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Re: [ptc] Shunts : types, pros and cons

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  • Heather B
    Bev, What a wonderful post! I read all the messages here, but don t often respond. For those of us who haven t had a shunt and may face it in the future, the
    Message 1 of 26 , Oct 30, 2002
      Bev,
      What a wonderful post! I read all the messages here, but don't often
      respond. For those of us who haven't had a shunt and may face it in the
      future, the info on the net can be confusing. You can find a lot of info on
      each specific shunt, but it's hard to find info on "the basics", and you've
      done a great job of breaking it down. Just wanted to say "Thanks."
      Heather

      >From: "Bev Bancroft" <bev.bancroft@...>
      >Reply-To: ptc@yahoogroups.com
      >To: <ptc@yahoogroups.com>
      >Subject: [ptc] Shunts : types, pros and cons
      >Date: Wed, 30 Oct 2002 20:54:19 +0200
      >
      >Hi Everyone,
      >
      >There seem to be a lot of concerns about shunts at the moment. As a nurse
      > although I haven't been nursing for 14 years now, I am still qualified!!!
      >)
      >I thought I'd try and explain the issue in layman's terms a bit. This is
      >slightly subjective - I have a shunt too!!
      >
      >Basiclly a shunt is a length of Latex tubing - it is between 1.7mm and
      >2.5mm
      >thick, and it can be as long as 1m. The lumbar shunts generally are the
      >thin
      >ones, and the ventricular shunts are the wider ones. The principal purpose
      >of the shunt is to physically drain excess CSF away from the brain and
      >spinal cord and into another body cavity where it will get excreted.
      >
      >Shunts are divided into two 'categories' : Lumbar shunts and Ventricular
      >shunts:
      >
      >Lumbar shunts : these are the shunts that are inserted into the area around
      >the spinal cord where the fluid is ( the place that they *should* get into
      >when they do a tap.... ). The shunt then exits the spinal cord through the
      >membranes, and it is usually led around the waistline - just under the
      >skin - and the end is usually put into :
      >- the peritoneum ( Lumbar-peritoneal or LP ) : this is a kind of 'pocket'
      >just in front of the intestines in the abdomen. It has good drainage
      >capability. This is the most common insertion point
      >- the pleural space ( Lumbar Pleural or LPl ) : this is the space created
      >by
      >a membrane around the lungs
      >there are other insertion points ( I have read of someone having the shunt
      >in her gall-bladder ) - but these are not common, and are ususally only
      >considered if there are problems with the other sites.
      >Lumbar shunts often have a valve or reservoir in the middle of them
      > more-or-less by the waistline ). There are various different valves
      >available : but most of them have the main function of regulating the
      >drainage in some way. There are many shunts that have no valve - only tiny
      >slits at the ends to drain.
      >
      >Ventricular shunts : this is when the one end of the tube is placed in the
      >ventricle of the brain ( kind of like a fluid/water space that everyone has
      >in their brains ) and it is usually led under the skin down the neck,
      >between the breasts and into the end-point :
      >Peritoneal ( Ventricular peritoneal or VP ) : as in the Lumbar : the
      >peritoneum
      >Pleural ( Ventricular Pleural or VPl ) : as in the Lumbar
      >or
      >Atrial ( Ventricular Atrial or VA ) : this is where the tube drains
      >straight into the heart.
      >
      >OK. Now for the pros and cons.... I will discuss the overall pros and cons
      >of shunts ( as a whole ) after : here I will discuss the different types:
      >Lumbar :
      >Pro : - easy insertion : most Neurosurgeons know how to place it
      > - less invasive : it doesn't involve Brain surgery
      > - *can* be the final solution in a mild, uncomplicated case
      >Cons - high failure rate ( I think that someone quoted it as being 80%
      >failure rate within 10 years )
      > - tend to clog, break or overdrain
      > - because of the narrow tubing, the valves available have to be
      >inserted with surgery : there are no programmable valves for Lumbar shunts.
      >There are certain doctors who can do this, but it is not FDA approved for
      >use in Lumbar shunts. This means that Lumbar shunts often have to be
      >revised
      >with surgery.
      >
      >Ventricular
      >Pro : - much lower failure rate : Ventricular shunts tend to have better
      >long-term prospects..
      > - Always have a valve of some sort - usually a programmable one :
      >which means that adjustments to the shunt can be done without surgery
      >Cons - more invasive surgery.
      > - often have to be placed with specialised equipment and
      >techniques
      >because PTC sufferers have small ventricles...
      >
      >Pros and cons of shunts ( generally!! )
      >Pro's : drainage of the excess CSF eases the pressure on the optic nerves
      >and a shunt will always therefore prevent any furthur deterioration of
      >vision.
      > - If the drainage can be regulated to suit the individual,
      >there
      >can be total relief from daily headaches.
      > - no furthur necessity for medications of any kind..
      >
      >Cons : failure of the shunt usually necessitates surgery - which can be
      >inconvenient or problematic
      > - As a person who has a shunt, you need to be aware that you have
      >a
      >'foreign body' inside you that can get infected : so you will need extra
      >precaution when you get sick ( my GP usually doubles-up on the antibiotics
      >)
      >or when you have dental work. Should the shunt get infected, you can not
      >only get a severe meningitis, but the shunt will also have to be removed.
      >
      >In closing ( sorry about the novel, but I'm sure that many of you will find
      >it informative.. )
      >I would like to say that whatever hassles I've had from my straight,
      >no-frills LP shunt, it is given me my eyesight back, and the headaches that
      >I've had ( from overdraining ) have been - on the whole - not NEARLY as bad
      >as before the shunt!! I've had this shunt now for just over 2 1/2 years -
      >and I've managed to get my life back!! I'd do it again in a heartbeat.
      >
      >Hugs to all
      >Bev B
      >Johannesburg, South Africa
      >
      >
      >
      >
      >
      >
      >*******************************************************************
      >
      >This message may contain information which is confidential and subject to
      >legal privilege. If you are not the intended recipient, you may not peruse,
      >use, disseminate, distribute or copy this message. If you have received
      >this message in error, please notify the sender immediately by email,
      >facsimile or telephone and return and/or destroy the original message.
      >
      >*******************************************************************
      >


