A VERY SLOW AND SCARY RECOVERY FROM MY SHUNT VALVE FAILURE

Walking around the house gives me the sensation of vertigo.  The ventricle over drained and leaves the brain without the proper cushioning.  It is estimated it will be the 28th before the ventricle recovers.  Then a week later I go back to my brain surgeon for a new CT Scan, to see if the subdural hematomas are decreasing in size.  It is simple, the full ventricle puts pressure on the subdural hematoma. 

This is the scary part and it is important people understand it is really no one's fault the proper care does not exist in the LRGV.  But the VA Harlingen can insure better care no ER doctor can ever provide, no matter how good they are.

Key to my care is coordination between the VA Harlingen and my brain surgeon.  I am going to have to do a second congressional complaint on the issue.  The VA's position is "we do not have anyone trained to care for the veteran so local services will not be provided.  The VA Harlingen is the only entity which can assure me proper care.

It is important everyone understand there are so few people with Normal Pressure Hydrocephalus an ER doctor can go their entire career never seeing NPH.  For sure they can go their entire life never seeing a failure in the valve.

Once you reach the point of subdural hematomas caused by a failure in the shunt valve, you are approaching stroke conditions.  The radiologist did find evidence of ischemia.  

The subdural hematoma by itself is a basis for an emergency referral to my brain surgeon.  But the actual data makes it easier to assess the patient.  Over drainage by itself is a basis for an emergency referral, but this is where local care is not available.

The radiology tech did a perfect lateral headshot as I requested.  But no one on staff knew how to read it.  I am being objective when I say it may have been the first lateral headshot the radiologist on duty had ever seen with a brain shunt.  There never would have ever been cause to train them into how to read the valve.

When I looked at it I estimated the valve was at 60, when it should have been at 90.

You have to look at it like a clock.  The setting is where you see the black notch.

If you view it as a clock, just shy of 6 o'clock, the setting is 90. That is where it should have been.  In fact it was between 4-5 o'clock, which is a setting of 60.  This meant I was overtraining.

The emergency referral to my brain surgeon would be the valve changed from 90 to 60, with evidence of subdural hematoma and ischemia.  With this my brain surgeon would have concurred in my emergency transfer to San Antonio.  

The repair requires use of a very expensive specialized ultrasound which ER's do not have, and no local surgeon would have.  It is very specific to the Codman shunt.

The potential malpractice issue is clear to me.  An ER doctor cannot diagnose a change in the value setting based on the patient's representation of the proper setting.  The VA can have this verified in my medical records, thereby making it possible for their radiologist to make the finding. 

So even if there are no subdural hematomas visible in the CT scan, the finding of  the valve setting failing becomes a basis to send the patient to the brain surgeon for an emergency correction before subdural hematomas develop.

This can only happen under the care of the VA.  I will try an meet with the Chief Medical officer to go over this, before I ask for Congressman Gonzalez to help.