Gabby_ A Story of Courage and Hope - Alison Hanson [124]
I knew I’d left Gabby in good hands, and as I imagined, Gloria’s e-mails were direct. She told me whatever she knew when she knew it, and she didn’t hold back on details when Gabby was in pain during recovery.
“Gabby seemed subdued while Dr. Kim shaved her head,” Gloria wrote in one early e-mail to me. She was at Gabby’s side for the shaving, along with Pia, Gabby’s operations director, Jen Cox, and family friend Suzy Gershman. “We all applauded when her head was finished being shaved,” Gloria wrote, “and though we all offered to get our heads shaved in solidarity, Gabby nixed the idea.”
I had thought I would be with Gabby for this cranioplasty surgery. But given the repeated delays in the launch of the shuttle, the procedure needed to go on without me. It was important that Gabby have the piece of skull replaced at the optimal time for her recovery. Doctors advised against waiting for me to return from space. She was ready.
The surgery, led by Dr. Dong Kim at Memorial Hermann Hospital, was not terribly complicated for brain surgeons, and they assured us it was low-risk. Gabby was actually pretty upbeat about it because once her missing pieces of skull were replaced, she’d no longer have to wear that dreaded helmet. (Gabby’s nurse, Kristy Poteet, wrote “5-17-11” on top of the helmet, so Gabby could be reminded of the last day she’d have to wear it.)
Pieces of Gabby’s skull had been removed on January 8 to reduce the impact of her brain swelling. Those pieces were frozen and preserved, but the passing bullet had shattered much of the removed skull and contaminated the bone with germs. The doctors could have attempted to piece together the bigger parts like a jigsaw puzzle, but it wouldn’t have been as smooth, strong, or clean as the ceramic implant they ended up using. The implant’s structure and dimensions were computer-generated to exactly match the missing section of Gabby’s skull, which was about the size of a person’s hand with his fingers spread apart. (After her implant was in place, Gabby’s Tucson neurosurgeon, Michael Lemole, successfully screwed together some of the larger pieces of Gabby’s taupe-colored real skull, which showed the bullet’s entry and exit holes. It now sits in a Tupperware container in our freezer.)
Gabby suffered from excessive buildup of cerebral spinal fluid after the shooting, and the doctors decided that it would require a permanent drain. So during the three-and-a-half-hour surgery to replace her skull with the implant, they added a tiny tube about the diameter and thickness of the cords used to charge cell phones. The tube snaked its way from Gabby’s brain, down her neck, and through her chest to her abdomen. This cerebral shunt would permit drainage of the excess fluid. The doctors inserted the tube so it was barely noticeable, running it down the left side of her neck just under her skin.
I talked to my brother and Gloria after the surgery, and also got reports from a press conference in which Dr. Kim said that everything had come together nicely—bone, plate, and skin. He explained that Gabby had developed mild hydrocephalus, which means “water in the head” in Latin. “It’s a condition that develops in many patients who have a brain injury,” he said. Every day, all of us produce about six ounces of clear cerebral spinal fluid that bathes our brain. That fluid is continually reabsorbed in our bodies. “When there is an injury,” Dr. Kim said, “that reabsorption can become partially clogged, just like having a partially clogged drain. When that happens, the fluid can build up, and that’s something that can be treated with a shunt. You can have it for the rest of your life and it doesn’t impede anything.”
The reattached skull and the shunt would allow Gabby to have a more vigorous rehabilitation. Without the fluid pressure, it was possible