Thursday, November 20, 2008

11/20/08 - MU - Ommaya Reservoir Surgery

Readers of my blog may remember an illustration of an Ommaya Reservoir that I posted (way) back on September 19th. At the time, I jokingly said to Laura, "At least I don't have one of those in my head..." Well, I soon will.

Ommaya Reservoir

I'm scheduled to have an Ommaya Reservoir implanted on 11/25, two days before Thanksgiving. It's actually brain surgery, to be performed by the same neurosurgeon that removed my brain tumor. The Reservoir itself is a small disk with a catheter (tube) that is going to extend through a hole in my skull into a ventricle (CSF-filled space) of my brain.

The Reservoir will be used to administer intrathecal chemotherapy, which is limited to my Cerebrospinal Fluid (CSF) which is in and surrounding your brain and spinal cord. My type of tumor (Medulloblastoma) usually only spreads to the linings of these cavities. Intrathecal chemotherapy should target any loose tumor cells that are in my CSF. Apparently, the CSF flows through your brain, down your spine, back up your spine, and then around your brain - one reason the "port" is at the top of my head.

The Ommaya Reservoir will remain in me unless it gets infected, or otherwise has some failure. It will reside between my skin and my skull. The hospital will shave the area (likely to be near the front of my head above my hairline on the right side) each time they have to access it. A hole will be drilled in my skull to route its catheter through my brain to the ventricle. On that, my nuerosurgeon said something like, "'ll be asleep. Having someone drill through your skull while you're awake can be annoying..." Funny.

I will stay overnight in the hospital, so I should be home 11/26. Hopefully, I'll post an update here not long after that.

I guess the other option to administer intrathecal chemotherapy was a Spinal-Tap like injection as illustrated above. There were two reasons that won't work for me. First, my platelets were still only at 67,00 last week and they would like to see them at 100,000+ to do a tap (remember blood and CSF don't play nice, and platelets control your clotting). Second, the needle is inserted by the doctor's sense of feel, too far and your spinal cord could be contacted, potentially causing a lot of undesirable reactions. So, Ommaya, here I come.


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