Inside the VP shunt catheter at the ventricle/proxumal end of the catheter.
I saw my neurosurgeon today she took out the gauze and staples (there are sutures in) and we talked about how I am feeling. I always hesitate to honestly tell her when im not feeling a whole lot better not because I dont trust she wants to keep helping at this point but bc I dont want to sound whiny. Ugh sometimes I hate being a patient!!! She said it's possible the shunt could have clogged off again with debris because there isnt enough resistance and we talked more about putting in a second valve. We decided to give it through the weekend to see if these H/A's and nausea improve at all and I will call her early-to-mid next week to let them know how I am doing. She also said if it wasnt improved she would have me come back in, she would fit in a spot and she would repeat the scans. She explained how the thinking is that a 2nd valve could provide more resistance to the CSF flow and thus prevent the ventricles from collapsing under the extreme pressure/flow occuring due to CSF and my single shunt valve not being able to keep up and thus the ventricle collapses in on itself as CSF flows until so much pressure builds up they almost explode (my word) open again against the forced pressure. She thoguht this could very well explain my cyclical up and down headaches. (the ventricles collapsing due to not enough resistance and being forced open because of pressure).
When she went out to get the staple remover kit she must have run down to her OR locker as this was where she had told me last weekend she had a picture for me from the surgery. This is a 8x10 shot from the scope camera she uses to thread the catheter in to my ventricle and that she used to see what was going on with my shunt last fri. The white spots scattered around the opening are body matter and she said although the picture doesnt show it these where scattered all throughout the upper (proximal) portion of the catheter and definitely the cause of the shunt failure. The picture shows the tip of the ventricle and then there is black space further in the hole and this is the tunnel created by the catheter (to use her description much like when an animal burrows underground and into the dirt but they leave behind a tunnel that doesnt fill up) - apparently this will always be the way my ventricle and brain look regardless if the shunt was takenout (which it cant be), Drfinitely kind of fascinating! Apparently also the majority of neurosurgeons do not use scopes to place shunts and she herself said she rarely used them before coming to UW/AFCH but the other neurosurgeon there convinced her to learn and it helps her better be able to thread catheters in to very small ventricles like mine. Interesting stuff to learn! (to use another of her analogies I said something about how I thoought being able to take the pictures would be fun but wouldnt want to do the rest (not because of blood and stuff just wouldnt be good at it!) and she jokingly said 6 year olds could probably do it well these days because of video games - having to operate the remote while looking at a screen to get the visual of the problem areas. I will forever laugh and think of neurosurgery in a funny way when my older nephew is plying video games here. :)
I'll update other things soon -
Take care,
Erica
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