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    • Diana
      Hi Bev Same goes for me, I have saved your post for future reference. I don t have a shunt and probably won t, but it did explain the differences, specifics
      Message 2 of 26 , Oct 30, 2002

        Hi Bev

        Same goes for me, I have saved your post for future reference. I don't have a shunt and probably won't, but it did explain the differences, specifics and was very informative.

        Thanks and take care...............

        Diana

         



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      • Valerie Fisher
        Bev, I wanted to thank you so much for this! It seems like quite a few of us are facing shunt surgery right now and your post was very clear and easy to read.
        Message 3 of 26 , Oct 30, 2002

          Bev,

          I wanted to thank you so much for this!  It seems like quite a few of us are facing shunt surgery right now and your post was very clear and easy to read.  Thank you for putting that together.  I really needed to read that!  Have a good day, dear!

          Love, Valerie



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        • Bev Bancroft
          Hi Everyone, There seem to be a lot of concerns about shunts at the moment. As a nurse although I haven t been nursing for 14 years now, I am still
          Message 4 of 26 , Oct 30, 2002
            Hi Everyone,

            There seem to be a lot of concerns about shunts at the moment. As a nurse
            although I haven't been nursing for 14 years now, I am still qualified!!! )
            I thought I'd try and explain the issue in layman's terms a bit. This is
            slightly subjective - I have a shunt too!!

            Basiclly a shunt is a length of Latex tubing - it is between 1.7mm and 2.5mm
            thick, and it can be as long as 1m. The lumbar shunts generally are the thin
            ones, and the ventricular shunts are the wider ones. The principal purpose
            of the shunt is to physically drain excess CSF away from the brain and
            spinal cord and into another body cavity where it will get excreted.

            Shunts are divided into two 'categories' : Lumbar shunts and Ventricular
            shunts:

            Lumbar shunts : these are the shunts that are inserted into the area around
            the spinal cord where the fluid is ( the place that they *should* get into
            when they do a tap.... ). The shunt then exits the spinal cord through the
            membranes, and it is usually led around the waistline - just under the
            skin - and the end is usually put into :
            - the peritoneum ( Lumbar-peritoneal or LP ) : this is a kind of 'pocket'
            just in front of the intestines in the abdomen. It has good drainage
            capability. This is the most common insertion point
            - the pleural space ( Lumbar Pleural or LPl ) : this is the space created by
            a membrane around the lungs
            there are other insertion points ( I have read of someone having the shunt
            in her gall-bladder ) - but these are not common, and are ususally only
            considered if there are problems with the other sites.
            Lumbar shunts often have a valve or reservoir in the middle of them
            more-or-less by the waistline ). There are various different valves
            available : but most of them have the main function of regulating the
            drainage in some way. There are many shunts that have no valve - only tiny
            slits at the ends to drain.

            Ventricular shunts : this is when the one end of the tube is placed in the
            ventricle of the brain ( kind of like a fluid/water space that everyone has
            in their brains ) and it is usually led under the skin down the neck,
            between the breasts and into the end-point :
            Peritoneal ( Ventricular peritoneal or VP ) : as in the Lumbar : the
            peritoneum
            Pleural ( Ventricular Pleural or VPl ) : as in the Lumbar
            or
            Atrial ( Ventricular Atrial or VA ) : this is where the tube drains
            straight into the heart.

