In Surgery

A little while ago we walked along side Silas as he was wheeled down to the operating room in his crib. We took the elevator down the surgical floor with the nurses, met with the anesthesiologist and had a few minutes to say our goodbyes to Silas. He will be in surgery for about four hours.

After being intubated and anesthetized, the surgery itself will take between an hour and a half and two hours barring any complications. The surgery is technically called Chiari Decompression Surgery and it is pretty rare -- limited to patients with spina bifida and a symptomatic Chiari II malformation. UCSF is one of the few places where he can have this procedure, and is done regularly here, so we are in good hands. We have already received one progress report from the nurse in the OR saying that Silas is doing great.

His neurosurgeon will place Silas in a prone position and will make a vertical incision in his neck at the base of his head. The surgery will involve removing small portions of Silas's C1 and C2 vertebrae and a small piece of bone from the base of his skull in order to create more space for his compressed cervical spine and cranial nerves which are now under severe pressure and impaired, which is causing his breathing problems. To ensure that the space remains sufficient, his surgeon will also open part of the dura and will place a section of tissue to hold it in place. We expect Silas to return to the intensive care unit with his breathing tube in place as a precaution since he was having serious breathing problems before his surgery. He will also be wearing a large sterile bandage on his head as a precaution, although his scar will be only about an inch long and will mostly be hidden by his hair as he gets older.

Silas's recovery may take several days and his symptoms are expected improve gradually as the extra space created by the decompression allows the damaged cranial nerves to begin to repair themselves. He will be monitored in the intensive care unit over the next few days and will repeat some of his breathing and swallowing tests later this week to measure his improvement. We will likely be in the hospital through the weekend and into next week.

Thanks everyone for your prayers and support. We'll post more news as things progress here at UCSF.