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Is it normal for a concavity / depression / dent to form where the bone was removed?
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.
"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.
COMMUNITY LEADER
Hi Lidiaggl and welcome to the Chiari forum.
The indent is typical and can worsen if you are not doing exercises to help those muscles keep from getting too tight or allow scar tissue to form.
Have you been doing neck exercises? Since going to PT I expect you are.....do you have a copy of your OR report? What all was done during your surgery....a laminectomy, but did you also have a dura plasty?
And are you aware of any other related conditions to Chiari you may have?
1 Comments
I have been doing the neck exercises since the day of the surgery. They told me that as soon as I could walk, I could go home, so I got up and walked! One aspect of the anesthesia on me was it made me claustrophobic. I could not stand having the pressure leggings on. So they required me to be walking from day 1, and I was discharged the day after my procedure.
Your questions about what exactly my surgery was reminded me that I don't know, exactly. I sent a message (just now) to Dr. Delashaw's office to get a more detailed answer. Originally, they had said it would be a reduction of the occipital bone, and possibly a laminectomy. At one point, the PA told me I did get the laminectomy, but later I was told I didn't. Nobody has told me that there was any duraplasty done. I had Type 1 CM with 6mm herniation of the tonsils.
If I have any related conditions, I am not aware of it. As I read the profiles on this site, it does make me wonder, since I have been treated without a lot of success for many of the symptoms others are describing. My CM and the related symptoms might explain much more than just what got me diagnosed.
Your questions about what exactly my surgery was reminded me that I don't know, exactly. I sent a message (just now) to Dr. Delashaw's office to get a more detailed answer. Originally, they had said it would be a reduction of the occipital bone, and possibly a laminectomy. At one point, the PA told me I did get the laminectomy, but later I was told I didn't. Nobody has told me that there was any duraplasty done. I had Type 1 CM with 6mm herniation of the tonsils.
If I have any related conditions, I am not aware of it. As I read the profiles on this site, it does make me wonder, since I have been treated without a lot of success for many of the symptoms others are describing. My CM and the related symptoms might explain much more than just what got me diagnosed.
COMMUNITY LEADER
WOW !! I was in ICU for 2.5 days I can not imagine going home that soon.
So your Dr did not rule out the typical related conditions b4 you had surgery?
That is surprising and then again it's not really.....it seems there are many that do this surgery that do not rule out related conditions and it can be the related conditions that can cause some of the continued symptoms.
When are your scheduled for another follow up? A MRI ?
2 Comments
As CM procedures go, mine was pretty minimal, though certainly uncomfortable enough! No duraplasty, which I'm told is the big difference. I can't say that other issues weren't considered and ruled out. I was seen by several doctors as my major symptoms worsened very rapidly. About two hours passed between the completion of my first MRI and my primary doctor calling me with the CM diagnosis.
I was lucky to get my referral accepted by the Swedish Hospital Neuroscience Institute in Seattle. Dr. Delashaw is very familiar with CM corrections, and he went over a whole series of imaging before my initial conference. He's so confident and direct that it would be almost awkward to ask if he considered these related issues. --- almost. I'm going to ask as soon as I get the reply to yesterday's questions.
I was told that the procedure I had was unlikely to solve every symptom I had, and that there were some symptoms that would probably be unchanged. I can say that most of the really 'impossible' issues are either improved or much less frequent. Wednesday was pretty rough, but I had a pretty active session of PT Tuesday, so maybe that stirred things up. Or maybe it was my DD's motorcycle crash on Monday, the 4 hours of ER, and taking care of her since. This is the most active I've been since the surgery.
My post-op was April 18, and my final follow-up was May 9. At that point, they were very happy with my progress and saw no reason for additional imaging. No MRI is planned, and unless things go really wrong, they don't plan to see me again. My suture has healed so well the PT says he can't believe it's only two months old. The line is almost invisible. Every doctor that has seen it has been impressed with Dr. Delashaw's sewing. Anyway, from here on out I just follow up with my Primary.
If it wasn't for the strange indent and the continued sharp pains and dull headaches from that same spot, I wouldn't even still be reading up.
I was lucky to get my referral accepted by the Swedish Hospital Neuroscience Institute in Seattle. Dr. Delashaw is very familiar with CM corrections, and he went over a whole series of imaging before my initial conference. He's so confident and direct that it would be almost awkward to ask if he considered these related issues. --- almost. I'm going to ask as soon as I get the reply to yesterday's questions.
I was told that the procedure I had was unlikely to solve every symptom I had, and that there were some symptoms that would probably be unchanged. I can say that most of the really 'impossible' issues are either improved or much less frequent. Wednesday was pretty rough, but I had a pretty active session of PT Tuesday, so maybe that stirred things up. Or maybe it was my DD's motorcycle crash on Monday, the 4 hours of ER, and taking care of her since. This is the most active I've been since the surgery.
