Date sent:11/14/99 03:42 PM
The latest procedure...
went well.
Dr. Black says that the cyst contents were "gunky, but not too bad." They did
replace the catheter, with a slightly different version, thicker tubing, flatter on top of
his head. They did flush the inside of the cyst with antibiotic and also filled the
catheter with antibiotic. They plan to drain using a larger guage needle for about 2 more
days. Thinking about discharging him in about 4 days. The cyst will then (theoretically)
collapse and heal over time (on the scale of months not weeks). Still will have several
more weeks of IV antibiotics. Other good news is that visually, the area around the
outside of the cyst is seemed unharmed. I guess sometimes there can be necrosis or damage
to the surrounding brain tissue caused both by the infection and by the physical presence
of the abscess. In this case, it appears as though there has not been damage to the other
brain tissue.
As an aside, there was a little tension before the surgery this morning. Last night,
Dr. Black said that it would be done with local anesthetic, maybe with a little IV
sedation. Then this morning, the anesthesiologist came in and described essentially
general anesthetic. We were very concerned about that and this anesthesiologist was pretty
unfeeling about our concern "Well, if Dr. Black thinks he can do this under
local..." When I asked Dr. Black about it he said that the anesthesiologist will
always just assume that it is general, unless the notes say that it is not. He said he
thought that it had been in the notes, but apologized if he didn't write it in. And he
said, in either case, that he and Dr. Malak, the resident assisting him, both knew that
the plan was to use IV sedation, and that it will always go the way the surgeon wants it
to go. They did use IV sedation and Dan slept through much of the procedure. He doesn't
remember seeing Dr. Black, but Dr. Black reports that Dan asked once "Am I still in
the operating room?" and then went back to sleep.
Right now, Dan is resting. We are still in the post-op holding area. He has had some
pain in his head, and they gave him drugs for that. He is also still getting his IV
antibiotics. He seemed a little concerned that at some point he will have to do this again
to get the shunt taken out. Hopefully, that will be down the road and we can cross that
bridge when we get to it...(platitude number 489... )
****
We spent about an hour and a half in post-op recovery. They made sure he was ok after
the anesthesia (little nausus for which they gave him something), that his pain was under
control (tylenol and oxycodon) and he was resting well. Then, we had to wait for the 10D
nurses to be ready to recieve him. So, we have been back in the room for about an hour and
a half. I have had food, Dan is sleeping well.
They shaved an area a little larger than the large flap incision (just in case they
needed it - though they didn't expect to...) and made a small incision (1 to 1.5 inch)
where the catheter was/is... There is a small gauze pad covering that now.
It is a gray and rainy day here in Boston. We are quiet and hopeful.
More later, With Love and Prayers, Abi and Dan
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