Saturday, February 2, 2013

Revision #25 - TPL shunt surgery

We opted to tao the TPL shunt Friday morning and was not flowing so Dr.Bragg suspected it was either an intermittent  occlusin issue or the catheter was just not working due to being blocked. We kept the OR time and te 2 Anesthesiologists I had opted to place a arterial line this time for which  I stayed awake through most of and then they gave mild sedating med after which I dont remember the rest.  As far as intubation they used the same equipment as previous surgeries w the lighted scope and device to help visualize better.  Dr.Bragg when she stopped by this morning talked about how she can now tell the Anesthesiologists exactly what equipment will help as she isnt usually familiar w this + the mechanics of whats going on. She talked about the Anesthesiologists told her I have the aitway of a severely obese person due to so much extra tissue (tonsils/adenoids where taken out as a kid) probably caused by the mucopoilysaccharide storage. The limited opening they think is probably also likely from the MPS storage.

As far as the actual Thoracic Pleural shunt surgery revision Dr.Bragg told me she opened up the area and initially thought she would have to dissect down to the catheter (I am unsure if she ulimately ended up having to) to free it and replace this as it wasnt flowing at all. I think she said she manipulated part of the shunt some that was closer to the surface (?) and after a bit this would flow then stop, flow then stop confirming her suspicion of intermittently occluding due partially to not enough back pressure. (the pressure in the lung is alot lower than that of say the normal drainage point, the stomach so the catheter is more likely to occlude and thus ultimately (I guess) fail.  She must have moved the catheter some and un-coiled it from the round-about way it was initially placed, shortened it (?) and secured it with  a metal type clip. I do have to ask if the clip is titanium or is it actual metal for future scans. I imagine it is titanium. She commented she would like me to have help putting on a bra (fastening it behind my back to which I said I cant reach behind me and do already turn it around to fasten it then re-position to behind my back.) Showering i'll have to be careful w washing my hair over my head as well as reaching for objects she said; I am unsure why but will try to remember to ask her tomorrow and think it may be she is concerned that anchor will come loose and the shunt move? Right now any reaching doesnt sound appealing so will find other ways to get things.

She also wanted to leave the setting on the programmable valve blinded so she can adjust it and if symptoms say improve w the setting at a higher setting (5 choices to set it at overall) it would help her know that say the valve at high resistanc, lower drainage helps keep the catheter open better or lower setting, higher flow helps headaches but intermittently ( think I got that right!? on-the-less we will see.  We also talked about the low pressure hydrocephalus article I sent her and which she had a chance to read + she said the reservoirs work well for people who have enlarged ventricles but bc mine are so small the risk of bringing brain tissue/debris in to the shunt catheter is high (similar to how we had reservoirs last year w the VP shunt valve nad reservoirs for testing the shunt.) and thus occlusion/failure is high. I think she wished it was an option; I sure do!

Will update if or when there is anything new,
Thanks for stopping by - please keep a family friend Sue in your thoughts as she lost her husband earlier this week and I cant imagine the grief she feels.

God Bless,


1 comment:

  1. Erica, I continue to be in awe of how you handle everything in such a matter of fact manner. Very sorry for your friend Sue's are right, it would be impossible to know the depths of her grief. Get well soon so you can start planning your trip to California!