Of biology, not manufacturing/marketing.
My father’s Normal Pressure Hydrocephalus is back, with jackboots on.
Basically what this condition does is deforms the cerebral cortex, because of an elevation of pressure in the CNF of the spine and ventricles. As the cortex is deformed various cognitive functions become impaired. In short it’s one of the many, many conditions that mimic Alzheimer’s Disease.
Last summer my father had surgery to install a shunt, or what I describe as a pressure relief valve, in his head, that would bleed off some of the CNF in his ventricles to keep the pressure down. After that surgery his cerebral functions returned to his norms from a couple of years back, and we all breathed a sigh of relief.
Prematurely.
Last fall, the NPH was back, doing its ballooning of the ventricles again. And again he was suffering urinary incontinence, poor gait, and some cognitive degradation. So they went back in to remove the old shunt and revise it with one that would bleed off more fluid. It was too much, and the cerebral cortex ended up falling, leaving voids around it, which then filled with blood - becoming hematomas. An even worse condition. So the shunt was revised again, and things returned to normal, til about a month ago.
At which point my father admits to little symptoms like: extended nausea, the return of his incontinence, and most noticeably a loss of core body strength. Which is a long-time complaint with him, anyways. He’ll hide symptoms if he doesn’t think that there’s anything that can be done about them. We’d also begun to notice that while his gait isn’t suffering (though his balance is) his judgment has gone through the basement. He is getting distracted by, oooh, shiny! All the time. The other night, at dinner, we were having fajitas, and he dropped a couple of onion slices onto the floor. And this man, who cannot get out of a chair without five minutes of effort, and who bends as easily as a telephone pole, gets up in the middle of his meal to pick up the onion slice, and eat it. Then sits back down to continue his meal. After this ten minute diversion. twitch
While that may be one of the more graphic examples of poor judgment, it’s far from the only one.
Well, the good news is that a revised shunt should be able to correct this. And, even better, this time they’re going to revise it with an adjustable shunt or valve that can be manipulated non-surgically with powerful magnets in the neurosurgeon’s office.
But the communications we’re getting from both the neurosurgeon, and my father’s GP are driving us batty.
First off, last week we passed on to the GP that we’d need a clearance for surgery from him. And he told us Friday that that should be quite doable. And once we got that from him, the neurosurgeon would be able to schedule the surgery. We were told Tuesday that we had the clearance. So I called the neurosurgeon’s office, to give them a head’s up that the clearance should be coming. This morning, I get a call from the neurosurgeon’s office informing me that they’ve still got nothing.
It was all I could do to keep the gibbering asshole in the back of my head from jumping through the phone to beat the woman at the GP’s practice when I tried to calmly and patiently relay that we’d really, really appreciate getting this lousy clearance put through so that my father [del]has a chance to stop being a shuffling piss monster[/del] can get this condition treated.
Add to this that the original date suggested for the surgery by the neurosurgeon is a week, now, before the tentative date that his office is now talking about, and I’m having even more fun trying to control that gibbering asshole. At the moment I’m spending the days here at my parents, and providing services like dressing my father, cooking meals, and being available to help should my father fall and need someone to get him picked up. Dealing with all that is bad enough. Add to that, his cognitive degradation, and both I and my mother are feeling our reserves being drawn down. We’ll be able to handle the situation for another week or two, but that’s about it. (I’ve always felt that those people who deal with elder care deserve great thanks for doing things that most people would find impossible, this experience just emphasizes it.) My mother is starting to talk about how, if he were to fall and need medical attention for the fall, it would have the benefit of getting my father to near the head of the line for this treatment, as well. And if not, the hospital/care provider, could be the one to keep dressing him, putting on his Depends, and dealing with the soiled laundry until he did get his surgery.
Of course, there’s also the imponderables: The sooner the pressure in the ventricles is reduced the more complete the return to the previous shape of the cerebral cortex will be. Which should correspond to a return to more effective cognition, reduction in the incontinence, and possibly even a return to his previous balance. So, we’re really hoping we can squeek in soon. But this run-around and forgotten permissions crap is getting us down.
Like I said - if I had the energy I’d Pit the situation. But as it is, I’m just coming here to vent.
Medical history forms are fun, too. Because my father’s judgment is off, I get to review them. The one he filled out for the neurosurgeon was interesting. My mother made a point to mention impotence and a loss of sex drive as a recent thing. Which while certainly of note for a neurosurgeon’s medical history - still leaves me wishing I could find the brain bleach.