My Dr informed me yesterday that if I have this surgery I will be awake. Anyone else have to go thru this? Can anyone tell me anything about it. I need more answers. This scares me.
Hi Chrissy,
I'm assuming you will have an embolization. I've not heard of conventional surgery while "awake". Yes, you are sorta awake during an embo. The process is they go thru your groin, into your brain. Chari said she could feel the probe moving through her chest.
You will be mildly sedated. The reason you have to be somewhat alert is they do a full neuro exam during the process. They get the probe in the potential target area, then inflate a balloon from the tube to seal off the blood flow. Then a neuro will run you through a neuro exam (touch your nose, say CAT, count backwards from 27 by threes, wiggle your toes, etc). You are also hooked up to neuro monitors, so they get confirmation from two sources. IF there is no neuro deficit (or a deficit that you can live with easily, such as potential colorblindness), they deflate the balloon and insert glue.
If there is a potential deficit that is significant, they deflate the balloon and move to a different target if possible.
Chari said it wasn't really painful--the insertion point in her leg hurt more than anything. Think she had headaches for a day or so following each (she had 4 or 5) embo.
The KEY THING is before they start in the OR, ask BOLDLY "WHO IN HERE IS FOLLOWING MY GURNEY TO ICU TO REMOVE THE PROBE????????????" Do not let them start until you know. Once they remove the probe, you (typically, but it might be changing) have to lie flat on your back for SIX HOURS. And since you've already been on your back for hours during the embo, it is painful.
Chari always checked the clock when she got to ICU to see when her six hours was up. One time, she was 2-3 hours into it, when the ICU nurse said "oh, no one has come in to remove it yet, your six hours hasn't started yet." Chari is normally a very patient person, but if she could have grabbed that DR's (ahem), he'd be talking funny for a long time!
From that point on, she DEMANDED to know who was going to follow her and get it out. It was UNACCEPTABLE to her for him to do anything other than walk beside her gurney--no bathroom breaks even.
Hope this helps.
Ron, KS
Thank you Ron. According to my team of doctors they are talking about doing conventional surgery and waking me up after the remove the skull and get into my brain. They say thus is the safest way to do this since it IA so close to the motor sensory part of my brain. He want to communicate with me during it so he know if he gets to a part that affects my speech or parts that could paralize me. I looked it up on the internet and there have been several of the operations done. I just wish to speak with someone before I make my decision. Thank you again… would this be something you would agree too?
Hi Chrissy,
I know of a pt. who had conventional surgery while 'awake' and understand you're still lightly anesthetized during the 'awake' part, just enough to respond to the team.
Ask your dr. if there's another pt. whose had 'awake' surgery whom you can connect with. But be sure to ask your NS for more reassuring details of what to expect.
Best wishes.
It's odd because I remember when I was first diagnosed with this in 1988 and discussed embolization with the neurosurgeon, I'm almost positive it would was going to be done while awake in order to monitor how the procedure was going, effectiveness and complications. I didn't go with it at that time.
I had a bleed in May of 2012 and again, embolization was brought up and when I went through the angiogram prior to an embolization, I was put under, in the event they could go forward with the procedure. I was a bit surprised asked about it when I awoke. I really don't remember what he said, I was groggy.
Ah Chrissy, the magic question: "Would you have it done?" The classic answer (as stolen from a sailing forum I'm on): It depends.................
What does he say the risk of doing nothing is? How many of these specific types of surgeries has he completed? What is his general success rate? What does he suggest (I know there is no guarantees) your risks and benefits are?
Only you can make the decision, and once you are comfortable with the decision, it is the RIGHT DECISION for you.
Best wishes, and let us know how it goes.
Ron, KS
It sounds to me like they are wanting you to have an awake craniotomy. This is actually common with brain surgery as they want you to be awake to ensure that they aren't damaging anything in your brain. It is often used when doing surgery to remvoe a tumor and i think during the implantation of a deep brain stimulation device.
As for wether or not I would ahve this surgery, it depends. I of course would want to ensure that I am going to the best surgeon who has done many of these before. And i would want them to let me know that having an awake rather than a sleeping carniotomy is necessary in order to ensure orpimual results.
le