Thursday, June 3, 2010

Lessons and tests

Kol is facing another pivotal point in his recovery. The neurosurgeon has clamped off Kol's EVD. We now wait to see if he tolerates that, and if his body starts draining his brain fluid on it's own.

For those who are interested, here's a quick lesson on some of the details of Kolbjorn's brain surgery and treatment, as I understand it. If you're squeamish, feel free to skip to the end.

After Kol's MRI last Friday, and before his surgery he was monitored very carefully, with frequent neuro checks. If he failed one of the neuro checks, we were told that he would be in surgery within 20 minutes to have the EVD inserted. If that had happened, he would have had a second surgery on Monday. The goal, however, was to make it through the night so he could have the EVD inserted at the same time as the tumour was removed. Also, the lesion removal would have been more difficult if the EVD was already in place.

An EVD is an Extra Ventricular Drain. It was inserted because the mass in Kol's head had been blocking the normal draining pathways. That caused fluid to build up, and which then contributed to the headaches. It is a tube inserted into the fluid space beside the brain, and it drains off excess brain fluid. It is a fascinating system. I won't go into too much detail, because I honestly don't quite understand it all. Basically, the tube drains into a vial that can slide up and down on a base that hangs from the IV pole. The bottom of the base is hung at the level of Kol's ear. Every time that he moved or slid down on the bed, was transported (like for a CT scan) or whenever the head of his bed was raised or lowered, they had to change the level of the collection vial. They used a lazer level for that. If the vial was too low, there wouldn't be enough pressure, and fluid would drain too fast - the drain would act kind of like a siphon. Too high would cause too much pressure, so fluid would continue to build up. Every change in pressure would cause his headache to get worse.

Yesterday, once the fluid started running clear, and there was no more blood in the fluid, the pressure was increased. Kol tolerated that relatively well, although he did vomit this morning. The increased pressure may or may not have contributed to the vomiting. However, there was much less fluid output per hour after the pressure was increased, which was a good sign. Because there was less fluid, they were able to clamp off the drain around 1 PM, which would hopefully force Kol's body to start draining on it's own. If it does, that's great. If not, he's looking at another surgery to install a shunt, or tube which will bypass the clot and drain it for him. The EVD can only be left in for about 7 days - 10 max, before the risk of infection and permanent blockage is too great.

He will be in more pain as this happens. After 48 hours of the tube having been clamped, Kol will have yet anothet CT scan to see if there is build up, or if it's draining. That will be on Saturday.

I have some pictures of the EVD, but I'm too lazy to upload them and try to figure out how to post them tonight. I'll leave that to Kirk.

Please pray that Kol's body starts functioning normally.

Praise God for all the blessings we have experienced through all of this. We Thank Him for all of the answered prayers.

I'm going to close with the words of an old hymn that's been running through my head much of the week.

To God be the glory, great things He has done;
So loved He the world that He gave us His Son,
Who yielded His life an atonement for sin,
And opened the life gate that all may go in.


Praise the Lord, praise the Lord,
Let the earth hear His voice!
Praise the Lord, praise the Lord,
Let the people rejoice!
O come to the Father, through Jesus the Son,
And give Him the glory, great things He has done.

Great things He has taught us, great things He has done,
And great our rejoicing through Jesus the Son;
But purer, and higher, and greater will be
Our wonder, our transport, when Jesus we see.

1 comment:

  1. Just to let you know we have been thinking of you and Kirk and your family as you deal with Kol's illness. If there is anything Lorne and I can do please let us know.
    Lorne & Sadie