Is it normal for a concavity / depression / dent to form where the bone was removed?

[Lidiaggl]

I had my decompression surgery about two months ago, and I have been noticing that there is a noticeable indent where the bone reduction was done.  I have been thinking it was getting deeper, and today my PT agreed.  Overall, I feel better than before the surgery, and my recovery is going about like I was told to expect.  However, I am still having some sharp pains and headaches centered right where the 'hole' is, and like some other people have posted, I can't lay down with the back of my head on a pillow.  I read the following post on here from 2011, which did not get an answer - it is similar to my situation:

"strawberry22 - Hi.. I am about 9 months post op.  I woke up last night with this intense pain right where the incision is.  It is usually sunk in pretty good.  But my husband and I feel it is even more sunk in.  In know this sounds weird.  But we are wondering if it us something to worry about or not? - Jun 26, 2011"

Like strawberry22, I am wondering if this is normal.  It was not mentioned by my doctor, and I don't find any other references to it on this forum or others.

[selmaS]

  Hi CW...I have a chart in my profile pages...in pictures....and I do explain which ones I was told to do....

http://www.medhelp.org/user_photos/show/171420?personal_page_id=197028&photo_collection_id=1369

I really believe doing these (which I still do) have helped me prevent the fusion surgery this long/far....and I pray it continues that way.

[ChiariWolf]

Thank You. :-)

[ChiariWolf]

selmaS - Tell me more about the exercises? I've never heard of them. But then it was right after my surgery that Dr Di had his own health issues and left the clinic.

As for the indentation- my surgery was endo but yes I have a huge indentation below the area. It shrank some after they put in the surgical mesh to support the area but there is still a good finger deep indentation

CW

[selmaS]

  Look at side effects for hydrocodone can be gall bladder issues....not sure how long you have to take it to have an issue...but it could be something to ask your DR about.....

[Lidiaggl]

Just got started at my new job and I had to call in sick with a sever neck pain, numbness on my right arm headache and nausea again.  I was so excited
and did not want to miss work.  Just want to cry.  

[selmaS]

  Just as I hit Post I thought about other possibilities...on the GB issue...were you on any med for a long time? Some meds can affect the GB.....

[Lidiaggl]

I was on muscle pain medications more then regular pain med.  Cyclobenzaprine for muscles and Hydrocodone for pain, but hardly used it did not like how it made me fee.  I settled for tylenol

[selmaS]

  OMG !....that was so unexpected huh?

I am not sure it is related  to Chiari....you may want to look into your families medical history to see if that is a common thread there.....

Sending prayers on that mass...keep us posted and rest up from your GB surgery.

[selmaS]

  You had your surgery ...back in April?.....It is not uncommon to have tender points and even pain in the area of the surgery from time to time.....sometimes it can flare up due to weather conditions and other times depending on our activity.

[Lidiaggl]

Well so far so good with my head.  No aches and pains, but for some reason I had to get my gallbladder out this past week.  I guess I was having some major problems that I did not experience, but they xray had three doctors concern so out it went.  Now they found a mass in my liver so a CT scan is scheduled for December.  They want to check from when they first noticed the mass to when my next CT scan is if it is growing.  So how is that connected to Chiari?  I was told that it can affect other parts of my body.  Really?

[selmaS]

  You did say that is what it felt like....with Chiari it can also distort a typical cold....as we have both symptoms together...

Hope you get over the cold soon.

[Lidiaggl]

ok need advice.  This morning woke up with discomfort in the top area of where they took my skull out.  Also the usual neckache which causes the headache.  What could be causing the slight pain to the tip of the skull where to remove the bone?  I hope I am making sense.

[selmaS]

  It is hard to say about individual symptoms as we all can have a different set of them.....only your Dr can give a full explanation of what is going on....

Breathing issues should be brought to your Drs attention ASAP !

[Lidiaggl]

I think I solved one of my head issues.  I have a massive head cold.

[selmaS]

  A metallic taste can indicate a CSF leak....let your Dr know about that and the other symptoms you are having.

Do you have a copy of the MRI?

