On the 14th, Niklas went to the University of Michigan for a neurosurgery follow up appointment. This appointment was supposed to be in December but, for a couple of reasons, Greta and I had it bumped up. A few weeks back, Niklas was especially cranky. His disposition is usually very pleasant so, of course, we began to wonder about the shunt. The poor kid does something out of character and automatically his Mom and Dad start doubting his ventricular hardware. Little did we know that it was just the start of a month long cold that was invading our family.
The second reason we moved up the appointment was this bump on the top of Niklas's head, just above his forehead. Back when he was in the NICU at St. Joe's, he had a temporary shunt implanted in this spot in hopes his hydrocephalus would clear up and a permanent device would not be necessary. This temporary device actually had a name, but I can no longer remember what it was. More and more I realize I have blocked out many parts of that whole experience. This device was a tiny little reservoir under the skin of his scalp into which the excess cerebral fluid would drain. In essence, Niklas had a tiny little tube going from his brain and through his skull. This tube drained the excess fluid in his brain when pressure built up into a plastic bubble implanted just beneath his skin. When the bubble filled up, the doctors would remove the excess fluid with a needle. When it came time to implant his permanent shunt, this temporary device had to be removed and the area that remained had to be patched up. You can read more about the first shunt here.
There has always been a little bump where this device was, but recently Greta and I felt it was getting bigger. I told this to Dr. Maher who, in my opinion, is one of the smartest people on earth. He told us that he patched up the hole in Niklas's skull with what is called an absorbable plate. Over time, these plates just dissolve once the bone has regenerated. He said he has installed thousands of these without an issue until one recent case in which the body was rejecting the material and building up excess tissue on top as a result. He wants us to keep an eye on this area to see if it continues to grow and remove the plate if it does. In a nutshell, this poses no risk to Niklas's health and is purely cosmetic. If surgery is required, he would go home the same day.
Niklas had to be sedated for his CAT Scan this time because the whole thing is just too scary. The poor guy couldn't eat anything all morning because of the sedation. He gets knocked out for the scan and then they have to wake him back up right afterwards, which also happens to be nap time. For the rest of the day Niklas couldn't even walk because he was intoxicated from the meds. This infuriated the poor little man because he knows how to walk but he couldn't understand why things weren't working properly. It was a rough day for us both and I don't think I will ever be able to look at my baby on a CAT Scan machine without tearing up.
Most importantly though, the ultrasound looked good. It was about the same as it was 6 months ago. The little pocket of fluid that he had surgery to alleviate a year ago is still there. It is smaller post surgery but still there, although no longer a real concern of Dr. Maher's. Niklas has been passing all of his milestones, says words in two languages, and is doing everything a little boy his age should be. Niklas is, and continues to be, a miracle. Praise God!