The light at the end of the tunnel is no more.

Carson had a Urology appointment last Friday and things didn't go as well as planned. It's come to that point to let you all know that Carson is going to be having surgery here in the next month or so.


Carson has been having difficulties with her bladder and bowels. Our urologist (who works hand in hand with our Neurosurgeon ) is 100% sure that it is nerve damage caused by her Chiari Malformation Type 1.

The nerves from her brain to her bladder/bowels are not working correctly and is showing signs of damage.

The 2 procedures that they will be performing during the surgery are called: the MACE procedure (for her bowels) and the Mitrofanoff procedure (for her bladder)

Here is a little info on both procedures.



Bladder:
Mitrofanoff appendicovesicostomy, also known as the Mitrofanoff procedure, is a surgical procedure in which the appendix is used to create a conduit between the skin surface and the urinary bladder.

In the procedure, the surgeon separates the appendix from its attachment to the cecum, while maintaining its blood supply. Then he creates an opening at its blind end and washes it. One end is connected by surgical sutures to the urinary bladder and the other is connected to the skin to form a stoma. Generally, an incision is made into the umbilicus so that it may serve as the canal for the catheter.

Urine is typically drained several times a day by use of a catheter inserted into the Mitrofanoff canal. The Mitrofanoff procedure allows the individual to self-catheterise so that he or she is not dependent on a family member or a medical professional to catheterize him or her.

The Mitrofanoff procedure has been found to improve the life of people with spinal cord injuries, by increasing their independence.



Bowel:
A Malone antegrade continence enema, also known as Malone procedure and by the abbreviation MACE, is a surgical procedure used to create a continent pathway proximal to the anus that facilitates fecal evacuation using enemas.

The operation involves connecting the appendix to the abdominal wall and fashioning a valve mechanism that allows catheterization of the appendix, but avoids leakage of stool through it. If the appendix was previously removed or is unusable, a neoappendix can be created with a cecal flap.

The surgery will take anywhere from 4 - 6 hours. Her hospital stay will be anywhere from 5 - 7 day and recovery is just about 6 weeks.

I have a feeling this will be a hardest surgery yet. As Carson gets older she will learn how the cath both stomas and become very independent but in the mean time, Matt and I will have our work cut out for us.

Thanks everyone for all your thoughts and prayers.