Saturday, September 17, 2011

In-patient 7, Post-op (1st) 4 days, Post-op VP shunt - 1 day

Well surgery for the VP shunt was yesterday about 1:30 and as with these previous surgeries I was completely awake in to the OR while they placed all the monitors, oxygen mask, and set-up. Once this was done they used the mask for the general anesthestic vs using a sedative before I got in to the OR and my being loopy. I dont love the loopy sedative and appreciate that the anesthesia drs and my neurosurgeon are ok with my being awake right up till they start. Anesthesia itself went well with the camera scope being used just as it was tues and with other surgeries. In total the surgery took a little over 3 hours and consisted of removing the ICP and EVD monitors from my ventricle and brain, placing the VP valve and tunneling this down the back of my head and back around my ear down the back of my neck to chest downward to peritoneal (stomach) area. According to neurosurgeon this tunneling in my neck and chest was difficult due to very little reserve bc of how thin I am and little fat so that took a little longer and the tubing is noticeable but then again so is the Port-a-Cath tubing on the other side of my chest albeit the Port-a-Cath tubing is smaller in size it appears. I dont have a cap on but have a gauze type cover on the valve incision at top of my head and this is stapled shut then there is more staples behind my head w/more gauze type stuff and more staples behind my ear. With the incision in my stomach my neurosurgeon had hoped to detach the peritoneal catheter tubing from the LP shunt valve and re-attach this to the new VP catheter but she ran in to to much scarring and could not locate the LP peritoneal catheter and so had to completely replace the peritoneal cathether.  She said it isnt a problem to have these 2 sets of catheters in that area.The LP shunt is also tied off at the valve side of the shunt in addition to the reservoir side of the shunt now to. . Lastly she cleaned off the CSF fluid that had built up around the lumbar incision cathether of my LP shunt and the last remaining small amount should dissolve on it's own. She opted to leave in the LP shunt but tied off in case we should ever need to go back to it and this way she wouldnt have to place an entirely new system and She left the LP shunt in place bc if we ever need to go back to it and given the difficulty and amount of scarring in my lower back where the shunt begins.

Interestingly last night I could actually feel the shunt valve working it does sort of a tapping thing I assume as it's letting fluid out - very strange and at first I was totally like what is this but then I realized it was likely the shunt valve and is kind of curiously, weirdly, fascinating.   Today nrsgn has ordered imaging which include both CT scan and shunt series - i'll update when I know anything new but so happy to be this weekend and not last weekend! Also very grateful to this neurosurgeon for recognizing last weekend what even I didnt rexognize with the LP shunt and though I dislike being in the hospital am grateful for her care and help in this all.
Take care -

Erica

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