June 25, 2010 – 8:25 PM – Sutter Memorial Hospital Pediatrics Floor

I’m up here on the sixth floor of Sutter Memorial Hospital, rooming with Katelynn for the night.  Dr. Ciricillo met with Jenn-Jen and me after surgery and the first words out of his mouth were “Cool would be an understatement!”  It was so very reassuring to hear the enthusiasm in his voice as he shared the good news surrounding the operation.  We reviewed some amazing photo printouts showing various steps of the endoscopic procedure, and it was hard for me to believe that I was staring at high-quality images of my daughter’s brain ventricles, captured internally by a tiny camera mounted on a thin, flexible endoscope, only minutes ago. 

Apparently, the existing shunt in Katelynn’s right lateral ventricle had become somewhat occluded and was not functioning as well as it could have.  With some manipulation from the instrument on the endoscope, Dr. Ciricillo was able to remove the coagulant that was affecting the shunt.  Additionally, we learned Katelynn’s choroid plexus (http://en.wikipedia.org/wiki/Choroid_plexus), which is essentially the cerebrospinal fluid (CSF) factory in our bodies, was actually not filling her fourth ventricle because a web-like layer of membranes had virtually trapped the flow into the space.  Had the CSF been entering the ventricle properly, we would have seen a severe dilation in the matter of a day or two.  This would have led to a much more alarming situation, which thankfully, we were able to avoid.  While the operation was a huge success, there will inevitably be another sometime down the road to help ensure the outbound flow of CSF at the base of Katleynn’s fourth ventricle is functioning properly.  We are scheduled for a MRI tomorrow morning to see the immediate effects of today’s surgery and will have a follow-up scan six months out to see the longer-term results. 

Katelynn did extremely well with her surgery, but has been very sluggish since she came out of recovery.  She also received the relaxant Versed (http://en.wikipedia.org/wiki/Midazolam), also known as Midazolam, before going to the operating room.  This pre-sedation medication was given to help Katelynn not feel anxious while she was separated from Jenn-Jen and me before she was put under anesthesia.  We haven’t been able to get her to eat much since surgery, but that may be due to some soreness in her throat from being intubated during surgery, or perhaps this is a slow recovery out of anesthesia.  Hopefully, Katelynn will bounce back to her normal self tomorrow after her MRI scan.  At this point, we may be able to take her home in the afternoon, but I am not completely sure. 

Tonight will be a little bit of a long night, punctuated by periodic visits by our nurse for vital signs and another dose of antibiotics that will come due at 2:00 AM.  The good news is that Pediatrics is unusually quiet with very few patients on the floor and we are fortunate to have a room to ourselves.  The sleeper chair that adorns the room is an old friend of mine I have not visited for over two years, but we will be reacquainted very soon.  I joke now, but only because things could not have turned out better today.  I would gladly spend many more nights in this sleeper chair knowing that my daughter is given every chance to reach her full potential.  Katelynn is quietly sleeping in the crib only a few feet away and I wholeheartedly thank God that I am blessed to be her father.

June 23, 2010 to June 25, 2010 – In the Surgery Waiting Room

Katelynn has been in the operating room now for the last thirty minutes undergoing an endoscopic fenestration of the entrapped left lateral and fourth ventricles.  Dr. Ciricillo is looking to create a pathway for the cerebrospinal fluid in the dilated ventricles over to Katelynn’s right lateral ventricle, where her shunt system is working fine.  The operating room nurse called a few minutes ago and says the procedure is going well.  We will hear from her again as Katelynn’s surgery is wrapping up.  She should awaken from anesthesia about an hour after the operation is complete, and Jenn-Jen and I will be there to watch her come to. 

I will spend the night here at Sutter Memorial Hospital with Katleynn up on the pediatric floor.  Hopefully we will be able to bring her home tomorrow or Sunday at the latest.  Thank you all for your prayers and I’ll provide another update this evening.