Shunt Surgery

Psalm 100:5

“For the Lord is good and his love endures forever; his faithfulness continues through all generations.”

Seraya has been doing good the last couple of weeks and there has been a big change for her this week.
She had a reservoir in her head which the doctors had been monitoring for a  couple of weeks now. Up until last week it had remained stable and seemed like it was draining the fluid, to prevent pressure from building up. But last week Wednesday, they did a head ultrasound and noticed that the ventricles inside her brain were a lot larger than they had been two weeks ago. So, they called a neurosurgeon to come up and take a look at Serayas reservoir. Dr. Ajani who was the surgeon who installed the reservoir, came up and examined her. He instantly noticed that there was pressure that had built up, as the area at the top of her head, where the reservoir was, was bulging and tense. He had to tap into her reservoir , and removed 32 mls of csf fluid to relieve some of the pressure. During and after this procedure, Seraya had several heart rate drops and started desatting quite a bit. So, they bumped up her oxygen and provided her with a little more pressure through her opti-flow. After a couple of hours she settled out and was more stable again. He ensured us that the reservoir was no longer working and that he would have to insert a vp shunt within the next couple days. A ventriculoperitoneal (VP) shunt is a medical device that relieves pressure on the brain caused by fluid accumulation. VP shunting is a surgical procedure that primarily treats a condition called hydrocephalus. This condition occurs when excess cerebrospinal fluid collects in the brain’s ventricles. CSF cushions your brain and protects it from injury inside your skull. The fluid acts as a delivery system for nutrients that your brain needs, and it also takes away waste products. Normally, CSF flows through these ventricles to the base of the brain. When this normal flow is disrupted, the buildup of fluid can create harmful pressure on the brain’s tissues, which can damage the brain. Doctors surgically place VP shunts inside one of the brain’s ventricles to divert fluid away from the brain and restore normal flow and absorption of CSF.

Brian and I had a meeting the following day with the neonatologist and the neurosurgeon, and they informed us that the surgery would take place on Monday, April 18th. 

She was doing good up until Friday early in the morning. The nurse went to handle her around 3:00 AM, but noticed that the blanket under her head was all wet. They quickly figured out that the puncture hole they had made with the needle, when they tapped her, had re-opened due to pressure that had built up again. The csf fluid continued leaking until they glued it shut with dura bond. Once it dried, they put a second layer on to ensure it stayed closed, and to prevent further leakage. Once again she started having clusters of heart rate drops, and started desatting a lot. They bumped up her oxygen and pressure again to help her body adjust to the change. They figured she lost 36 mls of csf fluid from the leak. Her reservoir was still bulging a little, and so Dr. Ajani came up around 11 Friday morning and tapped her again. He wanted to relieve as much of the pressure as he could to ensure that she would not leak again before Monday. He took out 18 mls of csf fluid during that tap. They started her on a broad spectrum antibiotics, just to be cautious and to prevent any type of infection, particularly meningitis from setting in, as her head was exposed during the leak. They also started her on ivs to replace all the fluid she lost during these taps and from the leak. She remained stable over the weekend.

Monday at 1 o'clock she went down to the OR, for her shunt surgery. She was in and out within an hour and a half, which we were happy about. We talked to Dr. Ajani afterwards and he said the surgery went really well with no complications. Once again we were so thankful that God blessed the hands of the doctors, as they worked on our little girl. All praise be to God for answering our prayers again! They did leave her reservoir in for now, as there was quite a bit of fluid in it, so he said if they had removed it, it would have been too much of a shock for her body. He will have to remove the reservoir at a later date. They wanted to be very cautious with her this time, just because after the last surgery she was so unstable for awhile. 

Currently she is recuperating nicely. They extubated her yesterday and put her back on opti-flow. She is back up to her full feeds, which means she is iv free:) She is still being fed through a ng-tube, as she is not able to orally feed yet. Her food is now being pumped into her, over an hour. She has been handling this really well. She is weighing in at around 8.5 pounds at the moment, but does have a little extra fluid on board from the surgery. They have stopped her antibiotics, as all her blood cultures have come back negative, which means no infection:)

Brian and I are extremely thankful she is doing so well after her surgery. We are continually humbled at how we have such a gracious and loving Father, looking after us. We are amazed at far she has come and for Gods goodness in our life. He continues to watch over her and us, and provide us with the strength we need to continue on our journey with Seraya. We are happy the shunt surgery is over, as this, is one step closer to going home!! 

We would like to thank everyone for their continued support and prayers for our family. We appreciate this very much!! 

Psalm 95:7

“For He is our God and we are the people of his pasture, the 

flock under his care.”