Swiss cheese brain update 29/10/08
Well today I managed to sleep in until 10am! That’s almost unheard of, even when I’m in my usual state of health. Initially I did wake up at around 6.30am, largely I suspect because I forgot to take my strong painkillers last night, and just took my usual bedtime ones. I didn’t think I’d get back to sleep – my head was pounding, but not enough to drive me out of my nice warm sleeping bag in search of painkillers – but get back to sleep I did.
I rang the surgery for my INR result and it’s still only 1.2, though that’s because the ward doc put me on 9mg of warfarin for two days when I came home rather than the usual two days of 10mg they start you off on. I think that was probably because they’d asked what my normal warfarin dosage is though, and it’s been 9mg for the last couple of months. With me though, from experience I know that it usually takes more than 10mg for a couple of days to get anywhere near the therapeutic range if I’ve been off warfarin for any reason. I did test it myself just after the district nurse had gone, but I knew the result wasn’t accurate as it took ages to get a decent sized blood sample, and although I did get a result, I was way outside the 15 seconds limit for lancing the finger to getting the sample on the test strip, so on this occasion I wasn’t expecting the result to be the same as the lab result (you only have 15 seconds from lancing the finger to getting the sample on the test strip because otherwise the coagulation process will have already started and the result won’t be accurate).
Still feeling rather sore, and my head’s itching like crazy, which although annoying is good, because it means it’s healing okay. I’m still getting the weird and wonderful random abdominal pains, which from what I remember from my first shunt take a fair while to settle down. The body doesn’t like having bits of plastic floating around inside it, and both the tubing of the distal catheter, and the draining cerebrospinal fluid irritate internal bits and pieces, and it’s common to get a variety of random shifting abdominal pains, especially in the early days with a new shunt. Fortunately my surgeon had warned me about them before I had the original VP shunt, and back then I certainly did get some severe pains from the distal catheter. The night I got out of hospital I was doubled up with pain under the ribs which felt just like gall bladder pain. Had I not been pre-warned about it, I’d probably have ended up dashing off to A&E, but fortunately it eventually eased. This time so far I’ve not had anything so severe, though as it’s just the lower portion of the distal catheter that’s been replaced, the tubing in that area’s not been touched. Usually the pain will ease with a little gentle rubbing, though once again I’m finding that eating a fair amount too quickly isn’t wise, as it seems to dislodge the catheter, requiring more gentle rubbing and encouraging it to move slightly to make it more comfortable.
My balance is completely off as well (even more so than usual) and I’m getting some extremely dizzy spells, but that’s pretty standard too. As an ENT specialist I saw last year explained, the CSF system and the cochlear fluid are closely linked, and a large change in CSF pressure such as after a shunt or an LP can totally confuse the body’s balance systems. From previous ops though what I’m getting now is about standard for this length of time post-op.
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