Post by hollygirl on Jun 21, 2007 6:50:11 GMT 10
Noa's brain has been scanned. A sample of CSF has been taken and brought to the lab for testing. The seizures stopped, and Noa woke up. Abby sits on the edge of the bed, his small hands in hers, with his eyes looking up at her. He's tracking. All four limbs are moving. Abby even got him to laugh. Kissing his forehead she slides off the bed and walks across the room taking Luka's hand. He looks up at her and sighs. "He's ok." She says. Luka nods. He was supposed to be the strong one. The one reassuring her. And now, here he was, falling apart. Watching his son seizing really shook him up. He started blaming himself as Abby had blamed herself. "Luka.."
"No he's not... He's not ok... he has an infection and needs a new shunt.. he had three seizures... right now CSF is building up in his brain... I really don't think that is ok."
"Luka... come here." She says pulling on his hand. He stands up, and she leads him over to Noa's bed. Looking down at him, Luka can't help but smile. Noa has his legs in the air, with his hands holding onto his feet. His eyes are still puffed and red, as are his chubby cheeks. Luka tickles his foot and he giggles, a small smile visible through his pacifier. "See?" Abby whispers into his ear. Luka turns his head, resting his forehead against hers before kissing her lips.
"Luka, Abby?" Dr. Brunson says. "I want to talk about our options before taking this little guy to the OR."
"Ok.."
"Well, right now, you know that Noa has an indirect shunt. The CSF is diverted from the cranial cavity and drains back into his abdomen. His shunt consists of a lumbar catheter, a valve, and a distal catheter... but I was thinking about it, and we could take out that whole shunt system and do a Third Ventricular Cisternostomy.. I would put a hole in the third ventricle, and this will allow the CSF to flow to the subarachnoid space where it can be absorbed."
"Why didn't you just do that in the first place?"
"We initially thought that Noa would be better off with an indirect."
"Then, why change now?" Abby asks.
"It would be better for him. If the procedure is effective he won't need a shunt."
"What else could you do? I mean if this doesn't work."
"We could put in the Codman Hakim programmable shunt. It's the newest design in shunt valves This shunt has a pressure differential valve whose resistance can be altered using a magnet field transmitted through the skin. The valve settings can be changed during a routine office visit avoiding any surgery.. you guys could even do it. But I really think we should go with the TVC..."
Abby and Luka glance at each other nodding in agreement and then look down at Noa before turning back toward Dr. Brunson. "Ok." Luka says. "Do the TVC."
"Ok... well, it's time to get Noa to the OR, you guys know where the observation deck is.." Abby rubs Noa's arm, as tears pour from her eyes. "I'll take good care of him." Dr. Brunson says.
She just nods, kissing his forehead before he's rolled away.
"No he's not... He's not ok... he has an infection and needs a new shunt.. he had three seizures... right now CSF is building up in his brain... I really don't think that is ok."
"Luka... come here." She says pulling on his hand. He stands up, and she leads him over to Noa's bed. Looking down at him, Luka can't help but smile. Noa has his legs in the air, with his hands holding onto his feet. His eyes are still puffed and red, as are his chubby cheeks. Luka tickles his foot and he giggles, a small smile visible through his pacifier. "See?" Abby whispers into his ear. Luka turns his head, resting his forehead against hers before kissing her lips.
"Luka, Abby?" Dr. Brunson says. "I want to talk about our options before taking this little guy to the OR."
"Ok.."
"Well, right now, you know that Noa has an indirect shunt. The CSF is diverted from the cranial cavity and drains back into his abdomen. His shunt consists of a lumbar catheter, a valve, and a distal catheter... but I was thinking about it, and we could take out that whole shunt system and do a Third Ventricular Cisternostomy.. I would put a hole in the third ventricle, and this will allow the CSF to flow to the subarachnoid space where it can be absorbed."
"Why didn't you just do that in the first place?"
"We initially thought that Noa would be better off with an indirect."
"Then, why change now?" Abby asks.
"It would be better for him. If the procedure is effective he won't need a shunt."
"What else could you do? I mean if this doesn't work."
"We could put in the Codman Hakim programmable shunt. It's the newest design in shunt valves This shunt has a pressure differential valve whose resistance can be altered using a magnet field transmitted through the skin. The valve settings can be changed during a routine office visit avoiding any surgery.. you guys could even do it. But I really think we should go with the TVC..."
Abby and Luka glance at each other nodding in agreement and then look down at Noa before turning back toward Dr. Brunson. "Ok." Luka says. "Do the TVC."
"Ok... well, it's time to get Noa to the OR, you guys know where the observation deck is.." Abby rubs Noa's arm, as tears pour from her eyes. "I'll take good care of him." Dr. Brunson says.
She just nods, kissing his forehead before he's rolled away.