Tuesday, December 18, 2012

CNS Infection update, shunt replacement date/info

We are on the downward slope!
It's hard to believe (but then again not really) what started as a at most likely 4-6 day surgery and post-op stay 2 weeks ago has now been just that 2 weeks and the final (God willing) surgery to replace the shunts we took out last week is scheduled for Weds afternoon.

The CNS/spinal fluid infection is cleared and so far nothing has grown in the cultures so tomorrow it will be 2 weeks on the IV antibiotics (daptomycin) and after Weds surgery only 7 days to go most of which i'll hopefully be out-patient for! (Infectious disease will cont to follow but since it is a pretty easy 5 min flush and I have the Port I can do the daily antibiotic myself and then just will have to hep-lock the Port each day.  Im not sure how exactly the supply side of it works.

As far as the shunt replacement Dr.Bragg is still debating if she wants to put in a VPL (ventriculo-pleural) shunt but in a different ventricle and could it be done on the opposite side (Port is on L side while VP shunt was on R) as she wants to avoid using the same shunt tract as before or will she do the thoracic pleural which is basically the same as lumbar peritoneal from what they've told me with the proximal (tip I guess)  in the mid-spine and valve on the side and then tunneled a short distance to pleura which is the space around lungs.

Otherwise the ventriculostomy (external drain in ventricle) is doing ok once I figured out if I was getting or had a headache and vision blurriness and the drain didnt seem to be emptying enough I could just leave it un-clamped and stand up + dump some CSF (for whatever reason makes me feel better but in most people would cause extreme low pressure headaches) and usually every hour or so it makes a big difference. I told Dr.Bragg about this a few days ago and she actually was pretty ok with it and just asked me to watch and see how much 'dumping of CSF' it took for the symptoms to go away as that might help her decide on a better valve or which shunt. This fluid dumping is also on top of the EVD being set to drain automatically at -5 which most people probably do better around fluid draining at 5-10cm.  We are just putting back in the one shunt and that is as I think I may have posted previously what makes me a little nervous; I hope just one shunt works and we can get away with this + doesnt constantly occlude and symptoms are well controlled! It is definitely worth a shot and just hope one alone works. :)

If not before will update sometime after Weds surgery.
Thanks for stopping by,


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