After a short 8 days at home we had to bring Parker back to neuro-surgery at Necker where he had emergency surgery to remove the shunt.
Just as Renee was preparing to take Parker to Garches she was changing his diaper and noticed that there was about 5cm of tube sticking out of his rectum-- the other end still attached to his cranium. Garches told Renee to take him directly to Neuro-Surgery at Necker. Dave and Leslie Arnold accompanied Renee to the hospital and Dave and I gave him a blessing.
At Necker they did a CT scan, an abdominal x-ray, and then, later, an abdominal scan. They determined that there was a reduced amount of liquid on the brain and they would prefer to take the shunt out completely as opposed to replacing it as they first anticipated doing.
The bottom of the shunt tube typically stays in the peritoneum (the sack where all the organs are held) but in the extremely rare cases, such as for Parker, this passes from the peritoneum into the intestines and then out the rectum. There are two large risks associated with this: first, the risk of peritonitis-- that bacteria in fecal material enters the peritoneum and causes an infection; second, the bacteria could travel up the tube into the brain and cause another round of meningitis.
We are praying at this stage that there will be no infection. They have sent the liquid in the brain and tube for analysis and we should know in a couple of days whether there was any bacteria present.
Dr. Puget (she placed the shunt) told us that we may only need to be in the hospital for 2 days as long as there is no infection and then we will need to come back for a check-up in three weeks.
Parker went into surgery at 8:25PM and came out at 9:35PM. The surgery went well, without complications as far as we can tell as the doctors did not give us an update afterwards..
It goes without saying that it is hard to be back at Necker. There is some comfort in knowing all of the people: the doctors, nurses, lab techs-- knowing the drill of what we can and can't do, where to go for a scan. It is still difficult to be here again--so soon. Difficult to hear him cry as they try to put in the IV for the 3rd or 4th time, to see him hooked up to machines and tubes again. Difficult to wait to see what the results of the bacterial tests are, debating if we prefer the known ravages of meningitis to the unknown ravages of peritonitis. Difficult to go back to the recovery room, to have him wear only his diaper and the head bandage, to see stitches that were slowly dissolving replaced with new ones. Hard to send out an update again on problems and not progress, to start unplanning all the re-adapted plans we had made. Wondering how many days before we will be back home.
Still, we might be naïve but it is much easier this time. Maybe because we have been here before, maybe because PJ is more alert and responsive, maybe because the support at home has continued through the past week even though we thought and said we didn't need it.
Maybe because as we went for the second CT scan of the day we ran into Dr. Oualha who was taking another patient for an MRI. He was surprised to see us but he told us to have hope, trust in Parker and that everything would be allright-- that is atypical for Mehdi-bunny's namesake.
Mostly it is easier because now we have a greater sense of faith than we had last time.
The fact that this type of shunt complication is incredibly rare, the fact that bacterial meningitis is incredibly rare, reinforces to us that our little boy is very special. He defies odds- sometimes in ways we wish he wouldn't. We start to understand that odds, chance, means nothing-- all of this is in the control of a loving Father who is watching out for Parker, and us.
