Saturday, May 16, 2009

During Surgery - Kay Quinn's Tweets/KSDK Cover Stroy

Kay Quinn Twittered in the Observation Room next to my surgical room @ Barnes Hospital

Kay Quinn from Channel Five here in St. Louis was there during my surgery - and Twittering the whole time! It was amazing to be able to read the tweets after surgery... which I did two days later. Craig and my family really appreciated the opportunity to get real time information on what was going on - as did my friends and coworkers! It saved Craig a lot of phone calls that day :) Kay is incredible and was very professional.... as well as respectful of my family. The Twittering was part of a Cover Story Channel Five did that can be seen by clicking here. It turned out great! Thank you, Kay! And note to the cranky quy that left a comment on the story -- I DO NOT twitter at work! So there!

Kay Quinn Twitter transcript (Taken from the Barnes Story.... which was taken from the founder of's personal blog)

Good morning from the second floor, West pavilion at Barnes-Jewish Hospital!
I'm in the IMRI, room 217, and Erin is on the operating table.

Everything looks great! I'm going to spend the next few hours sending Twitter messages from the O.R., reporting on Erin Kelley's neurosurgery.

As we get started, let me say that out of respect for Erin and her family, should something unplanned occur, I will stop my Tweets.

Erin has Cushing's disease, which is an endocrine disorder that means her body produces too much cortisol.

These high cortisol levels in the blood can cause a host of unpleasant symptoms, from weight gain to excessive sweating to fertility trouble

Erin's Cushing's disease has been traced to a tiny tumor on her pituitary gland.

She's having that tumor removed this morning. The hope is, the removal of the tumor will reduce or eliminate her symptoms

Erin's been mostly troubled by the excessive weight gain. She also gets sick a lot and is tired too much of the time.

Here's what I'm seeing now: Erin's draped on table, and until just a few seconds ago, her face was exposed.

She has fiducials all over her face. They allow doctors to use an MRI to get a 3-D GPS of her brain.

These little markers allow surgeons to locate her tumor exactly. The tumor is so small, it can't be seen on regular imaging.

Erin's face is covered now. Only her nose exposed. Surgeons will go in through her right nostril, through the spenoid sinus to pituitary.

Using an endoscope, they'll travel through this "tunnel" in the nose and sinus, right to the left side of her pituitary. That's the side making too much cortisol.

The tumor is called a microadenoma.

Sorry...sphenoid is correct spelling of the sinus. I'll have to brush up on my medical terminology. Sorry for the other typos.

Surgeons are now starting to insert the endoscope through the nose to access the pituitary. This process should take 30 mins.

All is well in the OR. The room is dark now. Surgeons are tracking their progress on monitors.
I just spoke with Dr. Ralph Dacey, the neurosurgeon who will remove the tumor. He says all is going well.

He also told me, what makes this operation so different from others of its kind is the MRI machine that is located right in the room.

There are only 7 or 8 hospitals in the country with this kind of MRI capability.

The advantage is that surgeons can ensure they've removed all they need in one operation.
Without this intraoperative MRI, Erin might have had to come back for a second operation if there was any tumor left behind.

Dr. Richard Chole is the otolaryngologist working on acessing the pituitary right now. Still dark in the OR.

Dr. Jim Johnston is the chief resident helping coach me through this.

He says it's dark so surgeons can see the monitors better. It helps him place the endoscope, as they make their way back to the sinus.

No music in the OR. Dr. Dacey says he doesn't like to listen to much music as he works. OK, sometimes he does.

He says the residents usually hook up and i-pod and force him to listen to U2.... Sorry again for the typos.

Dr. Dacey says not a lot of drama in the OR. Nurses and support staff are very professional. Not like TV show ER.

Dr. Dacey tells me the whole operation should take three-and-a-half hours.

Going through the nose is a new approach. Surgeons used to go up under the lip.

Dr. Dacey says this technique means less post-op pain/scars

Pituitary Gland Fact: 1 to 3% of adult population has a pituitary tumor. Very common. Most have no symptoms

Dr. Chole is in the sphenoid sinus now, getting closer to pituitary.

He just took out a piece of bone in the rostrum, which is the outer shell of the sphenoid.

Pituitary Gland Fact: While tumors in the pituitary are common, only a very small number of people will develop Cushing's disease.

Amazing images on the monitor in the OR: we can see images being sent back by the small camera in Erin's sinus.

We can see Dr. Chole removing tissue as he goes deeper into the sinus.

I look very attractive in my scrubs and surgical bonnet. I'll send a photo later. Cell phones don't work in here.

