First off, Happy Independence Day, we hope everyone is having fun celebrating this wonderful summer holiday!
Due to the lightning fast internet speed (notice the sarcasm), only one baldy head picture was uploaded so far, hopefully we will be able to get some more of them up shortly.
Charlotte was finally out of surgery and awake in the ICU about 3pm Friday, for a total of about 7.5 hours under anesthesia, making it one of our longer sessions if our facts are accurate. The surgery overall went very well. She has one very long incision from the hairline about in the middle of her forehead snaking all the way back to below her ear line on the back right hand side of her neck. This was so they could part the scalp to expose her skull to make the necessary openings for the tumor removals, and also it was the best way to reduce scarring and promote a full head of hair growing soon! There were two openings made in the bone, one for the two smaller tumors up front, and one for the large one in the back. A quote from the nurse making rounds for updates in the OR was, “WOW, your little girl has a lot going on in there!” Not something of course we wanted to hear, but it puts yesterday into perspective quite well.
The surgeon told us that the largest of the tumors was the size of about a small tangerine, the second a bit smaller than a golf ball, and the third one about the size of a marble. All came out cleanly, with exception of the largest one, of course. He described it as this one was trying to attach itself to the skull, extremely close to the sinus vein. Yes we were confused also, as we only knew of the word ‘Sinus’ to describe the empty opening above the nose or the sinus cavity. This vein, as it goes down the neck from the side and back of the head becomes the right jugular vein. So you know how big it is and how much blood flows through it.
There is a membrane that protects this vein, and the tumor had attached itself to that membrane. They had to scrape as much as possible off, without removing the membrane entirely as if so, would make it extreme vulnerable to rupture, and that would be very bad. This would be considered leaving some negative margin, as not all of the area that the tumor touched was removed. To help this, the surgeon cauterized (or burned with a laser) that spot very heavily. Since a tumor is alive, burning it like this should hopefully kill any cells left behind, lowering the chance for recurrence. We are not sure if Dr. Anderson will want to use some focused radiation on this site, just to be safe, so we will just have to wait and see what the plan is with the new information.
Other than that and the long incision, that is all the bad news that we received. He was very pleased with the surgery, and commented how well she did. The used sutures instead of staples to close the incision, this will help scarring, healing, and will be less painful to remove when the time comes. That was also one reason it took so long to close the incision. Fine ‘sewing’ like this obviously takes longer than just stapling the site closed. Some good news we received was that the 4th area in question, is just that. Questionable as he put it. Without biopsy or being able to actually look at it and touch it, he is unsure that it is a tumor and not just a blood vessel. If it grows, it is a tumor, if not, then it shouldn’t be. We just have to hope for the best there, as it is just heart breaking to think of another cranial surgery for Charlotte, not matter how small.
So the three areas for concern in the near future are the unknown spot, the negative margin area, and finally swelling and bleeding. We were told with surgeries like this depending on the patient; days 3, 4, and 5 can produce the most swelling, and can be very uncomfortable. Charlotte has swollen quite considerably today, looking almost a bit ‘Charlie Brown’ like on the right side of her face (much, much cuter of course). Her cheek and area around the ear and eye are very puffy and a bit black and blue. It took us a bit of time to get pain under control late last night, as some of the staff here I don’t think were used to dealing with kids, and potentially a surgery of this magnitude on such a small child. But after the Neurosurgery team visited today, they re-enforced how well her neurological function is, and just didn’t want her in any pain. YEA! (Neither do the parents!) She is resting comfortably again, wanting to play her DS and watch movies, of course eat was well. I think her food restrictions have been lifted today, as long as she continues the little nausea and vomiting we have seen so far.
She is tougher than nails; and we have never seen anything like this. She demanded that the nurses remove the catheter immediately after waking up, (not that we blame her, as they are yucky!) and wants to go home, she demonstrated how well her vocal cords were working then also! Tomorrow we should transfer to the pediatric floor of the hospital for a few days, and if all continues as it is now, homeward bound by mid-week.
It is still a bit mind numbing (no pun intended there) to think how fast this all went from finding the new tumors and the surgery date, of course yesterday took forever for us, but now sitting in the post-op ICU room we can’t believe she is cancer free, yet again. So it is official, cancers butt has again, been kicked!
Hopefully Dr. Anderson has the plan that will keep it this way!
We love you all,
The Rendine’s
