change of shape at procedure site

[JD]

Hi all

I had surgery in Feb (retrosigmoid) to remove a 4cm gremlin. I have been doing really well since and have resumed work and most of the sporting activities I would have participated in prior to my surgery. I have one query though, the indentation at the site of the procedure appears to change in depth regularly. Over the last number of weeks it appears to have 'sunken' and 'filled out' a few times. Each time there is movement I feel a little discomfort in the area, I wouldn't exactly describe it as pain, but it would certainly be more tender to the touch of a pillow.
Has anyone else experienced something similar?  Any opinions on what may be the cause and if it is something I should be worried about would be greatly appreciated.

Thanks
JD

[leapyrtwins]

JD -

I'm not a doctor, but I'm wondering if it's possible you have a CSF leak.

Maybe it's the way you describe the area as "sunken and filled out a few times".

From my experience, changes in the AN "site" area are common, but usually the changes don't go back and forth.  The site changes and then stays that way.

Jan

[JD]

Thanks a mill for the reply, would I have any other symptoms with a csf leak? I feel fine and have been able to start back doing fairly vigorous exercise.
Starting to get a little worried now as I haven't a clue what a csf leak could mean... best to get in contact with my consultant I reckon!

[leapyrtwins]

Don't want to alarm you - I could be totally wrong here.

But I'd still check with your doc.  I've never had a CSF leak, but know they are common with AN surgery.

Sometimes people have symptoms like clear fluid running out of their nose or down the back of their throat, but sometimes they don't have "obvious" symptoms.

I used to think that CSF leaks happened a day or two post op, but that's not true.  They can happen months after surgery.

If it were me, I'd get checked out just to make sure everything was fine.

Good luck,

Jan

[CHD63]

JD .....

I am not a doctor either but I would certainly contact my doctor to make sure this is not something that needs attention.  As Jan said, many times indentations occur at the surgical site, but I, as well, have not experienced it going in and out.

My gut feeling is if you have no alarming symptoms, no fever, no fluid leaking from your nose, down your throat, or the incision site ..... it seems unlikely to be a CSF leak ..... but again, I am not a doctor. He/she is the best person to determine if you have a problem, or not.

It never hurts to call the doctor's office for reassurance.

Best thoughts.

Clarice

[Lizard]

Could be nothing, but it also could be something serious, but if you are experiencing discomfort like pressure, it might just be from the healing process.  Does this happen after you are doing physical activity?  As changes in pressure are common.  It would be smart to give your Dr a call.
Take care,
Liz

[moe]

I concur! Need to get to the doctor, but it is not an emergent thing, since you are just experiencing some discomfort.
To me, looks like some fluid buildup of some sort that comes and goes (duh). Could be csf or simply some fluid from the cells leaking out.
Let us know what the doctor says!
Maureen

[kiwi]

Mine insicion site blew up in one spot - looked like someone had placed half an egg on the side of my head. It was soft and full of fluid and after 2 weeks it slowly disappeared (took 3 days) and left me with a small crater.  By this time fluid had started slowly dripping out of my nose.  By the time I had surgery (4 weeks later) it was running out of my nose and causing depressurisation in my head which left me with excrutiating headaches.
MY ENT/surgeon told me that if you get a CSF leak straight after surgery it can usually heal itself but if it starts later after surgery it is most likely that surgery is needed to fix it. Definately go see your ENT and get it checked, hopefully its nothing to worry about.

Sorry about the doom and gloom.....Im still recovering from my CSF experience and its still pretty fresh with me.

Jacqui

[jerseygirl]

Hi, JD,

I had the same thing going on after my first surgery in 1988 even after an LP shunt was put in. I was explained that it was a healing process and not a cause of concern by itself unless you have CSF leak out of your ear or nose, fever or headache. Before the shunt, the CSF pooled under the incision and my neck appeared swollen on one side and kept growing with no escape. The intracranial pressure built and I had terrible headaches and fevers. The shunt reduced the pressure and both the headache and the fevers went away. The pooling reabsorbed in 2-3 months and after that the incision went from full to sunken and back to full for a good year. Finally it became totally sunken, but I could not sleep on it for a few years.

 After the second surgery in 2007, there was a small pooling under the incision, a slight fever and headache. The second surgeon gave me antibiotics right away and both the headache and the fevers resolved immediately. The liquid reabsorbed in 2 months.

I agree with others - you should mention it to your doctor even if there is no emergency.

                           Eve

[JD]

Hi guys
Thanks for all the replies, still waiting to hear from my consultant, hes "on holidays", due back next week!
Can somebody tell me what causes the indentation, I was so happy to alive and well after the op I never asked any of the questions I should have  asked (I building a big list up for my next follow up appointment). I still have what feels like skull at the indentation site, could anyone explain why my skull is no longer the correct shape!!
Thanks
JD

[Lizard]

Not sure, did you have the bone flap replaced?  I had titanium mesh and I have an indent...also have a number of other indents around the scar, not sure what those are from. but I'm sure I can only imagine what they had to do to get in there...suboccipital can be tricky

[JD]

Hi guys

Still no response from my Dr. Spoke with his secretary yesterday and he was back at work this week but extremely busy!
Still have the slight change of shape in my head. Every morning when I get up the indentation appears to be almost gone, definitely reduced in size. As the morning and day goes on the indentation appears to get deeper. I have no headaches, a little discomfort around the scar but that's it.
I also think that the back of my mouth is filling with liquid and I'm continually swallowing to get rid of it.... to be honest I'm not sure if this bit is in my head or not (no pun indented!). Not sure what to do, does anyone know if there is a test, like a litmus paper test that can determine if, what I think is excess liquid in the back of my mouth is CSF?   


Thanks
JD

[kenneth_k]

Hi JD.

Try to get some glucose test stix at the drug store (normally for testing diabetes in urine, but they can test any fluid).
Make sure your mouth is totally clean. Try to spit some out in a cup or something. And run the test.
If it is positive, mention it to your doctor. If not, mention that too, but then you are most likely not leaking CSF in your mouth/throat.
Can you taste it? It should be salty or metallic.

Good luck,

Kenneth

[NancyMc]

JD,
My indentation is due to the fat that was installed to fill the void shrinking.
Good luck.
Nancy

[leapyrtwins]

JD -

call the secretary back.  Tell her you are concerned that you might have a CSF leak and would like to see the doctor ASAP.

Hopefully that will work.  Currently she might just think you want a routine appointment.

Good luck - and please keep us posted.

Jan