            OK. Now for the pros and cons.... I will discuss the overall pros and cons
            of shunts ( as a whole ) after : here I will discuss the different types:
            Lumbar :
            Pro : - easy insertion : most Neurosurgeons know how to place it
            - less invasive : it doesn't involve Brain surgery
            - *can* be the final solution in a mild, uncomplicated case
            Cons - high failure rate ( I think that someone quoted it as being 80%
            failure rate within 10 years )
            - tend to clog, break or overdrain
            - because of the narrow tubing, the valves available have to be
            inserted with surgery : there are no programmable valves for Lumbar shunts.
            There are certain doctors who can do this, but it is not FDA approved for
            use in Lumbar shunts. This means that Lumbar shunts often have to be revised
            with surgery.

            Ventricular
            Pro : - much lower failure rate : Ventricular shunts tend to have better
            long-term prospects..
            - Always have a valve of some sort - usually a programmable one :
            which means that adjustments to the shunt can be done without surgery
            Cons - more invasive surgery.
            - often have to be placed with specialised equipment and techniques
            because PTC sufferers have small ventricles...

            Pros and cons of shunts ( generally!! )
            Pro's : drainage of the excess CSF eases the pressure on the optic nerves
            and a shunt will always therefore prevent any furthur deterioration of
            vision.
            - If the drainage can be regulated to suit the individual, there
            can be total relief from daily headaches.
            - no furthur necessity for medications of any kind..

            Cons : failure of the shunt usually necessitates surgery - which can be
            inconvenient or problematic
            - As a person who has a shunt, you need to be aware that you have a
            'foreign body' inside you that can get infected : so you will need extra
            precaution when you get sick ( my GP usually doubles-up on the antibiotics )
            or when you have dental work. Should the shunt get infected, you can not
            only get a severe meningitis, but the shunt will also have to be removed.

            In closing ( sorry about the novel, but I'm sure that many of you will find
            it informative.. )
            I would like to say that whatever hassles I've had from my straight,
            no-frills LP shunt, it is given me my eyesight back, and the headaches that
            I've had ( from overdraining ) have been - on the whole - not NEARLY as bad
            as before the shunt!! I've had this shunt now for just over 2 1/2 years -
            and I've managed to get my life back!! I'd do it again in a heartbeat.

            Hugs to all
            Bev B
            Johannesburg, South Africa






            *******************************************************************

            This message may contain information which is confidential and subject to legal privilege. If you are not the intended recipient, you may not peruse, use, disseminate, distribute or copy this message. If you have received this message in error, please notify the sender immediately by email, facsimile or telephone and return and/or destroy the original message.

            *******************************************************************
          • Cherry Cubbage
            Hi Bev, Thank you ever so much for the wonderful explanation of shunts and the surgeries. I plan to make copies of your post to give to those -yes even those
            Message 5 of 26 , Oct 30, 2002



              Hi Bev,
              Thank you ever so much for the wonderful explanation of shunts  and the surgeries.  I plan to make copies of your post to give to those -yes even those in the medical field that I encounter that are unfamiliar with shunts. Your explanations are so clear.
              I had a former NSG who would tell me that "As long as your tubing is in place - nothing can go wrong with your shunt!!"
              Next Tuesday I am having surgery  - I think it is called ICP monitoring and possibly replacing  the shunt.  Right now I have a Codman - Hakim VP which I have had for two years.
              If any one in the group has had experience with the ICP monitoring - I would love to hear from you.
              Thank you again Bev for sharing this information with us.
              Cherry/Cincinnati


              At 08:54 PM 10/30/2002 +0200, you wrote:
              Hi Everyone,

              There seem to be a lot of concerns about shunts at the moment. As a nurse
               although I haven't been nursing for 14 years now, I am still qualified!!! )
              I thought I'd try and explain the issue in layman's terms a bit. This is
              slightly subjective - I have a shunt too!!

              Basiclly a shunt is a length of Latex tubing - it is between 1.7mm and 2.5mm
              thick, and it can be as long as 1m. The lumbar shunts generally are the thin
              ones, and the ventricular shunts are the wider ones. The principal purpose
              of the shunt is to physically drain excess CSF away from the brain and
              spinal cord and into another body cavity where it will get excreted.