My post-op was April 18, and my final follow-up was May 9. At that point, they were very happy with my progress and saw no reason for additional imaging. No MRI is planned, and unless things go really wrong, they don't plan to see me again. My suture has healed so well the PT says he can't believe it's only two months old. The line is almost invisible. Every doctor that has seen it has been impressed with Dr. Delashaw's sewing. Anyway, from here on out I just follow up with my Primary.
If it wasn't for the strange indent and the continued sharp pains and dull headaches from that same spot, I wouldn't even still be reading up.
This is what we were told by the nurse today. We never knew she had small dural tear.
The complete name of your surgery was a suboccipital craniotomy with a cervical 1 laminectomy for decompression of the chiari malformation, closure of small dural tear with sutures.
In talking with the doctors - the indent that you feel is likely scarring.
I don't believe that any imaging was performed during your surgery unfortunately.
Are the pains constant or are they intermittent?
The complete name of your surgery was a suboccipital craniotomy with a cervical 1 laminectomy for decompression of the chiari malformation, closure of small dural tear with sutures.
In talking with the doctors - the indent that you feel is likely scarring.
I don't believe that any imaging was performed during your surgery unfortunately.
Are the pains constant or are they intermittent?
COMMUNITY LEADER
Really? hmmm most have a MRI post op...mine was at 1 yr post op but I had several post op visits...one at 6 weeks then 6 months and then 1 yr....
It is pretty much routine where I went with the post op visits....except if you are having issues they see you more and do a MRI sooner.
Stress can trigger a flare of symptoms especially this soon post op....how is your daughter, is she ok?
1 Comments
I was surprised another MRI wasn't wanted, but I live 4 hours from where the surgeon is, so cutting down on follow-up visits is a good thing. They told me another MRI would only be advised if there are complications. Stress could sure be an issue, the way things have been lately.
My DD managed to flip her boyfriend's dirt-bike going off the road (yes...) about 30-40 MPH when she hit the ditch because she panicked and missed the brake pedal. She got thrown about 20 feet after her head, then her hips hit the handlebars. She broke my husband's brand new helmet, and after the paramedics got her to the ER on a back-board with a cervical brace and splints, and they had to cut her new jeans and everything else but her socks off her (I mean, why not cut the socks off, too, just to make it complete?), she had no broken bones, no internal injuries, and no abrasions. She is moving better today and is out of bed. The worst looking part is the rope burn from the helmet strap - it looks like someone tried to hang her. The ER doctor said she possibly sprained her pelvis. Still it's a good thing we're fearless and teenagers at the same time: Someone older would have broken 20 bones.
I'm hoping to hear from the NS's office in the morning. I am having some really weird feelings and not thinking quite right also. I keep getting this burning in my nose like when you get pool water in your nose. Also having heartburn along with crawly skin, tingling, and aches only on my right side. I do not want to go through the weekend feeling like this.
My DD managed to flip her boyfriend's dirt-bike going off the road (yes...) about 30-40 MPH when she hit the ditch because she panicked and missed the brake pedal. She got thrown about 20 feet after her head, then her hips hit the handlebars. She broke my husband's brand new helmet, and after the paramedics got her to the ER on a back-board with a cervical brace and splints, and they had to cut her new jeans and everything else but her socks off her (I mean, why not cut the socks off, too, just to make it complete?), she had no broken bones, no internal injuries, and no abrasions. She is moving better today and is out of bed. The worst looking part is the rope burn from the helmet strap - it looks like someone tried to hang her. The ER doctor said she possibly sprained her pelvis. Still it's a good thing we're fearless and teenagers at the same time: Someone older would have broken 20 bones.
I'm hoping to hear from the NS's office in the morning. I am having some really weird feelings and not thinking quite right also. I keep getting this burning in my nose like when you get pool water in your nose. Also having heartburn along with crawly skin, tingling, and aches only on my right side. I do not want to go through the weekend feeling like this.
COMMUNITY LEADER
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?
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.
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.
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!
1 Comments
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
COMMUNITY LEADER
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.
2 Comments
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.
Yes, that's correct.
"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.
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.
COMMUNITY LEADER
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.
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.
COMMUNITY LEADER
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.
1 Comments
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.
COMMUNITY LEADER
Vomiting like that can indicate a CSF leak...do push for answers....good luck and let us know how this works out for you.
1 Comments
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.
COMMUNITY LEADER
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.
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.
COMMUNITY LEADER
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....
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.
COMMUNITY LEADER
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.....
1 Comments
Ugh! Feeling terrible today. Sever headache, neck pain, shoulder numb.
COMMUNITY LEADER
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.
1 Comments
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.
COMMUNITY LEADER
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?
1 Comments
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.
COMMUNITY LEADER
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?
2 Comments
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.
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.
COMMUNITY LEADER
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 !
1 Comments
I think I solved one of my head issues. I have a massive head cold.
COMMUNITY LEADER
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.
1 Comments
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.
COMMUNITY LEADER
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.
1 Comments
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?
COMMUNITY LEADER
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.
COMMUNITY LEADER
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.....
1 Comments
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
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