Shunt Postponed

Today we received more proof that nothing ever goes according to plan
around here. I arrived to find a bit of a commotion in Karyn's room.
She was all readied for the journey downstairs to the O.R., unplugged
and prepped but no one seemed like they were going anywhere. Within
moments it seemed, Dr. Parsa appeared and expressed some concern over
Karyn's wound. He began to poke and prod, apologizing to her as he
did and turned to tell us that he felt strongly that the shunt be
postponed and an alternate plan be put into motion. He suggested
that, although I.D. had cleared her for the shunt (since the
infection are indeed gone), the risk of another infection was too
high. He proposed reopening the incision, removing the skull bone
plate and installing two new drains to replace the old ones. I was
still in shock at the thought of having the large of a piece of skull
missing when he asked if I was ok with it. I told him that I honestly
had no idea what to say and didn't feel I was in a position to make
that call either way. He then said, "Well, I'm kind of telling you
what I think you should do."

At that point Jim and I just said that she was in his hands and that
if he felt strongly that this should happen, then this should happen.
So, here we are... 8:30PM and still no sign of her on the 11th floor
(though we are told she is on her way up).

What does this all mean? Well, it's still sinking in for us, but what
it essentially means is that she will have a large hole in her skull,
covered only by the skin flap. This will provide an instant relief of
any pressure and should have a positive effect on her neuro status.
Dr. Parsa noted that this is a process that is common among head
trauma cases and that she could months or years without the piece of
skull there.

The next step will be to install the shunt, perhaps as early as
Monday, and then get her back on the Temodar chemo as soon as
possible. Then, someday down the road, they will create a replacement
bone plate and she will need to return to UCSF for yet another
surgery to put that plate in. You've heard of people having plates in
their heads.... well, you can add our sweet Karyn to that list of
people.

Today marks the fourth week she has been here in the hospital.
Hopefully this new procedure will pave the way for a quick return
back home. And hopefully we will get to hear her beautiful voice
again soon....

~Julian