Tuesday, March 3, 2015

Adhesions are NOT endearing--but they tell an enlightening story

Reading my surgical report has revealed some interesting new details. Even though I updated just a couple of days ago, I wanted to share here as well. 

I previously mentioned how the report said the arachnoid membrane (where CSF is housed--well, technically the subarachoid space just below it) had areas of opacity. Well, it also says this: "Numerous adhesions to the cerebellar tonsils were cut sharply...Other arachnoidal adhesions of the tonsils to both the posterior-inferior cerebellar arteries, the dorsal brain stem, and the upper cervical spinal cord were dissected and divided sharply." 

Now, when I read that, I somewhat assumed "adhesion" meant some sort of normal connective tissue that had to be severed during the decompression and tonsillectomy. Turns out, uh, nope. A quick search resulted in scores of medical-vernacular-dense websites describing the occurrence of adhesions specifically in situations of significant cranial compression. 

It took a lot of reading, parsing, looking up terms, and then verifying on other sites, but the gist is adhesions are somewhat akin to scar tissue (actually, one site described it as such) that can form on the anatomy in the area due to extended periods of cranial compression. 

The best description probably comes from, appropriately enough, a textbook called "Craniovertebral Junction: Diagnosis--Pathology--Surgical Techniques": "The effect of chronic severe foramen magnum [opening of the skull] impaction by the cerebellar tonsils is the formation of arachnoidal adhesions, which may be the primary pathological focus. The adhesions may be quite pervasive, involving the brainstem [in my case and as you see quoted in my report above, yes], posteriointeferior cerebellar artery [yes], and spinal cord [yes]. Microlysis of the adhesions is an important part of the internal decompression." 

Basically, everything was so compressed for so long (uh, 41+ years), it sort of started growing together. This explains what was going on with me even more. Here I am, post freakin' brain surgery, and I'm *still* relieved to see MORE black and white evidence that *something was very wrong* with my brain. (Well, brain, arachnoid membrane, spinal cord...) 

Oh, and incidentally, the arachnoid membrane is called that because of its resemblance to a spider's web. :) 

In other update news, I called the anesthesiologist's billing office and confirmed they had billed my primary insurance, but not my secondary. After I gave her the information over the phone, she was able to submit the claim via computer while still talking to me. So, thumbs up there as well. Yay for two months of overlapping coverage! 

And now, I would like to thank my son Trent for waiting until the 5 week post op mark to get sick. I can stay home with him and just be his mommy. I've been able to make him mac and cheese, play ball in the backyard with him, practice his letters and sounds with him, and otherwise more or less keep up with a 5yro who's almost completely unaware of his fever and cough. Almost. Team Umizoomi and an extra long naptime due to both illness and medication ensure I get my rest as well. 

Thank you all, again, AGAIN, so very much. February may be the month of love, but I've been feeling it long before it rolled around. Much love back from me, us, in return.

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