For the squeamish: This is not bloody at all. Very clean looking

I've got a Newschannel Five photographer by my side today. Joe Young is the best in the business. He's been at 5 for 25 years.

We'll shoot the operation and my Tweets and show the story sometime in May.

I'm making this sound easy, but Dr. Chole has to be very precise as he tunnels his way to the pituitary

The carotid arteries run along either side of his "tunnel," so he can't veer off course at all.

We've reached the bone that separates the sinus from the pituitary. Soon, Dr. Dacey will cut a window in that bone to get to the pituitary.

All is well, all is going as planned.

Big thanks to Dr. Jim Johnston. He's my John Madden...providing important medical background.

Barnes-Jewish, thanks for making this possible. This is an incredible opportunity

@kayquinn The tweets are great! Why the formal story delay until May? Are you waiting to add Erin's input post surgery?

I'll turn it into a longer story. Our Cover Stories are three or more minutes, so I'll get extra time to put it together

Surgeons never actually reach the brain, but they're very close. The pituitary is right behind the sinus at the base of the brain

Dr. Chole has done his work. Now Dr. Dacey will take over.

First up, he'll make the window in the bone that's between sinus and pituitary

Then, he'll be able to go into the gland itself

Just to recap if you've just logged on: I'm reporting via Twitter from a Barnes-Jewish Hospital OR Erin Kelley is having a tumor removed from her pituitary gland, a small gland behind the nasal sinus, at the base of the brain

She's hoping the operation will control or eliminate symptoms of her Cushing's disease

Temperature is very cool in here Dr.Dacey is now working at the base of the skull. Very vascular area. Seeing a little more blood, which is normal

Just got an update from Dr. Chole, the otolaryngologist. He says Erin's tissue is more fragile because of her disease

They're going slower than normal because of this. The tissue bleeds more easily, so they're moving cautiously

Dr. Dacey is operating now. He's through the bone and didn't have to drill to get through. This is good. Less traumatic for Erin

Dr. Dacey is at the dura, the covering of the brain that also encompasses the pituitary.
He'll go through that now to gland

Cushing's is named after Harvey Cushing, the father of modern neurosugeron.

He did basic research on role of pituitary, how to treat it

@kayquinn Wow, the detail on the surgery is amazing. Are you in some kind of sterilized area to do the tweets??

@ahawkcollinger I'm not in a sterile area. I'm in a control room with a window into the OR

@ahawkcollinger But I do have scrubs and a surgical bonnet on! Adorable blue color

Hello to Erin's family on the 10th floor. Dr. Chole just came by to tell me where you are. All is well! Hope to catch up with you later

Dr. Dacey is putting a needle into the area where the pituitary is now to make sure it's the gland he's reached and not a blood vessel

Dr. D about to make an incision in the dura to get to the gland

Joe Young took the camera back in the OR to get more shots of the operation. He's also been shooting me in the observation room on Twitter l

lama_3234I wonder what it would be like to be family of @erinmariekelley and watching the tweets of @kayquinn - nervous or relieving?

@llama_3234 Good question! Apparently, they can read our Tweets, but the hospital's system has blocked them from sending messages out.Dr. Chole says they're anxious to send messages out but can't.

Dr. D has opened up the dura and is trying to visualize the pituitary gland
Apparently the gland is an orange-brownish colored gland, shaped like a Hershey's kiss. Very firm. (dr. j's description. love it!)

Dr. D is using a blunt instrument to feel around the pituitary now for any unusual tissue

The hope is that by taking the left side of the pituitary, disease symptoms will go away.

Remaining right side should function normally

Dr. Dacey says he's in the pituitary and can see a milk nodule on the left hand side that he's removed and sent off to pathology

Now, he's going to remove the left portion of the gland This is great news! Dr. D got what he was looking for!

Now waiting for lab to call back with a preliminary report on what that nodule was. Takes five days for the full report on it tho

There has been some bleeding, but Dr. Jim tells me its completely normal. Dr. D's been working around it all, which has taken some time

Not planning to do intraoperative MRI because her pre-op scans were normal

28 year old Erin Kelley, mother and wife, is having the left part of her pituitary removed to alleviate symptoms of her Cushing's

She had a tumor or nodule on it.

The neurosurgeon just removed it and sent it to the lab

All happening on a second-floor operating room at Barnes-Jewish Hospital in St.Louis

Dr. Jim tells me the pituitary sits in a "web of veins" and that's why there can be bleeding during surgery It's very normal.

Also, because of all of the excess cortisol in Erin's blood stream, those veins have become very fragile

A lot of the left side of the gland is out now

Dr. D now looking at the bone fragments Dr. Chole took out. Looking at closing the "window" or hole already!

