Tuesday, April 15, 2014

MRI take 2

Yesterday we were up, in the car, and checked into Rocky Mountain Hospital for Children at PSL before dawn broke. After much waiting, lots of consent forms and meetings with anaesthesia and radiology, James was sent in for his sedated MRI and CT Myelogram. 

After only two hours we got the call that everything was done and James was in recovery; they didn't need to do the CT Myelogram after all as the MRI was able to get what three neuro-radiologists believed was a great view of James's arachnoid cysts and his tethered cord. 

We went to the PACU and met James in recovery, where I was pleased to find one of his former NICU nurses taking care of him. She did a great job and so did he; after an hour we were on our way across the hospital grounds to meet with Dr Osterdock. 

After some discussion and a review of the scans, our surgery was set for May 1st. It will be at least four hours to accomplish both procedures, the cysts being more difficult and the tethered cord being a bit more typical. 

It's difficult to put into words exactly what the cysts look like; but if you could imagine something the shape of a green bean sitting right along the sheath of the thoracic spinal cord, total length 5 centimeters. Its placement is putting severe and direct pressure on the spinal cord itself and that is one reason we have to operate. 

Black marks show the top and bottom of the cystic mass, 5 cms in length. 

Our neurosurgeon has to make incisions in 4-5 vertebrae to essentially access the cystic body and drain it. There are some other considerations she will take to ensure there are no complications with his VP shunt. 

Following this procedure Osterdock will move to the lumbar spine, where she will make a small incision in a vertebrae to access the fatty tissue that has attached to the spinal cord and detach it. This will allow the spinal cord to float freely as it should in the spinal canal.

James will be in the hospital for 3-5 days, primarily for pain management. Following discharge James is only prohibited from contact sports following the surgery for 3 months - meaning as soon as he's home we will have to watch Maisie closely but he will be back to chasing balls and getting into trouble pretty quickly! 

The hopes are that James will have better range of motion and less long term mobility issues related to these complications by operating now.

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I know it might seem strange; but if I had the choice I would prefer to do emergency surgeries. Less time to think about the "what ifs" and all the logistics involved. 


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