Olivia's 3 Week Follow-Up with Neurosurgeon

We had Olivia’s follow-up today. It went well. She is doing really well.


What she can now do

1. She can now take a bath and swim in the pool!
2. She can be a little more active now

We still have to wait
1. One more month before she can return to full activity, swing, bike, trampoline etc
2. 6 more weeks before she could go to the beach
3. 2 more months before I can put anything on her scar – like mederma

She has another MRI scheduled on October 10. This is to look at her spine and do a CSF flow study as well as look at the third ventricle of her brain for consideration of ETV. Basically this means they want to see how her back is healing from tethered cord release and they want to look at that ventricle in her brain to determine if they 1) do nothing 2) put in a shunt or 3) do an ETV. She is right on the border of doing nothing unless/until symptoms emerge from fluid on her brain to putting in a shunt. Doctors would be split 50/50 saying leave it alone until needs emerge with symptoms, another 50% so symptoms will come eventually so get ahead of it and put in a shunt. He is thinking that she may be a good candidate for an ETV. If so he would like to do that, but he has to make sure that would work for her. Some this is not an option for. Sometimes they can try and think it will work and end up having to shunt. If this surgery is needed it will be done over a long school break, most likely Thanksgiving.

So what is ETV, basically as I said it is an alternative to a shunt to treat her hydrocephalus. This technique opens a hole inside the brain to re-establish effective flow of the CSF (cerebrospinal fluid). The MRI will show the key points relevant to ETV. Basically this is a bit technical but if interested. The fluid flows from the lateral ventricle in your brain to the third ventricle and then finally out the fourth ventricle. If there is an obstruction or this ventricle is too narrow then ETV is a good option. IT means they make a hole in the front part of the third ventricle which allows the fluid to leave the third ventricle, by bypassing the obstructed part.

The advantage to her having the ETV instead of a shunt is that there is not foreign object in her body , i.e. shunt tubing and valve which reduces risk of infection. It also means fewer incisions so slightly less discomfort and lower long term complications compared to a shunt. The disadvantages however, are the chances of improving may be lower with ETV compared to a shunt and although very unlikely the risk of serious complications with ETV compared to a shunt operation.

Honestly I hate all of it but have to trust in the Lord and do what is best for Olivia. The thought of going in her spine was tough, the thought of going in her brain freaks me out too. The ETV is actually performed with a single small dime sized hole in the skull using an endoscope and can take as little as 30 minutes. Actually this procedure ETV or Shunt are both easier procedures then the tethered cord release she had, crazy but usually they are only in hospital for one day with this one and surgery is 30 minutes to an hour vs. 5 days and 3 hour surgery. The recovery is easier too, usually just a few days and she would be back at school

Just pray that God shows clearly in this MRI what is best for Olivia and that her recovery continues to go well from her surgery last month.