Thursday Update

June 26, 2008

by Judy

We hope that today's surgery will be the last that Doreen will need for a very long time! For the fourth time in the last month, she had a neurosurgical procedure done. This time it was the installation of a shunt. Dr. Kachmann removed the drain and threaded a tube from that spot in her brain through her neck and chest to her abdomen. This will be permanent and self-regulating. When the pressure from the cerebrospinal fluid is too great, it will allow for drainage from the brain into the abdomen where it will be absorbed by the body. When the pressure is fine, the shunt will stay closed.

When Dr. Kachmann removed the drain, he said that a significant amount of fluid spurted out. This confirmed for him that Doreen needed the shunt. That build-up explains some of the concerns that we all had about Doreen's behavior over the past few days since the drain was clamped off. It will take some more days to see whether things really improve now, though.

In the pre-op area, Doreen said she did have a question for Dr. Kachmann. She asked him if he was planning to use a chain saw. We interpreted that to mean that she was relatively relaxed before the surgery!

After she returned to her room, she was in a quite a bit of pain. She said her head hurt, and that her mouth and throat were sore. She also indicated that her abdomen was sore where 3 small incisions were made for laparoscopic procedures to locate the output areas of the shunt. Some of the problem with her mouth and throat would be due to the fact that she had a tube in her throat during the procedure again.

Because she was in pain, the nurse offered pain medications. Several possibilities were offered by the doctor's prescriptions. A dose of Demorol was given IV at the lowest prescribed level, but it clearly was VERY strong for Doreen. After getting that injection, her heart rate, pressure, and respiration dropped lower than was comfortable for any of the rest of us. The nurse did several things to keep her alert and try to raise those levels. A couple of hours later, she was resting very peacefully and sleeping well--even if it was somewhat drug-induced.

Before the family left in the evening, the nurses pried her eyelids open to check her pupils and asked the usual questions of where she was, what year it was, and why she was there. She answered the questions very well, although in a very drowsy way. We look forward to tomorrow when the drugs continue fade so that we can measure the success of this latest intervention. It is possible that she could be moved from intensive care back to the other hospital unit tomorrow, and the surgeon is predicting that she will be discharged from the hospital next week, although no day was given. We are looking forward to a new setting closer to where we are staying!