Two Questions

[Johno]

I recently returned home after a review on my wound to fix a nasal CSF leak which developed two weeks post AN removal. This time the wound is taking forever to heal properly and to make matters worse the ENT ordered my head put in a compression bandage, not unlike the one in the avatar to the right, because I've developed a large lump of CSF around the wound and behind the temple. Its not leaking but the doc wants to prevent leakage through the wound by "squeezing" the CSF back into my head. Has anyone had this complication before? Very frustrating because its another set back 6 weeks after initial surgery. I've been told that surgery is not out of the question if it does'nt settle as they will need to construct a drain to get rid of the excess. Bugger!
Also, is there any dramas with flying? My work involves a lot of commuting by plane. I've heard that altitude pressures can play havoc post AN removal.
Thanks Heaps
Johno

[deea]

Sorry to read that you are  having some more troubles.  Thankfully, CFL is one thing I did not have to deal with.  Unfortunally, I can offer no helpful advice about flying...I hate to fly and will be in no hurry to do so until the snow gets deep and I am freezing cold. 
Then getting on a plane and heading some place warm begins to sound a little interesting!

Hope you continue to heal without too many detours.  I will keep you in my thoughts and prayers.  I don't know if you remember me, but I "talked" with you just before your surg.  I have not been posting, but I do keep track of you.  My husband spent alot of time with the Aussies on work projects and I always enjoyed their humor.  Dry. 

Take care and get better quickly,
Claudia
   

[Pembo]

A lot of members here have flown shortly after surgery. I flew about 2 years after surgery and had no problems at all.

[Desilu]

Hi Johno,

I did not have any problems flying after surgery. I had my surgery done at HEI in Los Angeles and had to fly home within two weeks. I don't believe that the doctors would have let me board a plane if it was not safe. I must admit that I was a little nervous and thought that my brain was going to explode but it didn't!

On the other hand, I did not have a CSF leak, so that may pose a problem for you. I would definitely talk to your doctor about this. Sorry, to hear that you are having this issue. Hopefully the doctors will get it resolved soon and you'll be out and about flying all over the country. Wishing you a speedy recovery!  Ann

[4cm in Pacific Northwest]

Johno,

I had both CSF leaks post surgery and I had to fly home.

CSF

It is my understanding that if you have CSF leaks you should NOT be out-and-about or going to work. Mine were mild leaks - through the nose that did however stop with repositioning. If I did too much the leaks started up again. I was told to rest and lay down when I needed to. Also if you have CSF leaks your brain still has an open access stream to germs – leaving you more susceptible to meningitis.

I was put on Diamox
www.crlonline.com/crlsql/leaflets-english/5559.htm

Airplane
This was also prescribed to me for the plane trip home to ease the altitude adjustment. I found on the airplane trip home that ascending altitude was not an issue but descending was quite the head trip. I am also finding this when we go down hill in the car and when I walk our farm (which is on a hill). However this IS improving with time and daily walking on uneven ground (i.e. self imposed therapy)

Re  the Diamox
This is one nasty but effective drug (re side effects). I suggest that if it is prescribed- it be taken before bed as you can sleep at night through the worst of the nasty side effects (drowsiness and nausea being two). Also your physician, I presume, is having you watch your fluid and salt intake – as water retention will exacerbate issues. One word of caution is that if you come off the Diamox after being on in for a few weeks -wean off slowly. My follow up doctor at home pulled me off it abruptly and said increase my fluid intake. I bloated up like a puffer fish and then I had a mild CSF leak (after a 7 day stretch with no leaks on the meds). I did not say anything to the follow up doctor (or my initial surgeon) as I did not want to hear the “BS� words (Brain Shunt). I since took it very easy, gradually increased my fluid intake and I have gone 2 weeks ‘today’ without a CSF leak - touch wood.(Today I am at my 8 week post op mark).

level head
I also kept a level head. I am not talking figuratively but literally. Keep the head straight and not straining the neck (i.e. not bending over to even tie the shoes or bending back to slurp the last gulp in a glass of beverage). It takes 21 days for a good scar to form (i.e. no leaking CSF )

REST
As far as going back to your normal activities- including flying for work you should first take the rest you need to recover. Satman (aka “super 8â€?) posted that it takes 1 week for each hour you were in surgery. I was hoping by 6 weeks I would be all zippity-do–da again which many (those whose surgeries were less than 6 hours) told me I should be at.  However I was a 11+ hour surgery- so I should work on not being such an “impatient patientâ€?.

Each patient is different and there is no one set formula or magic number.

A.   How many weeks post op are you at?
B.   How long was your surgery (including any post surgeries for CSF week)?
C.   Are you resting and not lifting a thing (not even a 1/2 gallon milk jug)?
D.   Are you keeping a level head? (I do not mean figuratively… literally)
E.   Is your fluid intake being monitored?
F.   Do they have you in any diuretic medications?

Feel free to send me a private e-mail if you prefer- via the forum.

Cheers mate,

4

[Gennysmom]

Johno,

I had the same, nasal CSF leak 2 weeks post surgery fixed by lumbar drain for 8 days in the hospital....I was bound and determined to not have to have more surgery!!!  I had a pocket of fluid under my wound that eventually went away without a pressure bandage past the first week.  One thing I can say is that if it's still a concern....and they're not putting a shunt in....stay as still and quiet as you can till it's healed.  I found pushing myself and walking around more than just a little made the problem worse.  I didn't get it, but you do not want to have to deal with meningitis.  I know you probably want to get up and healed, but rest for right now.  I also slept on a wedge pillow so my head didn't go below 25 degrees or so. 

I flew for the first time 7 months after surgery (no reason to fly before that) and have no problems with flying or pressure/altitude changes.  Have flown 4 times since that inital flight, with layovers, and nothing....feels like before surgery.  Twice have gone from sea level to 6000-7000 ft in elevation for a few days, and that didn't bother me either. 

Good luck!

Kathleen

[Lainie181818]

Johno,
As Lainie's husband, she showed me your post. As an airline pilot,typically an aircraft cabin climbs to an equivalent altitude of 6000-7000 ft on a high altitude flight, As an ignorant USA pommie imigrant I would suggest, if your doctor agrees, for you to drive to as high an alititude as is topographically available to see if you encounter a problem - then try a flight. The rate of change of an aircraft cabin normally does not exceed 500'/min., but you cannot simulate this rate by driving!! Keep your spirits up, it's a long process as I can witness as the 'other half', but it does still continue to improve for Lainie even 18 mths. later.
Malcolm

[chelsmom]

Hi Johno,

My daughter, Chelsea, didn't have a CSF leak but does have a brain shunt.  Her neuro surgeon wouldn't allow her to go to the local mountains which are 6000'-7000'
elevation for 9 months after surgery.  She was given a go ahead to do a short test flight 11 months after surgery before she took on a 5 hour flight, both of which went smoothly.  Hope things settle down for you and your recovery countinues without further set backs.

Michelle