Shunts are often revised even as often as one or more times a year. When Dr. Reisner had to relocate the drainage end of her ventricular shunt due to the infection in her abdomen, he asked us how many shunt revisions Laura had had. He was amazed, if not shocked, when we told her she had never had a revision. Her ventricular shunt was the same one that Dr. Redding had placed in 1988 when she was just a year old.
Clearly it was working. He saw Laura some two years later and continued to be surprised that her brain scans again showed her shunt was functioning normally.
It was about then, however, that Laura developed seizures. It took three hours before we could get the first one stopped. Over the next nine years she had a handful of prolonged seizures lasting right at two hours. All the seizures were controlled by medication for the most part, but the long ones were difficult to stop.
In January of 2012, I was at work and Stacy was leaving Laura with her nurse. She went outside to get into her car, returned when she realized she had forgotten something. She walked in on the nurse slapping Laura sharply and repeatedly on the left side of her face, the same side as her ventricular shunt. The police were called and she was arrested.
Except for notable bruises on her face, there were no obvious injuries. She seemed to do OK until early April. Stacy noticed that she felt cold. When she measured it, her temperature was quite low. We had seen this once before with elevated phenobarbital seizure medications. Once again it was indeed elevated and proper adjustments were made.
This time her temperature didn’t bounce back to normal like it had before. She started having very brief, infrequent seizures lasting only 1 or 2 minutes and stopping spontaneously. She had no vomiting or other symptoms to suggest a shunt malfunction. Now twenty-four years old with the same shunt they had placed in her brain when she was a baby, we didn’t really think it was malfunctioning.
Still the mini-seizures and the very low body temperature bothered me. I ordered an MRI which she got the next day. On the way home the Pediatric radiologist called me directly on my cell phone to tell me that the shunt had a severe malfunction and the normally slit-like ventricles were extremely dilated. No sooner had we arrived home and got Laura situated in bed when Dr. Reisner called. He requested us to immediately come to the Scottish Rite hospital ER in Atlanta.
Her body temperature was now below 94°. She was still not vomiting or exhibiting any other signs of shunt malfunction. He took her to surgery for an emergency shunt revision. The next morning, her temperature was up, and the new shunt in place. Clear spinal fluid draining into an external container, a very good sign. Dr. Reisner thought we were out of the woods.
The next morning something woke me. We had been sleeping in the parents sleep room next to the PICU. I arrived in front of her windowed PICU cubicle to find the Pediatric intensivist and half a dozen nurses and respiratory therapists working feverishly over her. Her blood pressure had fallen precipitously and the clear spinal fluid was now bloody instead.
Two days later on April 24, 2012, after a stat CT scan of her head, it was certain. Laura has suffered a major brain bleed. Dr. Reisner confirmed that she was unable to breath on her own, and his neurologic tests confirmed that she was indeed gone.
With Stacy and me, her sister Andrea, and our close family all around Laura’s bed, our pastor led us in prayer. Sobbing and brokenhearted we watched then as they withdrew the ventilator releasing Laura fully back to our Father.