6.5 Months (3.5 Corrected)

Gabe had a tough week.  He had been quite irritable and not eating or sleeping well for the last couple weeks or more and the swelling of fluid around the shunt as it ran along Gabe's skull kept growing.  Last Wednesday, Dr. Riva-Cambrin, Gabe's neurosurgeon, decided that he needed to redo Gabe's shunt.  It was scheduled for the following Thursday, which would have been tomorrow.

Early on the swelling around the shunt looked like a sausage-shaped protrusion running along the side of his head.  By Sunday, it looked like you could fit half a dozen sausages in the swelling.  It was so bad it pushed his ear out.  And the pocket was very tight indicating great pressure in the skull.  In addition, Gabe's irritibility and eating issues continued to get worse.  So after consulting with the resident neurosurgeon on call we brought Gabe to the ER at Primary Children's.

After a brief evaluation, the neurosurgery team decided that the situation was not emergent and they scheduled the operation for Monday.  However, Gabe was admitted to Primary Children's so they could keep an eye on him in case his situation deteriorated.

The surgery took about 2 hours and Dr. Riva-Cambrin said it went well.  The surgeon first placed a new shunt on the opposite side of the first one.  He mentioned that usually he can just "dig through the skull with his knife" but that Gabe's skull was thick (6mm) and he had to "break out the drill".  When the new shunt was placed he noticed that there was pressure in the skull which was relieved immediately.

Dr. Riva-Cambrin then completely removed the old shunt and did some repair work so the old hole would not continue to leak into the swollen pocket under Gabe's scalp.  Dr. Riva-Cambrin evaluated the shunt after the surgery and found that it was blocked with "gunk"---that gunk being old blood and tissue from Gabe's original en utero brain injury.  Dr. Riva-Cambrin mentioned that when he placed the original shunt, the CS fluid was yellowy, but now it was "crystal clear" as it should be.  So he is confident that the new shunt will not get blocked.    The new shunt does not have a programmable valve and will has a statistically less chance of getting blocked.

Gabe was in a lot of pain following the surgery and was drugged heavily to alleviate it.  He did not want to eat very much for 48 hours following the surgery.  But he has now turned a corner, his pain is visibly reduced, and he is starting to eat well.  We are about to take him home.