Happy 10th Surgery

Friday I celebrated a ridiculous milestone; I was having my 10th surgery in 8.5 years. I am including my 3 C-sections, which were worth the incisions because I got to bring home a baby. The latest surgery was an umbilical hernia repair...the easiest surgery to date. Now I did not have this hernia before my May Hysterectomy, but did after. When I asked my OBGYN how I developed this hernia, she kindly said I didn't take it easy enough while recovering from the Hysterectomy. So looking back, the gardening, vacuuming, and grocery shopping I did right after my surgery in May wasn't a great idea. Apparently I should of listened more to Kyle when he obsessively told me to sit down and relax (damn it, I hate it when Kyle is right).

 So I found myself back in a pre-op bay getting hooked up to blood pressure and O2 monitors. Once again I am stripping and putting on the attractive hospital gown, booties, and hair net. Once again I am telling doctors and anesthesiologists my medication list and ALL the previous surgeries. It is all so familiar that I have no fear or anxiety. It is so familiar I have the same pre-op nurse I did for my May surgery. Judy, a 62 year old mother of 4. All her kids went to college but it took her fourth child 6 years to graduate from Missouri Valley. She recognizes me from my brain/VP shunt history. Luckily everything is running on time, and I am in the OR right at 9:00am. No 4 hour wait in a Jayhawk-infested hellhole this time! As I enter the OR I get a few more nurses mentioning  that I look familiar. Soon I am given oxygen, then the sleeping medicine.

I wake up in recovery, and my belly actually hurts. I tell them it is an 8 out 10 on the pain scale. I had really thought this would be an easy and near painless procedure, but my belly tells me different. After an hour, I am moved to a post op room to recover before heading home. The IV meds they were giving me were not working, so I ask for some oral painkillers. When the nurse, not Judy, goes to give me the pill she begins to freak out because there is a lake of blood on the ground. Meanwhile I begin to feel woozy. She is wrestling my with my sheets and IV to see what had happened. Kyle keeps calling my name and before they ask him to leave he insists to the now 3 nurses that I am going to pass out. Unfortunately, he is pretty good at recognizing the "pre-face out face."

Needless to say he was right, and I wake up to 3 nurses and a doctor shaking me and saying "April, you need to wake up." I guess a cap fell off a IV port and my IV was literally draining me of blood. I felt like some poor sap on True Blood. STAT blood tests showed them I didn't lose too much blood, and I was able to go home shortly after. Scared that this nurse's mistake would keep in the hospital over night, I jumped at the chance to go home.

I have no more surgeries on the horizon and that is such a relief. Now I have to figure out what to do in my surgical patient retirement. And United Health Care won't know what to do as I won't meet my deductible next year.

Cerebral Venogram: No stent for me.

Earlier in the post titled:

The 18th lumbar puncture gone wrong and the calm husband who turned ASSHOLE I talked about possibly being a candidate for an alternative treatment called a stent. Then we could remove the shunt and leave me less prone to infection and malfunctions. However, today an invasive test concluded that I was NOT a candidate for a stent. The test Dr. Abraham performed  today was a Cerebral Venogram. It was a very interesting test and yet another procedure that had to be the brain child on a 4-day drug and alcohol bender. After waiting four hours in a Jayhawk facility due to an emergency before me, it was my turn to go in "the room." This room resembled a training facility suited for NASA. Huge machines decorated the room and 20+ oversized monitors hung on the walls and the ceiling. In the middle of all the major technology was a tiny, cold table for me to lie on. Exactly how anyone would want to spend a beautiful Monday morning.   I was laid flat on the table underneath a 3 part x-ray machine. After all the technology was in place, Dr. A came into the room and began to saturate my groin with Lanacane. Don't worry, Kyle, that sounds way naughtier than it really was! After my groin was numb, Dr. A strung a very long catheter through my groin into my Venous Vein. This vein provided a pathway for the catheter to travel up my thigh, stomach, chest, neck and finally to my head where it spewed out contrast and measured the pressure in the major veins in my brain. The oversized monitors were aiding in the threading of the catheter.   Earlier Dr. A had seen some stenosis in two major vessels leading to my brain on a scan called an MRV. This alarmed him enough to proceed with the Venogram. However, his MRV findings raised my hopes for getting a stent and saying adios to the trouble making shunt.   Once the catheter hit the blood vessel in the right side of my head, pain radiated throughout my brain. As I mentioned this to a nurse she started pumping Fentanyl, a pain killer, through my IV. Also I could hear the catheter releasing the contrast...very eerie.   Next he had to take pictures. He had me close my eyes and mouth and breath in through my nose to take a picture of the vessel. Then the catheter was able to measure the pressure in my veins to see if the narrowing was causing increased pressure in my brain. After the right side he had to do the whole thing again on the left side. The left side was even more painful due to my naturally curvy veins. More Fentanyl was pumped into my IV though it was not helping the headache. Once contrast was released, measurements taken, and pictures obtained on the left side, Dr.A pulled that long catheter out of my groin and applied pressure to the puncture site for ten minutes.   In recovery I continue to battle a raging headache. After two more rounds of ineffective Fentanyl they decided to give me Oxycodone which helped my 8 out of 10 headache subside to a 4 out of 10. That is when Dr. A came into recovery to deliver the bad news that I was not a candidate for a stent. After he delivered the news, I was rushed off to a STAT C-SCAN because my blood pressure had dropped, one of my hands was freezing and the other was warm, and my smile was lopsided. Fear of a stroke, they got me to the CAT-SCAN room within 10 mins and the scan was read within 2mins. It was a clean scan and everyone could breath again.   On the way home, Kyle asked me how I felt about not being able to get the stent. All I could say was I 75% disappointed and 25% relieved. Relief from not having to endure any other brain surgeries and relief from knowing that the shunt IS the best treatment for me. I am glad I consulted with Dr. A and had the Venogram because it gave me peace with having a shunt

