at the hospital
Impression: MILD/BEGINNING NONOBSTRUCTIVE HYDROCEPHALUS IS CONSIDERED.
February 1. Mommie was admitted at the hospital due to nausea and headache.
At first, we thought it was just an ordinary headache..or a cause of high blood pressure because since December, her BP status does not go down to normal.
It started December, during the Sea Games–where she’s stressed, pressured..especially that not only the country’s event was her priority but of course, talented as she is, she was being hired by companies to choreographed Christmas parties, dance, etc.
At the hospital, my lolo was also admitted..at the same time my mom was. Two rooms seperated them.
The doctor (our internist) gave her pain reliever which made her feel better for a week. The headache was gone which we got out February 5..but we have to undergo CT scan just to make sure since she got cancer of the breast.
i Was thinking then, that maybe it was just depression since dud was assigned in Cebu. He went home as soon I let him know that mum was in the hospital. Honestly, mummie felt better when he saw dud. Frankly speaking, you will see the glow in her face…(well, there love story is another kind of story..)
February 7. The headache got worst. She was brought to the hospital and admitted again.
A recommended neurologist came and check her. 24 hours observation-if pain continues, CT scan is required.
I was thinking she was just acting like from one of her plays..(sorry, can’t blame me though…i got a mom and a best actress in one!!) But this was different..she was shouting in pain—undescribable pain…sleepless nights because for a pain reliever–it was just a matter of minutes that she can go to sleep and when she can feel the pain again. (..this was an advantage for me since i got to lose pounds on watching mum…hehehe)
She was asking for a sleeping pill (..or tranquilizer as well) just to got some ZZZzzz’s and will not feel the pain. I asked the nurses if they could give mum xanor (..a sleeping pill) so that she can sleep well and will not suffer from the pain. The nurses gave her half of the tablet which I also told them "indi na kaya ang half lang coz ang whole tablet gani she can sleep for 5-6 hours lang then she can feel the pain again…how much more kung tunga lang?"
The next day, she was scheduled for a CT Scan. The lower part of the short bond paper says:
IMPRESSION: MILD/BEGINNING NONOBSTRUCTIVE HYDROCEPHALUS IS CONSIDERED.
I was crying when I called dud that mum has hydrocephalus. I was thinking of the children with this sickness…big heads, etc. What came from my mind is, "Will mum’s head become big like those babies with hydrocephalus, too?" I was thinking..how much more those little angels feel when my mum..an adult.. was screaming for pain.
What is hydrocephalus?
Hydrocephalus is a condition in which excess fluid builds up in your brain. The word "hydrocephalus" comes from the roots "hydro" meaning "water" and "cephalus" meaning "head." The fluid that accumulates is cerebrospinal fluid (CSF), a fluid that normally surrounds your brain and spinal cord.
In hydrocephalus too much fluid builds up, causing abnormal enlargement of the cavities in the brain (ventricles) that contain CSF. Too much CSF in the ventricles can put increased pressure on the brain, potentially damaging the brain.
Hydrocephalus can be present at birth or you can develop it later. The outlook for people with hydrocephalus varies depending on how soon the condition is diagnosed, whether any other disorders are present and whether treatment is successful. With no treatment, hydrocephalus is nearly always fatal.
Signs and symptoms
Age, how far the disease has progressed and how well a person can tolerate increased cerebrospinal fluid pressure all affect the signs and symptoms. Babies may better tolerate increased CSF pressure because the bones of their skulls haven’t completely fused together, and thus their skulls have more flexibility to handle the pressure.
