I Couldn't Speak! after My Surgery

Very soon after my surgery, two of my daughters, Eleanor and Julie, visited me.

Eleanor’s notes describing their visit:

"Thurs. 5:30 PM after surgery – (Julie was with me )
Mother awake and very alert. Paralysis of both limbs on right side. IV in hand. Tube with blood drainage from gauze wrap around head running into sack. Urinary catheter running into another sack. Right lip drooping over teeth. Mother very responsive. No speech. Auditory comprehension for slow, simple speech. No articulation in mouth. Seemed aware of paralysis."

In ICU After Brain Tumor Removal

Then at 1:10 P.M., according to Eleanor’s notes, Dr. Paysinger, having finished the operation, came out to the waiting room to give this report:

7:30 A.M. – 1:10 P.M. Thursday surgery- My daughter Eleanor's notes:
"The tumor (the second meningioma) was much larger than anticipated even from CT Scan or arteriogram studies. Grew through the dura, up into skull bone and almost into brain so it was hard to remove. Thinks he got it all.
Could not put plate in. Surgery took longer than expected so couldn’t get plate in. Mama had been through too much. Will put plate in in 6 months-12 months. (Another operation? The surgeons would need to put a plate in as a substitution for most of the skull on the left side of my head. I was not even awake from this operation and I was already needing another one?) Mama is resting. Could see her 4-5 hrs later when she wakes up."

After the surgeons had sewn my scalp flap back in place, a large bulky dressing consisting of a kind of gauze wrap, about an inch thick was applied to my bald head and a drain, left in the epidural space, drained from the fresh incision and my swollen brain into a sack. The dressing came down over my eyebrows and partially covered my ears making it hard for me to hear.

When I awoke from the surgery I was in the Intensive Care Unit. I was still a little drunk from the anesthesia and kept dozing off… waking up… coming… going. I didn’t much care about anything… I was just so sleepy. There was nothing I needed to ask for; my every need was being anticipated so I was hardly aware of not being able to speak. There was, of course, no problem with the use of my tongue; the problem was with the use of my brain. It was injured and swollen and wouldn’t perform. My mind was blank. I had no thoughts… until I took one look at myself and my mind responded to what I saw.

My right arm lay limply on a pillow, as if dead. My right leg was propped up against a second pillow. The right side of my mouth was numb with my upper right lip drooping down over my teeth, and my throat was raw. I realized then that “I had already had the operation.” It had taken only four hours to turn me from an able-bodied, independent person into a completely dependent, helpless, disabled human being. This tumor had really done me in; I looked as if I had had a stroke. It would be a long, hard road ahead… bringing me back from the depths.

Eleanor and Julie, not even knowing whether I would know them or not, came in the ICU to see me as I was trying to regain consciousness. I immediately recognized them… my precious daughters! I managed a smile. (I didn’t want them to know that I couldn’t think of either of their names, or, in fact, think of anything. My mind was blank.)

Brain Surgery – Operative Notes

“Incision was made slowly with the larger vessels being controlled and coagulated as we opened the scalp. Scalp flap… was wrapped in a warm saline soaked pad and fishhooks attached… to maintain this exposure…

(10:30… as my family waited patiently in the waiting room for Dr. Paysinger to finish the operation, many things they had heard the neurosurgeons say kept running through their minds)

“The plate from the previous craniotomy was removed by cutting the wires and lifting the plate out of the defect… the rotary saw was placed on the Midax Rex and remainder of the (skull bone) flap was sawed out and removed… was sent to Pathology…”

(11:30… risk of surgery greater this time due to location of tumor, scarred tissue, lengthy operation including doing away with plate from first tumor)

“After we removed totally the diseased bone the edges were waxed. The dura was lifted with a swivel hook and opened and the intradural meningioma was seen underlying cortical tissue.”

(12 o’clock. Will Mama still know us? …she might not even make it through the operation)

“We kept the cortex covered with cottonoids as we moved along and slowly dissected the tumor off of the cortex… then the tumor was removed… with dural attachments still present. The underlying cortex was very raw… with gentle saline irrigation, the cortex was irrigated…”

(12:30… tumor on “speech area” of brain will affect speech, comprehension, reading… maybe even cause paralysis… should expect 5-15% speech and/or motor problems to be permanent…)

“Dural substitution was then used to close the large dural defect that had been left. This was sutured into place covering the underlying cortex. We felt there was going to be a tremendous amount of swelling because of the large tumor that was removed, and adherence to the brain. It was elevated not to try and carry out a cranioplasty (put a plate in)—at this time for that reason. A drain was left in the epidural space and the scalp flap returned to its normal position. A large bulky dressing was loosely applied and the patient sent to RR.”

Physicians’ Reports Preceding Brain Surgery

Physicians’ Reports – Sally Spends The Night

Neither did I know Eleanor was taking notes on what the physicians were reporting to her in private about my condition.

Tuesday – Dr. Dial

Risk of surgery – Greater this time than for the first brain tumor due to location and scarred tissue. Risk is damage to right side, anywhere from paralysis to poor muscle tone.

Lengthy surgery – Getting to it is easy. Excising it is hard. Surgery will be a lot longer. The longer it is the more chance of problems. Tumor is in the skull. Will require plate on whole left hemisphere. More concerned than at first. Probably after surgery will have speech and motor problems. He expects this.

Seizures – Frontal-temporal meningioma might cause seizures.

Tuesday afternoon – Dr. Paysinger

Expects speech problem and weakness or paralysis after surgery. Said Mama might not make it through the surgery. About 15% chance of speech and/or motor problem will be permanent. Probably plate on most of left hemisphere. He will operate Thursday morning.