What...you want to operate where? Not my head?

Throughout this winter I was having wicked side pains. The pain mostly sat on my right side and the stabbing feeling prevented me from doing simple things like rolling over in bed or pulling my right leg up into our van. Now up to this point, all ridiculous medical mishaps had been due to the effin' shunt. So what do you imagine was my first inclination for the side pain? Yes, I envisioned the shunt tubing wondering around my abdomen whipping any organ that got in its way. Reserving that thought to myself, I went to my family doctor, who has struggled through this whole soap opera with us, with my side pain complaint. When a normal patient shows up with side pain the appendix, liver, or gall bladder are looked at. However, he, Kyle, and me are programmed to go for a Dx of a shunt malfunction. What else could it be in me? After three revisions in two years, the past had to dictate the future. I was sent off for a CT. Mysteriously, other than some fluid collection around my liver my CT looked clean.

So what was causing this pain? Still thinking it was the shunt we contacted the neurosurgeon and was abruptly excused with some serious accusations that I will further explain in a post called "An ice pick to the head: The accusation that I am compromising my shunt on purpose."

Thinking outside the box-I thought maybe, just maybe, my side pain had NOTHING to do with my shunt, despite my past history. Therefore, my next stop was to see my OBGYN. I know this was a normal stop that should of happened a lot earlier, but we were consumed with a shunt Dx.  My OBGYN is the antithesis of all the "Nuero" guys I had been working with. She is calm, talks slow, listens to me, and acts with diagnostic tests(as opposed to hunches). All this, while being a very capable doctor in her field. After an ultrasound, CT, and MRI it was discovered that both my fallopian tubes were filled with fluid. This condition is called hydrosalpinx. She compared my fallopian tubes to stuffed sausages, so I had eggs and sausage in pelvis...sorry...poor joke. Her recommendation was a hysterectomy via a minimally invasive ROBOT...yeah a ROBOT!

I initially pictured a robot feeling me up, but it is more like an arcade game where the doctor is moving scalpels and cameras inside the patient via a control board five feet away from the patient. This seemed similar to the iconic game Pac Man. Dr. Woods is behind the controllers maneuvering her Pac Man to devour my cervix...500 points; one fallopian tube 250 points; my uterus 900 points (the big one).

Now using the Pac Man robot has many advantages. It is the least minimally invasive method for a hysterectomy because the instruments Pac Man is using to devour my ovaries are very small, so there is very little tissue damage. I have four small holes and not a huge across the belly incision like I did for my C-sections. Also there is less bleeding and less chance of infection.

Pre op was a bit weird, as I was used to them prepping my head by putting faducials on and marking and shaving places on my scalp. However, a hysterectomy pre op has shaving, just not on the head and every once in awhile I would catch myself from telling the nurse "No, you need to mark my head so the surgeon knows what side to operate on." It was all very foreign having the other end worked on.