              Shunts are divided into two 'categories' : Lumbar shunts and Ventricular
              shunts:

              Lumbar shunts : these are the shunts that are inserted into the area around
              the spinal cord where the fluid is ( the place that they *should* get into
              when they do a tap.... ). The shunt then exits the spinal cord through the
              membranes, and it is usually led around the waistline - just under the
              skin - and the end is usually put into :
              - the peritoneum ( Lumbar-peritoneal or LP ) : this is a kind of 'pocket'
              just in front of the intestines in the abdomen. It has good drainage
              capability. This is the most common insertion point
              - the pleural space ( Lumbar Pleural or LPl ) : this is the space created by
              a membrane around the lungs
              there are other insertion points ( I have read of someone having the shunt
              in her gall-bladder ) - but these are not common, and are ususally only
              considered if there are problems with the other sites.
              Lumbar shunts often have a valve or reservoir in the middle of them
               more-or-less by the waistline ). There are various different valves
              available : but most of them have the main function of regulating the
              drainage in some way. There are many shunts that have no valve - only tiny
              slits at the ends to drain.

              Ventricular shunts : this is when the one end of the tube is placed in the
              ventricle of the brain ( kind of like a fluid/water space that everyone has
              in their brains ) and it is usually led under the skin down the neck,
              between the breasts and into the end-point :
              Peritoneal ( Ventricular peritoneal or VP ) : as in the Lumbar : the
              peritoneum
              Pleural ( Ventricular Pleural or VPl ) : as in the Lumbar
              or
              Atrial  ( Ventricular Atrial or VA ) : this is where the tube drains
              straight into the heart.

              OK. Now for the pros and cons.... I will discuss the overall pros and cons
              of shunts ( as a whole ) after : here I will discuss the different types:
              Lumbar :
              Pro : - easy insertion : most Neurosurgeons know how to place it
                      - less invasive : it doesn't involve Brain surgery
                      - *can* be the final solution in a mild, uncomplicated case
              Cons - high failure rate ( I think that someone quoted it as being 80%
              failure rate within 10 years )
                      - tend to clog, break or overdrain
                      - because of the narrow tubing, the valves available have to be
              inserted with surgery : there are no programmable valves for Lumbar shunts.
              There are certain doctors who can do this, but it is not FDA approved for
              use in Lumbar shunts. This means that Lumbar shunts often have to be revised
              with surgery.

              Ventricular
              Pro : - much lower failure rate : Ventricular shunts tend to have better
              long-term prospects..
                      - Always have a valve of some sort - usually a programmable one :
              which means that adjustments to the shunt can be done without surgery
              Cons - more invasive surgery.
                      - often have to be placed with specialised equipment and techniques
              because PTC sufferers have small ventricles...

              Pros and cons of shunts ( generally!! )
              Pro's : drainage of the excess CSF eases the pressure on the optic nerves
              and a shunt will always therefore prevent any furthur deterioration of
              vision.
                          - If the drainage can be regulated to suit the individual, there
              can be total relief from daily headaches.
                      - no furthur necessity for medications of any kind..

              Cons : failure of the shunt usually necessitates surgery - which can be
              inconvenient or  problematic
                      - As a person who has a shunt, you need to be aware that you have a
              'foreign body'  inside you that can get infected : so you will need extra
              precaution when you get sick ( my GP usually doubles-up on the antibiotics )
              or when you have dental work. Should the shunt get infected, you can not
              only get a severe meningitis, but the shunt will also have to be removed.

              In closing ( sorry about the novel, but I'm sure that many of you will find
              it informative.. )
              I would like to say that whatever hassles I've had from my straight,
              no-frills LP shunt, it is given me my eyesight back, and the headaches that
              I've had ( from overdraining ) have been - on the whole - not NEARLY as bad
              as before the shunt!! I've had this shunt now for just over 2 1/2 years -
              and I've managed to get my life back!! I'd do it again in a heartbeat.

              Hugs to all
              Bev B
              Johannesburg, South Africa






              *******************************************************************

              This message may contain information which is confidential and subject to legal privilege. If you are not the intended recipient, you may not peruse, use, disseminate, distribute or copy this message. If you have received this message in error, please notify the sender immediately by email, facsimile or telephone and return and/or destroy the original message.

              *******************************************************************


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            • oneals7@bellsouth.net
              Ditto, from me! Regina ... From: Diana To: ptc@yahoogroups.com Date: Wednesday, October 30, 2002 11:14 AM Subject:
              Message 6 of 26 , Oct 30, 2002
                Ditto, from me!
                Regina
                -----Original Message-----
                From: Diana <nmat350650@...>
                To: ptc@yahoogroups.com <ptc@yahoogroups.com>
                Date: Wednesday, October 30, 2002 11:14 AM
                Subject: Re: [ptc] Shunts : types, pros and cons

                Hi Bev

                Same goes for me, I have saved your post for future reference. I don't have a shunt and probably won't, but it did explain the differences, specifics and was very informative.

