Thursday, November 19, 2015

Shea's admitted again, drainage problems / and csf leak or shunt issues

Shea continues to battle an on and off fever.  His drainage is much more than it should be at this point and he's been needing dressing changes multiple times per day.  It is confirmed from imaging that he has a very significant hematoma.  The question is... may he also have a csf leak from a failure of fridays dural repair during surgery. 

Originally until yesterday evening, csf leak was thought to be low on the liklihood scale.  Then last night he developed a severe headache, worsening when upright, and we watched him through the night.  By morning he had light sensitivity and eye rolls.  For a bit he even had mental status changes, ( not able to say the alphabet etc ).   So of course we were off to the ED.  Dr Sanders is in Boston, and Dr Cook has stepped in to cover in his absence.

So far the CT scan shows enlarged brain ventricles.  Now we have to figure out why.  Neuro here at Strong stated talking immediately about shunt revision surgery, but i strongly advocated and was backed by others ( in buffalo neuro and roch ortho ) that  we need to rule out other causes before we jump to that conclusion.  Right now we have lab work off to test the fluid that is draining so profusely right now.  ( they did a needle aspiration )  Once we find out if it contains CSF ( cer. spinal fluid ) we will know which direction to take with treatment. 

Thank you for prayers not only for Shea here in the ED, and for doctors to be likeminded and on the correct track... but also for Dan at home, and the trickiness of managing the family, and all that entails that we usually do as a team. 

Shea has been in ED for 12 hours now... we were officially admitted at noon and waiting for a room, and i'm told one is opening up now in the children's hospital and we will be moved soon.   I will keep you posted as we know more.... 

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