Update for 7-8-13:
Libby’s sister Ellen posted a detailed update on Caring Bridge this afternoon:
The results of the CAT scan, MRI, and EEG tests helped Libby’s neurological intensive care medical team at Memorial Hermann hospital conclude that Libby is suffering from hydrocephalus, which is an excess of spinal fluid accumulating in her brain. This is a common side effect for stroke patients, and we had been warned during her last hospital stay that it could be a possible development. On the negative side, it is rarely reversible, but on the positive side, it is controllable by a shunt, which involves a valve with a programmable setting, a tube to the ventricular cavity in the brain, and drainage tube to a cavity near her stomach where the body absorbs the excess fluid. We are so grateful for the vigilance of the therapists, Pia and Savannah, at UP who noticed a slight swelling of Libby’s head and initiated immediate action to get Libby to an Emergency Room for care!
The solution was to insert an external shunt through a small hole in the top of Libby’s head on the left side (where there is still a bone covering) to drain off the excess spinal fluid and relieve the pressure and discomfort that the excess fluid causes. This worked beautifully, for a short time. Unfortunately, Libby’s external shunt became clogged and nonfunctional today, so it was replaced this afternoon. This procedure took about an hour, and was done in her ICU room after she had been sedated. Those attending were a neurologist, assistant, ICU nurse Elise, and for the critical insertion part – Libby’s neurosurgeon Dr. Dannebaum.
Dr. Dannebaum told Lester and I that if all goes well with the new external shunt, and it drains properly, and they are able to get a good reading on the pressure in her brain, then he would like to do surgery to put in a permanent internal shunt as early as possibly Wednesday. If that surgery goes well, Dr. Dannebaum would like to immediately follow the shunt surgery with surgery to replace the two pieces of skull bone which were removed on the right side of her head during her prior hospital stay. (Looks like another buzz cut for Libby, and Lester, too, if he’s up for it.)
Dr. Dannebaum was hopeful that resolution of Libby’s hydrocepahlus pressure problems by a properly functioning internal shunt (which is programable by a machine with a magnet put to her head on the outside – Thank goodness!), would enable her to return to UP a couple of days after surgery to resume her recovery therapy. We all hope and pray that his hope comes true!
It has been a rough few days on Libby and all the family, but we are anxious to have the next two surgeries done and to return Libby to her room at UP. She is naturally, not currently as responsive or alert as she was before the hydrocephalus hit her, but …she is less anxious, fidgety, and does Not seem to be suffering the minor seizures which were afflicting her before the shunt/drain insertion.
Lester reported that Libby still responded positively when he asked some medical staff members to speak Spanish to her. For some reason that romance language seems to bring her comfort, (or at least it does when it is spoken properly). Thank God for anything that might ease her anxiety or discomfort!
Also, my 12 year old granddaughter Carlee, called me this afternoon when she heard about Libby’s new diagnosis. Carlee received her first shunt for hydrocephalus at three months old, and she received her most recent revision for new shunts during the same time Libby was first in the hospital in May. Carlee’s words of encouragement to me were that Libby’s new shunt surgery is “something to be Joyful about, not sad, because Aunt Libby will feel sooo much better!” She should know. Libby has been there for Carlee so many times for her multiple shunt revisions, and now Carlee is there for Libby. God is Good.
Thank you all for your prayers and support during this difficult time for Libby and those who love her! We appreciate you ALL, and your messages of encouragement, prayers, suggestions, and interest mean more to us than you will ever know.
Update for 7-9-13
From Sister Cathy:
Today we met with Dr. Dannenbaum, Libby’s neurosurgeon, who said he has scheduled the surgery to put a permanent shunt in Libby’s brain tomorrow. He may or may not also replace her skull pieces that are in the “bone bank” at the hospital. Depending on the amount of fluid and swelling in her brain and some other issues, he may determine that it would be the most conservative and safest plan to do that surgery separately at a later time.If all goes well, Libby should remain in Memorial Hermann ICU for a few days and then hopefully be able to return to University Place to resume rehab. The hydrocephalus has certainly been a set-back for her, but hopefully she will recover quickly and be able to return to her physical, occupational, and speech therapy soon.I apologize that we are not able to answer your specific questions in your comments in the guestbook, but please know that everyone on TEAM LIBBY reads them everyday. There are so many wonderful messages, good advice, and spiritual and uplifting words of faith and encouragement. But in light of tomorrow’s surgery, I can’t resist repeating a beautiful message from Deanna Ripley-Lotee to Libby:“As you go into this new step of your life, see your students beside you, your family beside you. Those of us who knew you in Asilomar, hold in your mind the coolness and loveliness of the ocean, the waves crashing on the Pacific coast, the soft sand beneath your feet–we are there watching the sunsets, we are there listening to the gulls, we are there looking through the tide pools, we are there laughing at your jokes, taking your instruction, creating art of our own. We are there holding your hand, smiling, happy, loving the wonder that is you. We are there.”Thank you all for “being there” for Libby and her support team at this scary time.
I never thought I would rejoice at the word “uneventful”, but Dr. Dannenbaum used it several times in describing Libby’s surgery this morning and it sounds wonderful! They put in the permanent shunt in her brain, but chose not to do the bone replacements today. Although we would have loved for Libby to have that skull protection (and to no longer have a concave right side of the head), the more we learned about the pros and cons of replacing the bones at this time the more we are grateful that she has some room for any future swelling and/or fluid buildup if necessary. (Thank you to those of you who advised us on this.) Libby is still in post-op, and has not returned to the ICU, but all reports indicate that she is doing well. If all goes well in her recovery from surgery, she should be able to return to University Place in a few days. Praise the Lord! Thank you for surrounding Libby in love and prayer. Kudos to her medical team for their skill and compassion. Hear that sound? It is a universal sigh of relief and gratitude.
The road to recovery has not been a smooth one for Libby. Today she has been in a lot of pain and discomfort, with some vomiting. Lester noticed her head seemed to be swelling again, so the doctor used the machine on the outside of her head to adjust the flow of the shunt. This procedure resulted in a reduction of the swelling, but now there is some concern that the shunt is draining too much and might have to be adjusted again. Doggoneit. Until the setting is right there is a lot of pressure in her head which is painful. At least with modern improvements to the shunts, adjustments can be done without additional surgeries which were necessary years ago, and before shunts were invented- well, let’s not go there. Thank God for his mercies and for revealing knowledge for discoveries by researchers in the medical field every day which relieve suffering and increase healing. In the meantime, the medical team watching over Libby in her new Intermediate Care room at Memorial Hermann hospital will be monitoring her condition closely. She has been given some anti-nausea medicine which seems to be helping, and hopefully, soon she will be feeling better. Both Lester and Susan Gartner reported that Libby is understandably, not up to interaction with them today, except for recognition and slight acknowledgement of their presence. Lester said the best she could manage today was a fleeting attempt at a smile, which is probably more a reflection of her sweet spirit than her physical condition. We are all hoping and praying that the shunt flow setting can be found which is Just Right for Libby’s special circumstances, and that she will feel relief from the pain as soon as possible. We know there are many friends praying for her and supporting her all over the world, and we are grateful and appreciate each and every one of you! Hope to have better news tomorrow.
To learn more about how you can help for Libby and her family, please visit How We Can Help Libby Lehman. Entries for Alex Anderson and Ricky Tims’ quilt contest must be received by Satuday, so if you plan to do so, act quickly. Please consider carefully what you can do.
The Quilt Shop Navigator is working on another way to show our support for Libby and her family. We hope to be able to announce it soon.