I really don’t even know where to start/continue. For the past 2 days, she is throwing up everything that goes into her stomach, her heart rate is way elevated, her O2 sats are hanging in the lower 70’s, she is extremely uncomfortable and agigated, she has lost about 200 grams of weight in the past 48 hours. No fevers, no signs of infection at all. The docs are stumped once again. Everything was going so well after the brain surgery.
There is nothing that the intesivists and cardiology have changed, so they are narrowing down the problems to the VP shunt. I have been waiting for a consult with neurosurgery all day and finally got a hold of the fellow on call on the phone tonight. There are several things that might be going on:
- The ventricles in her brain are trying to find a new baseline of fluid…pretty much just adjusting to the shunt which would get better in about 3-4 days (this is obvsiously what we want)
- There might be an infection in the shunt, but given that she was just on a hefty dose of antibiotics and there are no signs of infection, this is probably not likely or
- The valve in the shunt needs to be adjusted. It is definitely working but may be overdraining the brain. I can’t even imagine how painful that would be.
The cardiac intevisits are having some disagreements about how to handle her discomfort. Some want to put her on anti-nausea meds, others do not. What they have agreed upon is to stop feeding her because she just throws it all up, so she is on pedialyte until tomorrow morning. We’ll see what tomorrow brings. Right now, she is watching baby einstein and trying to fall asleep. She actually smiled at me several times today in between vomitting, poor little thing…