Sunday, September 19, 2010

Post from Joe and Gin via Lisa--Sunday, Sept. 19, 2:11 Central

This is copy and pasted directly from email from Joe and Ginny with direction to post. I apologize for my earlier mistake in thinking Dr. Long did the surgery--Dr. Louis did this surgery yet Dr. Long will be doing a future surgery. It is all so confusing. Thank you so much for your prayers, cards and well wishes. The entire family is very grateful.

Blessings,

Lisa

So many people have asked for details of the surgery. I checked with Joe and he is fine with us posting the details of last Thursday's surgery. So here goes--

Slice of history--

We had told about a month ago that UAB physicians would likely be able to do several procedures at the same time, saving Joe from a "one thing at a time" situation with multiple surgeries and recoveries. However, as the doctors more closely examined his CT scans (no MRI can be done due to pins in his cheek), the recommendation was made to go back to the "one thing at a time" approach. Most of this is because they don't know what they will find until they are doing the work and the potential for swelling might change the approach.

So on Thursday, Dr. Louis', goal was to repair any holes in the upper right eye socket and determine, when in surgery, what other holes are present and either repair them or determine a strategy for next procedure. The upper right eye socket had to be repaired to in order to do anything with the right eye ball, which has sunken into the socket due to all the fractures.

The entry point was through an incision in the crease in the right eye lid. The incision is the length of the lid. From there Dr. Louis was able to determine with scopes, I suppose, the upper orbital (socket) defect (hole) and thereby determine the bone graft necessary to cover the hole. The graft was taken from Joe's left skull, obtained from an incision cut zig zag, deep in the hair line, starting above the left ear and going up. It is a long incision, closed with about 15 staples. Somehow the bone graft was obtained and implanted then over the orbital hole which was determined to be the somewhere between the size of a quarter and 50cent piece.

The surgery was a complete success. The hole was repaired. Dr. Louis also determined that the rest of the right eye socket is healing extremely well, including the bottom so no additional bone grafting or plastic surgery should be needed.

Dr. Fisher, a neurosurgeon, met with us the day before the surgery. He was available for Dr. Louis if any 'brain" issues came into play. When the surgery went over our expected two hours, and lasted four hours instead, we felt certain that issues had arisen and Dr. Fisher had to be called in. Much to our relief, when Dr. Louis spoke to us post-surgery, he said everything went great and there was no need for Dr. Fisher to join in. I must have had a look of alarm, or something, when asking about the duration, his comment was something like, "Well, we like to take things slowly". That I do appreciate!! When he explain the size of the hole, length of grafting incision, it all made sense. And we were sure relieved Dr. Fisher's expertise was not needed. Even minor movements of brain tissue is a scary thing. I did not want to give back any of Joe's recovery thus far. There was no brain herniation nor any cerebral spinal fluid leakage present so that was fabulous news too.

The next step will be repairing the defect (dent) in Joe's right forehead. (Unknown to us previously, Dr. Fisher showed us that the skull fracture extended a long way across the skull, like maybe 8 or so inches. This fracture has healed but is somewhat misaligned.) Dr. Fisher recommends that we go with a relatively small implant and simply repair the dent rather then go with a much larger one that would repair the misalignment given that Joe's hair is thick and completely hides the ridge. This seemed very practical and reasonable. We hope to have this surgery done in the next month or so.

Surgery was Thursday, finishing at 5:45 pm. Friday morning, at 7:30am, Joe was conversing, starving to death and asked Dr. Fisher when he could be released, have normal food, and most importantly if he could attend Stephen's cross country meet Saturday morning. Dr. Louis was surely willing to keep Joe in the hospital but Joe really wanted to leave, felt well enough and I knew I had Jackie and Phil to help with any issues and concerns. By noon, after both a wonderful breakfast and lunch, Joe was ready to go. It was a done deal.

The cross country meet was great. Joe is tired but we still made 5:30 Mass and saw Fr. Phil. Some things just seem right. Joe has some serious swelling on his right eye lid. (Think the first Rockie movie--ouch). The left skull incision looks great and is healing. No hair was shaved so it is like searching in a forest for the staples. Incredible what now can be done.

Today we are in resting mode. It is about 95 degrees here so a short walk this morning was plenty. Joe is helping Stephen with a genealogy project now so more normal is good. There is still a long road, but little things each day brighten my spirits. The boys, the company of Phil and Jackie, the support of my folks, our siblings, the kind words, friendly smiles, and prayers of so many who are on this journey with us. Words can not express the depth of our appreciation.

Joe and Ginny