Saturday, July 4, 2009
On Thursday, I thought that Shelby's shunt was looking bigger than normal, but was not completely sure. It is hard to tell if I am just being overly paranoid sometimes--I was second guessing myself. Anyway, yesterday morning, I thought it looked big again, and Trip agreed that it was. It just looked "puffy". One of the signs of VP Shunt malfunction that we were told to look out for is the pooling of fluid around the shunt site. Trip and I thought that it was definitely fluid causing this puffiness. We called Duke Hospital and they paged the on-call pediatric neurosurgeon for us. He did not seem overly concerned. Last night, we noticed that this puffiness would come and go almost instantly, depending on Shelby's position and demeanor. We paged the neurosurgeon again, and he said that we should probably go to the ER to have it checked out. So, we nervously headed back to Mission Hospital last night around 8:30 pm. The ER staff were great to us. Apparently, you get seen immediately when there is concern about a brain shunt. Anyway, the ER doctor looked at the shunt site and then called the Duke neurosurgeon again. He was actually able to talk to the attending, Dr. Grant, who was there performing an emergency surgery. Dr. Grant told the ER doctor, who in turn told us that it is normal for there to be a little pooling of fluid around the site in the weeks following surgery until a good "seal" is formed. What we should be looking for is drastic pooling of fluid and of course a bulging fontanelle (soft spot). It is frustrating that the resident neurosurgeon we talked to twice yesterday couldn't have told us this over the phone. However, it was probably worth the ER copay so that we could sleep last night and enjoy this holiday weekend knowing that Shelby is okay. Happy 4th of July everyone!