In infants, common signs and symptoms of hydrocephalus include:
- An unusually large head
- A rapid increase in the size of the head
- A bulging "soft spot" on the top of the head (anterior fontanel)
- Vomiting
- Sleepiness
- Irritability
- Seizures
- Eyes fixed downward (sunsetting of the eyes)
- Developmental delay
In older children and adults, common signs and symptoms of hydrocephalus include:
- Headache followed by vomiting
- Nausea
- Blurred or double vision
- Eyes fixed downward (sunsetting of the eyes)
- Problems with balance, coordination or gait
- Sluggishness or lack of energy
- Slowed development or loss of development
- Memory loss
- Urinary incontinence
- Irritability
- Changes in personality
These are common signs and symptoms of hydrocephalus. However, the signs and symptoms of hydrocephalus may vary from person to person.
Causes
Hydrocephalus can be present at birth (congenital hydrocephalus) or you can develop it later (acquired hydrocephalus). Hydrocephalus results when the flow of cerebrospinal fluid is disrupted or when your body doesn’t absorb CSF properly. CSF provides a number of important functions, including acting as a cushion to protect your brain and bringing nutrients to your brain.
Inside your brain are four ventricles. CSF flows through the ventricles by way of channels that connect one ventricle to another. Once CSF passes through the ventricles, it flows into closed spaces (cisterns) at the base of your brain. Eventually, the CSF is absorbed into your bloodstream. Keeping the production, flow and absorption of CSF in balance is important to maintaining normal pressure inside your skull.
In adults, a variation of hydrocephalus called normal-pressure hydrocephalus may occur in which the CSF pressure is normal, but the reabsorption of CSF is defective. In normal-pressure hydrocephalus, the ventricles of the brain are enlarged but not under high pressure. This type of hydrocephalus is most often seen in older adults and may be the result of injury or illness, but in most cases the cause is unknown.
The main causes
The causes of hydrocephalus fall into two main categories:
- Obstructive (noncommunicating). This type of hydrocephalus results from an obstruction within the ventricular system of the brain that prevents CSF from flowing or "communicating" normally within the brain. Aqueductal stenosis, a narrowing of a channel in the brain that connects two ventricles, is one of the most common types of obstructive hydrocephalus.
- Nonobstructive (communicating). This type of hydrocephalus results from problems with the production or absorption of CSF. A common cause is bleeding into the subarachnoid space in the brain (subarachnoid hemorrhage).
Doctors don’t completely understand the specific causes of hydrocephalus. For congenital hydrocephalus, the causes may be genetic disposition or a developmental problem. The most common developmental problems that may lead to hydrocephalus include failure of the tissue surrounding the spinal cord to close properly (spina bifida) and herniation of the brain (encephalocele). For acquired hydrocephalus, the cause may be a disease or condition such as encephalitis, meningitis or a brain tumor that causes blood vessels in the brain to rupture and bleed. Or the cause may be a head injury.
Risk factors
Premature infants have an increased risk of intraventricular hemorrhage in which severe bleeding within the ventricles of the brain can lead to hydrocephalus. Other problems that can occur during pregnancy may increase an infant’s risk of developing hydrocephalus, including intrauterine infection or a disorder involving incomplete closure of an infant’s spinal column (myelomeningocele).
Congenital or developmental defects can increase older children’s risk of hydrocephalus. Lesions or tumors of the brain or spinal cord, central nervous system infections, bleeding in the brain, and severe head injury also can increase the risk of hydrocephalus.
Prenatal testing: What’s involved and who should consider it?
When to seek medical advice
If you notice any of the signs or symptoms of hydrocephalus, call your child’s doctor. A high-pitched cry, problems with sucking or feeding, fever, acting lethargic, exhibiting an unwillingness to bend or move the neck or head, breathing difficulties and seizures are all reasons to seek immediate medical care by calling 911 or other emergency help or by going to the emergency room. In addition, seek emergency medical care if you or your child experiences a severe head injury. If you become pregnant, talk with your doctor to begin receiving proper prenatal care.
