We're settled in Giraffe 3022 with Summer now. She was still pretty groggy and cranky when they first brought her down to the room, but is doing much better now. She's cuddling with Jason in the rocking chair, watching Toy Story 3.
Dr Browd said the surgery went well. It took about an hour, and everything went just as planned. She has a small incision on her belly. They shaved the side of her head completely and re-opened about 1/3 of the length of the previous incisions. She has tiny punctures all down her chest that must have been to help guide the tube or lift the skin, but nothing else requiring stitches. There's a little puffiness around her eyes, but the swelling is nothing compared to her last surgeries.
The shunt itself is actually pretty big - much larger than the Ommaya. Prior to today, I didn't realize there would be any sort of device implanted. I had just pictured one big tube connecting to the catheter and running down into her abdomen. In reality, the shunt looks something like this. I'm not sure if that's the exact one she has, but the specs are similar. It is about as thick as your thumb, according to the neurosurgery resident we saw before the surgery, and has five flow-level settings.
As you can imagine, that leaves a good-sized lump on the side of her head. It's currently hidden by a bandage, so I'm not sure what it actually looks like, but hopefully it won't be too noticeable once her hair grows back.
Dr Browd could tell the cyst was putting some pressure on the Ommaya because of the rate of fluid production. The shunt is currently set at 1 (the settings range from .5 to 2.5), which will drain the cyst at a slower pace. They'll probably do a set of CT scans tomorrow to see how it's progressing and again in about two weeks. They can always adjust it as needed using a magnet, and they'll actually have to re-program it after every MRI going forward.
The catch with this shunt is that we'll never be able to tell whether the radiation has stopped the cyst from refilling or if the shunt is just continuing to do its job and drain the cyst. Of course, if after radiation the cyst continues to refill we know that both radiation and the shunt have failed. It is a relatively temporary solution as shunts have a 40% failure rate within two years. The hope is that the shunt will get us through radiation, the radiation will work and if/when the shunt does fail in the future, it won't matter because the cyst isn't refilling anyway.
As of right now, the plan is still to head home tomorrow.