                Thanks and take care...............

                Diana

                 



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              • betsybug2000
                Bev, Thanks for all the information that was pretty much what I was looking for and in addition what the people here on the board experiance on the whole from
                Message 7 of 26 , Oct 30, 2002
                  Bev,
                  Thanks for all the information that was pretty much what I was
                  looking for and in addition what the people here on the board
                  experiance on the whole from the shunts.

                  Betsy
                  Oklahoma

                  --- In ptc@y..., "Bev Bancroft" <bev.bancroft@l...> wrote:
                  > Hi Everyone,
                  >
                  > There seem to be a lot of concerns about shunts at the moment. As a
                  nurse
                  > although I haven't been nursing for 14 years now, I am still
                  qualified!!! )
                  > I thought I'd try and explain the issue in layman's terms a bit.
                  This is
                  > slightly subjective - I have a shunt too!!
                  >
                  > Basiclly a shunt is a length of Latex tubing - it is between 1.7mm
                  and 2.5mm
                  > thick, and it can be as long as 1m. The lumbar shunts generally are
                  the thin
                  > ones, and the ventricular shunts are the wider ones. The principal
                  purpose
                  > of the shunt is to physically drain excess CSF away from the brain
                  and
                  > spinal cord and into another body cavity where it will get excreted.
                  >
                  > Shunts are divided into two 'categories' : Lumbar shunts and
                  Ventricular
                  > shunts:
                  >
                  > Lumbar shunts : these are the shunts that are inserted into the
                  area around
                  > the spinal cord where the fluid is ( the place that they *should*
                  get into
                  > when they do a tap.... ). The shunt then exits the spinal cord
                  through the
                  > membranes, and it is usually led around the waistline - just under
                  the
                  > skin - and the end is usually put into :
                  > - the peritoneum ( Lumbar-peritoneal or LP ) : this is a kind
                  of 'pocket'
                  > just in front of the intestines in the abdomen. It has good drainage
                  > capability. This is the most common insertion point
                  > - the pleural space ( Lumbar Pleural or LPl ) : this is the space
                  created by
                  > a membrane around the lungs
                  > there are other insertion points ( I have read of someone having
                  the shunt
                  > in her gall-bladder ) - but these are not common, and are ususally
                  only
                  > considered if there are problems with the other sites.
                  > Lumbar shunts often have a valve or reservoir in the middle of them
                  > more-or-less by the waistline ). There are various different valves
                  > available : but most of them have the main function of regulating
                  the
                  > drainage in some way. There are many shunts that have no valve -
                  only tiny
                  > slits at the ends to drain.
                  >
                  > Ventricular shunts : this is when the one end of the tube is placed
                  in the
                  > ventricle of the brain ( kind of like a fluid/water space that
                  everyone has
                  > in their brains ) and it is usually led under the skin down the
                  neck,
                  > between the breasts and into the end-point :
                  > Peritoneal ( Ventricular peritoneal or VP ) : as in the Lumbar : the
                  > peritoneum
                  > Pleural ( Ventricular Pleural or VPl ) : as in the Lumbar
                  > or
                  > Atrial ( Ventricular Atrial or VA ) : this is where the tube drains
                  > straight into the heart.
                  >
                  > OK. Now for the pros and cons.... I will discuss the overall pros
                  and cons
                  > of shunts ( as a whole ) after : here I will discuss the different
                  types:
                  > Lumbar :
                  > Pro : - easy insertion : most Neurosurgeons know how to place it
                  > - less invasive : it doesn't involve Brain surgery
                  > - *can* be the final solution in a mild, uncomplicated case
                  > Cons - high failure rate ( I think that someone quoted it as being
                  80%
                  > failure rate within 10 years )
                  > - tend to clog, break or overdrain
                  > - because of the narrow tubing, the valves available have
                  to be
                  > inserted with surgery : there are no programmable valves for Lumbar
                  shunts.
                  > There are certain doctors who can do this, but it is not FDA
                  approved for
                  > use in Lumbar shunts. This means that Lumbar shunts often have to
                  be revised
                  > with surgery.
                  >
                  > Ventricular
                  > Pro : - much lower failure rate : Ventricular shunts tend to have
                  better
                  > long-term prospects..
                  > - Always have a valve of some sort - usually a programmable
                  one :
                  > which means that adjustments to the shunt can be done without
                  surgery
                  > Cons - more invasive surgery.
                  > - often have to be placed with specialised equipment and
                  techniques
                  > because PTC sufferers have small ventricles...
                  >
                  > Pros and cons of shunts ( generally!! )
                  > Pro's : drainage of the excess CSF eases the pressure on the optic
                  nerves
                  > and a shunt will always therefore prevent any furthur deterioration
                  of
                  > vision.
                  > - If the drainage can be regulated to suit the
                  individual, there
                  > can be total relief from daily headaches.
                  > - no furthur necessity for medications of any kind..
                  >
                  > Cons : failure of the shunt usually necessitates surgery - which
                  can be
                  > inconvenient or problematic
                  > - As a person who has a shunt, you need to be aware that
                  you have a
                  > 'foreign body' inside you that can get infected : so you will need
                  extra
                  > precaution when you get sick ( my GP usually doubles-up on the
                  antibiotics )
                  > or when you have dental work. Should the shunt get infected, you
                  can not
                  > only get a severe meningitis, but the shunt will also have to be
                  removed.
                  >
                  > In closing ( sorry about the novel, but I'm sure that many of you
                  will find
                  > it informative.. )
                  > I would like to say that whatever hassles I've had from my straight,
                  > no-frills LP shunt, it is given me my eyesight back, and the
                  headaches that
                  > I've had ( from overdraining ) have been - on the whole - not
                  NEARLY as bad
                  > as before the shunt!! I've had this shunt now for just over 2 1/2
                  years -
                  > and I've managed to get my life back!! I'd do it again in a
                  heartbeat.
                  >
                  > Hugs to all
                  > Bev B
                  > Johannesburg, South Africa
                  >
                  >
                  >
                  >
                  >
                  >
                  > *******************************************************************
                  >
                  > This message may contain information which is confidential and
                  subject to legal privilege. If you are not the intended recipient,
                  you may not peruse, use, disseminate, distribute or copy this
                  message. If you have received this message in error, please notify
                  the sender immediately by email, facsimile or telephone and return
                  and/or destroy the original message.
                  >
                  > *******************************************************************
                • CrabbyWithPTC@aol.com
                  Cherry, I had ICP monitoring three years ago. A small hole was burred into my skull and an epidural sensor was placed for 48 hours. It s not as bad as it
                  Message 8 of 26 , Nov 2, 2002
                    Cherry,

