Shunt

The Journey of a shunter

The following is personal experience only.
It may help someone

If it does help to deal with any difficulties
and it gives support, encouragement
and hope then all will be worthwhile.

Take care and keep going

Louis

Shunt - Meningioma and Hydrocephalus (specialist)
Hydrocephalus and Shunts

• a long way has been travelled on this journey. There is still a long way to go

• on this journey, I met a man with no shoes. Then I met a man with no feet

• my journey (since 15^th August 2015) has provided me with an opportunity to think about ALL this. The more I feel I understand, the less I seem to know. I do know now, however, that the brain is much more complex than it once seemed to be

• the physical and mental parts are somehow connected though how... ???

• So very, very subtle - even the subtlety is subtle. Nails (finger and toe) grow faster than any change, but upwards, forwards and onward is still progress. However slow, progress is still... progress.

It does not matter how slowly you go

As long as you do not stop

Confucius

• the brain remains 'aware'. Even when 'neutralised' for surgery. Only a part can be rendered 'unconscious', but the brain still... knows.

• 'routine' (though very careful) neurosurgery is for the skilled surgeon, but for the first-time patient it is a new experience. It appears that receiving may not be quite the same as giving

• still (November - 2016) puzzle over how the 'shunt' was/is done. It is a simple idea, but very clever and skilful. Think of a beaver re-routing river flow: something blocks the free flow, so re-route around it to allow the continuance of movement.  

Simple!!!

• can make out the probable course of tubing under the skin. Over clavicle and through centre chest. Disappears. No pain. Clever... how?

• unsupported walking is currently not possible, but in the future...? Walking backwards - longer less controlled steps - can cause problems. It's educational to take a staircase descent backwards! This encourages smaller (careful) steps. Also, it is beneficial to attempt sideways (crab-like) walking, too.

• calf/ankle attention demonstrates the importance to walking. The 'bounce' from proper heel-lift takes pressure off the knees and helps stop the 'clunk/click' dynamic.

• practice, practice and then more practice are key. Repeat your best form and always 'raise the bar' - just like any training.

• the 'core' seems to be critical. Strengthen and use - effectively.

• QI: the leg (limb) is farthest from the brain, but is quickest to respond to heat (hot water/topical = skin deep). Right leg was immediate. Left arm/hand slowest to respond, but never cold (blood temp?). Reynauld issues (left middle left ring-finger) - seems to have gone. Micro-tremor in right arm - gone. Immediate! Associate discomfort with returning sensation - left arm/hand last to (gradually) respond. Discomfort on usage - middle finger and thumb appear physically connected (both to forearm). Issues are right-sided, but any returned sensitivity is at least a 100% improvement

• aching (left side) may have a spinal origin and this suggests a nerve-based issue. It's similar with left arm/hand (neck region). It's interesting to speculate whether a lower back pain is caused by compromised walking or poor walking is the result of one or more (sciatic?) nerves being affected

• it's all about repetition and making neural (re-)connections. The concept of the 'mind muscle' is better described as learning again. The brain 'remembering' how to control a muscle. This also incorporates familiarity and the repetition of 'good form'

• feedback is crucial (patient - therapist - patient) and psychology seems heavily implicated.

Added: 24.01.2018

It's been a while since I began my journey. Still making (slow) progress, but onwards and forwards. And upwards. Tried swimming recently: partial success in that I still can and have reasonable speed though reality didn't match the experience! Visualising is quite different to the actual physical movement. Response not as expected. Daft really. Sort of delusion by unfamiliarity. Leg-work too aggressive. Upward/downward motion places considerable pressure on knees - water resistance. Never considered that. Ouch!! Will use the water as supportive and overall more gently to encourage improved muscle control. Sensation and other long-term issues gradually improving. Hot water recognition just about normal - everywhere.

   Strength/flexibility working well. Supported walking progressing. Up/down inclines vs level very different. Vertical alignment change. Working on this. Very aware of imbalance of effort (left/right) in walking. It's all about relearning as an adult toddler. Makes me realise how complicated simple (!) walking actually is.

   A couple of years ago (that all!) I heard someone say Life's Good. I couldn't understand that comment then. I really do now.

LG

   It really is.

Added: 08.08.2018

A comment on the mechanics of walking. The heel-spring. This is critical for smooth walking (not there yet. I may have travelled a long way on my three-year journey, but I still have some way to go -Keep Calm and Carry On).

   Equal thrust: I used to think that balancing the push off with a foot/leg was key. It isn't. The heel-raise/spring is the action. This shifts the body left/right placing weight over the standing leg, altering balance.This allows the following leg to move forwards without scuffing the floor with the foot. The Trendelenberg sign ("hip drop") is the answer. Maintaining a level pelvis.

   Climbing stairs. It is important to place the toes and ball of foot on the stair (running or walking) and raise the heel that remains in the air. This prevents the knee locking with a 'clunk-click'.

   It is easy to imagine that walking is not particularly taxing. Actually it is very complex, but it is done without the need to think about it. Even walking up/down a slope is complex. Either direction involves altering the angle of the foot/leg. Up and this angle becomes smaller. Down and the angle increases, all of the time still maintaining a vertical alignment.

Good luck (and you can only make your own)

       but above all

Keep calm and carry on

Louis Brothnias

and

Percy "Biffo" Veir

Note: "BIF" = bloody independent ****er and "BIFFO" is a tad more expressive. Suits me well. Apparently.