Screening and diagnosis
Diagnosing congenital hydrocephalus
Your doctor may diagnose congenital hydrocephalus in your unborn child during a routine prenatal ultrasound, but it’s often discovered during infancy or early childhood. Your doctor may suspect hydrocephalus before other signs and symptoms appear if your infant has a large head that seems to be rapidly increasing in size. If the soft spot on your infant’s head is still open, an ultrasound of the head can distinguish between a normal large head (macrocephaly) and hydrocephalus. If the results of the ultrasound are abnormal, your infant will need further evaluation.
Diagnosing acquired hydrocephalus
The evaluation of a child or an adult who develops signs or symptoms of hydrocephalus begins with a careful medical history and a physical and neurological examination. X-rays, a computerized tomography (CT) scan or a magnetic resonance imaging (MRI) scan can provide detailed pictures of the brain. If these pictures reveal hydrocephalus or other abnormalities, referral to a brain surgeon (neurosurgeon) for further evaluation and treatment is likely.
Fetal ultrasound: What can it tell you?
CT scan
MRI: Viewing the body’s hidden structure
Complications
The severity of hydrocephalus depends on the time of onset and whether the disease is progressive. If the condition is well advanced at birth, major brain damage and physical disabilities are likely. In less severe cases, with proper treatment, it’s possible to have a nearly normal life span and intelligence.
Other complications of hydrocephalus include:
- Intellectual impairment
- Neurological damage, such as decreased function, movement or sensation
- Problems with the artificial CSF drainage channel (surgical shunt), such as a blockage or kinking of the shunt tubing
- Infection at the site of the shunt
I asked the neuro what will be the next step. LUMBAR TAP. This is where the doctor will get water through the spinal column to lessen the pressure and for examination.
I was afraid. I’m strong, yes, in the outside. Deep down, I’m weak. A family friend suggested for a second opinion. I texted Dr. Mario Marchadesch, a neurosurgeon, if I could ask for a second opinion from him considering it was 11:00 in the evening. No reply. I waited. Things wandering inside my head…what if he doesn’t reply? what will i do? will i let the neurologist do the lumbard tap without asking for a second opinion?
3:00 am. Mum’s cell beep (since I used her phone that night)
From: Dr. Marchadesh
Sure, i can see your mom. Just ask permission to your doctor first.
I was relieved..not really because the "ask permission to your doctor" was blogging me since I am ashame to ask the neurologist to have another opinion from other doctors. I was thinking, maybe the neuro will think that I am questioning his profession.
Dr. Marchadesh did went to the room and explained to us (before the lumbar tap) all about hydrocephalus.
The day after the lumbar tap, the neuro asked mum if there’s family history of tuberculosis. I don’t remember anybody from the family with TB. Cancer, yes. The neuro explained to us that the mum’s hydrocephalus is caused by either: infection or her cancer spreads out to her brain. He also told us to go for MRI (this to see unhidden parts of the brain) because he was not sure of his findings. He even told us that maybe mum has meningitis, which scared us a lot.
After the Lumbar, mum feel better. She was being observed still. We got out from the hospital for the second time around, February 14.
February 15. Mum feels the same. Its getting worst. She continues to vomit…no intake. Headaches still there. She was dextrosed…this time in the house. I was in Cebu and dud texted me to go home as soon as possible. My lola, too, was not feeling well. A little line for nervous breakdown.
I went home February 19. I was talking to mum of my adventures in Cebu and ask how and what she feels and I suddenly noticed she was not responding but she was gripping my hands. Her eyes went up and struggling the intense pain. I called dud and my uncle and grab the phone immediately to call for an ambulance.
February 19. Third visit in the hospital.
We were in the ER. The residents were checking mum. Asking her of what she feels…this time, I observed lot of things not normal to her:
- her eyes were wide enough so she could see me
- her hearing was not that good
- the resident doctor asked her some questions…she answered it all correctly except for one. That one question really made me feel bad: "May bana ka na? Mum answered "yes". "Ano ngalan nya?" she answered, "Cyril"
This third admission was really emotional for families and friends. Mum was sleeping for three days. She was very weak. She was inserted with NGT and catheter. We went to a point that she can no longer identify us and those who came to visit her. Yes, she was bedridden.
