Saturday, February 23, 2008

Low Pressure...

We have been dealing with low pressure symptoms here. The only thing worse than HIGH pressure is LOW pressure. Friday around 5:30pm Gabe started crying and grabbing his forehead. By 6pm he could only lay flat to get relief. The minute he stood upright he became nauseated, dizzy, blurry vision and had eye pain. By 8:20pm, I called Darren and we discussed it and we decided that we needed to place a call to neurosurgery.

Finally, after a 2nd page, I spoke to the (dumb ass stupid ns resident that I do not like...there are 2) and our options were. 1) increase his shunt setting or 2) drive all the way to Comer ER and get a shunt x-ray to make sure that all the shunt connections are connected and not leaking. It was almost 9:30pm and Gabe could not stand/sit upright for 3 minutes and you want me to drive to the ER 1.5 hours away? I asked him what to increase his setting to and the resident said that he did not know. Then after a long pregnant silence he said, I will call and talk to Dr. Frim about that.

9:50pm and one of our favorite residents, Dr. Steve, calls me back and we discuss what we think is going on. He had me check Gabe's back and incisions for signs of a CSF leak. There was no bogginess or squishiness so we ruled out a leak from the spine or the connectors. The biggest concern with Gabe is that he is SOOOO sensitive to high pressure. What some people can function at, he cannot. So we have to extremely slowly raise his pressure. We were to take him from a setting of "3" to a setting of "4". Leave him there and recheck him in a couple of hours. Do this throughout the night, call with an update in the AM. If we cannot get him comfortable or upright by Monday then we were to bring him into the ER. After resetting him to "4" Gabe started sleeping very well. We opted to NOT mess with his shunt any more during the night as he wasso hard to rouse and we wanted him to rest. This morning he still had pain so we reprogrammed him to "5". At Noon we programmed him to "6". He started doing well and while he still had a headache while upright, he was ABLE to be upright. Which was a HUGE improvement. He was doing well until 4:30pm when the headaches started in and he needed to constantly lie down. That is where we are at now. I will most likely either 1) call the NP on call tomorrow or email Dr. Frim tonight. As long as he is down he is little to no pain. He can get up, but then his pain increases. Sometimes it is a few minutes before the pain starts...other times it is an hour. It makes no sense.


Mommy I have pain...I have to lie down.


His Side.




3 comments:

Lynn said...

Wow the pictures are really cool! Hope our favorite patient is feeling good today!

HUGS!

Kristen said...

Wow that's a neat little device. I sure hope he's doing better this morning!!

Jessica said...

I hope that the pressure evens itself out and the little guy gets some pain free time. Heaven knows he deserves it.