Surgery number 2

Today we have our second surgery. Today's procedure is the C Spine Fusion. While i am saddened by the fact that she will have such limitations in flexibility and ability, I am grateful that she is getting the best possible care. She has the best surgeons, with the best equipment, and a well thought out plan.

Dr. Mirza came and talked to us this morning, and we were able to talk with him for almost 30 minutes. We spoke of the plan for todays surgery and the plan for rehabilitation.

They are going to fuse from the Cranium to the C4 vertebrae, using titanium plates and bone grafts. during the first surgery they had to remove some of the remaining bone to get to the tumor, so they are going to have to use a bone graft to replace that. they are going to then put in the Titanium plates screwed into her skull, going down the spine tied to each vertebrae, to the C4 vertebrae. this will support the head while the body regrows bone using the graft as a "scaffolding" fusing the bones together. During the 3rd surgery they will have to go in and remove more bone, so the plan is to also do another bone graft on the other side at that time. Due to this, Dr. Mirza wants to wait a little longer before doing the 3rd surgery, Dr Sekhar wants to do the 3rd surgery on Monday June 2nd.

Zoe's last question this morning was if she could eat after her surgery, so we made sure to ask Dr. Mirza about that. He does not expect her to have to be NPO (no food or drink by mouth)for more than a day. So that is good news. They are doing the surgery with her face down so there is a possibility of swelling (face down for 5 hours would cause swelling in anyone). She will still have to ease back into eating, but hopefully that won't take long.

We have had some issues with pain management this week, so we were worried about the pain getting out of control. Our original system was using Tylenol and Oxycodone, this did not work well, but it was hard to judge because Zoe doesn't like the High feeling. It was suggested that we start her on Methadone, I always thought that this was only used for Heroine maintenance. Methadone is used to maintain the baseline pain, it worked. We are then able to address the acute pain with Oxycodone. The theory is that with the Methadone on board, pain management should be easier. As far as long term pain, we should not really expect any chronic pain, outside of the probability of early onset of arthritis in her neck but that shouldn't be for 30 years or so.

All in all, this surgery is a good thing. We have some distinct steps that we need to take to get her better and this is the second major step. After the next surgery, we have some healing to do, and then we are looking to Proton Beam Radiation treatments.

While it has been infuriating trying to wade through all of the changes in plans, and speculation, I take comfort in the knowledge that these Dr's are some of the best at what they do. We have been at the mercy of these very busy men trying to clear their schedules to accommodate us, and save my little girls life, and for that I am eternally grateful.

Henry