Thursday, December 13, 2012

#18 Shunt removal, Infection update

I apologize ahead of time if there are a lot of errors in this post as my vision is super blurry and having a very hard time seeing what I am typing.

We went back to the OR about 1:40 yesterday and I was awake as is my preference while all the monitors, machines, etc where hooked up and then surgery itself took I think till 4:30 though it originally was thought to be about 1 1/2 hrs. I woke up in post-op to Residents and then Dr.Bragg to trying to get the EVD (ventriculostomy) catheter to work and re-doing the tubing on that as well as the head wrap. 

The surgery itself had just  a few minor glitches with Dr.Bragg running in to ALOT of scar tissue in my belly (she always comments how amazed she is at how fast my body re-builds/produces scar tissue but I imagine part of that is the storage material to) that she had to I guess take out or work around to remove the shunt catheters where-as she said in most shunt removal surgeries they can feel the shunt tubing and when they open up the patient they can visualize it right away to. She said they ended up using X-ray imaging to visualize where the catheters where before they could finally get them out. With the mindfind (aka my back) Dr.Bragg again had some troubles apparently because of scar tissue (despite that last surgery only being in late April/May) and I definitely could feel how much more removal she had to do in that area as it felt just like w the 2 lumbar laminectomy surgeries she has done to get shunt catheters in I guess maybe she had to go through muscle or something to get to the catheter and as well it has to be withdrawn from my upper thoracic spine down and out of lumbar incision which likely I would imagine causes some irritation to.
Thankfully my stomach, side (where the valve and reservoir where anchored) and collarbone incisions really dont hurt or uncomfortable bc my back and head more than make up for those other 3 incisions. With my head incision to remove that catheter I guess when they where pulling the tubing out from the ventricle it must have hit a blood vessel and that bled apparently something like crazy but the only way they could stop it was to apply alot of pressure externally which resulted in one massive aching pain in the R side of my head coupled w a almost burning like sensation inside caused they said likely from the pressure that had to be applied and resulting bruising and swelling. My R sided vision is super blurry, sometimes kind of double likely from teh swelling making reading and focusing kind of hard. We initially had the ventric drain set at 5 so I was also having on and off pretty bad pressure headaches and I thought the vision was solely from the blood vessel but then when Dr.Bragg's NP stopped by earlier today I asked if we could drop the drain down to '0' and that helps vision a little. This ventrics/EVDs definitely dont seem like they do a great job of simulating an actual shot and after feeling mostly good for the past 4-5 or so days  (I actually think the shunts where starting to work better as I could once again hear the VP shunt everytime it would drain as it causes a faint buzzing noise) and I had more energy whereas now even though I know surgery is still taking its toll I just feel really tired and headachy and some nausea. Boo! I hope this improves cause I so dont want to spend the next week feeling this yucky again. Hopefully this will improve.

Dr.Bragg and Infectious Disease where here this morning together (as was my Mom so she could hear what was being talked about so I am glad it was good timing). As mentioned above they are continuing the IV antibiotics for the next week and if need be will add a second one either directly in to the EVD catheter to my CSF or just as with the Daptomycin done as a regular once daily IV med.  The other Infectious Disease doc who has been on my case also stopped by today and told me he thinks the earliest surgery will be is Weds as they will get back some in-depth bacteria analysis test on Tues along with the daily CSF cultures and that will tell them if they are fine to do surgery Weds or is it better to give it a little more time and do it Fri. Clearly Weds would be better as I desperatly want out of here before Xmas Eve and ideally before sunday morning so I could go to my sunday school class holiday party with my co-teacher. :) Whatever is God's plan though will be, easy to accept or not. I would imagine if we do place the distal end of the shunt near the lung that we will have to watch it for an extrs day or two as Dr.Bragg has said previously she doesnt know if this area will absorb CSF well enough or with my overall absorption issues there be problems. Lets hope not.

On top of all this yuck I itch, I itch so bad I cant even tell you; as soon as I scratch one spot I have another and another and another. I am sure it is from all the bandages and dressings as I dont do well with tapes and dressings and get red and itchy + also have all this surgery garbage in my hair and covered by a ridiculously stupid and over-done turban type bandage all around my head. I am the type of person who can barely stand wearing 2 shirts much less stuff directly touching my skin and feel alot like I have fleas on me. Is seriously going to drive me up the wall batty.

Last night was god aweful hard emotionally I just wanted (and still want badly) to be home with my cats who I miss terribly and I want to be back to the comforts of my apt and bed and clothes and doing things right away vs having to wait for someone else for every little thing. I slept ok with Ativan by IV and decent pain cocktail control and this morning my Mom came to spend the day plus by noon I went back to bed and slept for a few more hrs while my Mom read and just stayed by. I am hoping so badly tomorrow is still a better less mentally and physically exhausting day.

I will try to update again soon,


1 comment:

  1. I hope that today is a better day for you, my friend. Keeping you in my thoughts and prayers!

    -Robin Piefer