Less than a week away

Hannah’s brain surgery is now less than a week away.  Here’s some of the details…

Day Before (July 27th)

On Monday we have to be at the hospital at 9:30 so Hannah can have some blood tests done.  This is to make sure she doesn’t have any type of infection going into surgery.

After the hospital, we’re taking her to The Spaghetti Factory for lunch, which is one of her favorite places to eat.

Craniotomy

On Tuesday, July 28th, we’re supposed to arrive at the hospital at 6:00 in the morning. After she’s admitted, she’ll go to a surgery prep area, and be given some medication to relax her in preparation for anesthesia.  Then she’s put to sleep, but we’re not sure if that will be in the prep area with us, or after she goes into the operating area.  The surgeon did tell us that things like the IV, clipping of the hair, catheter, etc. will be done after she’s asleep so she doesn’t have to worry about those things.

The first operation is the craniotomy and grid placement and will take about 3-4 hours.  This involves opening her skull over the left frontal lobe, and placing electrodes directly on the surface of her brain.  (if you’re brave enough to look, here are some images of a subdural grid placement: image1, image2).  The surgeon said he would give us progress reports about every hour on how things were going.

Once the surgery has been completed, she will be moved to the ICU area, where we will join her.  They will keep her overnight in the ICU for monitoring of things like infection, vitals, etc.  They hope to have her eating, drinking and sitting up by the next day.

The surgeon said that typically there is a lot of pain and swelling of the head and left eye after this first operation, and they will be administering morphine to help alleviate the pain.

PEMU

After the ICU, as long as her vitals are looking good, she will be moved to the Pediatric Epilepsy Monitoring Unit (PEMU).  This is where they’ll “plug” her in.  The wires coming from the electrodes in her head will be hooked up to the computer for monitoring of electrical activity, and they will video tape her the entire time.  This will probably last two or three days, long enough to record substantial data during several seizures.  The idea is to try and further pinpoint where the seizures are originating from.  They also may send electrical activity to the grid in her head and see what happens (see what moves).

Decision Time

After the monitoring, we will meet with our neurologist to discuss if they were able to isolate more where the seizures are originating from and if a resection (removal) of that area can be done.  It’s possible that the origination point of the seizures is too close to the areas in her brain responsible for movement and that the risk of paralysis is too high for continuing with the resection.

Resection

The second surgery would involve opening up the incision again, removing the electrodes, and doing a resection on as large a portion of her left frontal lobe as they feel is safe to do.  The success rate of eliminating seizures is higher when they are more aggressive with the removal (sorry “resection”).

After the second surgery she goes back to the ICU overnight and then to a normal hospital room for recovery.

Recovery

After the second surgery, it is typically three or four days of recovery in the hospital before going home.  Once home, it’s about two weeks before she can do things like school, etc.