So after have 4 brain surgeries, I thought this surgery was going to be a walk in the park. Dr. Woods was telling me I would have a 2 to 4 week recovery. However, in my warped brain I gave myself 5 days to heal. Yep, only 5 days. Hell, I had Zac Brown tickets bought for Lincoln Nebraska 6 days after the surgery.  No one told me 5 days recovery, I just thought that was a reasonable amount of time to heal after getting major organs cut out of me. As a result I overdid it on all physical activity and gave myself a hernia. After that I did begin to take it easy. But seriously I thought this surgery was going to be like getting a mole removed, so much so I asked if I could go home the night of the surgery. I actually begged if I could go home.and they said absolutely not. This turned out to be a good thing since my bladder took a while to wake up. I was unable to void, so I had to stay two nights until I could pee on my own. And, boy I did the Potty Dance once I peed on my own! Yipee, I could go home then!!!!

Though I have had some little infections and the hernia, my side pain is completely gone. I have learned there is no reason to automatically jump to the shunt. Yes, it should be in the back of our minds, but it should not guide my medical treatment. And always, I learned to see several doctors to get their opinion on the situation because they might have the answer!

The 18th lumbar puncture gone wrong and the calm husband who turned ASSHOLE.

As part of the Neurologist's intense follow-up to my minor migraine inquiry, I was to have a Lumbar Puncture (spinal tap) the day after X-mas. When the first shut was fitted my neurosurgeon look me in the eye and promise the Lumbar Punctures were a thing of the past, and I was to never have one again. This was because they could simply "tap" my shunt and get pressure readings and collect fluid for testing. Wow! that was a relief, but NOT true. Since that empty promise, I have had 3 more LPs. And lately they make this whole vodka-worthy situation worse with the need of a blood patch. In the post #3-If only Edward Cullen were Real... I explain how, the needle prick from the LP sometimes doesn't clot correctly and the spine leaks CSF. The leak leads to brain sagging... I inappropriately picture my back brain lobes resembling old boobies without a push-up bra. Then the droopy lobes cause a mind bashing headache. Now the medical answer for this sagging is disgusting and I often wonder who and how this remedy called a blood patch was discovered. It had to be one of those accidental discoveries that involved a boat-load of alcohol and/or drugs.

I have had 2 blood patches. My first one was explained and executed with sweet care by an anesthesiologist named Dr. Poe at St. Lukes in Lee's Summit. The second patch did not involve a gentleman, but an arrogant short man who resembled Sammy Davis Jr at Lee's Summit Medical Center.

So I dutifully went on December 26th  to my appointment to get my spine pricked again. There was a lot of talk about how they had to use a higher spinal area due to scare tissue from the earlier 17 LPs. I measure out above average at 25ccs. Normal was 14ccs-20ccs. The radiologist drained me down to a 4 ccs, yeah a 4. Seemed like a drastic drainage, and I knew my body would need a blood patch. So, I confirmed with both the ER doc and the attending nurse that if I were to need a blood patch that I could come here to Lee's Summit Medical Center despite it being a weekend. They both said, "Yes." Kyle and I had been down this road and were covering our bases before going home.

We went home and sure enough the Spinal Headache came 48 hours later on a Saturday. Now a spinal headache is the worst of all the types of headaches I have ever had. The pain radiates from an inside core and paralyzes my head with agonizing pain whenever my head moves. It is worse that a high pressure headache or a meningitis headache. So we had to have a battle plan for when this hell came over my head. As we were told we went up to LMC's ER. There, they made feel nice and cozy with some intravenous Dilauded. However, when they came in with a second dose of "heaven" instead of an anesthesiologist to patch my spine we started asking questions like, "When can I get the patch?" and "What is taking so long," The ER doctor only said that they were treating me with the Dilauded and that was the best they could do right now SINCE AN ANESTHESIOLOGIST WASN'T IN THE BUILDING."  I was in so much pain, I really didn't comprehend the fact a blood patch wasn't going to happen. However my mild mannered husband laid into the doctor by asking "We were told to come here to get a patch and now you can't give her a patch?" "How can you run a hospital without a anesthesiologist?" "What do we do now?" "Why can't we call in the anesthesiologist on call?" Kyle, normally being a soft teddy bear became a monstrous Papa Bear demanding answers and action. I kind of liked that rare glimpse into Kyle's dark side.

