Beth just came back from the operating room where the doctors talked with her immediately after the surgery. The surgery went well. The first shunt was removed and the infection appears to have been limited to the outside of the skull around the shunt. They are running cultures to determine if there is any infection in the cerebral fluid. It will take a couple days for those results to come back.
In the meantime, the doctors are hoping that the remaining shunt will be able to drain the cerebral fluid for all of the ventricles. Whether that is the case or not should be evident within about 4 days or so. If the remaining shunt does not properly drain all of the ventricles then another operation will be required to install another shunt.
- That Jerard's infection clears up soon.
- That the current shunt is sufficient for draining the whole ventricular system.
- That Jerard's brain continues to grow.
- That the hospital stay is no longer than it needs to be.
Jerard was readmitted into the hospital again this afternoon. The first shunt is infected and needs to be replaced. Two neurosurgeons and other doctors are in agreement with this course of action. We hope to find out later today when the surgery will be -- either tomorrow or Friday. This will be Jerard's fourth hospitalization and fourth surgery.
Correction: The surgery was originally going to consist of removing the infected shunt and replacing it with a new one on the other side of his head all in one operation. But both neurosurgeons decided that the better course of action would be to remove the infected shunt in the first operation. They will decide at that time whether to install an external drain from his head to a bag or just to drain a lot of fluid at that time or to just leave it. Then after the infection is cleared up (hopefully in 4 or 5 days) another operation would be required to add the new shut on the other side of the head. So, it looks like Jerard will get two more operations during this hospital stay if things go well.
Beth is with Jerard at the hospital this afternoon and she will spend the night there tonight. I will be at home with the other children.
As always, your prayers are much appreciated.
The surgery is scheduled for 1 PM on Thursday (tomorrow). We are still waiting whether the doctor will order blood to be on hand. If/when the order comes, I need to go to the Red Cross tonight and try to obtain the blood. If things go well, I will walk out the door with blood in a bag on ice which I will then take to the hospital. If they do not have it, we will need to try to find a AB+ donor, which is relatively rare here in the Philippines, and then I will walk out the door with the blood.
This is something that I still have trouble getting used to as compared to the US -- driving around the city in a taxi transporting blood to the hospital for an operation.
Thursday night, Kurt and I noticed that Jerard's first shunt site seemed red and swollen.
Friday morning it looked worse so we took him to Dr. Soriano, the neurosurgeon, for a check up. Dr. Soriano drew off some puss- like fluid to test it.
Over the weekend Jerard starting running a fever and the sore on his shunt site 'popped' and oozed out stuff.
Today, Jerard had a check up and we obtained the results of the culture and sensitivity taken Friday.
He has pseudomonas aeroginosa - an opportunistic pathogen which exploits a break in the host defences. It can cause UTI and other infections. It's the number 1 hospital-acquired infection.
So what's that mean for Jerard?
Probably more IV antibiotics and a need to replace the shunt.
A determination will be made tomorrow about the need to rehospitalize him and a shunt-replacement surgery.
Pray for Jerard to get well. Pray for our family for the stamina and endurance we need for another hospital stay if that is determined to be the best course of action.
On Saturday we took a needed break from hospitals and doctors and went on a snorkeling boat trip. We left the twins with yayas (baby watchers) and went out on a boat called the Flying Squid (pictured above). We had a great time!
Kirsten and Ben swimming off the side of the boat which was anchored over a coral reef.
Mikayla and Kurt snorkeling. The coral and fish are stunning.
We stopped for a picnic lunch at Talicud island.
Eating lunch and spending time with friends.
After lunch we stopped at a dive spot called "The Wall" which is named after the beautiful sheer drop off just about 20 feet from the shore.
This is the coral under the boat in about 5 or 6 feet of water. It looked much better under the water, believe me.
What is a boat trip without a funny face from your daughter!