10 surgeries and counting (part II)

Ryan's surgeries to date:

October 2011 - reservoir placement

As I mentioned in his story, Ryan had a reservoir placed when he was exactly one month old.  This was a route through which his nuerosurgeon could extract CSF from the ventricles in his brain.  The purpose of this was to prevent further brain damage until he could 'make weight' for the shunt surgery.  See?  He was a fighter from day one.  Ryan was tapped every other day.  The days that he wasn't tapped, he had a much harder time remembering to breathe and keeping his heart rate at normal levels.  

This was a day or two after the procedure.  He was re-intubated while he was under anesthesia, and needed a few days before he was able to breathe on his own again.

November 2011 - shunt placement

Finally, baby boy was big enough for his shunt.  We were nervous, but we knew he was in good hands with Dr. Mittler.  And we knew that this was the surgery that would get him off oxygen.  I guess I should explain exactly what a shunt does.  The boys have what's called a  vp (ventriculoperitoneal) shunt.  They have a plastic valve implanted in their brains that is attached to rubber tubing.  The valve fills with CSF where it then travels through the tubing that leads to their belly.  This is where the CSF is absorbed back into their bloodstream.  They have around 6 feet of tubing in there so that the shunt can grow with them.  Unfortunately, shunts are not perfect and can malfunction or become infected.  You can see the valve through the skin on their heads and you can follow the tubing with your fingers and feel it all the way down to their bellies. 

A few days post-op, Ryan came off oxygen :)

January 2012 - laser surgery for ROP

Same deal as Aiden's ROP surgery. 

Not post-op, but cute nonetheless

February 2012 - shunt revision due to malfunction

At some point, Ryan's shunt started working too well.  You see, the body is great at balancing how much CSF should be circulating through the ventricles at any given time.  Shunts, not so much.  Because Ryan's shunt was taking too much CSF from his brain, his sutures (the four pieces of bone that make up the skull) were overiding.  In addition, his head was getting smaller, and misshapen.  That's why his head is now lumpy and bumpy.  The hope is that it will round out eventually.  He now has a programmable shunt that can be adjusted if need be.  Dr. Mittler uses a magent to adjust it through his skin.  So cool.  BUT, we have to be careful as any MRI will re-program it and it can malfunction.  So all our MRI's must end in a visit to Dr. Mittler who will make sure Ryan's shunt is programmed properly. 

You see the ridge on his head?  That is one of the sutures.

Ahh. The end. :)

P.S.  As I finish this post, my child is crying out for me.  Thank God we live in a time when surgeons have the knowledge and tools to do what they do.  I'm coming Ryan.  I'm the luckiest mama in the world.

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