Her oncologist also told us that maybe her cancer spreads. She gave mummie also 3-6 mos. to enjoy God’s beautiful creations.
The doctor we contact is still the neurologist recommended to us. He gave mum pain relievers and sleeping pills. No antibiotics. Mum’s detoriating. No improvement at all. This time the family decided to change doctor.
We called Dr. Marchadesch, the neurosurgeon I asked for a second opinion. I never contacted him since we never expected mum will be operated. He scheduled mummie for another CT scan. This time, the ventricles were larger compare to the first CT scan we had.
The doctor thoroughly explained to us what happened and what to do. VP shunt was the only treatment.
Treatment
The goal of treatment is to re-establish the balance between cerebrospinal fluid production and reabsorption.
Shunt is common approach
Doctors most often treat hydrocephalus with surgery to insert a system to divert the CSF. This system, called a shunt system, consists of a flexible silicone rubber tube (shunt) and a valve. This artificial channel allows CSF to flow away from the brain to elsewhere in the body, where it can be absorbed.
One end of the channel begins inside one of the ventricles in the brain. At the other end of the channel, CSF fluid may drain into the abdominal (peritoneal) cavity. In this case, the shunt is called a ventriculoperitoneal shunt. Or the fluid may sometimes be drained into a chamber of the heart, in which case the shunt is called a ventriculoatrial shunt. A valve along the channel serves to keep the flow going in the right direction and at the proper rate.
Sometimes, a medication such as acetazolamide (Diamox) or furosemide (Lasix) is used to temporarily reduce pressure from excess CSF. Lumbar puncture (spinal tap), a procedure used to measure CSF pressure and remove small samples of CSF for laboratory testing, is sometimes also used to relieve some of the extra pressure.
Complications of shunts
A successful shunt system allows an infant’s head size to become normal and relieves signs and symptoms in older children and adults. Shunt tubes may require replacement as a child grows. Successful shunts usually are maintained for life, but there can be complications.
Mechanical failure, infections and obstructions are possible complications. Sometimes, the tube needs to be lengthened or replaced. Shunt systems require monitoring and regular medical follow-up. When complications happen, a shunt usually requires some type of revision.
A shunt system that isn’t operating correctly can result in either too much or too little drainage of CSF. If too much drainage occurs, the ventricles can collapse. When this happens, blood vessels can tear, causing blood to collect just below the lining of the brain, a condition known as subdural hematoma. If too little drainage occurs, the signs and symptoms of hydrocephalus return or remain.
Infections from a shunt may cause a low-grade fever, sore muscles in your shoulder or neck, and redness or tenderness in the area of the shunt.
Another treatment option
An alternative procedure for some people with hydrocephalus is called ventriculostomy. Doctors may use this procedure when there’s an obstruction of flow between ventricles. In the procedure, your doctor makes a hole in the bottom of the third ventricle. The procedure uses a small camera to help your doctor locate the correct place to make the hole. This lets CSF flow toward the base of the brain, where normal absorption occurs.
Treatment for hydrocephalus can be lifesaving and life sustaining. Lifelong follow-up examinations are needed to evaluate changes in developmental, intellectual, neurological and physical impairments and to maintain proper functioning of a shunt system.
Spinal tap (lumbar puncture)
Prevention
Protecting the head of your infant or child from injury by handling your child carefully may help prevent the development of hydrocephalus. Prompt treatment of infections such as meningitis and other disorders associated with hydrocephalus may reduce the risk of developing the disease. If you’re pregnant, you may reduce the risk of hydrocephalus in your unborn baby by taking precautions to reduce the likeliness of premature birth.
Coping skills
With the help of rehabilitation therapies and educational interventions, many people with hydrocephalus live with few limitations. Public health providers, social services and local agencies can provide you with emotional support and assist with the care of a child with hydrocephalus. Local support groups for people with hydrocephalus and their families may be available. Hospitals often sponsor these groups. Doctors and nurses also may be able to make recommendations on where to find emotional support.
