I went to rehab after my injuries in March 2014. I would go in an out of consciousness for like a week after my injuries while I was in rehab. I would be in Speech Therapy and then everything would go black next thing I knew I was back in my room. The numbness I felt throughout my body after my injuries continued for about two weeks afterward while I was in rehab. I also had double vision as my right eye since it had been moved as a result of my injuries.
While in rehab I had Physical, Speech and Occupational therapy twice a day. I had to do everything with someone watching me, eat, shower, bathroom in case I fell and needed assistance. Being in rehab was quite depressing as you can imagine. I'm not the first nor the last person to have injuries (brain or other type) then go to rehab to begin recovery. It was exhausting physically, emotionally and mentally since you're trying to do this rapid recovery all at once while your body/brain are also recovering.
The distal catheter in my stomach was still broken when I was in rehab. When learning about to walk and stand, this was an additional challenge. When you walk and stand you have to suck in your stomach to keep your balance. Every time I did this, I had pain in my stomach as the distal catheter was broken and scraped the inside of my stomach.
Dr IN who had done my surgery in March 2014 had told myself, my family and the therapists in rehab that I had one stroke. I learned during physical therapy that this was not true.
While I was learning how to stand again ( it took a month for this to happen ) I was holding onto a table while in the hallway when the Neuro Psychologist came to get an update from my physical therapist about my progress. He would then give these results to my neurosurgeon (Dr. IN) The conversation went as follows:
Dr NERO: How is she doing?
PT: She's doing good. She had one more than one bleed though.
DR. NERO: She only had a stroke.
PT: No, she didn't. She had more than one bleed. I can tell because of how her legs are moving.
Upon hearing this I was both shocked, angry and curious...
My legs were doing what they call scissoring. This is when one leg crosses over the other like scissors. For example, my right leg would cross over my left leg causing me to lose my balance and fall on my face if I'm not aware of it.
My legs still do this sometimes, I have to pay attention.
I returned home from rehab the first week of April 2014. My cat Stella (2000-2023) brought me all of her toys. I also ordered a copy of the operative report from March 2014 to read about what really happened.
Then I returned to see Dr. IN for a follow up appointment on April 23, 2014. He marveled and how great I looked because I was sitting up on the examination table. Then I said the following:
VB: The distal catheter is broken in my stomach. I can taste cerebral spinal fluid and I can smell it. It's leaking out of the distal catheter into my abdomen and it's very cold.
Dr. IN: You're having heartburn, Veronica. Take medication for that and call me back in a week.
Oh no he didn't....
Both my mom and I got angry at him.
VB's Mom and VB: Here we go again!!
Dr. IN repeated what he said about the heartburn.
At this time, I had been out of school for almost two months. I returned to classes on April 26. Since I had stayed 1 - 2 months ahead of my assignments by the time I returned to school, I only had two papers to write for one class. I struggled to write those two papers as I was mentally, physically and emotionally exhausted. I also still had the double vision. I only had a month of school left before the semester was over. My mom would drive me to class ( they were once a week ) and I would start sobbing before going into the building because I was just overwhelmed. I was tempted to drop out like five times before the semester was over.
I was able to complete the semester and handed in my last two papers.
As I mentioned in the previous post, I had expressed concern about appetite symptoms and vibrations in my head....This went ignored by Dr. IN. Those are symptoms that the shunt is broken and it is a medical emergency.
The first week of May 2014....I called his office and left him the following voicemail quite angry:
"Hello Dr. IN. This is Veronica. The distal catheter is hanging my a thread and it is going to poke a whole in my stomach and other organs if you don't fix this now."
Then he schedule surgery for May 12, 2014:
Diagnostic Studies: A CT of the abdomen and pelvis performed in May 2014 demonstrated the catheter intraperitoneal and positioned within the pelvis.
Description of Procedure: The patient was transferred to the operating room. She was given preoperative prohylactic IV antibiotics.
