Miss Diagnosis: One Week To Go

Thursday, July 9, 2009

One Week To Go

Dr. F was supposed to call Tuesday night; they rescheduled to Wednesday night between 5:00 and 7:00. I waited till 10:00 and the went to bed after sending their office an email. This morning there is a response saying he is sorry and will call this morning around 8:00. This should be a quick, easy call, I'm not expecting any problems!
Alex has her first lesson driving with an instructor today. She got her permit about 2 weeks ago, but in California it isn't valid until you drive with an instructor. Brian took her out twice and I took her once, despite it being illegal. It seems pretty dumb to me to put a 15 year old behind the wheel for the first time in a neighbor hood full of people, cars, and traffic. Brian found an area where development of a neighborhood was halted by the economy- roads with no people- a ghost neighborhood! It will take 6 months to get her license, 5 lessons with an instructor and 50 hours behind the wheel with one of us. With surgery and recovery I imagine it will take more than the 6 months.

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Transphenoidal Pituitary Surgery- From the UCSF web site

What happens during surgery?
The surgical removal of the pituitary adenoma is performed by a technique called a transsphenoidal operation. The word 'transsphenoidal' describes the path the surgeon follows to reach the pituitary gland. The word comes from 'trans', meaning 'to cross or pass through', and 'sphenoid', the name of the cavity (the sphenoid sinus) that is passed through to reach the pituitary gland. Newer techniques and improvements in technology now allow removal of these tumors without the need for an incision under the lip or within the nostril. The surgeon begins the approach by entering through the nostril on one side. The surgeon uses a brilliant fiber optic light to illuminate the internal anatomy, a microscope to magnify the area of surgery to 12 times the actual size, and very tiny microsurgical instruments especially designed for this particular operation. The surgeon guides the surgical instrument into the nasal cavity and an opening is made in the sphenoid bone. The sphenoid sinus is entered, and then an opening is made in the wall of the sella turcica to expose the pituitary gland. The adenoma can be readily distinguished from the normal pituitary gland tissue and is removed without removing the normal gland. After the surgeon removes all the tumor tissue, the small cavity that is left is treated with alcohol to destroy any tumor cells that may remain. This cavity is then sealed, sometimes with a piece of fat that the surgeon removes from the patient's abdomen. The surgeon then applies a biological 'glue' that helps seal the pituitary area from the nose and promotes natural healing. No nasal packs are used with this approach.