MVD #2 Diary - Connie Cutler
November 2004:
I knew I wanted to have another MVD because the first in Chicago was not successful, so I thought getting a second opinion on where to go this time would be a good idea. I saw a different neurosurgeon in Chicago and asked if he thought I would have any improvement from my MVD the previous February if I waited any longer. He responded no, so I told him I was contemplating surgery in Pittsburgh after researching on the HFSA web site. He immediately said, “Dr. Jannetta?” When I replied yes, he said, “Well, he wrote the book on the procedure, so you’d be in good hands!” Therefore, I put the maximum away for 2005 in my company’s flexible spending healthcare account to cover the expenses not covered by insurance.
December 2004:
I had a repeat MRI and MRA.
February 2005:
I contacted Drs. Jannetta and Casey’s office by phone. Kathy Evan, their nurse, said I should send my MRI and MRA films and fax my operative report and a copy of my insurance card. Later, Ruth, an office staff member, asked me to fax my hearing test results. She also contacted my insurance company (Humana PPO) and got approval for surgery. She also sent me a packet of information to read and fill out pre-operatively, including hotel information. I selected the Hawthorn Suites (Pittsburgh) Greentree at 700 Mansfield Avenue, Pittsburgh, PA 15205 (Phone: 412-279-6300, Fax: 412-279-4993).
Monday, March 14, 2005:
I flew to Pittsburgh from O’Hare in the afternoon and took a taxi to the Hawthorn Suites. In retrospect, I should have called the hotel for the shuttle bus. I checked into a penthouse suite with two bedrooms, including one Murphy bed, two bathrooms, and a full kitchen. I chose this because of my desire to have enough space so I could take a nap post-operatively without being disturbed by the noise of my wonderful friend who volunteered to accompany me and cook for me! The cost online to reserve the room for eight nights was $109/night. The room had two floors and was quite spacious. Free appetizers and drinks (soda, beer, and wine) were available Monday through Thursday nights from 5-7 PM. I was pleasantly surprised that my wireless laptop worked, but only from one area in the room because the signal was low. Before bed, I arranged for the hospital shuttle bus in the AM to the hospital for a doctor’s appointment.
Tuesday, March 15, 2005:
I ate a small free breakfast in the lobby and met another woman having an MVD the same day while waiting for the bus. She and her husband are from North Dakota. The trip through the poor northern neighborhoods of Pittsburgh to AGH took about 20-25 minutes. I registered in the neurosurgery office and turned over my paperwork. Kathy Evan called my name and introduced herself. She escorted me into the small exam room. Soon Physician Assistant Rick Kortyna, the teams Physician's Assistant, came in. His friendly and knowledgeable attitude put me at ease. I told him that I am an RN as he took my history and did a mini-physical exam. My face was spasming quite a bit, and he noticed movement in my forehead and neck of which I was not aware. He then left, after thoroughly explaining what to expect during and after surgery, and said the physicians would be in soon. Dr. Casey arrived first and I immediately liked him. He and I have something in common. He has relatives who live in my suburb of Chicago! He reviewed my case briefly and reviewed the risks of surgery, including more hearing loss (I have lost the ability to hear the two upper tones on my affected side after my MVD last year). Finally, Dr. Jannetta arrived and shook my hand firmly. His jovial and relaxed personality was evident by the way he sat down next to me. He said that he had read my previous op report and felt that the surgeon had probably not found the offending vessel that was compressing my facial nerve. After the appointment, I took a long walk to downtown Pittsburgh across a bridge to do some exploring. I walked back to the hospital to catch the shuttle bus back to the hotel. Then, I arranged for the shuttle bus for the AM’s EMG test.
Wednesday, March 16, 2005 -
I returned on the shuttle bus for an EMG with lateral spread test. Dr. Small performed it and said my results were typical for HFS. After the test, I walked to the Andy Warhol Museum, about a 5-block walk from the hospital. Although not my favorite artist, he certainly did make a difference in the pop culture of his day. I called for the time of my procedure and was told to arrive at 8:30 AM for a 10:30 AM surgery. The nurse told me to take my current medications with a sip of water. I ate and drank until the deadline of midnight, then sleep quite well. I am at peace with this decision and have many family members, friends, and co-workers praying for me.
