scars

If I had a pound for every time somebody has exclaimed; ‘you’ve had brain surgery?  What was that like?’,  I wouldn’t have to work.  Well, maybe I’d have to work a bit – but I could certainly reduce my hours drastically.  Brain surgery has a stigma surrounding it similar to that of cancer; people fear it.  Even though, like cancer, treatment had catapulted in effectiveness and safety over the years, it still holds a dread for many people and when faced with it, it can be all-consuming.  It’s not surprising really, given the fact that the brain controls your entire body.  To have it once is certainly an experience, a story to tell at the pub.  To have it nineteen times as in my case is, I suppose, a little odd.
I thought I’d do a series of short-ish (I can hear the cheers already) posts on what it really feels like to have brain surgery, to have a shunt inside you, to experience overdraining/underdraining and so on, to give an honest picture of what it’s like for those maybe facing it for the first time or who sometimes wonder if they’re the only ones who feel a certain way.   Although every body is different, my experiences over the years and conversations with the many, many shunted folk I have had the pleasure to meet have taught me that actually, our experiences can feel quite similar, both physically and emotionally.  I’ve linked to some pictures of scars and so on which you may not want to look at, so just don’t click on the links if so.   So let’s start with the big one;

Well, I’m not going to lie; it’s not exactly fun.  Given the choice of that and a champagne picnic in the park, I know what I’d choose.  But it also isn’t necessarily all that awful.  In fact, in many cases it can be better than you’d hoped.  A lot of what makes it bad stems from what takes place in our minds and we can, to a degree, control that.  This, I have learned, is the difference between having a horrible experience and an okay one.  Yes, brain surgery can be okay.

Pre-surgery
The days leading up to the surgery itself are important; depending on how ill you are will determine what you’re able to do, obviously, but it’s good to have distractions if you can.  My first ever brain surgery (to install the first shunt), even though it happened thirteen years ago, is crystal clear in my mind to this day.  That’s because I was so damn scared.   My stomach was in knots all the time (this is normal), I lost my appetite (also normal) and wanted to crawl under the bed until it was over (again, normal).  Luckily I was well enough – just – to be driven around in a car so the day before my parents took me for a pub lunch (no alcohol!) to take my mind off it.  It worked.  It was a lovely Spring day and even though the thought of the surgery tomorrow kept looming up at me like a tidal wave, I found myself wanting to and needing to push it to the back of my mind.  So I did and managed a lovely lunch with my family.  Eating is important; keeps your blood sugars steady as well as your blood pressure level and that helps.  It also helps if you can remind yourself of the thousands of people across the world who have brain surgery every single month and who are fine afterwards.  Focusing on the teeny proportion who might be suffer a complication, I found, does not help.  At all.
The morning of the surgery itself I was starving; nil by mouth, obviously!  This doesn’t help the nerves so again, keeping busy is good.  I watched a lot of crap telly that morning.  When I didn’t want to watch telly any more, I read crappy magazines – you know, those ‘chat’ type magazines where people sell their stories of how their breasts ‘exploded’ after surgery and so on.  Some of the stories are so awful (if they are in fact true) that brain surgery suddenly does seem like a champagne picnic in the park.
I did have a complete break-down though, mid-morning.  Suddenly the fear and nerves got the better of me and I bawled like a two year-old, loudly, snottily and unashamedly.  I’d never had a surgery and having seen my dad go through it when I was eleven (he had two brain haemmorhages and a blood clot and very nearly died), I simply wanted to crawl under the bed I’d mentioned earlier.  It didn’t last long though.  Fifteen minutes later and I felt a lot better.   Cry if you need to and don’t worry what others think; also talk to your surgeon/anaesthetist about your fears.  He/she will have heard it all before and be very kind and give you a hanky, the way mine did.

The anaesthetic room
Funnily enough, this scared me probably more than the thought of the actual surgery.  I dreaded it, not having had an anaesthetic before.  I couldn’t see how I could be wide awake one minute and then something would force me to go to sleep the next.  Fast foward thirteen years and the anaesthetic is my favourite part of any hospital stay.  Yes, I’m being serious!  I actually look forward to it!  In the National Hospital, they have special anaesthetic rooms next to the operating theatres themselves, which I prefer.

Operating theatres I find a bit large and scary.  They’re okay; but I prefer the little cosy rooms next to them.  It’s always the same; you lie on your trolley, blanket over you whilst the anaesthetic team take your blood pressure, check your heart rate by sticking those little sticker things you see on ‘Casualty’ over your chest, ask you lots of questions about who you are (they don’t want to knock out the wrong person) and then chat to you about all sorts to relax you and put you at ease.  They’ll put in a cannula if you don’t already have one; that’s a very fine tube in the back of your hand so they can put the medicines in there without having to keep on injecting you.  It’s a pin-prick, really not that bad.  Then the fun starts!  First they (sometimes, not always) give me what they call a ‘painkiller’ which will help relax me.  This might also be given to you as a ‘pre-med’ on the ward.  God, it’s fun.  Seriously good stuff.  It’s like having just had the BEST night at the pub, ev-ah.  I have sometimes started singing after they’ve given me this.  I kid you not.  I sing loudly, too, like I’m hoping they’ll all join in.  Sometimes they do; it depends on who’s in there with you.  Having an anaesthetic truly feels like being very drunk; dizziness, sleepiness, a strange urge to giggle…sometimes you get pins and needles in your face.  None of this is unpleasant, I promise.  A bit strange the first time, yes…but not unpleasant.  I think it’s fab.  The really, really strange thing is ‘waking up’.  I put ‘waking up’ in inverted commas because most of the time I’m not even aware that I’ve gone to sleep and then woken up later.  I usually think I’m still in the anaesthetic room and the staff have just changed over.  It’s that quick and that seamless.  Seriously, you don’t even dream!

