Brain fluid buildup might delay Giffords’ rehab in Texas

[CountAllVotes]

Source: Holly Bailey Yahoo!

Two days Rep. Gabrielle Giffords was transferred from Tucson to a Houston rehabilitation center, she remains in intensive care because of a buildup of fluid in her brain.

The fluid, doctors said Saturday, doesn't appear to be infected, but the Houston Chronicle's Todd Ackerman reports, it will likely keep her Giffords from entering full-fledged rehabilitation until at least next week.

On Friday, Giffords was flown from Tuscon to the Texas Medical Center in Houston, where she had been scheduled to enter the Institute of Rehabilitation and Research. While the transfer went smoothly, Dr. John Holcomb, one of Giffords' doctors, told reporters that the trip had been medically "stressful" for the congresswoman, who was shot in the head at point blank range two weeks ago.

For now, doctors are draining the fluid in her skull through a catheter but they said Saturday there was a possibility of inserting a permanent shunt.

Read more: http://news.yahoo.com/s/yblog_theticket/20110123/ts_yblog_theticket/brain-fluid-buildup-might-delay-giffords-rehab-in-texas

---

No comment except I hope she gets better very soon.

[grasswire]

1. not good

I hope the transfer was not premature.

Be well, lady.

[CountAllVotes]

2. no it is not good

They shouldn't have moved her so quickly IMO. :(

:kick:

[MissDeeds]

9. I agree

I was concerned that the flight might be detrimental to her recovery. Bless her heart, she has fought so hard. Now is certainly the time for renewed thoughts, prayers and good vibes.

[Merlot]

15. True, but on the other hand, getting out of a hospital is good.

There is much stress involved in being in a hospital as well as more exposure to bacteria. The rehab centers are usually calmer places and still have all the emergency facilities available.

And, this brain fluid might have happened even without the move.

[alwaysdemocratic]

3. Any Medical Experts here? What does this mean?

Any medical experts here?

I hope she is better soon.

[Ruperto32]

4. Excessive fluid buildup can lead to...

...symptoms such as headaches, seizures, blurred vision, vomiting, problems with balance and coordination, memory loss and other changes in mood and behavior.

They are doing the right thing by inserting a shunt.

[CountAllVotes]

5. Welcome to the DU

:hi: And thank you for your input on this.

:dem:

[bear425]

6. The doctors most likely have a ventriculostomy inserted

that will temporarily drain the fluid. If the fluid continues to build after the ventriculostomy is temporarily turned off, they will most likely surgically implant a permanent shunt that will work automatically if fluid builds.

edit: clarification

further edit: I know this because my partner has one.

[trud]

12. bear

Is this a permanent possibility?

[bear425]

30. yes. It is a permanent possibility.

My partner has a shunt that is permanently there and works if/when it's needed. If it is not needed, it is just there.

[du_grad]

10. On the minus side, shunts can become infected...

I work in a medical microbiology laboratory, and have been a medical technologist for over 35 years. Placement of shunts happens fairly often. We get spinal fluid (CSF) from shunts fairly frequently for culture. Unfortunately, these shunts can become colonized with bacteria - many times the bacteria are the ones normally found on the skin that can coat the actual shunt itself. When that happens, they must pull the shunt and put in a new one. Obviously they will keep a close eye on this. Infection is her biggest problem right now. Any time a foreign body invades a sterile space (bullet in brain) it can bring bacteria with it. Heavy duty antibiotics lead to other bacteria causing infections. Many times these bacteria become very resistant. She is, unfortunately, in for a long haul. I am glad they got her off the vent quickly. That is another portal into the body that can become infected with resistant bacteria.

http://medind.nic.in/iau/t06/i1/iaut06i1p52.pdf

http://microbugs.org/showabstract.php?pmid=3077288

[molly77]

13. The seriousness has been downplayed.

Remember when the news said she was better and that they were doing a tracheotomy and feeding tube?This was several days after she was shot. That told me her injuries were devastating or they would have done that immediately.That is just my opinion. Did a clinical rotation on a neuro unit..not experienced.Could be wrong. I sincerely would like to be wrong.

[Lost-in-FL]

20. Tracheotomy and feeding tubes are normally used when a patient is on heavy sedation or induced coma.

Sedation in her case was used because otherwise she would be afflicted with severe headaches and/or to prevent her from moving and hurting herself. She was still breathing on her own (cause you really don't want to have someone with head trauma under induced coma cause she could end up in a permanent coma) even with a tracheotomy so yes, she was heavily medicated. if I was her I would beg to be sedated too.

