Wednesday, 1 April 2009

Follow up on cranioplasty and NCCU

We went to Cambridge today to see the neurosurgeon, who professed himself pleased with the progress of the healing post-cranioplasty. There is still the risk of infection but he said that risk was very low.

Apparently the dura did have to be repaired as it had stuck to the skin but there were only a few small holes to be sutured and the whole operation was completed in a short time, which lessens the risk of infection.

The neurosurgeon also commented on the slight indentation on Jo's right temple, which he said was due to muscle wastage. He did talk of plastic surgery to remedy this, which involves taking fat from the thigh, emulsifying it and injecting that in the forehead but he was not recommending the procedure and Jo is not keen. The indentation is slight, barely noticeable, mostly hidden by her hair and we both have hope the muscle tone will return as the muscles in that side of Jo’s face were cut from the middle of her temple to just below the ear again.

In the afternoon we attended a surgery, which was a follow up from the treatment Jo had received in the Neuroscience Critical Care Unit at Addenbrookes. Jo was in NCCU for 11 days and the new news to me was that they had considered a tracheotomy to help with her breathing. Fortunately that wasn't necessary. They did say they often see an improvement in neurological condition after cranioplasty which is heartening as they would actually see more of that and monitor it more than the neurosurgeons. The nurse also said that symptoms such as Jo's neglect often return before improving again after cranioplasty.

Whilst at the Lea Jo effected a transfer from her wheelchair to the toilet and back again. When she came to transfer back onto the wheelchair, on her affected side, at my command she lifted her left foot and placed it back down forward and to the left, a proper step and the first she has taken completely unaided.

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Different strokes...

It has been nearly seven years since Jo suffered a "controlled" stroke whilst undergoing brain surgery to clip the blood vessel that had caused a subarachnoid haemorrhage in 2000. Sadly two successive coilings did not occlude the bleed and so Jo had a craniotomy in August 2008. During surgery the surgeon discovered the coiling had penetrated the rear of the aneurysm, occasioning emergency repair procedures. Consequentially they spent one and a half hours longer in surgery than expected, leading to the right half of Jo's brain forgetting it has to look after the left side of her world.