Read Online Neurosurgeon...and Mum! by Kate Hardy - Free Book Online Page B
Authors: Kate Hardy
Ads: Link
face. Once I knowwhich part of the nerve I’m working on, my patient would be back under sedation so she wouldn’t be aware of what I’m doing. That’s when I’d deaden the nerve—either by injecting glycerol, or using radiofrequency.’
‘You’re right, it’s a scary procedure,’ he admitted. ‘That’d be tough for anyone to deal with, let alone someone who’s terrified of hospitals.’
‘And it might need to be repeated,’ Amy told him. ‘The pain relief lasts from a couple of months through to a couple of years. It leaves the face feeling numb, and some people find that hard to deal with.’
‘And that’s it? Deadening the nerve under sedation, or open surgery?’
‘There’s a third possibility,’ she said. ‘Gamma knife.’
‘Which is?’
‘A radiation beam, based on cobalt,’ she explained. ‘It destroys the nerve, and that sorts the problem.’
‘It’s really not something I’ve come across,’Tom admitted.
She spread her hands. ‘You’re a GP. You can’t be expected to have in-depth knowledge of every single condition and its treatment. That’s why you refer patients to specialists.’ Her tone was matter-of-fact but she was smiling, and the tightness in his chest eased.
‘Would you mind talking me through it?’ he asked.
‘Sure. Again, some of it sounds scarier than it really is. First of all, I’d need to attach a metal frame to the patient’s skull with pins. The frame’s really important because it stops her head moving during the scan and the treatment, and it also means we can be precise about where we’re going to direct the radiation beam. It’s a bit like the difference between someone taking a photograph at a slow shutter speed and getting a blurred picture, or someone using a tripod so the camera doesn’t move and the picture’s really sharp.’
Tom liked the way her mind worked; she’d explained it in a way that a layman could understand really well. The sort of specialist he’d be delighted to refer a patient to. ‘Does the frame hurt?’
‘Yes and no. It feels a bit strange, but it’s not heavy, and we’d put a local anaesthetic under the skin at the places where it’s pinned—it’s no more painful than, say, an injection at the dentist.’
‘What happens next?’
‘We do an MRI scan, so we can plan the treatment. Then the patient has a break while we look at the scans and work out where the radiation’s needed to treat the nerve and how many shots we need to fill that area. We make some final checks then take them into the treatment area. It doesn’t hurt and it isn’t noisy like an MRI scan is; and if the patient wants to listen to music, we can arrange that.
‘What happens after the treatment?’
‘We remove the frame and take the patient to the ward for a rest. They might have a bit of a headache and feel tired afterwards, but that’s usually from tension rather than the result of the radiation. Some people get a little bit of swelling at the pin sites where the frame’s attached, but that goes down in a couple of days.’
‘And it’s safe for anyone?’ Tom asked.
‘It’s painless, you don’t have the risks of an anaesthetic or the risk of haemorrhage or infection that you do from surgery, and the patient can go back to normal activities the next day. So the short answer is yes—but it’s still a fairly new procedure, so we don’t have any long-term results.’
‘If it’s new, do I assume that not many centres offer it yet?’
‘Not yet,’ she admitted.
‘Did you use it?’ he asked, suddenly curious.
She nodded. ‘Last summer, I did a stint with the radiotherapyteam, because it’s kind of cross-discipline. They use it mainly for treating tumours, but it’s also used for movement disorders and for intractable pain, like TGN.’
‘So you treated adults rather than children.’
She took a deep breath. ‘Sorry, Tom, I’d rather not go there.’
He’d pushed her too far. Time to backtrack swiftly.
‘You’re right, it’s a scary procedure,’ he admitted. ‘That’d be tough for anyone to deal with, let alone someone who’s terrified of hospitals.’
‘And it might need to be repeated,’ Amy told him. ‘The pain relief lasts from a couple of months through to a couple of years. It leaves the face feeling numb, and some people find that hard to deal with.’
‘And that’s it? Deadening the nerve under sedation, or open surgery?’
‘There’s a third possibility,’ she said. ‘Gamma knife.’
‘Which is?’
‘A radiation beam, based on cobalt,’ she explained. ‘It destroys the nerve, and that sorts the problem.’
‘It’s really not something I’ve come across,’Tom admitted.
She spread her hands. ‘You’re a GP. You can’t be expected to have in-depth knowledge of every single condition and its treatment. That’s why you refer patients to specialists.’ Her tone was matter-of-fact but she was smiling, and the tightness in his chest eased.
‘Would you mind talking me through it?’ he asked.
‘Sure. Again, some of it sounds scarier than it really is. First of all, I’d need to attach a metal frame to the patient’s skull with pins. The frame’s really important because it stops her head moving during the scan and the treatment, and it also means we can be precise about where we’re going to direct the radiation beam. It’s a bit like the difference between someone taking a photograph at a slow shutter speed and getting a blurred picture, or someone using a tripod so the camera doesn’t move and the picture’s really sharp.’
Tom liked the way her mind worked; she’d explained it in a way that a layman could understand really well. The sort of specialist he’d be delighted to refer a patient to. ‘Does the frame hurt?’
‘Yes and no. It feels a bit strange, but it’s not heavy, and we’d put a local anaesthetic under the skin at the places where it’s pinned—it’s no more painful than, say, an injection at the dentist.’
‘What happens next?’
‘We do an MRI scan, so we can plan the treatment. Then the patient has a break while we look at the scans and work out where the radiation’s needed to treat the nerve and how many shots we need to fill that area. We make some final checks then take them into the treatment area. It doesn’t hurt and it isn’t noisy like an MRI scan is; and if the patient wants to listen to music, we can arrange that.
‘What happens after the treatment?’
‘We remove the frame and take the patient to the ward for a rest. They might have a bit of a headache and feel tired afterwards, but that’s usually from tension rather than the result of the radiation. Some people get a little bit of swelling at the pin sites where the frame’s attached, but that goes down in a couple of days.’
‘And it’s safe for anyone?’ Tom asked.
‘It’s painless, you don’t have the risks of an anaesthetic or the risk of haemorrhage or infection that you do from surgery, and the patient can go back to normal activities the next day. So the short answer is yes—but it’s still a fairly new procedure, so we don’t have any long-term results.’
‘If it’s new, do I assume that not many centres offer it yet?’
‘Not yet,’ she admitted.
‘Did you use it?’ he asked, suddenly curious.
She nodded. ‘Last summer, I did a stint with the radiotherapyteam, because it’s kind of cross-discipline. They use it mainly for treating tumours, but it’s also used for movement disorders and for intractable pain, like TGN.’
‘So you treated adults rather than children.’
She took a deep breath. ‘Sorry, Tom, I’d rather not go there.’
He’d pushed her too far. Time to backtrack swiftly.
Similar Books
