What the doctor said

(This is copied from FB)

I saw my doctor this afternoon and there is good news and bad news. The bad news is that I definitely have a CFS leak*. He doesn't know where the leak is at this point, but I will soon have a myelogram* to find out exactly where it is. He suspects one or more of the new screws tore a hole. Therefore, surgery will need to be done to remove the screw(s). : ( It is possible that they'll be able to do a patch without surgery, but not likely. I will find out after I have the myelogram exactly where the leak is and if they will attempt a non-surgical patch or go straight to surgery.

One interesting fact about this whole thing is that I had my original rod insertion surgery back in December done percutaniously*. He doesn't normally do these surgeries that way, but he suggested we try it that way because it a) reduces the risk of infection, and b) reduces recovery time. I told him to go for it. Today he said that he has fixed numerous dural tears during surgeries and he thinks that the reason he didn't see the tear during my surgery was because I wasn't wide open and he couldn't see the tear. So in a way, doing the surgery percutaniously turned out to be a bad thing.

The good news is that he let me stop wearing my brace! I feel so much better without it, both mentally and physically! The other good news is that he gave me some drugs to help reduce the headaches. This means that instead of sitting up for only 45 minutes, I should be okay to sit up for about 2 hours. This is very good news considering Gillian is performing in a play on Friday and a dance competition on Saturday! She and I were both very concerned I wouldn't be able to attend.

So... it looks like I'll be having another surgery. I didn't ask my doctor details about the surgery, but obviously it won't be as intense as the two I had in December. What I least look forward to is getting an IV. I HATE IVs and I've had more than my fair share of them. The veins in my hands and arms have been stabbed so many times that numerous attempts are usually needed to get a good IV site. It's funny how when I was a child needles didn't bother me that much. Now I absolutely DREAD them.

* A CSF leak is an escape of the fluid that surrounds the brain and spinal cord. The fluid cushions the brain and so with the fluid leaking, it causes a severe headache and nausea. My CSF was most likely caused from the new screws that were inserted back in December.

* A myelography is an imaging examination that involves the introduction of a spinal needle into the spinal canal and the injection of contrast material in the space around the spinal cord and nerve roots using a real-time form of x-ray called fluoroscopy. As the patient lies face-down on the examination table, the radiologist will use the fluoroscope, which projects radiographic images in a movie-like sequence onto the monitor, to visualize the spine and determine the best place to inject the contrast material. The contrast material usually is injected into the lower lumbar spine, because it is considered easier and safer. Occasionally, if it is deemed safer or more useful, the contrast material will be injected into the upper cervical spine. At the site of the injection, the skin will be cleaned and then numbed with a local anesthetic. Depending on the location of the puncture, the patient will be positioned on their side or abdomen or in a sitting position as the needle is inserted. The needle is advanced, usually under fluoroscopic guidance, until its tip is positioned within the subarachnoid space within the spinal canal, at which time a free slow flow of fluid is obtained. The contrast material is then injected through the needle, the needle is removed and the skin at the puncture site is again cleaned. The patient is then positioned on the table, usually lying on their abdomen. Again using the fluoroscope for guidance, the radiologist then slowly tilts the x-ray table allowing the contrast material to flow up or down within the subarachnoid space and to surround the nerve roots or the spinal cord. As the table is tilted, the radiologist monitors the flow of contrast material with fluoroscopy. A CT scan is then performed immediately following the conclusion of the myelography while contrast material is still present within the spinal canal. This shows exactly where the hole in the dura is.

* Percutaneous surgery means they made multiple small incisions instead of one big wide open incision.

p.s. I will post some photos later.