Thursday, November 13, 2014

PFTs/breathing, Shunt surgery, PMR/botox

I'm not sure what made me realize or think of it but the Pleural Effusion symptoms that have been occurring for some weeks (with the cough that has been occurring for the past 2-ish wks) is the same symptoms that occurred for weeks after the 2nd OHS (open heart surgery). - I'm not sure what the deal is but the symptoms ebb and flow throughout the day, seemingly the worst at night. Definitely annoying and really wishing would improve or go away... Surgery is next Thurs and makes me a little nervous.
Apparently the consensus atleast between my PMD and Peds Neurosurgeon is this Pleural Effusion is caused both due to the TPL Shunt and partially heart related. Last year with these symptoms the TPL Shunt was temporarily re-routed to drain (along w the VP Shunt) to the peritoneal cavity so it would seem it was different causes each time?..
Overall I've not heard anything regarding the PFT results from Cardiology nor if they have a problem w the surgery going on, though they are aware it is next wk. (my PMD wants their blessing on the shunt surgery going ahead). I guess or would imagine they'll likely give myself/my PMD the ok before next Thurs or give us the PFT results but would indeed be a relief to know sooner than later. I don't imagine they have a problem w the surgery given the NP didn't seem to think there would be the other wk but there's also been somewhat mixed communication regarding the PFts and f/up. Non-the-less i'll just be happy when the surgery is over (hopefully next wk) and dealt with.
As far as the blood thinner (Coumadin) i'll take the last dose of that on Monday which gives 3 days prior to surgery though haven't heard if they'll require testing the day before of just test the morning of surgery (during the 2 hr pre-surgery time). Generally INR should be low enough within that 3 days range though last time (unsure if it was related to General Surgery working w my Nrsgn) they required the level to be within the "normal" range whereas other surgeries Dr.Bragg/Anesthesia has just done Plasma ahead of surgery if the level wasn't low enough.. Unsure this time.

The PFTs (breathing tests) where yesterday (Tues) with 6minute walk test and seemed to go relatively ok. I didn't ask the Tech what her opinion was but asked my Cardiology Team to to send the report to my PMD (outside medical center) and to let me know if they'll clear for the shunt surgery.. Per my PMD and her having apparently talked with Dr.Bragg last wk Dr.Bragg wants to go ahead with surgery if possible. I am sure hoping we can just get it done.

PMR F/up - Botox
Today (Thurs) was 3mo f/up for Botox (spine spasticity; botox injections calm the c-spine, thoracic and shoulder muscle signals from becoming overly reactive). Overall Dr.C did 15 injections at the various points trying a different strength to see if it would have the same benefit. Follow up once again in 3months. She commented that some of the muscles seemed more tense/tighter than normal, asking if I'd still been doing massage (Physical Therapy) which was a little surprising she could tell but I have not been to PT for a little over a month. It always surprises me how many of my Providers can really tell a significant difference between when I am and when I am not actively doing PT.

I'll update when/if I hear anything from Cardiology or my PMD or otherwise if anything new comes up regarding the VP Shunt surgery.
Thanks for stopping by,

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