Monday, May 19, 2008

The Official Word

We've just arrived home from the doctor's office and we think, at least now, that we've received some encouraging reports. So first of all, thank you for your prayers. Let me break it down.

Dr. Comair came in and was his normal quiet, comforting, and attentive self. He asked a bunch of questions about the exact nature and location of Liza's headache pain. He then went on to explain that this type of headache was in no way related directly to the Chiari - or now, lack thereof. A Chiari-type headache comes on strong and fast, usually when an individual is lifting something or straining in some way. It then dissipates rather slowly. Liza's headache is more pressure-related, and manifests itself constantly behind her eyes and on the top of her head. Dr. Comair was certain that there was some other cause.

As the conversation continued, two types of headaches were discussed: tension headaches and vascular headaches. It is Dr. Comair's opinion that Liza is suffering through a cycle of the two types, both of which can cause pain in the sufferer for an extended period of time - Liza's headache is now almost 6 weeks old.

He then explained how the vascular and tension headaches play off of each other and repeat in a cycle - likely beginning with the extra tension Liza experienced around the several Easter dancing performances in which she participated. This tension headache led to a vascular headache which likely manifests itself in pressure-style pain.

He then took us in his office and showed us the extensive MRI images from before and after the surgery. The difference was noticeable even to our untrained eye. I think he was quite proud of his work. He also explained away other potential causes that we feared, like a leak in the incision site of cerebral spinal fluid. He actually almost chuckled at this serious question and assured us that there was a zero percent chance of a leak. He showed us on the MRI where the leak would be easily detected. That was very reassuring.

One final cause, which combined with the other headaches, began to make perfect sense. He also showed us in the MRI images how the cerebral portion of Liza's spine is also TOO straight. She asked if it was because, as a dancer, she was trained to straighten her spine. He agreed that might be true, but more likely a trained dancer that is highly aware of their body would only slightly straighten their spine beyond the NORMAL curvature that is expected. The spine normally curves three times, slightly in at the top, slightly out in the middle, and then in again near the base. This curve actually supports the weight of the head and shoulders. Without it we would all be in severe pain when we stood or sat upright. Liza's neck is apparently too straight, which is a sign that her muscles are still very much in the healing process and are "spasming" quite severely.

His prognosis: go back and see the neurologists that we saw a few times before meeting Dr. Comair and he will prescribe some medication that will help relax the muscles of the neck and another to help break the cycle of tension/vascular headaches. This will hopefully bring some relief to Liza's pain and help her neck muscles continue to heal.

And that's about it. We are encouraged by the MRI images and that there seems to be no negative results from the surgery itself, other than the continuing recovery steps, which are both necessary and difficult. Now we are going to try to make yet more appointments to bring more resolution to Liza's struggle. Thanks again for all of your concern, prayers, and thoughts. Continue to pray that she would be able to rest more - which is a big key, sleep better, and that our wonderful children would cooperate which this plan. Many blessings.

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