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Pre-Op Studies

by on December 29, 2009

With a positive attitude and a bit of pre-medication for the long drive, Satomi and I returned to the City of Hope.  It’s too bad I couldn’t take advantage of the pre-medication option-that drive is a pain in the booty.

The visit went quite well. 

We already knew where to park to minimize Sat’s walking-remember that walking is more comfortable than sitting so we try not to use wheelchairs.  Our wait was also minimal since I had verified on my previous visit that everyone was on the same page.

We started with a simple chest X-ray from the front and the side.  According to the Tech, it was primarily for the Anesthesiologist to verify that Sat’s chest was clear.

Then it got interesting.

We met Dr. Chen and entered their Fluoroscope room.  Here’s a stock photo of a Fluoroscope.

A fluoroscope is basically a complicated X-ray.  Instead of a still picture it takes real-time moving pictures.  Take a look here for more info:

As you can see from the photo, the table tilts completely vertical.  It made loading and removing Satomi from the machine much easier.  All she had to do was step onto the ledge and hold on.

The goal of this scan was to verify which vertebrae were going to receive the cement.  Before our visit, the doctor had preliminarily planned to remedy T8, T10, and T12.  Even to the untrained eye, the damage to these vertebrae can be seen in the MRI.

During Satomi’s exam under the fluoroscope, it was determined that T12, L1, and L2 were more painful and should be the focus of the initial operation.  Other damaged vertebrae could be fixed in a separate and future procedure.

Surprisingly, the procedure is commonly done on an outpatient basis.  Given Satomi’s other ailments, the doctors are planning to perform the procedure under a general anesthetic which will likely require an overnight stay.

We discussed the specific type of Vertebroplasty that was to be used.  The doctor recommended the standard procedure (without any balloons or RF devices) but utilizing the most viscous cement available.  Apparently, Satomi’s vertebrae are fractured around their perimeter and leakage could occur if a thinner cement is used.

Dr. Chen also arranged an EKG and additional blood work in anticipation of the procedure.

The Vertebroplasty procedure was first performed in the mid-80’s but hadn’t become more commonplace until the late-90’s.  It’s popularity continues to grow.  Some nationwide estimates indicate a growth from about 3,200 per year to over 6,500 procedures a year over these past 6 years.

According to Dr. Chen and several online sources state that the risks of additional pain, spine/nerve compression, and cement leakage are typically 3% to 5%.  In Satomi’s case, her fractures are serious so the risks are elevated; the doctor estimated it at 10%.  If any of these problems were to occur, a small percentage of effected patients could suffer serious complications (pulmonary embolism, paralysis, etc.).  Overall, the typical risk of serious complication is less than 1% or about 2% in Satomi’s case (I’m taking the liberty of doing some math).

All-in-all, that sounds pretty good to us.  Maybe I shouldn’t be so optimistic given our recent streak of crappy luck.  But hey, it’s a new year and things just have to get better sometime, right?  I sure hope so.

The procedure is scheduled for next Wednesday January 6th at 9:00 am.  Cross your fingers!!

From → Medical Update

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