Wednesday, November 19, 2008

Surgery is a go!

We drove down to Iowa City today to meet with the Neurointervential Radiologist about Jake's AVM. Jake ended up having a field trip today in Iowa City today, so we ended up meeting him and his teacher down there. It worked out pretty well!

We met with 2 doctors, one being the head of the department (and will perform Jake's surgery.) The head doctor was very optimistic about everything. He said that placement of Jake's birthmark is very optimal for treatment, and cosmetically will be a fairly simple fix. Working with AVM's is this doctor's speciality, so that was encouraging to hear as well.

Jake is scheduled on December 12th at 7:15am for an angiogram and an embolization. He will have to stay overnight for at least 1 night, with the possibility of having to stay over the whole weekend. They are hoping to take care of the whole AVM with the initial embolization, but may require a second embolization that will be done through "direct puncture." During the angiogram, he will have the catheter run up his artery through his leg, and they will be taking constant x-ray pictures to see how the mass is shaped. Then, for the embolization, they will inject glue (which is chemically very similar to Krazy Glue) into the AVM and it will solidify and block the blood flow to the AVM. The procedure, we are told, will last approximately 3-4 hours. He will be under general anesthesia, so he won't feel anything. They will keep him over night that night to observe and follow up with the procedure, and if necessary do the direct puncture embolization on Sunday. Direct puncture would be less invasive, and as the name indicates, involves the glue to be inserted directly into the birthmark via a needle.

The doctor was optimistic that, given time, the embolization will take care of a lot of the mass of Jake's birthmark. He said that we may need to have some excess skin removed eventually, but he should see a big improvement in the weeks and months following the surgery.

Jake, again, was simply amazing during the appointment. He is so grown up and mature - and the doctors and nurse noticed. At one point, when the doctor was telling us about the direct puncture procedure, I leaned over and joked with Jake that if they do that, he might hear a hissing sound from all the air coming out of his birthmark. Jake took the joke from there and said that if they're not careful, he'll go flying around the room like a balloon. Jake took both doctors by surprise so much, that they both stopped mid sentence to laugh at Jake's joke, and tell him what a funny guy he is. The head doctor even said that he was impressed with Jake's sense of humor, and most patients (even adults) really freak out and get scared when they hear about how the procedure is done. It was pretty neat to see him interact and react to such weighty information.

He had to have his blood taken for some lab work for the procedure. He was quite the trooper in getting another needle prick.
We left the hospital feeling optimistic and thankful that Jake will have some relief. This has been weighing on him for quite some time. He's happy to have an end in sight!
Please keep praying, as the bleeding is still an issue until the embolization is done and is successful. He's getting pretty frustrated with having to deal with it. He'll be glad to not have to carry a roll of gauze in his pocket, "Just in case."
I'm sure Michael and I will have a laptop with us at the hospital, and will keep everyone updated as he goes through surgery and recovery. Thanks to everyone for all their prayers for Jake. They are greatly appreciated!


GrGrandpa said...

We too are amazed at Jacob's presence of mind and calmness in dealing with the situation. We are proud of you,Jacob!

Love you,

GrGrandpa and Grandma

aroea said...

He is such an awesome kid. I can totally see his face when he told them his head might go flying around like a balloon. That's so Jake! Also, glad to hear there's an end in sight. Thanks for the update and we'll be praying that everything thing goes better than planned.