Saturday, January 26, 2013

Revision #23 VP shunt, day one post-op

Yesterday Dr.Bragg did the shunt tap and opted to just tap the VP shunt for now which did show the shunt had re-ccluded within a couple days (tues to probably thurs) which those who know much about shunts know this actually isnt all that uncommon and occurs quite frequently especially for some people.  The failure rate in the first 6 months is 60% and especially high rate of failure in the first days or weeks.

She opted to book an OR last night after she finished another un-planned surgery in another of her pts who had surgery earlier in the week presumably (but I dont know) for a shunt to.  I had a different, new Anesthesiology team last night and they opted to not do a arterial 'A' line  to monitor cardiac issues as the dr was specifically a Cardiology Anesthesiologist and felt we would be fine with just careful BP monitoring and less invasive. Nice and score - take the blessed small things with the unexpected bad occurences in this case being the surgery.  As far as the revision Dr.Bragg wasnt sure up till we where in the OR if she would leave the 2nd (new) catheter in place or remove it as we didnt really know if it was helping or hurting given so quick an occlusion. She ended up leaving it in place.
She moved the catheter from the back of my head (2nd ventricle) and created a new tunnel (the former frontal shunt tunnel from Dec had closed off already; likely secondary to the MPS I think Dr.Bragg said as that shouldnt occur typically so quickly; almost makes yah understand why the shunts are so hard to figure out if that same storage is occuring in the CSF and shunts as the shunt catheters are smaller than a straw in width and already as prevously written very prone to malfunctions.

During the surgery the catheter and former valve where removed and catheter moved + then placed  in the new shunt tract line and re-connected to the new (but same style) aesculap mini-nav in-line valve. She had to use 2 different pieces of equipment to get the catheter located well and straight within the ventricle as the initial photos where grainy and they had trouble getting a clear view of where she was trying to place but also make sure the catheter wasnt occluded.  She ran in to some troublesome looking CSF as she placed the catheter at the top of my head (so they opted to do additional antibiotics) and enlarge the incision they where going within as she didnt think it would close or heal well if they left the catheter underneath it and stapled. Apparently the incision is now about double the size but hopefully still coverable by hair. (so vain I know)

I cant think of what I might be forgetting but we just wait and see now if the shunt will stay working; hope so! It seems like even though it was short lived at just a few weeks (at most) the shunt in Dec was brilliant in how I felt compared to this! Part of it is the 2nd valve at my collarbone is sore and these numerous surgeries take a toll and in reality the first couple days are the hardest. One day at a time..

Apparently Dr.Bragg in talking to my parents last night said to them something about how I hold alot inside and she thinks there's alot going on I dont talk about (or something like that.) Sweet that she cares and although I dont want her to she takes my ups and downs so personally. She wouldnt go out of her way like she has if she didnt care.  She wanted them/I to know we can always talk to her (I know and apprecate this I just am notoriously quiet when it comes to wanting to ask for help or really talking about how I feel physically much less emotionally as I dont want to whine and already have to ask for so much help from people like Dr.Bragg. Id rather not complain until something is really bad and I need to ask for help which maybe isnt always the best for my providers trying to figure me out.

Stay tuned, we'll figure this stuff out and hopefully soon!


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