[Lidiaggl]

What does it mean when I have a feeling of a head cold starting from my head and heading towards my nose and spreading?   But it is not a cold.  I have the feeling of having just jumped into the pool burning sensation up my nose and some kind of metal smell too.

[Lidiaggl]

I forgot to add.  I went to the ER a couple of days ago because of pressure in my chest that made it feel like I could not get enough air, but I was so not that scary.  Now that I am home my daugther noticed my skin under my eyes the blood vessels are popped.  Not sure if it is related or not.

[selmaS]

  I know daily chores need to be done....but not by you.....

In re-reading your post you stated you had the minimally invasive decompression....sometimes that procedure has short lived benefits and some have to have another surgery and the 2nd is the more invasive procedure where they open the dura.

Do you have a metallic taste?

[Lidiaggl]

Yes I have a metallic taste.  A few weeks ago I went back and had an MRI.  They said everything looks good and their is no signs of problems from the Chiari.  It just seems like the physical problem has been fixed, but all the symptoms are still there.

[selmaS]

  Do you have a major change in weather...rain or a drop in barometric pressure...I tend to have bad days with the changes in not only the weather but seasonal changes as well....so always look to the weather....if it is not changing then look to your previous days activities.

Take the day to allow your body to regroup and heal....relax.

[Lidiaggl]

People are constantly telling me "hey you had major surgery.  You need to take some time to rest"  Well then who is cooking the dinner, laundry, dusting, moping, sweeping, mowing, washing cars.  When I do something as light as clean the refrigerator I am hurting the next day.  Last night I went to bed and got such a sever pain around the area were they removed a piece of my skull.  If I turned my head around to try to get comfortable the pain would increase.  My taste buds suddenly did not want to work right.  I had garlic bread that my son made and oh was it good.  After they all went to bed except my husband and I  I took another piece of garlic bread and oh it tasted awful.  I tried something else and it was the same.  Now my nose is giving me the feeling I got water up my nose.  Just awful.  I am supposed to be getting better not developing other problems.  Sorry just frustrated that this issue hasn't totally gone away.

[selmaS]

  I have IBS and just b4 taking the gabapentin I had gotten it under control and asked if it would affect it....I was told it would not.....BUT it did....and it took a year to get it back on some kind of regular routine again....ugh....

I also did not see any other effects of the med being it did noting for the symptoms I was having at the time.....

[Lidiaggl]

Ugh! Feeling terrible today. Sever headache, neck pain, shoulder numb.  

[Lidiaggl]

I never was told how long to take Garbepentin,  I assume until I do not feel any of the weird nerve feelings.  What side effects did you develop with this medication?  I wonder what I am starting to develop.  I feel I am snapping a bit more then I should to my family.   I still feel the nerve acting weird that hasn't changed.

[selmaS]

  How long are you on the gabapentin? I was on it and it didn't help my symptoms and caused some side effects.....we are all so different as to what may help and what does not.....

The grinding could be some of the bone due to the surgical changes made but it may also be the muscles if they are tight.

Well it is bcuz they only give so much time, after you use the time they drop you to find someone to work where you may not be able to.....I knew I was not going to go back to that job as I could not work the hrs they expected....I was doing 70 plus hrs a week...way too much regardless if I was sitting or not....

[Lidiaggl]

The medication they put me on is called Gabapentin.  Do you know if it is normal to hear grinding noises from the back of the head more towards the neck.  I wonder if it is coming from the place where they made a larger hole and took out the atlas.  I am just having a hard time understanding why would one drop a person because of the surgery they had no choice, but to have it done.

[selmaS]

  Glad to hear you will have another MRI.....
What meds are you on?

Sorry about the job.....I lost mine too ...this condition is not one you can be relied on to show up when needed.....I used to be HR, and I would not hire me.....not now anymore...lol....I am trying to work from home....not there yet but checking into different ideas.

[selmaS]

  Vomiting like that can indicate a CSF leak...do push for answers....good luck and let us know how this works out for you.

[Lidiaggl]

The Dr requested for another MRI this time with contrast and increased my dosage so now I am in la la land and not getting anything done.  I just was told from Worksource who was going to help me with job hunting well the dropped me from the program.  Because I was not able to fulfill the visits for training.  Because of this passed week I could not attend. Because I was ill and not allowed to drive.