Anesthesia: The patient was sedated and intubated without difficulty by the anesthesia service. Eyes were taped shut after ointment was applied to prevent corneal abrasion.A Bair Hugger was placed over the exposed lower body to maintain control of the core body temperature.
Positioning: The patient was positioned in supine with the head rotated mildly to the left. A small roll was placed underneath the shoulder. All pressure points were carefully padded. Hair was clipped over the right side of the pre prepping was then done utilizing alcohol. Superficial landmarks had been identified including the right external auditory meatus, the right sided prior ventricular peritoneal shunt incisions.
Operating Technique: The head, neck and abdomen were then prepped and draped in standard sterile fashion. The mark cranial incision was infiltrated with the 1% lidocaine with epinephrine. Incision was made sharply with a #15 scalpel blade. Hemostasis was was promptly achieved utilizing self-retaining retractor. The shunt valve was disconnected distally and CSF was noted to be dripping from the valve. A rubber shod was then attached to the distal portion of the valve. The distal catheter was removed.
In summary, using diagnostic laparoscopy, the peritoneal cavity was entered, the previous VP shunt catheter was noted and removed. An adequate position for the new VP shunt catheter was then determined. At this point, a pass was then made form the belly incision to the scalp with an intermediate incision over the clavicle.
It was then tunneled from the incision behind the ear to the clavicular incision then to the abdominal incision with a 2-0 silk ties. At this point, the distal catheter was then connected to the distal portion of the valve and secured in place with a 2-0 silk tie. The distal catheter was then inserted into the peritoneal cavity with the assistance of general surgery. All wounds were then irrigated with antibiotic solution until clear. The galea was closed using sequential 2-0 interrupted inverted Vicyl suture followed by running 3-0 Vicryl suture and a running 3-0 Monocryl suture for skin. The abdominal incisions were closed using sequential 2-0 Vicryl suture, followed by 3-0 Vicryl suture, followed by a 4-0 monocryl suture for skin.
The shunt was tested with irrigation and Dr. IN then re hooked it up to the shunt. So, at this point, then the abdominal cavity was examined there was no injury to the bowel, there was no other pathology there was good homostasis and no drains left in place.
All needle counts, sponge counts and instrument counts were correct at the end of case x2. The patient tolerated the procedure well, and was transferred to the recovery room in stable condition.
I was told later there were pieces of the distal catheter floating around my abdomen which were removed. There were also pieces behind my right ear.
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| Above: Stitches after distal catheter revision in May 2014. |
You what happens when you don't get any sleep.
In the morning I got up and sat in a chair next to my bed. Around 9am, Dr. IN came into my room with who I believe was a student. He was making his rounds checking on all of his patients. I don't recall him asking me if it was okay or not for this person to be there.
The first thing he said to me was:
Dr. IN: Well, I guess when Veronica's shunt is not working, I should listen to her.
I almost kicked him in the face or somewhere else. I probably would have had I actually gotten sleep the night before. I was livid. I didn't look at him. I just said:
"Discharge me, I want to go home."
He agreed then left the room with the student.
Moments later, my family came to visit. I then expressed how angry I was at his comment. I also asked the nurse to shave the other side of my head... This way hair could grow back evenly. As mentioned in previous posts, surgeons shave the side of the head they are working on. Whenever you have surgery on your scalp, the hair doesn't grow back, it grows around and over the scars. See photo on the right of hair growth after surgeries in 2014.
For the first time in 5 years, my shunt was working properly.
The type of shunt he had given me was one of those programmable ones...
This one in particular wasn't one of those were you know the exact setting as soon as it's placed. This one you have to wait a while to see what the right setting.
It took an additional three months to get the shunt on the correct setting. The first time I went back in June 2014...Dr IN told me I had to get used to the shunt on my own. Another doctor had told me different. He had said he didn't use that type of shunt because it takes months to know what the right setting is.
When I saw Dr. IN for the last time in August 2014. He made an adjustment and told me to call him back in two weeks to let him know how I was feeling.
I didn't call him back.
My eyes were still crossed by the end of 2014. I would get my vision corrected in 2015.
