Craniotomy It Is

We’re doing the craniotomy, which is a procedure similar to the way you cut out the top of a pumpkin to carve it. Except on Teague’s head.

Originally I was pretty dead-set on the needle biopsy because please, let’s not mess with this kid any more than we have to. But we met again yesterday with Dr. Cheshier, and while this growth is small enough to be removed with a needle, it’s more complete if he takes a margin.

We’re all very sure that whatever this thing is, it's benign (everyone except Quinn, that is—he’s already 10 miles down the cancer road in his mind, living in all the stress that brings). But benign things can regrow if you leave some behind, and we don’t want to ever have to do this again.

So here it is. Tiny, little troublemaker. Image makes it look like it's on the left, but they tell us MRIs are that way, and it's on the right. 

The procedure will involve an incision of several inches, most likely along Teague’s hairline just above his temple. Dr. Cheshier will retract the flesh, saw out a patch of skull, then take out a cube of brain tissue where this growth is. He tore off a piece of measuring tape to show us the length of what he’ll take out, but said to imagine it like the end of a Slim Jim for full dimensions. To a surgeon, it’s small, but to a mom, it looks huge. Because we’re talking about a piece of my child’s brain.

 The size of the chunk to be removed. Kind of horrifying. This is also about the depth from the outside of Teague's head to where the growth is, roughly 2 cm. 

Dr. Cheshier will then put the piece of skull back and secure it with pieces of titanium. I asked if we have to have the plates because really? Plates in his head? He said yes. When Teague was two, his skull was soft and was still growing and forming new bone, so they just sutured the piece of skull back in place. It’s different now. If the doc doesn’t put the plates on, the bone won’t stay still enough to heal, and eventually an indentation will form. So titanium plates it is.

Teague will spend 8 – 12 hours in ICU so they can watch for bleeding. Brain bleeds are rare, but they happen. Because you can't tie off vessels in the brain, they have to cauterize, which causes little scabs that can loosen and bleed. That only happens in about 5% of patients, and it’s within the first few hours if it’s going to happen. Teague will stay a night or two on the floor, and they’ll do an MRI before we leave the hospital to double-check for bleeding.

Dr. Cheshier explained that while this area of the brain does do lots of things, the info is repeated in other places, kind of like having cloud backup. So any gaps should be filled. He expects Teague to be unaffected by the resection. Prayers for that to be the case.

Pathology will come back within a week. They won’t do an immediate frozen sample on this one because the lesion is so small that they’ll need the whole thing for pathology. If it comes back as anything more than a non-cancerous, stupid nothing, everyone but Quinn will be surprised.

I keep mom-guilting that we should have done Teague’s MRI earlier in the summer. Not like we didn’t have things going on, like a missionary coming home and moving into a new house. And we had honestly expected to just go up there that one day, check everything, and come home and forget about it. Now we’re headed back to the land of brain surgery with regular follow-up MRIs.

I’m not thrilled about Teague having surgery right as he starts junior high. He’ll probably miss a good week of school, and he’ll go back with a visible, healing incision. New school, new town, and this. Bleh. But he doesn’t seem too bothered about it. This kid has always been so much better than I am.