Ironically after Kyle's tirade  an anesthesiologist was found in an OR and he was inserting a syringe into my spine within 15 minuets.  This whole procedure and the high opening pressure pretty much went unnoticed until I fired my neurologist and got and new nuerologist who has sent me down a whole new path of Nueroptamologist and a possible stent rather than a shunt to treat me.

Today, I had that appointment with the Nuero Interventionist to see if I was a candidate for this less invasive stent. However, my scans did not show up in time for the appointment (this, despite my call to assure the scans would be there),  so Dr. Abraham was not able to apply theory to my specific case. In my Candyland World my shunt could be permanently removed in order to insert a small 2-inch mesh stent in a large vein that is narrowing, which could be causing my brain's inability to drain the spinal fluid.

VS

The stent would then keep my vein open to an appropriate circumference for drainage. The stent would be skull-contained, so rose thrones, counter corners, or bunk beds could not damage it. Dr. Abraham has to see my scans though to see how bad my narrowing is before he can order a semi-invasive test to see where the narrowing is the worst. If I can "pass" both these tests, I would be a candidate for a stent and I could get this efffin' shunt out of my body. However, I also have to be at peace if I am not a candidate for the stent...be at peace with my current plumbing system I have. But good thoughts and prayers never hurt!

A Routine Neurologist Appointment Leading to DEFCON 4 Emergency Tests and the Panic that Ensued!

In December, I felt like I was having headaches more and they became harder to numb, so I figured it was my migraine heritage finally rearing it's ugly head. The headaches did NOT resemble the nauseating pressure headaches that caused my skull to feel like it was going to blow apart. Therefore, I was very confident that all was well in the shunt department. Several generations of women in my family had suffered nasty migraines, and I had mostly avoided the dreaded migraine all my life. I figured my luck had ran out and I was now going to learn how to handle these headaches now.

I shared in the post:

The Chick Who Hyperventilated in Birthing Class that I am crazy (not a fair label, but it makes it feel more light hearted and less serious to me.) and have been diagnosed and have effectively dealt with a panic disorder. This whole Cluster of Crap has added more triggers to this situation.

Despite my panic, I was "flying solo" at this neurologist's appointment. My panic is mostly triggered with any event that has the prefix "Nuero" in it.  So, it was unusual for me to go without my Kyle safety net. As a coping mechanism, Kyle usually escorts me to the majority of "Nuero" appointments because I don't hear the doctor correctly and ,quite frankly, rationally. I can't listen because I am trying so hard to stifle back tears, vomit, or dizziness that accompanies my panic. Sweat attacks embarrass me and I am constantly excusing myself to urinate because my body is on hyper drive. However, this appointment didn't phase me because I was just asking for a migraine medicine and that was it.

Now when I first had my shunt fitted, the neurosurgeon said that all other doctors will automatically freak out and jump to the diagnosis of a shunt malfunction. However, I figured my neurologist would be intelligent enough not to automatically jump to the shunt. After I explained textbook migraine symptoms and shared my family history, she surprised me and immediately said she thought it was a shunt malfunction. Yep...sweat waterfalls hit, vomit burnt my throat, words got lost, and my mind started to spin. "Wait, can we try a migraine med before we jump to the shunt?" Nope, she just was set on her assessment and ordered (1) A head CT (2) Blood work (3) An eye exam (4) A Neuropsychological exam and (5) My 18th lumbar puncture (spinal tap). So much for just getting my piece of paper with a migraine med scribbled on it. I was trying so hard to keep it together, I forgot to check out and the receptionist had to chase me down the hall to get my co pay. Then I sat in the van on the phone the with Kyle trying to calm down enough to drive home. I guess he should of come anyway.

I spoke of my Neuropsychological Exam in the post called:

Short Term Memory Loss and A Bedazzled Belt Clip and I will talk about the lumbar puncture later in a post called: The 18th lumbar puncture gone wrong and the calm husband who turned ASSHOLE on an ER doctor. Yet my head CT is the most real example of how my panic sets in during the most routine and safe situations.