We don’t have a choice this time since mum really need this…to bring back the DOLLY we had before..fun, enjoyable, our barkada..mummie has to go under operation or else it will fall down to comatose. First thing came out from dud’s mouth was "How much will it cost?". We’re just an average Filipino citizens..not belong to the "rich and famous Negros clans". Php90,000 is needed for the surgeon’s and anesthesiologist’s fees not included the hospital bills.
February 22, 7:30pm. Mum was brought to the OR. She kissed her visitors and said "goodbye".
February 22, 11:00pm. Mum was in the ICU.
We gave up our room because our doctor expected mum to recover 2 days or 24 hours. But mummie got out from the ICU 12hours from the time she was out from the OR.
We were relieved. Praising, mom was ok. But mixed emotions, because we never expected these things to happen. Who can expect a "Dolly" will be diagnosed with hydrocephalus…admitted thrice in the hospital…operated in the brain…ICU…stayed 1 mo. in the hospital which we considered already our new home.
I can never get mad at the first doctor. I remember when I asked him of his number so I can contact him in case of emergency, he was hesitant to give his number to me. Well, he did actually with "Basta indi ka lang mag text or mag call kung gab-i na or kaagahaon ha." Huh? I mean, naaahhhh!!! Never mind. And there are findings which are not true. He made my mum his experiment. A trial and error. But I can never get mad at him…he was not my priority that time. He was not that important. I entrusted him to God.. But when I saw mum in the ICU and recovered, I was thinking to find him, drag him in our room and let him see my mum was ok…very ok.
Mummie got a mild stroke which causes the hydrocephalus. No connection with her cancer. That’s it. No meningitis. No cancer cells spread.
But these things has purposed. Miracles did happen and lessons were learned.
1. Over flowing friends. Mum always say this "Treasure your friends." Mum was never run out of visitors. Batch by batch. We cannot even accomodate them since the room was small enough to have packs of concerned friends. Her inbox says "memory full", non stop beeping of different text messages from prayers to quotes from friends all over the archipelago as well as from other countries..
2. Count your blessings. Honestly, 80% of the money paid to the hospital bills were from friends. (…thank you, from the bottom of our hearts)
3. Prayers are powerful. During mum was operated, a PRAYER-THON (..like the 700 club) was done. Surrender everything to Him, he’ll do the rest..and I can attest to that.
4. There are still good doctors and very accomodating nurses. Blessed them.
5. I did not believed then that when you are in the hospital bed, you will see people who passed away…or even Jesus, Mama Mary or whoever it is. Proven by mum, no question asked.
6. That I need to cry when I feel to cry. We’re human beings…it’s natural to feel weak.
7. That I should be strong, think positive.
8. That I still ahve responsibilities to do…not just being a daughter.
The family would like to grab this opportunity to say a million thanks to those "FRIENDS" who prayed and continue praying for mummie…for the gifts and blessigns you shared…for your time to visit mummie…THANK YOU and GOD BLESSES you more.
journals 101 | Comment (1)CoLLeGE CluEs
Going to college? It’s a different world and you’re finally part of it..you are also still crazily clueless. Here are some tips to help you tread the college seas!
Be yourself.
It’s easily to spot a fake.."Magpakatotoo ka, sister!" (remember Toni Gonzaga’s famous tag?) Be yourself. You’ll feel more at ease if you don’t wear any character masks and people will, in turn, be more at ease to relate with you.
Examine the perimeter.
There have been grads of certain schools who never knew where to go to complain for a misprinted grade. Be in the know! Explore your university like you would a new home (besides, that’s exactly what it is!). Read your school handbook. Trust me, it is useful.
Take care of your skin.
It’s not being vain. It’s all about taking care of yourself. With a clear complexion, you sometimes don’t need to wear make up, and you don’t look that harried especially when a hectic college skedhits.
