The Ultimate Dilemma...

So this past week I have been presented with the ultimate dilemma. Last Tuesday, I met with a Neurosurgeon who does surgeries at both Valley and Columbia. He was originally not supportive of doing my Chiari surgery because he felt there were other possible causes for my symptoms. This was one of the doctors who consulted on my case while I was in the hospital. When I walked in to his office I was ready for a serious discussion. I was fed up with meeting with doctors who said that my issue was not related to the herniation in my brain and yet could not give me any answers or solutions.

When I walked into his office we discussed the fact that since my spinal tap during my last hospitalization my symptoms had worsened quite considerably. This was a concern when they decided to do the spinal tap but they felt the risk was worth it in order to rule out Multiple Sclerosis completely. M.S. was ruled out but I ended up with a Spinal leak and headache for nearly 2 weeks. Once that went away my Chiari symptoms had worsened keeping me from returning to work.

After this he went over all of my MRI's old and new. He measured my herniation on my recent MRI and said it was more than 5mm. This is an increase from the original one last February which was 3 mm. The other thing that was shown is that there is a blockage of CSF flow. It is not completely blocked but is hindered. These MRI's are done lying down so there is a possibility that this is worse when upright and gravity has its effect. He then explained to me how the surgery that they use to fix Chiari is done. The next thing I know he turns to me and says, "I really want to help you! I can see that we are at the end of our options and I would like to do the surgery for you!"

Wow, I was not expecting this! I had had so many doctors who had dismissed me, I was hitting the end of my rope. I had gone from running marathons, working overtime, spending time with friends and leading a busy life to now I work by the skin of my teeth and forget my love of running...that is impossible. I have gone from a very active person to an inactive person that sometimes I don't recognize. I have taken up knitting and reading. None of these things can replace my active lifestyle or my love for activity. One day I dream of returning to those things I love but in the mean time I must focus on getting better.

Thursday I went to The Chiari Institute for a follow-up visit. They are specialists in this condition. They treat thousands of patients with the same condition that I have. He told me that we were at the point where surgery was the next step. Now starts the ultimate dilemma!

I now have 2 neurosurgeons willing to do the surgery that gives me the opportunity to get better. It is not a 100% guarantee. It may fix all of it, or just some of it. But we know that nothing else has worked and we are at the last option.

Neurosurgeon #1:

Columbia Presbyterian/Valley hospital surgeon

Director of Columbia's North Jersey office

only does a handful of this particular surgery a year

Insurance covers same as the other Neurosurgeon but because of my employment at Valley it would be waved.

Opens up the area and makes more space to release pressure but leaves the herniated cerebellar tonsils as they are

Neurosurgeon #2

Surgeon at The Chiari Institute

Does 100's of these surgeries a year and more than 3000 total

uses a special color Doppler in surgery

Opens up the area and makes more space to release pressure. Has a system for determining the need for deciding whether to leave the tonsils or to move them back where they are supposed to be.

Would have to cover what insurance does not cover.

Negative: has lawsuit in process but is not related to the surgery I am having. Was able to openly discuss this with them. they have been very diligent in their evaluation of me and have not been pushy towards surgery at all.

When I speak to people at the hospital I work at they say that I should make a decision not based on money but based on the one who does more of this particular surgery. Initially this was my mindset. However, now that I am at the decision point that is not so easy to do.

This is one of the most difficult decisions I think I have been faced with. Normally I am a decision maker but in this one I find myself at a loss for words.

This experience is drawing me closer to God rather than further. It is putting me in a place where I am fully dependent on Him...the best place...the place where He can mold me and shape me. Some people ask why? I know why. No I don't know exactly why I must go through this but I do know the broad reason. God uses these things to mold us and shape us...to make us into a better person. His word says that "He works all things together for good for those who love Him." Of course I don't want to go through this but if I can grow closer to my God through this and learn to love others better, become a stronger person then it will all be worth it. If I choose to let this learning opportunity slide then it will have all been in vain.

A few verses that have been of comfort to me lately:

If God is for us, who can be against us? He who did not spare His own Son, but gave Him up for us all--how will He not also, along with Him, graciously give us all things?...Christ Jesus who died--more than that, who was raised to life--is at the right hand of God and is also interceding (praying) for us. Who shall separate us from the love of Christ? Shall trouble or hardship or persecution or famine or nakedness or danger or sword?...In all these things we are more than conquerors through Him who loved us. For I am convinced that neither death nor life, neither angels nor demons, neither the present nor the future, nor any powers, neither height nor depth, nor anything else in all creation, will be able to separate us from the love of God that is in Christ Jesus. Romans 8:31-32,34-35,37-39

Psalm 31:

In you, LORD, I have taken refuge; let me never be put to shame; deliver me in your righteousness. Turn your ear to me, come quickly to my rescue; be my rock of refuge, a strong fortress to save me. Since you are my rock and my fortress, for the sake of your name lead and guide me. Keep me free from the trap that is set for me, for you are my refuge. Into your hands I commit my spirit; deliver me, LORD, my faithful God...

Be merciful to me, LORD, for I am in distress; my eyes grow weak with sorrow, my soul and body with grief. My life is consumed by anguish and my years by groaning; my strength fails because of my affliction, and my bones grow weak...But I trust in you, LORD; I say, “You are my God.” My times are in your hands;...Let your face shine on your servant; save me in your unfailing love...

How abundant are the good things that you have stored up for those who fear you, that you bestow in the sight of all, on those who take refuge in you. In the shelter of your presence you hide them from all human intrigues; you keep them safe in your dwelling from accusing tongues.

Praise be to the LORD, for he showed me the wonders of his love when I was in a city under siege. In my alarm I said, “I am cut off from your sight!” Yet you heard my cry for mercy when I called to you for help.

Love the LORD, all his faithful people! The LORD preserves those who are true to Him, but the proud he pays back in full. Be strong and take heart, all you who hope in the LORD.