The Recovery Room
  This is usually where you’ll wake up.  After nineteen surgeries, I am yet to wake up anywhere other than here.  These rooms are much bigger than anaesthetic rooms but are not as cosy as hospital wards.

To be honest, waking up is not my favourite bit.  Once I’m properly awake, I usually feel a bit uneasy because I don’t know what’s been done exactly during the surgery (sometimes when they ‘get in there’ they have to change their course of action) and I feel all groggy and confused.  My heart rate tends to race and sets all the alarms off but it’s never dangerous; it’s just what my body does after anaesthetic.  As I said before, every body is different so you may well not experience this.  You will shiver because the operating theatres are kept very cool indeed and you’ll have been lying in there for hours.  The nice thing is having the heated blankets put on you, which they have lots of..very toasty!  Your throat will probably be sore from the breathing tube but you should be able to have sips of a drink.  At the National, they always let us have a cup of tea (through a straw) and I swear, it’s The. Best. Cup. Of. Tea. In. The. World.   Nothing ever tastes as good!  Usually I’m pumped full of morphine for the pain so I can still feel pretty woozy from that alone.  As you become more aware as the anaesthetic wears off, you may become aware also of pain and discomfort.  Don’t be a warrior; take the drugs!   After a few hours in the recovery room, once they’re happy with how you are, they release you for good behaviour.  Back to the ward you go.

The first few days
The first day itself you’ll probably feel sleepy but okay.  They pump you so full of painkillers during the surgery itself that it’s relatively easy to keep on top of the pain.  Back on the ward they’ll check your blood pressure, pulse, heart rate and so on every couple of hours.  You can EAT!  Hurrah!  But don’t be surprised if you feel quite nauseous; lots of morphine can do this.  I tend to vomit for hours if I have too much so I try and limit it.  Morphine can also make going to the loo a bit weird; even if you have a full bladder, it seems to not want to come out.  Again, all this is normal but it can be odd the first time!  The physiotherapists or nurses usually try and get you up and about at some point on the first day unless you’ve had your surgery late or if you’re really floored afterwards.  Don’t do what I tend to do and try and go for a walk on your own after five minutes.  I blame the morphine again!  It can make you feel invincible.  I have got into trouble for leaving the ward to go for a walk as soon as I’m back.  Wait until they get you to do it with their help, unless you want to end up in the ‘naughty spot’; right next to the nurses station so they can keep a close eye on you!
The next few days you should (hopefully) start to feel bored with being in hospital.  I say ‘hopefully’ because this is usually a good indicator that you’re well enough to go home soon.  The stitches or staples will probably itch a bit but as long as they’re not oozing or looking infected, that’s fine.  Depending on what type of brain surgery you’ve had, you’ll probably feel some strange and not altogether welcome sensations in your head.  With a new shunt, I feel very tight and stretched over where the new shunt tubing is.  With my first one, I heard ‘gurgling’ in my head which was rather alarming.  Turned out it was just the fluid passing through the shunt valve.  Now the shunts I have ‘buzz’ when the valve works.  Anything that alarms you, tell your surgeon.  Chances are, he/she has heard it all a hundred times before and can reassure you.

The next few weeks
I covered a few points in my post about recovery: click here to read it.  I think the most important thing post-brain surgery is to remember that you’ve had a whopping great operation.  Your brain is going to be swollen and bruised from having someone rummage around inside it.   The anaesthetic itself is a powerful cocktail of drugs and that’s just for starters.  So you’re bound to feel wiped out.  Recovery can be hard; everything hurts, the scars itch like mad, you’re left with half a head of hair and resemble Frankenstein.  I have added a photo of me looking absolutely rubbish post-op to reassure those who feel the same way that you’re not alone.  I’ve also added three photos of scars immediately post-op – the other one’s here – and one taken a couple of weeks later.   Scars like this can look a bit shocking at first.  But you should be proud of every scar; they’re proof that you’ve been through a lot and come through the other side.  Yay you!
As the weeks go on, you’ll feel stronger but don’t push yourself.  It’s very easy to overdo things without realising.  Rest when you need to, don’t rush back to your job too early (I once returned after ten days; stupid, stupid me) and hey, enjoy some R&R!!  You deserve it!  Heck, you’ve just had brain surgery!