I Shunt Complain

Two weeks and one day in the hospital. Seems like this is never going to end. I think that when I heard the words "Tim's survived the surgery" my heart wanted to believe so much that everything would be peaches and cream going forward, but it hasn't.  Tim has been dealing with double vision eye sight, neck pressure from where the incision is, to fevers as high as 102.6, as well as dealing with an infections. This kinda slapped me in the face with the reality of.. this is not going to be over for a while.
      The good news is he is out of the ICU and Step Down for that matter. They did a lumbar tap to gain some spinal fluid for testing. The tests take a couple days but so far they don't think that his infection is in the brain (meningitis) I am thinking he may have MSSA which is a staph infection of the blood or a urinary tract infection. Either way they have him on two different types of anitbiotics twice a day. Vancomycin is one and a Cephzollin type is another. The surgeons also told me that they will have to put a shunt in his brain. Because where the tumor was placed and that it was placed there for a least 20 years. the muscles on the fourth ventricle are parlayzed and stuck in the same position. This shunt will be placed (a metal stent lik thing) so that the spinal fluid to get back and forth the way its properly needed. This should help with the confusion, the aggitation, and incontinece (he rarely has that) and also help him see straight.
 I have some information on Shunts that also show signs and symptoms if you think this pertains to you or a loved one.

Brain Shunt

A shunt is a narrow piece of tubing that is inserted into the brain in the fluid-filled ventricle.  The tubing is then passed under the skin into another area of the body, most often into the abdomen.  Occasionally, the shunt tubing can be placed into one of the chambers of the heart or the lining of the lungs.  The shunt tubing relieves pressure on the brain, a condition known as hydrocephalus, by draining the extra fluid in the brain ventricle(s) to a different area of the body where it can be absorbed more quickly.

Types of Shunts

• Ventriculo-Peritoneal – The shunt catheter goes from the ventricle in the brain to the abdominal cavity
• Ventriculo-Pleural – The shunt catheter goes from the ventricle in the brain to the pleural space located outside the lung
• Ventriculo-Atrial – The shunt catheter goes from the ventricle in the brain into the right atrium cavity of the heart
• Programmable – These shunts have special valves that can be adjusted to allow more or less fluid to drain
• Fixed Pressure – These shunts have valves that drain at a set rate, either low, medium, or high

The type of shunt a patient receives is dependent on their symptoms and specific diagnosis.  Talk with your doctor about the exact shunt he or she will use during surgery.

About Your Shunt Surgery

For most shunt surgeries, patients are given general anesthesia to put them to sleep.  A breathing tube may also be inserted to assist your lungs throughout the procedure.
Patients are placed on a special operating room bed that allows for optimal access to the head and room for the surgeon to work and helps greatly reduce the potential for blood loss.
Your surgeon will make an incision in your scalp.  A small hole will then be made in the skull.  Your surgeon will then place the catheter into the ventricle.  The other end of the catheter will be tunneled under your skin into your abdomen, chest or heart, depending on where your neurosurgeon has decided.

Length of Stay

Your length of stay in the hospital depends on the reason you had a shunt and what type was inserted.  Also, patients may experience difficulty with walking, talking, balance and strength after surgery.  Most patients who have a shunt inserted will go home the day after surgery, but your surgeon will decide when you are ready for discharge.
If you require rehab before going home, a doctor from the Physical Medicine and Rehabilitation department will see you and make specific recommendations regarding your discharge.
You need to be able to walk, eat, urinate and your surgical wound must be healing well.

At Home

• You should continue to gradually increase your activity and walking within and outside the home is encouraged.
• Avoid lifting and strenuous activity
• You are not allowed to drive a car.  Your doctor will give you specific instructions about driving on discharge or when you follow-up in the office.  You can ride as a passenger in a car as directed.
• Sexual activity may resume when indicated by your doctor
• Remember to call and schedule your follow-up appointment with your doctor once you are at home
• If you have a programmable shunt, it will have to reset each time you have an MRI
• You may shower, but try and avoid bathtubs, whirlpools and swimming pools until cleared with your doctor.
• If you have steri-strips (strips of tape), cover your incision as directed by your doctor.  You or a companion may remove the tapes as directed.  If your tapes do get wet, you pay pat tapes dry or use hair dryer on cool setting.
• If you have staples, you may wash your hair but not scrub over incision.
• DO NOT apply lotions or creams near incision site.  No hair dying/perming until cleared by your doctor.

Contact your doctor immediately if:

• Swelling on around the incision
• Incision becomes red and hot or has drainage
• Difficulty breathing or chest pain
• Fever of 100° or higher
• Double or blurred vision
• Seizure
• Vomiting or nausea
• Severe headache
• Change in level of consciousness

http://www.brainandspine.org.uk/information/publications/brain_and_spine_booklets/hydrocephalus_and_shunts/index.html