Neurosurgeon

It felt strange to be meeting with a doctor who would eventually perform brain surgery on the child I was currently growing. Getting the meeting with the doctor proved a little difficult initially. When the office called us to set up the appointment, they initially tried to get us an appointment with the neurosurgeon's partner. While I'm sure the partner is an amazing physician and surgeon, his specialty is in epilepsy and ways that brain surgery can relieve the symptoms of that. The surgeon we wanted to see is the leading expert in hydrocephalus in the region. The receptionist explained we would have to wait over a month to see that physician, and we replied that was fine (our hydrocephalus patient was still baking - clearly we had time). The receptionist placed us on hold, apparently consulted with the surgeon's physician assistant, got back on and told us to come in in a week to meet with the surgeon.

The day of the consult, we presented ourselves to the office and found ourselves in the waiting room by ourselves. A man in a lab coat came out carrying a bag full of comic books from the store that Mike and Zachary liked to shop at for comics. He went into the area of the waiting room reserved for children, sat down on a child sized chair and began weeding out comic books from the book shelf on the wall. Each time he removed a battered comic, he would replace it with a new one from the bag. Zachary inched closer and closer to the man until the man finally winked at us and handed Zachary a comic, asking "You like comics? What do you think of this one?" As he finished up and headed  back into the back of the office, I commented to Mike that he seemed nice, to which he replied, "That's the doctor we're here to meet." I was fairly astonished that he would take on such a "menial" task himself, but it also spoke volumes about the caliber of person we were about to entrust our child's brain to.

We were called back to meet with the doctor and found all of the questions we didn't know we had about hydrocephalus and shunt placement surgery answered. The doctor was calm and eased our minds somewhat by telling us that he was very pleased to see our son's head was measuring quite large for his gestational age. That meant that his ventricles were growing but it also meant his brain was growing too. He said it was worrisome for a baby in utero to have a gestationally age appropriate head size when they had a hydrocephalus diagnosis because it meant the ventricles were growing into the areas the brain was meant to grow in. It was more indicative of major brain damage. 

We learned our son would have brain surgery on his first or second day of life. We learned that a shunt would be placed in his ventricles, run under his skin along his ear, down through his chest, and then end up floating in his abdominal cavity where it would drain the cerebral spinal fluid (CSF) that was currently not draining from his ventricles. A small incision would be made in his head, he may have an incision behind his ear, and another small incision would be made in his stomach. As long as there were no complications, he would likely be in the NICU for 7 days then home to our arms. We learned the percentages of infection from the surgery, the chance of mechanical malfunction of the shunt, and that the only thing our physician didn't recommend with a shunt was scuba and sky diving, though he had had patients who had done both and been fine. 

The surgeon agreed with our high risk doctor's decision to perform the c-section at week 37. He said once we had the c-section date, call his office and let them know and they would book the OR for the next day for the shunt placement surgery. We left the appointment still worried about what our child's future held but more confident that it wasn't totally grim.