So, What Exactly Went On?
This is hard to get a handle on because we all want to put things in familiar context. As Dr. LA said, "Gamma knife surgery involves no knives and no surgery, but those are the terms people comprehend so that's our reference."
To help people understand the procedure, Cleveland Clinic has developed patient resources, including a Gamma Knife Treatment Guide. This gives a better overview of the procedure I went through than I can, but I can add some personal details about what I encountered. I hope the details will be of interest to you; they're certainly of interest to me!
First off: The head frame is fitted with screws directly against the skull in 4 places, very like installing a glass lampshade on a floor lamp. Small plugs (between 1/16" and 1/8" in size) are cut through the skin for direct contact with bone, but there's no penetration into the bone. The head frame in essence allows the patient to become a part of the table during the procedure. The only bleeding I experienced was at the pin site on the right side of my forehead. Given how head wounds can bleed, no surprise that something flowed at the end of the day!
What's so important about being "part of the table"? The precision involved with this procedure is mind-numbing. It takes longer to map the procedure than it does to perform it, for most patients. In my case, the mapping took 4 hours and the zapping took 2-1/2 hours. As Dr. LA and Dr. Sam C both stated, "We're dealing with the brain, not a toe." I am still blown away by the idea of radiation from 192 sources focused on tissue to sub-millimetric accuracy, but if it can be done why demur? So being "part of the table" allows that precision throughout the procedure, and the computer controls allow the team to start, stop and adjust as needed.
I realized part-way through the procedure that "women of a certain age" have a distinct advantage over men during gamma knife: we've all slept on a headful of curlers at some point in our lives, and from that experience we learned how to balance the skull on an uncomfortable surface while relaxing the neck. I haven't slept on curlers since high school over 40 years ago and I still remembered that trick! (Eat your hearts out, guys!)
Stopping and starting the table at will is an advantage for the patient as well. The cylinder is generously sized, the table is comfortable, and the imaging is quiet - no banging magnets, no buzzing, no disruption. I hadn't expected to feel quite so pampered, actually. A nurse was on call for me at all times. About half-way through the procedure my nose started to itch, so I asked that we stop so I could scratch it. That turned into a trip to the waiting room to visit with Saint H and sister/friend M while I retrieved some saline spray and got more comfortable, a little "walkabout" and stretch, and a trip to the bathroom. When I felt ready, I went back in, got repositioned, and continued.
I've given myself plenty of time this week to recuperate. Of all that happened, the most troublesome is the bruising at the pin sites but that's nearly cleared up, and I've had to take some non-aspirin pain reliever from time to time for slight headaches, but that is it.
Who wouldn't like surgery without cuts, bleeding, pain, or recuperation? I ask you!
To help people understand the procedure, Cleveland Clinic has developed patient resources, including a Gamma Knife Treatment Guide. This gives a better overview of the procedure I went through than I can, but I can add some personal details about what I encountered. I hope the details will be of interest to you; they're certainly of interest to me!
First off: The head frame is fitted with screws directly against the skull in 4 places, very like installing a glass lampshade on a floor lamp. Small plugs (between 1/16" and 1/8" in size) are cut through the skin for direct contact with bone, but there's no penetration into the bone. The head frame in essence allows the patient to become a part of the table during the procedure. The only bleeding I experienced was at the pin site on the right side of my forehead. Given how head wounds can bleed, no surprise that something flowed at the end of the day!
What's so important about being "part of the table"? The precision involved with this procedure is mind-numbing. It takes longer to map the procedure than it does to perform it, for most patients. In my case, the mapping took 4 hours and the zapping took 2-1/2 hours. As Dr. LA and Dr. Sam C both stated, "We're dealing with the brain, not a toe." I am still blown away by the idea of radiation from 192 sources focused on tissue to sub-millimetric accuracy, but if it can be done why demur? So being "part of the table" allows that precision throughout the procedure, and the computer controls allow the team to start, stop and adjust as needed.
I realized part-way through the procedure that "women of a certain age" have a distinct advantage over men during gamma knife: we've all slept on a headful of curlers at some point in our lives, and from that experience we learned how to balance the skull on an uncomfortable surface while relaxing the neck. I haven't slept on curlers since high school over 40 years ago and I still remembered that trick! (Eat your hearts out, guys!)
Stopping and starting the table at will is an advantage for the patient as well. The cylinder is generously sized, the table is comfortable, and the imaging is quiet - no banging magnets, no buzzing, no disruption. I hadn't expected to feel quite so pampered, actually. A nurse was on call for me at all times. About half-way through the procedure my nose started to itch, so I asked that we stop so I could scratch it. That turned into a trip to the waiting room to visit with Saint H and sister/friend M while I retrieved some saline spray and got more comfortable, a little "walkabout" and stretch, and a trip to the bathroom. When I felt ready, I went back in, got repositioned, and continued.
I've given myself plenty of time this week to recuperate. Of all that happened, the most troublesome is the bruising at the pin sites but that's nearly cleared up, and I've had to take some non-aspirin pain reliever from time to time for slight headaches, but that is it.
Who wouldn't like surgery without cuts, bleeding, pain, or recuperation? I ask you!
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