[selmaS]

  If it is anything I have learned having this condition is we can't help but develop patience with time as we are always waiting for the next phase or answer.....

I am glad you saw the Dr and they feel it is just the healing process.

Around 3 months post op many do have a return of symptoms as this is the nerves healing and sometimes they (the nerves) are over stimulated and can cause a bit of havoc.

Hang in there and keep us posted on your progress.

[Lidiaggl]

Well I am heading back to the Swedish hospital to see the Dr.  Started dealing with the same symptoms again.  I so do not want to have another surgery.  This episode was so bad I threw up so hard I lost my voice  and had sever shakes.  I keep getting told I need a massage, but my insurance will not cover it.

[Lidiaggl]

I had my appointment date messed up - it was today.  Even my Neurologist was confused about why the NS staff had me follow up with her rather than returning to them.  That is how it goes when you go out-of-town for surgery, I guess.  She seems to feel that my symptoms are all explained as normal stages of healing, and that I can expect some of these ups and downs.  Also thinks I should give the Gabapentin a few weeks to take effect.  If it doesn't do much, maybe increase the dose and wait another month.  I guess sometimes I expect modern medicine to just fix things right now.  But when I'm in pain, I am not patient.

[selmaS]

  I am  glad that is working for you.

And I know how much we want to "get back to a normal life" but we do need to take it very slowly,,,,I pray you continue to see improvements.

[selmaS]

  So you had the less invasive decompression and the dura was not opened, but there was a nick in the dura which was repaired via one stitch...do I have that correct?

I was on Gabapentin and the only thing it did was trigger my IBS to flare...I hope you have better results with it.

With scarring it can cause the muscles to twist and turn and depending on which way they twist could cause some what of an indentation, but I feel that it would begin to go the other way at some point,,,,I don't understand this reasoning.

[Lidiaggl]

So you had the less invasive decompression and the dura was not opened, but there was a nick in the dura which was repaired via one stitch...do I have that correct?

Yes, that's correct.

[Lidiaggl]

"So you had the less invasive decompression and the dura was not opened, but there was a nick in the dura which was repaired via one stitch...do I have that correct?"

Yes, that's what it looks like.  I was having the really bad headache and back to the numb tingly right arm Tuesday and Wednesday and I called Dr. Delashaw's office about it.  They told me to alternate between Aleve and Tylenol every three hours until I can get in to see my Neurologist this Tuesday.  I guess that is helping since I been able to do a few things and went to town today with my DD but I am so tired.

[KerriC1]

I have a significant indent along my scar. I'm 11 months post op but at 4 weeks after surgery I had a choking spell which caused violent coughing. At 7 weeks I developed a soft spot at the top of the incision and then the dent started. It's hollow and  hasn't gotten better since it began. I do have EDS and have since been diagnosed with CCI and my NS thinks the combination of surgery and instability is what caused it. I'm with you tho, I can't see how that causes such a large sinkhole so to speak. Good luck in getting answers!

[Jazzfnnybnny246]

Hey I have an indent in under my insicision area to is that bad or something? Cuz I kinda just felt it and was like eh guess it's supposed to be there lol Xd

[Lidiaggl]

As near as I can tell, the small dural tear was a "boo-boo".  DH says the surgeon mentioned it when he came out of the O.R., but it was like a little nick and was closed with one suture.  Other than that, there was no involvement of the dura.  

I still don't quite get how scarring or scar tissue can cause the indent to form.

They prescribed Gabapentin/Neurontin to see how many of the side effects I'm feeling will go away.  It should take about a week for that to have some effect.

I asked at my post-op whether there would be another MRI.  Dr. Delashaw said that unless there was some specific reason for concern, he didn't normally need one.  If the prescription I have now doesn't work, they might ask for a new MRI.  I can get that done locally and have it sent to Seattle electronically.

[selmaS]

  I just do not understand they would not want to follow up with  MRI to make sure the CSF flow is ok post op....or that scar tissue is not forming.

Was a dura patch used? I am confused a dural tear?