[Skink]

17. I've lived 30 years with a shunt in place from the brain to the stomach..

my doctor said it is working even now. I had 4 drains in my head during the surgery for the tumor.

[glinda]

7. Personally I thought they moved her too quick.

[trud]

11. shouldn't have moved her.

It was convenient for her husband's work, but her parents live in Tucson, I gather.

[molly77]

14. The move could have been for her safety.

[glinda]

18. Don't think it is safe where she went to though.

[kentauros]

26. I disagree,

as I live and work in Houston. She's at the best medical facility in the country for her care.

Just because we're a (currently) red state doesn't mean it's an unsafe place to live. And Houston is quite blue, by the way, what with our Democratic and nation's first lesbian mayor ;)

[w8liftinglady]

8. Took care of a lot of brain injuries.

Many tertiary hospitals have an ICU-such as the one she is in.Their affiliation with a top trauma center is to her benefit.i have had patients transferred to my facility because of the neurology team...shunts or intraventricular pressure monitors in place.the nursing staff is generally specialized in this area,which is also a benefit.she has the plus of having specific therapy that can visit her bedside,which is also a benefit to her recovery.
increased intracranial pressure is an expected side effect of brain trauma/surgery.i had it for several months after my totally controlled,planned brain surgery.I didn't have a shunt,but was on steroids for about 6 weeks.the key to recovery is early and consistent therapy.they,in my opinion,did her a benefit by transferring her.

[Posteritatis]

16. I'm still reeling that, after that kind of an injury, we're merely hearing about "delaying rehab."

Whole lotta trauma specialists earning their pay there, to say nothing of the technical and intellectual foundations those guys are building on going back god knows how long..

[Lost-in-FL]

19. News services have a way of getting people worked up over nothing. Swelling is a common...

ocurrance after such trauma. Lots of people live almost perfectly normal lives with a permanent cerebral shunt to drain excess cerebrospinal fluid from the ventricles.

My bet is that this yahoo reporter (no pun intended) has no clue about what this even means and it is just causing unnecessary stress on people over nothing. It is serious but not as critical as the reporter puts it. Like a few people here I think that moving her was too quickly, however I heard that it is better to start therapy as soon as possible.

[Skittles]

21. could I ask something?

how do they give all this info and not violate HIPAA rules - does the family give them permission? Anyone know?

[du_grad]

22. I have been wondering the same thing...

There must be official press releases or something that the family okays. The information is pretty detailed.

I have worked in a lab for over 35 years and access many lab reports on a daily basis when I'm working on patient cultures. I never ever go snooping outside of what I'm working on because that can get you fired. People are really stupid to do that. You sign in with a hospital ID and password and they can literally track everything you do online. We are required to read HIPAA updates and take quizzes on the information a couple of times a year. I would imagine that most hospitals require that now of their employees, so ignorance of the rules would be hard to prove when this is required of your job.

[Skittles]

24. I hear you

I worked in Medicare/Medicaid transactions when HIPAA first came about - even back then they were quite stringent but less well known - it would seem everyone knows about them now - I keep wondering how such info is given freely about Ms. Giffords who is clearly not able to articulate consent at this time

[Lost-in-FL]

23. Great question. Nt

[Skittles]

25. my guess

is because of the intense media attention and public desire to know, some info is granted as releasable by, say, her husband - I doubt they are given permission to say anything and everything

[BlueIris]

29. What I heard on NPR the other day--yes, the family has given permission.

But it's NPR. :shrug:

[melm00se]

27. I know 2 people who have suffered significant brain injuries

My mother suffered brain injury/damage as did my best friend's brother. One died (I miss Mom) and the other spent 1 year in the hospital and just went home. He is suffering from right side paralysis and bouts of aphasia.

from these 2 instances I learned that brain injuries are tricky. Folks will show mile long positive jumps followed by .98 mile backslides...it is the nature of the beast.

Rep. Giffords is in for a long long long road and there will be ups and downs during her treatment and (hoefully) her recovery.

Please don't get excited when you see/hear good news on one day because there may very well be devastating bad news 3 days down the road.

[BlueIris]

28. (((( GG ))))

I know you can do it. All Democrats are pulling for you.