Left side of the gland completely out. Peeled it off. Tofu-like substance

Now, surgeons will take a little fat pad from the abdomen to also use to seal the hole

Dr. D placing gel foam used to minimize bleeding. This is all part of the process of finishing the operation

I'll be away from the computer for several minutes. Going to grab a quick interview. I'll be back to wrap it all up.

Awesome experience! Erin's surgery is complete! She'll leave any moment for the recovery room
Thanks to all who made this possible: Erin, BJ Hospital, KSDK. It was an incredible experience!

Funny to see all the lights on in the OR. It was dark for 99% of the operation

I'll keep you posted on when you can watch the story on Newschannel 5!

@kayquinn A lot of us "Cushies" are out of area. Will the story be online?

@cushings It will be on-line the day it airs. I'll let you know!

The Night Before Surgery and the Morning of....

Hot, Right?

Pre Surgery MRI - April 26, 2009

I have to admit. The day before this I was a mess. A real mess. Never again will I roll my eyes when someone says they are having an anxiety attack. Now that I have felt it -- wow. Terrible. But on Sunday morning I woke up very peaceful.... and ready to face everything that was to come starting Sunday night with the pre-surgery MRI.

Jrue went to his Dad's house at about 3 - we had to get to Barnes for the pre surgery MRI at 4. The neurologist that was there put these fun little circular things on my forehead before I went into MRI. He explained that they were to map for the surgery. They did the MRI. Note to self - they mean it when they say NO METAL. I had a tiny tiny bit on my hair rubber band. They had to stop the MRI and start over. Woops. I was very uncomfortable with the scan (they scare me now) and it had to be redone after they finished because there was too much movement.

Still not exactly sure what the round things on my head were about. But it was interesting to walk around with them on my face for the rest of the night. Craig and I had a great last night before temporary misery... I will spare everyone the details. lol.

Who shows up late for their Brain Surgery?! and a kiss from the Hubby! - April 27, 2009

Craig and I woke up in the morning at about 6 to arrive at Barnes around 7:30 am to check in. We were pulling together last minute things when Craig's phone rang around 6:45 - apparently we were supposed to BE THERE by 6am and the surgery was supposed to START at 7:30! It is amazing how quickly you can move when you need to. My mom was going to meet us at the house at 7:00 and follow us to the hospital... so I called her and let her know what was up and we were on our way. We were at Barnes around 7:25 and whisked through the registration process and pre-testing (they wanted to get a urinalysis and a few blood tests) I had a UTI that was treated over the weekend that they wanted to check if that was still there. We were upstairs and I was in a gown and on the bed in pre-surgery by 7:45. Doctors came in and introduced themselves... nurses were sticking iv's in me and checking BP... it all went so fast! I was really just worried about saying "I love you" to my mom and sisters that were there before I went back..... Craig went to find them and got them back there on time. Gotta love that man!

It was time to head into surgery (about 8:00) and I got one last kiss from Craig. That is the last thing I remember... and if you ask me - that is not such a bad thing.

I am back! Kind of! And let's start Weaning!

Jrue on the kiddie roller coaster at Spirit Fest

I have the mental energy to get back to this blog! That is improvement if you ask me. Today was a great day.... and a long one. Jrue and Tommy were supposed to have their first baseball games of the season today - but they got rained out for the second week in a row. Lindbergh's Spirit Fest (the public school version of the catholic School Picnic) was today. We went (yeah!) and made it for about 3 hours before everyone had enough. Nonna and Papa (Craig's parents) met us up for lunch, and Bre, Morgan, Maggie and TJ came up for a while. It was so nice to get out for a while. I came home and went into a coma-like state for about an hour and feel much better now.

Have been feeling good off and on lately. It is wierd. Literally half of the day I will feel amazing and the other half it is like the worst flu ever. When the Channel Five story came out it was kind of mortifying how "puffy" my face looked..... so I decided that it would be a good idea to not take my Prednisone the other day. Not a good plan!!!!! It took a day - but for about 24 hours it was the worst kind of awful. There was an hour or so where I thought that we were headed to the hospital. Lesson Learned! Apparently the side effects will just have to be tolerated for now.

One really really fun thing going on right now is sweat. Out of bed for more than an hour I start profusely sweating - it drenches my scalp and drips off my face. A call to my Endo and I found out this was probably a sign of too much Prednisone. She called in 90 (1 mg) tablets and I am going down from 10 mg per day to 8 mg per day as of this morning. So far so good the sweat was not as bad today and the day was really good.... the Spirit Fest might have been pushing it a bit too much... but it was so fun to see the boys on the rides. I used to LOVE the school picnic when we were younger.