                    I had ICP monitoring three years ago. A small hole was burred into my skull and an epidural sensor was placed for 48 hours. It's not as bad as it sounds, just more of a nuisance since you are restricted to the bed and depend on the nurse for everything. It was just sometimes hard to get the nurse's attention. I have a site that explains the procedure well and the link is below. I hope it helps.

                                 E

                    http://thirdage.adam.com/ency/article/003411.htm




                    In a message dated 10/30/02 12:07:14 PM Pacific Standard Time, ccubbage@... writes:


                    I think it is called ICP monitoring and possibly replacing  the shunt.  Right now I have a Codman - Hakim VP which I have had for two years.
                    If any one in the group has had experience with the ICP monitoring - I would love to hear from you.


                  • Cherry Cubbage
                    Thanks so much for explaining what the surgery is all about and sending me the site. One more question - did you have to go back into surgery to have the
                    Message 9 of 26 , Nov 2, 2002
                      Thanks so much for explaining what the surgery is all about and sending me the site. One more question - did you have to go back into surgery to have the procedure reversed - the bolt removed,etc?
                      I already have a shunt so he may be replacing the one I have once he has monitored the pressure for a while.
                      Thanks again for taking the time to send me the information.
                      Cherry/Cincinnati





                      At 08:02 PM 11/2/2002 -0500, you wrote:
                      http://thirdage.adam.com/ency/article/003411.htm





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                    • CrabbyWithPTC@aol.com
                      Cherry, I didn t have the bolt monitor. I had the epidural sensor. The doc just opened up the stitch, took the wire out and closed it back up. He didn t have
                      Message 10 of 26 , Nov 3, 2002
                        Cherry,

                        I didn't have the bolt monitor. I had the epidural sensor. The doc just opened up the stitch, took the wire out and closed it back up. He didn't have to numb the area at all that time. The stitch was taken out a week later by my primary and I just followed the after instructions on the healing process. My LP shunt pressures showed to be in the normal ranges so no revision was necessary. Since you have a shunt in you, don't be surprised if they order a cisternogram to watch the shunt flow. This is where they might be able to see a problem in the tubing. All they do is insert some radioactive isotopes into the shunt and watch the CSF flow. It's the same procedure as a tap but no CSF fluid is taken out so the chance of a headache is very minimal.

