and now I was being whisked over to a CAT scan so they could do a final map and overlay it with the MRI.  
The prelims were now over.  I was back in the operating room and here is where the meat of the operation was going to take place.  They moved me onto a narrow but surprisingly comfortable molded chair and my head gear was fastened down.  As many monitors were attached to me as my available open skin space would allow.  A quick shave of the head area and it was time for some Lanicane on my scalp.
"Ouch," I shouted out as the surgeon cut into my head with the scalpel. "you felt that?" was his response  "Yes!" I said emphatically.  After more Lanacane was administered they finally got to work. It was a weird feeling, knowing they were doing something up there but not being able to feel it.  At one point I heard something that sounded like the Doctors were scraping on the metal bars surrounding my head.  I asked the nurse what they were doing and the Surgeon piped up that they were removing some tissue covering my skull.  It was almost surreal.  Here they were, scrapping directly on my skull.  I couldn't directly feel it, but the sensation I had was like it wasn't attached to me.  
Drill time.  They prepared me for the drilling explaining exactly what will happen.  Loud noise followed by a loud click as the clutch engaged and voila, you have a new hole in your head.  The first one took about eight seconds and was exactly as described.  The second one was much quicker but didn't sound right.  The drill must not have done as good a job this time as I could feel the surgeon doing some clean-up with some nippers. No pain mind you, I just could feel it.
Probes.  They inserted the probes and then it was the neurologists time to shine.  Her job was to make sure they got the probes in the correct place.  A lot of it was done with sound which is cool as they listen to your neurons fire as they move your limbs. The last bit was a little strange, though.  They purposely go too far to make sure the probes are where they think they are.  This puts them into the part of the brain that works with the eyes.  The neurologist tells me to look for sparkles or lights and tell her where they are in my field of view. Not sure what this does for them but they seemed pleased with my responses., They temporarily applied voltage to the probes and it was amazing!.  My arm completely relaxed which it hasn't done in five years.  I could make a fist again and there were no tremors.  Now, this is what I had been waiting to see.  I got to keep most of that freedom even after they turned it off because of something to do with the trauma of the surgery creating some sort of temporary improvement. It lasted about three full days and was wonderful!
Closure.  With probe placement now complete, it's time to button me up.  Picture a staple gun attaching a small titanium disc to your head.  That's what it sounded like.  Again, there was no pain just this weird sensation of them attaching something to my me. Shortly after that it as back to where I started in Pre/post op.  I was exhausted and dozed off for a couple hours.  I know my family was anxious to see me but there was nothing that could keep me awake at this point.  I woke up around 3pm and had the family come in along with four ice cream cups!  My reward for making it all the way through.
I found out later that after each step of the process a nurse would call my family and update them on how I was doing.  Again, I would like to compliment the staff at Strong URMC for their wonderful care.
You get one night in the hospital so they can monitor you.  Then after a quick check by the surgeons, you're out the next morning.
Recovery.  Apparently, exposing the brain to the air can cause some of it to be trapped inside your head when they close you up again.  This gives you the feeling of having a sinus infection.  Your head pounds a little when you bend over and you feel a little dizzy...  This took me about 5 days to get over.  After that, the most annoying thing was how much the stitches itched as the wounds healed.  My scalp was a little sore too, where they tucked the wires awaiting attachment to the stimulator in the next Operation.
Speaking of which, on to the next post
Battery Stimulator placement.

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