It was thought I would be in the hospital for about a week, like with the first brain tumor, so plans were being made for Julie to come with her ten months old baby boy, Lane, when I got home from the hospital and stay with me while I was getting my strength back. I expected nothing but that my recovery would be like that of my first tumor… quick and complete.

I had asked my daughter, Sally, who is a registered nurse, to please come st ay with me the night before I was to have my surgery. I thought I might need her in the nurse capacity but I knew for sure I would need her for support. She and I slept very well that night until the hall nurse came in and woke us up about 5 AM Thursday morning to “get up and start getting into the surgical gown in order to be ready for surgery”. I wanted so badly to have my little cross, that I had been carrying in my wallet for years, to be somewhere on my person during the surgery… but where could we hide it? I had been stripped of all jewelry and was jut about naked in that scrimpy little, split-down-the-back, short, no-modesty-at-all, surgical gown. Sally and I looked at me. Then we looked at each other. And then she made a real good suggestion… so, when the hall nurse came back about 6 o’clock to see if we were ready, my little cross was hidden, securely tucked long ways under my hospital bracelet and hardly even showed.

I, having already been sedated, was no sooner rolled out of the room on a stretcher than I was fast asleep. I didn’t know anything after that, not even when somebody shaved my head for the operation.

Tumor in the Speech Area

Each of our four children needed to be informed of my condition, a suspected second brain tumor. Three out of the four could come home Saturday.

Saturday was a gorgeous, warm February day and the whole family was sitting outside talking and sunning in the courtyard behind our house when Claire B. came over from next door. She and I chatted a little while, then she told me she had heard the news and that she was so very sorry.

Jack drove me up to Columbia the next day, Sunday, February 20, 1983, the day before my 55^th birthday, to admit me to the Richland Memorial Hospital. I was to have the same neurosurgeon, Dr. Danny Paysinger, in whom I had grown to have great confidence.

Mary Ann R and Joan M drove up to Columbia Sunday afternoon to visit me and Carlos G, minister at St. Andrews, came also. According to Eleanor’s notes that she jotted down all during my stay in the hospital Sara S, Donna R and Nancy A called later. Nancy told Eleanor that she had noticed Ashlyn being put out with Jack. That they had fussed regarding her tennis. …What happened was that about a week before I found the tumor, Jack was out riding his bicycle while I played tennis with the girls. He decided to ride by the tennis courts and then stopped to watch us play. I was very conscious of his being there watching and then proceeded to miss four consecutive shots. When I got home he had plenty to say about my poor tennis playing… Nancy was questioning in hindsight, “why Jack hadn’t noticed at tennis that something was wrong!”

After having an arteriogram on Monday, it was determined that the tumor was on the “speech area” of my brain. I can imagine how this must have affected Eleanor, she being a Speech Pathologist in Summerville, SC herself. She would better understand and, maybe, know too much about the ramification of the tumor being on this area. I hadn’t thought to ask, so I didn’t know where the tumor was.

Something Abnormal

Months later Claire B, my interior decorator and next door neighbor, and I were standing, in what was to become the guest wing of our new house, discussing which wallpaper to use in the guest bedroom when I began to feel real dizzy and felt like I was going to faint. There was nowhere to sit down so I just leaned my back against an unfinished upright and sank to the floor to a squatting position. Soo the dizziness passed away. I called the doctor the next morning and told him about my dizzy spell so he called in a prescription for Anti-Vert from the pharmacy and this seemed to take care of the problem. But little did I realize how much lay ahead of me.

At another time, Jack noticed that I was having trouble understanding some things that I normally would have been able to understand easily. AS we look back over it now, he didn’t know about my dizzy spell and I didn’t know I was having trouble understanding, so neither of us suspected anything. We were so busy trying to finish up the new house.

Finally, we moved in July 4, 1982. We got the boxes unpacked, the books on the bookshelves and the pictures hung. We were having such a good time entertaining our friends in our new house… a church choir supper, a party for our tennis group, my church circle, our supper club, etc.

Eleanor came for Christmas, 1982 and she noticed that I was having a problem with my memory. I brushed it aside with, “I don’t think anything could be wrong with me; I feel too good… and it’s been nearly nine years since I had the brain tumor. And, too,” I argued, “we were told that it would be most unlikely for me to ever have another one.”

But, after about two months, I woke up three consecutive mornings with bad headaches that seemed to not want to go away. I started putting two and two together and realized that I was feeling more tired than usual and my tennis game was not up to par… and that dizzy spell! I knew, since we now had a CT scanner in our Orangeburg Hospital, I should go have a scan made.

My appointment was Friday, February 18, 1983. Jack and I had no sooner walked in the door from the hospital than our family physician called. We, Jack on one telephone and I on another, we were told that “something abnormal showed up on the scan! It was big! And in that same general area as the first brain tumor”. I felt numb… I could hardly take in what I was hearing. I was to be admitted to the Richland Memorial Hospital in Columbia by two o’clock Sunday afternoon. Jack was to pick up the CT Scans from our Orangeburg Hospital to take up to the Richland Memorial Hospital for consultation.

Four Years Later

October 27, 1980, Jack and I bought a lot on one of the Country Club golf course ponds, and I began drawing floor plans for a new house with some special features that would fit all our needs. When Larry B, after making numerous helpful suggestions, finished drawing the complete set of plans, we broke ground in June, 1981 on Jack’s 53^rd birthday, and started building.