NIGHT BEFORE SURGERY

It is the night before the surgery. Mom and I were up at 5:00 to start the day. Several comments that were made throughout the day made me even more comfortable about being here.

First, on the way to our testing (MRI, X-rays, etc.) our cab driver told us that his daughter had surgery for Arnold Chiari years ago BEFORE TCI was established. He has meet approximately 40 patients over the past few years with ACM. He said that every single one of them has had nothing but good things to say about TCI. Listening to him share stories about how bad off these people were confirmed my decision NOT to have surgery locally.

At noon, we went to the hospital for pre-surgical testing. The nurse was surprised that I didn't take medications on a regular basis. She said most people with what I have are on several medications. Then she said that out of all the people she has seen with Chiari I was in the best condition. She stated that most are "really messed up" when they get to New York. We were there for about 1 1/2 hours. They asked a panel of questions, took my blood, and performed a electrocardiogram.

I spent the next 3 hours at TCI. Dr. S meet with me for over an hour. He was very informative. He stated that the amount of pannus formation was significant and further explained in detail the potential dangers of basilar impression and retroflexed odontoid. After talking to him it did confirm that surgery is the best alternative at this point in time. Then, Dr. V spent a very long time discussing the surgery tomorrow. I was very disappointed that I didn't get to talk to Dr. B. Dr. V told me that my herniation was the longest that he had ever seen. I was really surprised by that... Previously, Dr. B told me that I would have Invasive Cervical Traction while I was here and then Tethered Cord Surgery in a couple of months after I was decompressed. However, Dr. V told me that he thinks I should adopt a "wait and see" approach. Sounds great to me....but I would like to discuss this with Dr. B if possible. Dr. V and S explained to me why they think I should adopt a "wait to see" approach to the tethered cord and craniocervical instability surgeries. I really, really was impressed with both of these doctors.

All three of us were pretty comfortable about everything when we left TCI tonight. When Dr. V mentioned mortality rates I specifically asked what TCI's rate was...0%! That made me feel great. I feel SO MUCH BETTER. Also, even though my brain herniation is so severe, the part that they are going to "fry" is not important...good. Also, the rate of dura leak is .2% here compared with a MUCH, MUCH higher rate at other hospitals. I will have NO STAPLES. That is a nice surprise! Also, Dr. B and Dr. M pioneered some cool procedure to detect leaks. (NOTE TO FRIENDS: As I am writing this, Charlie is sleeping. I am looking at his notes from the discussion to provided more details about what the surgeon stated. I found NO notes from the discussion from the surgeon, but Charlie did write down the name of the steak restaurant that the surgeon recommended for dinner tonight!! Burton and Doyes in case anyone is interested!)

HAIR LOSS: As you know...huge concern for me...ha/ha. I was told to go and fix my hair one last time because tomorrow a bunch of it was going to be gone! He explained that they will take a section from the upper part of my head and form a patch over my dura. So, that is why they are going to shave so much hair. Again, no notes from Charlie so I can't be specific. In summary, they do not use human cadaveric pericadium or bovine pericardium. This is good news for my health, not for my hair.

The most surprising new of the day: Charlie actually talked my mother into having a pedicure! It was the best part of the day! The weather was incredible. We had a great meal tonight under the stars to celebrate. At this point, I am so comfortable with the decisions made thus far to get us to this point. Had I decided to have surgery 4 years ago, the surgery would have been competely different. So much has changed in the past few years. They have performed literally hundreds of surgeries since then and altered the approach (for people that have ACM, RO, and BI). I have this unexplainable peace right now. I know that I have literally dozens of people praying for me this week. The peace I have right now could only come from above. Thank you so much for your prayers.

Much love, Kelly

PS. I know that I have received several calls, and would love to return the calls right now because I am NOT TIRED AT ALL since I consumed a bucket of tea tonight. However...Charlie and Mom are asleep so I can't make any phone calls. Please forgive me. I have to be at the hospital early, so we are getting up at 4:15. Please feel free to call mom or Charlie as much as you want tomorrow. I love you all....