Specifically my triggers are Research Medical Center, my neurosurgeon and anything to with his office, any headache that lasts more than 3 days, and going days w/o sleep . On December 23rd, I had to enter one of these triggers head on. I had to get a routine head CT there at that scary RMC. Kyle made sure to be with me this time. To prepare, I downed a Xanax (my crazy pill, I call it) at home before leaving. Now, the smell, the décor, even the employees' scrubs can send me into a panic tail spin so much so that I am sure I resemble a solider dealing with PTSD. Except soldiers deal with true trauma, death, and tragedy and I am just walking down to RMC's radiology's waiting room. Can we say weak willed? As I wait in the radiology waiting room with Xanax in my system, my body wants to rock back and forth; Kyle tries to stop my motion, but realizes that is futile and stops. My eyes can't focus and I can't complete sentences with Kyle's distracting conversation. The deep breathing I try is really just dramatic shallow breathing and I want to scream LETS GET THIS DONE SO I CAN LEAVE! Obliviously, the Xanax was not working, so I take another one. However with the swig of water going down, vomit meets it as it is coming up and I scurry to the restroom to lose my lunch. My body is fighting so hard not burst out into hysterics...it is exhausting! Finally they called my name and the poor tech who takes my somber shell back gets no laughs for his witty jokes and one word answers to his questions. He quickly gives up communicating with me and just gets the CT done as quickly as possible.



The irony is that after 1) A head CT (2) Blood work (3) an eye exam (4) A Neuropsychological Exam and (5)A Lumbar Puncture we found out that I do have migraines that respond perfectly to a common migraine medicine called Topamax and that I have some short term memory loss. All the tests and anxiety to prove that I, the patient, knew my own body. I am sure may struggle with panic, anxiety, or depression and/or have been correct about your body despite others' opinions. All we can do is keep moving forward while advocating for our own health!

Short Term Memory Loss and A Bedazzled Belt Clip

This whole cluster of crap has depleted my depth perception, banned me from the Armed Forces, and restricted my roller coaster life. All concerns I can easily live without. Weeellll....maybe not the depth perception. Our poor swaggerwagon has received 3 or more "accidental" dents due my parking. I need to stick to those back empty parking spots where the old and automotivally proud park.

 

Anyway, as I continued with my long term sub job I noticed tasks I normally would remember, like picking the class up from recess, coming back to a student to answer a question, or changing a lunch order would completely skip my mind. This lack of memory was very unusual for me. Typically, I enjoyed boasting to my forgetful Kyle that I didn't need to write anything down and that I was impeccable with names. However, as my mind was being challenged in "the big girl world," my mind, in fact, was failing me. I denied it for a while chalking it up to stress, but Kyle approached me about it after I forgot Franki and Moe at school (no judgment), and I got that dreaded phone call from the school's secretary inquiring if I was on my way to pick them up. "I forgot them, but don't tell them," I said into the phone as I dropped my shopping bags on the front step of house, ran to the beat up swaggerwagon and sped to get my stranded birds.

 

Right around then I had a neurologist appointment where Kyle urged me to bring up this memory situation, so I did. And the neurologist sent me to a Neuropsychologist; whoever knew such an occupation existed?  After a 2 hour consultation, a 4 hour mind numbing testing session, and another hour long recap consultation, it was concluded that I, in fact, had some short term memory loss and delayed processing skills. Personally and honestly, I feel like we could have shortened this 7 hour process to one quick test. The test involved the test proctor giving me 20 random words to remember in any order. She said them verbally and as soon as she was done saying them, I was to recite as many as I could remember back to her. Planning on this being an easy task, I was devastated when I could only spit out 4, yes 4, of the 20 words she had told me. That simple 3 minute test told it all. The Neuropsychologist recommended some cognitive rehabilitation and hinted at some compensation skills.

 

One of the compensation skills was to keep a meticulous calendar. So I went out to T-Mobile to find the phone with the most user-friendly calendar and began adding EVERY minor event I could think of. I set up an extensive network of alarms to trigger my brain that the kids need to be picked up or Henry had speech therapy. I was set...or, I thought I was set. The key, my friend, to using a cell phone calendar is having the calendar/phone with you at all times and having the ringer turned up. I often left my phone at home or forgot to turn the ringer up. So my alarms would go off, and I would be oblivious and in the same situation as before.



My phone isn't too conspicuous.

