June 30, 2010 to October 25, 2010 – Back to the Operating Room

Disappointment swept over me like a flash flood that strikes without discrimination or warning. Jenn-Jen was in tears as she spoke over the phone from Dr. Ciricillo’s office, “Katelynn needs to go back into surgery.” It was the afternoon of October 6th, and my wife had brought my young daughter to have her follow up appointment with our pediatric neurosurgeon. Exactly a week ago, on September 29th, Katelynn underwent a MRI scan of her brain to assess the progress of the endoscopic fenestration procedure performed back on June 25th. Upon review of the images, it became quite apparent that my dear Katelynn’s fourth brain ventricle remained swollen with cerebrospinal fluid (CSF). The operation had failed to bring the results we had hoped and prayed to see.

Dr. Ciricillo explained to Jenn-Jen that Katelynn’s brain was still growing and he believed the channels he created endoscopically had essentially sealed themselves back up like the cave-in of a tunnel. Repeating the same procedure would probably have a fifty percent chance of success, so our doctor decided that it would be best to place a second ventriculoperitoneal (VP) shunt (http://www.nlm.nih.gov/medlineplus/ency/article/003019.htm) to relieve the intracranial pressure from the enlarged ventricle. While there was no imminent threat that required immediate action, we were also advised not to wait. I had already been scheduled for an important business conference out in Florida during the week of October 18th, but it worked out well when the surgical coordinator informed us that we should realistically target October 25th for the surgery. After a couple of days, we received confirmation that Katelynn would have her operation at 7:30 AM on the 25th.

While Jenn-Jen and I are practically veterans when it comes to pediatric inpatient procedures, it is still so very emotionally taxing to bring our little angel of thirty-two months to this place that has given us some of the best and worst memories of our recent past. We kept consoling each other with reminders that, perhaps the timing of this unfortunate circumstance is actually a blessing in disguise, as Katelynn is so young that she has no idea where we were bringing her and what she was about to undergo. It is so difficult for us to imagine going through this a few years in the future when Katelynn is old enough to openly express her fear and anxiety, and worse yet, have the traumatic event carved into her long-term memory in full detail. As much as they say time smoothes out all things, I can still attest to clearly remembering events of my childhood that had matured into full-blown phobias. I just cannot fathom the thought of Katelynn one day being terrified of doctors and hospital visits, yet this may be the path we are ultimately heading down.

With a 7:30 AM operation, we needed to begin our day quite early and check into the Sutter Memorial promptly at 5:30. My business trip back east last week has actually prepared me to adjust to a shortened and uneven sleep schedule, but I was more impressed to find Katelynn to be so alert and in good spirits at such an early hour. We checked in at the hospital, almost the very same way we did back in June, and waited for a quick briefing with the anesthesiologist and Dr. Ciricillo before we would entrust Katelynn to the care of the medical staff. Considering all of the time needed for preparation, you would think we are getting ourselves ready for a day-long operation. The whole procedure was completed in no more than thirty minutes and Dr. Ciricillo came by surgical waiting area to explain how the operation went very smoothly. We would need to have Katelynn stay one night in the hospital for observation and a CAT scan the next morning.

As Katelynn came to from the general anesthesia, we moved her up to the sixth floor to Pediatrics and settled her into her room, which we were fortunate to have to our own. She was still a bit woozy from being under, but it brought us great joy to see our sweet daughter be so strong during the surgery. Unlike the operation back in June, the placement of this second VP shunt required the use of a more invasive procedure. We learned that the site on Katelynn’s skull and scalp where the shunt is placed would probably cause less pain than the incision on the left side of her abdomen. This incision is necessary to allow the thin flexible tubing connected to the shunt to be drawn down into Katelynn’s peritoneum for her excess CSF to drain. With Katelynn’s first shunt placement, she was only a couple of weeks old and in such a critical state that we were unable to see outward expressions of pain as we do now. To help alleviate the pain, the nurse has been slowly pushing a small dose of morphine into her IV stream every two hours for the past six. This is been very helpful in allowing Katelynn to rest more comfortably, which also gives us a greater peace of mind.

I am now sitting her in the sleeper chair nex to Katelynn’s crib, listening to the constant hum and buzz from the IV pump two feet away. The clock shows that is 11:00 PM and I am now feeling very worn from the long day that has passed. It looks like Katelynn is also stirring from her sleep and may be due for some more pain medication. Hopefully the rest of the night will be peaceful and we pray for good results from the CAT scan in the morning. As disappointing as it has been to find out the surgery from June was unsuccessful, I give my thanks to God that Katelynn came through today’s operation with flying colors and am very eager to bring her home where she belongs.

Advertisement