The Family

The Family
For Christmas 2010

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Saturday, May 1, 2010

The External Ventricular Drain

The night was short for both of us.  We each only got about 2-3 hours of sleep that night.  Bekah called around 10am to let me know that they were getting ready to take Nathan into surgery.  So I hurried and got ready and headed up to the hospital.

By the time I got there, Nathan was already in surgery.  Since the shunt was infected, they needed to remove it.  But since Nathan currently had an infection, it was unsafe to install a new one.  So the plan was to remove Nathan's infected shunt and run antibiotics for 2 weeks to clear up the infection.  But Nathan still needed to drain excess fluid from inside his brain.  So Dr. Riva-Cambrin was going to externalize the shunt with an External Ventricular Drain (EVD) for the duration of the antibiotics.

An EVD is a small flexible tube that is surgically implanted into one of the venticles of the brain.  The CSF then drains into a collection bag at the patient's bedside.

The surgery was one of the quicker ones that we had waited through.  But quick doesn't always mean trouble-free.  After Nathan had been moved to Post-Op Recovery, his nurse noticed that the EVD was not draining.  But since it sometimes takes an EVD a little bit to start draining, it wasn't something to be overly concerned about it until about an hour had passed since the surgery was over. 

Since it still wasn't draining at that point, they tried to flush it.  But when that didn't work, they suspected that it was likely blocked.  So they took Nathan for a CT scan.  Apparently, Nathan had had a tiny little bleed in his skin and the blood had seeped into the EVD tube and clotted, thus preventing the tube from draining.

So the good doctor had to take Nathan back into the OR to replace the EVD tube.

The most interesting thing about the EVD, at least for me anyway, was how unprepared I was for what it looked like.  I knew that the shunt would be externalized, but I guess I just wasn't prepared for Nathan having a tube sticking out of the top of his head with a little bag at his bedside collecting brain fluid.  It was actually quite a shocker:


  1. How much can one little baby boy go through. That had to be shocking to see your precious baby like that. I knew he had shunt problems but I never knew how extensive the trials had become for you all. My heart aches for you and all the trials your family went through.

  2. Isn't it amazing the things that can be done to help this baby boy out. The body is such a miracle how it all works, I think more so how we have surgeons that can fix the things that aren't working correctly. It's so cool to me. I'm a retired Surgical Technologist, so things like this is so cool to me. I don't know how I would handle it though if it were my own baby. That's where you are much better than me. I've minor hospital stays with my kids. Those are so draining, I couldn't imagine doing it for your childs hole life. YOU GUYS ARE AMAZING