                                     E



                        In a message dated 11/2/02 5:15:46 PM Pacific Standard Time, ccubbage@... writes:


                        Thanks so much for explaining what the surgery is all about and sending me the site. One more question - did you have to go back into surgery to have the procedure reversed - the bolt removed,etc?
                        I already have a shunt so he may be replacing the one I have once he has monitored the pressure for a while.
                        Thanks again for taking the time to send me the information.
                        Cherry/Cincinnati


                      • Cherry Cubbage
                        Thanks again for all the information! It sounds like you have really been through a lot and know what you are talking about. All my NSG told me was that he
                        Message 11 of 26 , Nov 3, 2002

                          Thanks again for all the information! It sounds like you have really been through a lot and know what you are talking about.  All my NSG told me was that he was going to pull the valve out and attach an instrument to it to monitor the pressure. Does that sound like the bolt monitor to you?  I hope they do check out the shunt.  I want all these done once and for all!
                          Cherry




                          At 05:19 AM 11/3/2002 -0500, you wrote:
                          Cherry,

                          I didn't have the bolt monitor. I had the epidural sensor. The doc just opened up the stitch, took the wire out and closed it back up. He didn't have to numb the area at all that time. The stitch was taken out a week later by my primary and I just followed the after instructions on the healing process. My LP shunt pressures showed to be in the normal ranges so no revision was necessary. Since you have a shunt in you, don't be surprised if they order a cisternogram to watch the shunt flow. This is where they might be able to see a problem in the tubing. All they do is insert some radioactive isotopes into the shunt and watch the CSF flow. It's the same procedure as a tap but no CSF fluid is taken out so the chance of a headache is very minimal.

                                       E



                          In a message dated 11/2/02 5:15:46 PM Pacific Standard Time, ccubbage@... writes:


                          Thanks so much for explaining what the surgery is all about and sending me the site. One more question - did you have to go back into surgery to have the procedure reversed - the bolt removed,etc?
                          I already have a shunt so he may be replacing the one I have once he has monitored the pressure for a while.
                          Thanks again for taking the time to send me the information.
                          Cherry/Cincinnati



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                        • CrabbyWithPTC@aol.com
                          Cherry, I haven t heard of the procedure. It could be a form of bolt monitoring. Do you have an LP or a VP shunt? To me it sounds more like a lumbar drain
                          Message 12 of 26 , Nov 4, 2002
                            Cherry,

                            I haven't heard of the procedure. It could be a form of bolt monitoring. Do you have an LP or a VP shunt? To me it sounds more like a lumbar drain where the shunt could be attached to a monitor.

                                         E



                            In a message dated 11/3/02 9:29:30 AM Pacific Standard Time, ccubbage@... writes:


                            Thanks again for all the information! It sounds like you have really been through a lot and know what you are talking about.  All my NSG told me was that he was going to pull the valve out and attach an instrument to it to monitor the pressure. Does that sound like the bolt monitor to you?  I hope they do check out the shunt.  I want all these done once and for all!
                            Cherry


                          • Cherry Cubbage
                            Hi! I have a VP shunt. - Codman - Hakim programmable. What is a lumbar drain? BTW - how are you doing? I know you are recovering from surgery. Mine is
                            Message 13 of 26 , Nov 4, 2002
                              Hi!
                               I have a VP shunt. - Codman  - Hakim programmable.    What is a lumbar drain? 
                              BTW - how are you doing? I know you are recovering from surgery.  Mine is tomorrow at 2:00. I am sitting here drinking a cup of coffee and thinking that  by this time tomorrow  I am going to be in some serious withdrawals - wanting something - anything to drink!!!!  I don't do the fasting thing to well.  I have to have my glass of water as soon as I get up every morning!  Am sooooooooo dreading tomorrow!
                              Cherry



                              At 05:15 AM 11/4/2002 -0500, you wrote:
                              Cherry,

                              I haven't heard of the procedure. It could be a form of bolt monitoring. Do you have an LP or a VP shunt? To me it sounds more like a lumbar drain where the shunt could be attached to a monitor.

                                           E



                              In a message dated 11/3/02 9:29:30 AM Pacific Standard Time, ccubbage@... writes:


                              Thanks again for all the information! It sounds like you have really been through a lot and know what you are talking about.  All my NSG told me was that he was going to pull the valve out and attach an instrument to it to monitor the pressure. Does that sound like the bolt monitor to you?  I hope they do check out the shunt.  I want all these done once and for all!
                              Cherry



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                            • Valerie Fisher
                              Cherry, My thoughts and prayers are with you today, honey. Let us know when you can how your surgery went. Take good care of yourself! Hugs, Valerie ... Do
                              Message 14 of 26 , Nov 4, 2002

                                Cherry,

                                My thoughts and prayers are with you today, honey.  Let us know when you can how your surgery went.  Take good care of yourself!

