Message From The Editor:  Thoughts On Surgery, In Memory of George DiClemente...

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As I reported in last month's issue, on March 16th a live Chiari surgery was broadcast over the internet.  In case you missed it, you can still view it by visiting:

www.or-live.com

You will need to go to the archives.  You can look it up by date (3/16).

I wasn't sure how I was going to respond to seeing the surgery (having gone through the surgery myself), especially since the patient was a child, but I found it to be very informative and worthwhile.  As I watched  Dr. Fletcher work (a neurologist answered emailed questions from viewers), I was struck by a couple of things:

1.  Chiari decompression surgery is incredibly invasive.  Somehow seeing it happen brought this home.  I have written numerous times about how invasive it is and felt that way after my surgery, but the visual is very powerful.  Seeing the muscles cut, the dura opened, and seeing the way the surgeon poked around inside made me realize that patients should try to brace themselves for how traumatic this can be and what their recovery might entail.

2.  Several neurosurgeons have told me that decompression surgery is technically simple.  I never quite knew what they meant, isn't it brain surgery after all?  Isn't the failure rate between 15%-20%?  After seeing what is involved, I think I understand what they mean.  I'm not sure what I expected, but given a neurosurgeon's education and training, I can see how the actual act of the surgery can seem simple.  It is after all fairly straightforward.  I think this is good news for Chiari patients.  While right now picking the right surgeon seems to be very important, with enough research to answer the questions regarding what techniques to use, picking the right surgeon may become less important in the future.

3. I was really surprised by how much the cerebellar tonsils pulsed (with the heartbeat).  I knew they did, yet somehow I didn't realize how much.  This was a sedated child lying down.  I imagined what happens in an adult running or straining.  It seems obvious how if the dura is tight or if the tonsils are pressing on other tissue bad things will happen, especially during coughing, exercise, or straining.

I'm really interested to hear what other people thought about seeing the surgery.  Drop me a line and let me know at editor@chiari-syringo-news.org

On a separate and more serious note, George DiClemente from Matins Ferry, Ohio passed away on March 18th at the age of 76.  The DiClemente family asked that memorial contributions be made to this Foundation.  George's many friends and family responded by generously donating close to $1,000.

I want to extend my personal condolences to the DiClemente family and thank them for thinking of others in their time of grief.

-- Rick Labuda

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