 

This lack of phone care actually became a huge deal in my marriage. Kyle just couldn't fathom having his phone further than an arm's length's away, and I just didn't have the same urgency. Even though I, unlike him, actually needed my phone to keep me on time and in the right places. So I got one of those super hip belt clips to keep my phone attached to me. I know belt clips scream "SHE IS AWSOMELY HIP!" However, Kyle was not a fan of my solution. He made fun of me and mentioned denying marital relations if I kept wearing my magnificent belt clip. I was even willing to bedazzle it, but rhinestones were not going to convince him to accept wearing my phone on my hip.
 







Well, if a bedazzled belt clip wasn't going to be accepted I saw another idea for keeping the phone on me. At Henry's speech class one of the moms wore her phone around her neck like a backstage pass to a concert. MIND BLOWN! Perfect, I thought to myself. That night I brought the backstage pass idea to Kyle. I think he was more disgusted with that than the belt clip. So we have met in the middle. I try harder to make sure my phone is with me and he is more forgiving if it is on the bed side table and I am at Hobby Lobby. 

Thorns In The Head

This story does not have me saving my head similar to a superhero zombie like the previous post. Instead, I am more of an oaf left standing dumbfounded with thorns in my head.

 

This past Fall, I had enthusiastically accepted a long term sub job in 6th grade at Moe and Franki's school. It was extremely refreshing to be back in the classroom creating lesson plans and making what we called " big girl checks." Being out-of-practice to the whole full-time working mom gig (props to those full-time working moms who balance everything), the house resembled a battle zone with dishes unwashed, toys strung about, and landscaping unkempt. We had leaves in flower beds, crispy dead perennials that needed to be dead headed and a few ugly, scary rose bushes that had grown out of control. One rose bush in particular had thorns on the base that were the size of a guitar pic. Spoiler alert: I would end up fighting this exact rose bush.

 

Thinking I needed to get as much Fall clean up as possible done in a quick Sunday afternoon, I got my nippers, rakes, and yard waste bags. The weather was nice; however, the wind was gusting at 30 mph. I had this one afternoon and wind was not going to slow me down so I started digging those crispy dead annuals out of their pots. Next I put on heavy duty gardening gloves and got my large nipper to tackle our rebellious and unruly rose bushes. I went head first (this will be even funnier in a second) into the base of the biggest rose bush, the one with the guitar pic sized thorns, and started grooming. The wind made it hard to keep my balance, but damn it I was going to at least get the outside of the house looking neat again (even though the inside was a disheveled disaster). Well the wind won, and dropped me head first into the rose bush.







 

Once again I was laying on the ground wondering what had I done to myself. With gardening nippers in one hand and thorny rush bush vines in the other, I didn't have a chance to protect my head this time. After all, nippers to the head is generally frowned upon whether you've had brain surgery or not. After pulling myself out of the bush, I felt a warm trickle  of blood running down my face.
 

Leaving my pile of weeds on the ground I race inside to survey the damage. I am bleeding from my head, and the punctures are around the shunt site. I also see that there are some thorns embedded in my scalp. I yell some obscenities and throw the bloody wash cloth on the ground because I am embarrassed to show Kyle I am also having flashbacks of how a small cut turned into bacterial meningitis and two more surgeries last fall. I need him to pull the thorns out, so with sheepish eyes I approach him and explain what happened. The look on his face said, "How in the hell did a rose bush kick your ass?"
 

Tweezers in sanitized hand, Kyle pulls out at least 3 thorns from my scalp. Then I apply an antibacterial cream every hour completely paranoid of infection. I walked around for two weeks with a permanent greasy spot from my compulsive application of Neosporin. However, after pulling 3 thorns, I still felt like there was still something in my scalp. Sure enough the next morning a 4th thorn came to the surface. It was completely submerged; Kyle couldn't even see it.

The first three thorns Kyle pulled out of my head.



Paranoia also made me call the neurosurgeon-on-call at Research Medical Center on a Sunday afternoon with my issue. He was polite enough, but I am sure that surgeon was thinking "What a quack!" We also called my neurosurgeon on Monday wanting an emergency appointment. All I could think of was last December, and I wanted to do EVERYTHING possible to prevent an infection, hence my perpetual greasy Neosporin spot and the rubbing alcohol on my vanity. Well, my neurosurgeon did not see my situational urgency and refused an appointment.  Its not like he wasn't busy ;) Everything turned out fine and everything healed, but it did start the thought process of if I was the best candidate for a shunt with all my klutzy tendencies. It also made Kyle seriously consider buying me a helmet. But a helmet with a wig so I could still look awesome, of course.