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June 10, 2013
Apr 17 Email: Surgery!
I had my surgical procedure on April 15, 2013. Two days later, I put this email together.
Date: Wed, 17 Apr 2013 23:32:59 -0400
From: Jon Nathan
Subject: Re: Neurological issues
Hi everybody. Thank you again for your wonderful support and concern.
I went through the procedure as described on Monday. It is now
Wednesday night. There were some risks to the procedure that were
realized, such as further loss of function and neurological deficit.
My surgeon went into my spinal cord and was unable to visually
distinguish any abnormalities. He used imaging techniques to locate
the area of enhancement. He cut out three or four small pieces of
tissue, about 1 mm squared each, and gave them to the neuropathologist
for examination. The neuropathologist noticed gliosis, which is a
symptom of neural damage. The damage could be either inflammatory
or neoplasmic in origin. We won't know results until we get the
full lab report back. At this point in time, the results should be
back tomorrow or Friday.
In the process of removing these tissue samples, one or more of my
neural tracts that control touch sensitivity was severed. This was
a known risk, but it is causing me problems right now. The right
side of my body from the middle of my pectoral muscle to my toes
is numb. I have poor proprioception of my right hand and foot.
This makes it extremely difficult to walk and causes discomfort.
Also, my neck is very sore from the procedure. I have to wear a
hard collar for the next 3 weeks. This prevents me from moving my
neck, so I can't look down at my feet to understand their position
in space. I am viewing this new deficit as a challenge to be treated
with hard work and pharmacology.
I hope to be released tomorrow, but it will likely be to a
rehabilitation facility. I will make those arrangements tomorrow
morning. I will probably be in the rehab facility for 3 to 4 days,
but that is just speculation. I am able to stand up, but my balance
is unsteady because my feet do not get feedback from the ground. I
cannot walk on my own, and probably cannot walk with an assistive
device such as a cane or walker either. Right now, I need two people,
one on each side, to hold my arms while I clumsily walk down the
hall. *Update: I can now walk with a single assistant!* I am on a
full course of medications. It seems that each drug has a side
effect that necessitates another drug. I've been on two different
antibiotics, a skeleto-muscular pain reliever, vascular constrictors,
nerve signal blockers, antacids, steroids, insulin, muscle relaxers,
and painkillers. I am not in pain, just discomfort. Sensation has
been slowly returning to my right hand and foot. I think it will
continue to improve.
I'm grateful to Siri for allowing me to dictate this message. I
definitely cannot type. Apologies for the disjointed nature of
this message. It is hard to edit and reorder.
I was just transferred out of my private room in the ICU to a shared
room in the spinal recovery floor. My roommate is a very confused
old man. He says he has been here 3 years, and he wants to watch
the football game. Redskins! He is constantly babbling. I'm not
sure how aware of his surroundings he is. It's a little sad, but
annoying as anything. I am trying to convince the nurses to bring
him a large dosage sleeping pill. Or even better, bring that for
me. "We're not too far from the airport, you see." And now he's
threatening to take a shit right in his bed to the tune of Mary had
a little lamb. Get me out of here! :)
The next step is to get discharged to the rehab facility. I never
fully understood the concept of relearning how to walk until now.
My brain knows how, but it can't tell my body. There is some degree
of plasticity in the spinal column and brain, but it will take some
time to reroute the signals. Days, months, years, we'll see. I think
that once I get in to a program I can regain function quickly.
Then we wait for the neuropathologist's report. My neurosurgeon
think that if there are tumor cells, they will find them in the
biopsy samples. Then I'll work with a radiation oncologist to
determine an exact radiation plan. If not, and this is just
inflammatory, I'll be put on an even stronger course of steroids.
The uncertainty of the diagnostic process is frustrating and
depressing, but that's how the scientific method works. Develop
hypotheses, devise and execute tests for them, and refine your
understanding of the situation. Exclude unlikely possibilities, and
repeat. There have been some backs and forths in my process. It
makes me long for a Star Trek medical tricorder.
"My birthday is right around the corner, June 6th. Pearl Harbor
Day."
I will keep you posted as I learn more.
-Jon
Posted by jon at June 10, 2013 12:44 AM