Saturday, October 18, 2008

Under a Little Less Pressure Now


The surgery was a success.

Over the past 5 years or so, my mother was having difficulty. She recently retired from her career as a Presbyterian/UCC minister, but of course, as the sign in the novelty store says, "Old ministers never retire ~ they're just put out to pastor." So, like any good retired minister, she kept working, doing interim jobs and supply preaching nearly all the time. And she traveled overseas a lot.

But she was having more and more difficulty. The most obvious thing was that she couldn't walk normally. She couldn't seem to pick up her feet from the ground, so she would shuffle, and her balance was off. It got so she couldn't walk more than a few blocks.

I thought it was mostly arthritis, but that it could be other things that I don't know about. I know about arthritis, because I have it, from running too much. But I went to the doctor, and found out what I could do to make it go away, so I could keep running too much.

I kept telling Mom to go to the doctor. I also asked my daughter and my brother to tell her to go to the doctor. Maybe if enough people told her, she would do it. (She said she was too busy. Until there was a break in all the activity of her retirement. Then she finally went. Audrey gets the credit, because she was the last one to tell her, before she finally made the appointment.)

So she went to the doctor, and was hospitalized that day. They said she might have a brain tumor. In the hospital, they found a diagnosis that we were much happier with.

What my mom had was "Normal Pressure Hydrocephalus," otherwise known as "water on the brain." There are many things that can cause it, but it commonly happens after age 60. In fact, Billy Graham had it, and recently had the same surgery. So I think it is caused by preaching.

We waited a long time to find out when the surgery was going to be. Mom was planning to go to Chicago with us, and even reserved an expensive hotel room in downtown Chicago. But then we found out that the surgery would be a few days after the marathon, so she decided she'd better stay home and rest up. She still helped us with the hotel room, though. (Thanks, Mom!)

So the day after the marathon, Audrey and I drove to Iowa, and took Mom to Omaha for the surgery. We spent a day at the hospital, going to various doctors and anesthesiologists and lab technicians. It was good to meet these people who were going to be messing around with my mom's head.

On the wall, there were photographs of some of the distinguished physicians of this hospital, and my mom's surgeon was one of them. I told her "I'm going to take his picture!" She said I should just leave it there on the wall.

With the help of the doctor and a magazine article in Neurology Now, I think I understand more about this disease.

In the inside part of the brain, we have these cavities called ventricles. There is fluid in the ventricles that helps to cushion the brain, and deliver nutrients, and take away waste. Normally, we produce about 8 oz of this fluid each day, and it gets absorbed into the body as we create more fluid.



But with hydrocephalus, we produce the fluid faster than the body can absorb it. (I think the problem is on the absorbing end, not on the producing end.) So it builds up, and presses on the brain. This can cause headaches, trouble walking, balance problems, bladder control problems, and dementia, among other things.

Since these symptoms can look like normal signs of aging, or like Parkinson's Disease, or other things, the diagnosis is often missed. A lot of people in nursing homes have this, and it's undiagnosed. My mom is lucky, because they got it right away! (To diagnose it, you have to have an MRI or a cat scan.)

The way to treat this, usually, is to install a shunt, to drain off the extra fluid. Mom now has a length of tubing running from her brain to her abdomen, carrying off the extra water. The cool thing is that now they have these adjustable shunts, so the doctor can control how much fluid is drained from the ventricles. They didn't used to be adjustable, and people had more problems with them. (I think Billy Graham had the old kind, and he recently went in to have it replaced with the adjustable kind.)

If you drain too much fluid before your brain gets used to it, you can have bleeding complications. That's serious. So the doctor told me that they set it at a medium-high pressure at first. When she goes in for her visit, he will adjust it downward. (He just turns a dial on a remote control. It takes a few seconds!) If her symptoms continue, they will keep adjusting it downward, but gradually.

After the surgery, the doctor told me that everything went as well as it could possibly go. It went in on the first try, and he wasn't expecting any complications, or anything out of the ordinary. (But he explained what the "ordinary" complications would be ~ infection, or injury caused by overdoing it, or mechanical failure of the shunt.)

I know this guy is a brilliant doctor, because he was operating on one head, and he relieved the pressure in dozens of heads, including mine! That takes some kinda genius.

I think he raised our I.Q.s, as well. I know that Mom was very smart when she woke up. She answered all their questions correctly, and did everything they told her to do.

She was proud of her hair-do ~ she will have a Donald Trump comb-over for awhile. Immediately after surgery, she asked me to take her picture, and send it to my brother, and to her friend Loretta, and ask her to put it on Facebook! So I did. Doesn't she look beautiful?



The doctor said it would be okay for me to go back to Kansas City to work, and come back the next day. The soonest she would be released from the hospital would be Saturday ~ or Friday, maybe. Today was Wednesday. Perfect. I left some of my clothes and things in the room we were staying in (the hospital has wonderful apartment-like accommodations for family members!) Since my aunt and uncle were coming, they could stay with her for the next 24 hours, and then I could come back to Omaha.

The next day, Thursday, I called from Kansas City to see how she was doing. She said "Don't come back ~ I'm going home today!" I was astonished. She said "I woke up at 3am, and said 'I'm gonna blow this pop stand!'"

Audrey and I wondered if she had made such a pest of herself that the nurses wanted to get rid of her. I think that is what happened.

She woke up at 3am, ready for the day. She asked if she could take a shower and wash her hair. The nurses said no, they have things they need to do at that time of night, and there are people who come in (in the day time) to help with bathing. And she really needs to ask for assistance when she goes to the bathroom! She said she could do that just fine on her own ~ she's been coping with this for years, after all, and hasn't ever fallen ~ now that she feels better, she ought to be able to handle it.

By mid-morning, the health care professionals all agreed that she needed to go home, for everyone's sake.

So my aunt and uncle took her home, along with my stuff, and I did not go to Omaha that day.

On Friday, I went up to Iowa to fill her freezer with food. I knew she had no groceries, and this was my chance to sneak some vegetables into her.

I brought all the Tupperware I had, and drove to Clarinda for groceries. Then I took the groceries to Villisca, and spent the day cooking. This is the most cooking I've ever done at one time, and it wore me out! But I filled the freezer, and I know she will have at least some vegetables in the next couple of weeks.


2 comments:

Lesley Looper said...

So glad to hear your mom came through the surgery so well! Thanks for the update!

Anonymous said...

This is wonderful news! I hope your mom's recovery continues to go well.