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Fluid Accumulation

4pm Thursday 18 November 2010　

Michele seemed to be recovering nicely from surgery (28 Oct) until Tuesday afternoon, (16 Nov)

Shortly after one o'clock, Michele became highly agitated and soon developed a severe headache. She said that she was experiencing the worst pain of her entire life. She believed that she was about to die.

The surgical wound area under her scalp became engorged with fluid and nearly clear fluid began flowing out of the incision area. When the ambulance arrived, her blood pressure was elevated to well over twice normal levels.

At the St David’s emergency room, morphine and other drugs were administered and a CT scan was done, The scan indicated a large accumulation of blood and cerebral spinal fluid (CSF). Dr Kit Fox, her surgeon, extracted about 50 cc of cerebral spinal fluid from between the scalp and skull in the area of last month’s surgery. This greatly improved Michele’s condition.

In the vernacular, Michele had “blown a gasket.”

Michele was sent up to the fourth floor at about 8:30 PM and was able to rest quietly throughout Tuesday night.

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Wednesday morning, Dr Fox decided to implant (under the skin) a small “shunt” (plastic tube) to redirect or drain the excess cerebrospinal fluid from the surgical area to Michele’s abdominal area.

Michele was in surgery from 4 to 6pm Wednesday.

When Dr Fox opened the wound area, he did not like the color and texture of the fluid he found. Instead of putting in a shunt, he drilled a hole in the skull outside of the wound area and inserted a catheter to reduce the pressure and to drain the fluid into a collection bag. He has ordered an analysis of the fluid. The results will be available Saturday morning.

Another 100 cc of CSF has been collected in the 22 hours since surgery closure. Scans are scheduled at 12 hour intervals.

Michele will remain in ICU at least through Monday.

Dr Fox will evaluate the situation Monday and determine our next action.

RKS