Thursday, June 26, 2014

Hydrocephalus in infants - VP Shunting - Dr B Chidhambaram - Child Trust Hospital

Now the Hydrocephalus is becoming a common problem in kids. 
The only possible solution to this is doing a Ventriculo Peritoneal Shunt surgery 
Here are the two doctors whom you should meet immediately 

Dr B Chidambaram, Child Trust Hospital

 Dr K Santhosh Mohan Rao, Child Trust Hospital

Hydracephalus,should be or say detectable during the anomaly scans of the mother. But it happens that, it may not get detected in 21st week of the pregnancy, but may occur in the 38th week of scan. 

In our case it was detected in 38th week of pregnancy. So we initially took the scan of the baby at the time of birth and had a measure of 1.2 mm

After the birth, you need to keep on monitoring the head cirumfrance and keep a check on it, so that it is with in the limit.

Also look for the symptoms from the baby's side, like the downward eyeballs, not feeding properly or vomiting.

The major drawback of the this case is, that it gets unnoticed until at the age 2yrs, when the child starts facing some severe problems like Fits.

So to get a clear picture, you need to get a MRI Scan on the baby. (it is also one of toughest job, as it requires 20 -25 mins, with large amount of noises to bear from the MRI machine.

As we went and met the doctor with the MRI scan & Report, for his opinion to proceed further, he just looked at the scan and reports and suggested to an shunt operation, no other alternatives. 

So the next question was, when it is to be done..? the doctor said that, no more delay, and so we can do it tomorrow and asked us to get admitted today itself.

We had lot of questions in our mind..
 How it will be done..?
 What is the procedure ..?
 Will the baby have pains..?
 what are the precautions to be taken before and after the operation..?

So we got admitted and before that, we had take an ECHO test to see that the heart rate of the baby is doing fine.

We were put in the AC Sharing, where we had 3 more patients in a Big Room. Then Dr Santhosh, came and explained about the operation how it is going to be done, what are post and pre measures to be taken, risks factors and other doubts.

One thing he explained us was that, all shunt operations have to reviewed over a period of time.

Instructions prior to operation:

The surgery was scheduled at 8 am in the morning, the scope of the surgery was to create a path in the Larger ventricular and drain the excess CSF to the abdomen through a means of capillary tube or some other means. So when ever there is excess fluid in the brain, it would be drained to the abdomen.

some thing like the below image
Instructions prior to operation:

- Since the operation was scheduled at 8 or 8 :30 am, last feeding of the baby should be 4hrs before, i.e, 4 am was the last feed for the baby

- Inorder to prevent infections, the baby should  be put to shampoo bath before entering into the Operation Theater. So proably, by 7:30 am you need
to give a head bath to baby and be ready by 8 am.

- the baby will be given anesthisia, so not worry about the pain

- and antibiotic will be given (since this is the first time your baby is experiencing antibiotic), and we need to make sure that the baby is not allergic to this antibiotic, and in case if the baby is allergic, then we need to
make a note of this antiboitic and avoid it in future medications

Instruction Post operation :

 Once the operation is complete, you will be asked to give 2 teaspoons of water and make sure the baby doesn't vomit.  And now you can happily feed the baby to full extent. 

 - avoid water on the operated part (head and the abdomen stiches )
 - avoid oil on the stitches for at least for one month (basically to keep it 
    dust free )  
 - and from the 3rd day on wards you are free to give regular bath to baby.
 - the most important things, not to allow visitors (or outsiders ) to handle
    the baby (this is to keep away from infection)

 Sign of functioning of the shunt 

Before the operation was , you could probably feel the bulge in the upper part of the kids head (generally called as Bulging fontanelle). 

This can be felt because , the skull bones have not yet firmly joined together.

Once the operation is done, and if you touch the upper part of the head, now you should feel a "Normal fontanelle" ,which means the shunt is working properly ( in other words, the excess fluid in the ventricle are being drained out from the head.)

So not to worry when you have detected the Hydrocephalus, when it is detected as early as possible, and you are in the hands of Dr. B C sir.

Dr Santhosh is a cool person, and he will answer all your questions, so do not hesitate to ask your doubts.

Once everything is fine.. treat your child as a normal kid.

Hope this helps other parents, who are worried...!



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