Thursday, March 17, 2005 - “MVD Day”:
The day of surgery arrived bright and cold. My friend and I got on the shuttle with the woman from North Dakota whose procedure was scheduled after mine. I registered and went up to the ambulatory surgery area on the 11th floor to have final pre-op checks performed. I put on TED® hose, slippers, and a gown. The OR staff came to take me on a cart into the pre-op area where an IV was inserted (she missed the first time because I told her I was a nurse). Around 11 AM, staff brought me to the OR and I slid over to the operating table. I fell asleep quickly. The next thing that I remember was that two hours had passed and I woke up in the PACU. I had inflatable leggings on to prevent a deep vein thrombosis (blood clot) and an electronic BP monitor on my arm. I was comfortable for several hours. Unfortunately, many hours went by and I could have been moved to a more comfortable bed in a regular patient room, but no one could find Dr. Casey to give the official order. Finally, at 10 PM, a resident came by to give the approval. By then I was stiff and sore because of the difficulty in repositioning on the narrow hard cart. The movement to my room caused me to have some nausea. Once in my room, I convinced the nurse to leave off the inflatable boots by walking to the bathroom and moving my legs frequently. The view of Pittsburgh from the 11th floor at night was spectacular, but I did not sleep well. The nausea and vomiting was limited to one other time in the hospital and once back at the hotel, so not terribly bad.
Friday, March 18, 2005 - Day 1 Post Op:
Rick, the PA, came in the next day in the AM and found me sitting in a chair. He said that Dr. Jannetta would probably discharge me that afternoon. He said I could get up and take a shower, which thrilled me. I had “goop” in my hair and found some staples on the top of my scalp…far from the incision. I also had a Band-Aid® on my forehead covering two small cuts, probably from the positioning of a halo traction device. I used a washcloth to try to avoid the bandage on my incision as much as possible and felt 100% better after the shower. Dr. Jannetta and Rick came in later in the morning and told me I could go back to the hotel! I went for a walk around the unit with my friend and was happy to be able to call the shuttle bus for the trip back to the hotel. We returned around 1:30 PM and I spent part of the afternoon napping.
Saturday, March 19, 2005 - Day 2 Post Op:
The spasms are still occurring, but less often and to a much less degree than pre-operatively. I feel that every day will be better. I did not want to take any hydrocodone for pain because of the constipation it caused last year, so I asked my friend to get me some Extra Strength Tylenol®, which “took the edge off”. Dr. Jannetta and Rick said that there would be improvement up to a month later, most often from 9 to 14 days. I went for a walk outside with my friend and felt strong and steady on my feet. My appetite has returned and my friend is an excellent cook! She is a special blessing to me.
Sunday, March 20, 2005 - Day 3 Post-Op:
I have not slept a full night yet, but felt well enough to attend Palm Sunday Service. We arranged for the shuttle bus to take us to a church about two miles away. The service was long and while waiting for the shuttle bus, I became exhausted. I went back into the church and finally the shuttle bus came. By the time I got back to our room, I was really tired. After lunch, I took a nap and felt better.
Monday, March 21, 2005 - Day 4 Post-Op:
My friend and I walked outside twice and I felt stronger. The only pain is temporary pressure pain in my temples when I change position. I still have not slept an entire night.
Tuesday, March 22, 2005 - Day 5 Post-Op:
The shuttle bus took us back to the hospital for a post-op check. Kathy called me to the exam room and soon Dr. Jannetta and a resident or medical student came in. My face still had spasms. Dr. Jannetta said he wanted me to call the office if the spasms disappear for 48 hours or if they do not end by 30 days post-op. I hope I can call with the disappearance message. The shuttle bus picked us up at the hospital and drove us to the airport. The check-in process went smoothly, but I took the walk slowly to the gate (no wheelchair because I am stubborn). The flight home was uneventful and I was thrilled to take a nap in my own bed. I had a sporadic night of sleep again.
Wednesday, March 23, 2005 - Day 6 Post-Op:
I finally spent an entire night in my own bed sleeping. What a good feeling! The spasms are continuing unfortunately.
Thursday, March 24, 2005 - Day 7 Post-Op:
I woke up early this AM without spasms, just a few minor eyelid flutters, exactly one week post-op! I felt wonderful and will notify Dr. Jannetta’s office on Monday if this continues on Friday and over the weekend. My mom and I enjoyed lunch at the local restaurant and it was great giving my order to the waiter without worrying about my face contorting. I walked about a ½ mile after lunch and enjoyed the sunshine of this early spring morning in suburban Chicago. A friend from work came to visit today and was thrilled for me. My kids still think my smile is crooked, but it always was uneven, even before this started ten years ago! I will give thanks at church tonight, this holy week. I thank God for giving the neurosurgeons and hospital staff the skill to cure this condition and my family and friends for their prayers.
Friday, March 25, 2005 - Day 8 Post-Op:
Today was another day without spasms. I only noticed a couple of eyelid flutters, so I am optimistic about joining the spasm free club soon. I will wait until Monday to notify Dr. Jannetta’s office if my face has a quiet weekend, because he asked me to call after 48 hours of spasm free time.
Saturday, March 26, 2005 - Day 9 Post-Op:
No flutters at all today, so I am ready to call this MVD a success and to proclaim that I am "SPASM FREE"! Thanks to all of you for your thoughts and prayers. I can’t wait to show off my smile tomorrow at the Easter service!