Don’t dress to impress.
Unless you’re up for an oral defense or class presentation, keep your fashion style in check. Leave the stilettos and plunging necklines. Go for comfort in your own personal style and you won’t go wrong.
Hold out on L-O-V-E!
The thrill of finally being in the co-ed world might lead you to hook up with the first cutie who will whisper sweet nothings into your ear. Take your time and meet as many prospects as you can…who knows? you might just be waiting out for mr. BEST!
Get "deblocked"!
Its pretty easy to spot freshies in campus…they travel in packs. i’m not telling you to ditch your pals, just don’t be afraid to wander around your "new home" in sweet solitude. you can also enlarge your social network by enrolling in electives or classes with other blocks!
Enjoy your college days!!!
GREAT HAIR ANYWHERE
ey! going to college???……when you move away to college, you’re not just leaving your family behind, you part ways with your favorite hair stylist, too!!
here are a few tips to help you get a great cut wherever your college may be.
Find another "soulmate" stylist.
you’ve been harping about revamping your look and what better way than to get another opinion? just make sure it’s an expert one. just ask friends to recommend someone who specializes in your hairstyle and texture before you make an appointment. don’t make the mistake of going to a salon and not knowing anyone…that can spell T-R-O-U-B-L-E!!
Scope out the place.
when you hear a friend saying she’s having her hair cut down at this fab salon, that’s your cue to volunteer to go with her. there’s no better way to judge whether a salon is made for you than by dropping by the place personally. it allows you to give exiting clientele the once-over to see if their finished cuts jibe with your style.
Bring a few photos of hairstyles you like.
this way, you can show the length, shape and bangs youprefer. just remember: you can’t always get a model’s or celeb’s exact cut. it’s foolish to insist that your stylist make your hair look like Renee Zellwegger’s cute and trendy bob. you’ll just have a catfight with your stylist, and that can be very awful to your hair!
Freeze-frame your look.
speaking of photos, why not bring your own when you felt 100% beautiful especially when your hair had a lot to do with it? when you can’t stop raving about your new do, take photos and use them yo guide a new stylist!
BEAUTY IS BEING…
ACTIVE. Take an interest in keeping the blood pumping. Burn those calories for a fitter you.
BRIGHT. Brighten up! Be optimistic enought to know that your beauty woes aren’t permanent.
CONFIDENT. Be confident enough to know that you (yes, you!) are beautiful.
ENTHUSIATIC. Beauty is being willing to think out of the boxand being eager to try out new things.
FUNKY. Quirks can also be beautiful in a fun way. Remember that anything boring is a beauty no-no!
GOAL ORIENTED. Going for your ambitions makes you beautiful because it shows people that you’re confident enought to follow your dreams.
JOLLY. Put a smile on your face. Being happy makes stress and pains float away like magic!
KNOWLEDGEABLE. You’ve got to know the ABC’s of beauty to stay beautiful. Remember to share your beauty secrets.
LOVING. Anyone can be beautiful if she knows how to love. Give some TLC tot he people close to your heart and you’ll definitely bloom!
METICULOUS. Beauty is in the details! Going the extra mile when it comes to filing your nails or tweezing your eyebrows can give you an instant beauty boosts.
NATURAL. Being yourself is being beautiful. Don’t put up any pretensions and stick to who you are.
QUICK. When beauty mishaps occur, think fast and act quickly to avoid any embarassing incidents.
RESOURCEFUL. The best beauty secrets come from things you take for granted. RAid your kitchen for your DIY makeovers!
SMART. Stay smart about which products to use. Always check if anything’s dermatologist-approved before trying it out.
WOMANLY. Take pride in you curves and your feminity, girl! Wear your girly charm with a big grin.
YOUTHFUL. Cherish your youthful glow and know that true beauty lies in those that stay young inside and out.
ZEALOUS. Having passion in life makes you live it more beautifully. Find something you’re zealous about and live life fully.