                                Hugs, Valerie



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                              • CrabbyWithPTC@aol.com
                                Cherry, A lumbar drain is where they drain CSF fluid over a 24-48 hour time frame. Obviously it s done in the lumbar region so I don t think this is what you
                                Message 15 of 26 , Nov 4, 2002
                                  Cherry,

                                  A lumbar drain is where they drain CSF fluid over a 24-48 hour time frame. Obviously it's done in the lumbar region so I don't think this is what you are going to have done. I posed your question to the larger forum. There are a few advanced medical techs in there and may have an answer. I'll forward anything they say to you.

                                  I understand the fasting. Even though my surgery was at 9:00 AM my stomach was singing!  I did a little better once the IV took effect. I'm doing okay. I'm suffering from serious high pressure and if I lay down I end up with my head in the toilet bowl. I don't want to take the Darvocet unless I really need to and I'm fine walking around the house. It's just when I find myself in a comfortable position the pressure strikes. I'm trying to hold out until Thursday when I go have my staples removed and first follow-up. Hopefully the nsg can just open me up and switch me down right there. The Chiari is better, though. I don't lose my balance anymore and the arm/leg pains are gone so something right did happen with this surgery.

                                  I know what you mean about the dread. The wait is horrendous, especially the night before. But you know it's something that has to be done and hopefully answers will be found. Good luck with your procedure!

                                               E



                                  In a message dated 11/4/02 7:56:02 AM Pacific Standard Time, ccubbage@... writes:


                                  Hi!
                                  I have a VP shunt. - Codman  - Hakim programmable.    What is a lumbar drain? 
                                  BTW - how are you doing? I know you are recovering from surgery.  Mine is tomorrow at 2:00. I am sitting here drinking a cup of coffee and thinking that  by this time tomorrow  I am going to be in some serious withdrawals - wanting something - anything to drink!!!!  I don't do the fasting thing to well.  I have to have my glass of water as soon as I get up every morning!  Am sooooooooo dreading tomorrow!
                                  Cherry


                                • Cherry Cubbage
                                  Dear E, Thanks for the encouragement and the helpful information. After reading about Ken and what he is going through - I am almost ready to back out of this.
                                  Message 16 of 26 , Nov 4, 2002
                                    Dear E,
                                    Thanks for the encouragement and the helpful information. After reading about Ken and what he is going through - I am almost ready to back out of this. Poor guy - he has really been through it.  I'm so glad you have seen some improvement!
                                    I will be so glad when it is this time tomorrow night and the waiting and anticipation is over.
                                    Thanks again for your help!
                                    Cherry

                                    At 05:11 PM 11/4/2002 -0500, you wrote:
                                    Cherry,

                                    A lumbar drain is where they drain CSF fluid over a 24-48 hour time frame. Obviously it's done in the lumbar region so I don't think this is what you are going to have done. I posed your question to the larger forum. There are a few advanced medical techs in there and may have an answer. I'll forward anything they say to you.

                                    I understand the fasting. Even though my surgery was at 9:00 AM my stomach was singing!  I did a little better once the IV took effect. I'm doing okay. I'm suffering from serious high pressure and if I lay down I end up with my head in the toilet bowl. I don't want to take the Darvocet unless I really need to and I'm fine walking around the house. It's just when I find myself in a comfortable position the pressure strikes. I'm trying to hold out until Thursday when I go have my staples removed and first follow-up. Hopefully the nsg can just open me up and switch me down right there. The Chiari is better, though. I don't lose my balance anymore and the arm/leg pains are gone so something right did happen with this surgery.

                                    I know what you mean about the dread. The wait is horrendous, especially the night before. But you know it's something that has to be done and hopefully answers will be found. Good luck with your procedure!

                                                 E



                                    In a message dated 11/4/02 7:56:02 AM Pacific Standard Time, ccubbage@... writes:


                                    Hi!
                                    I have a VP shunt. - Codman  - Hakim programmable.    What is a lumbar drain? 
                                    BTW - how are you doing? I know you are recovering from surgery.  Mine is tomorrow at 2:00. I am sitting here drinking a cup of coffee and thinking that  by this time tomorrow  I am going to be in some serious withdrawals - wanting something - anything to drink!!!!  I don't do the fasting thing to well.  I have to have my glass of water as soon as I get up every morning!  Am sooooooooo dreading tomorrow!
                                    Cherry



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                                  • Cherry Cubbage
                                    Thanks so much Valerie! I was doing pretty good until I read about Ken an his infection and now I am really nervous! Will email you guys as soon as I can and
                                    Message 17 of 26 , Nov 4, 2002
                                      Thanks so much Valerie!  I was doing pretty good until I read  about Ken an his infection and now I am really nervous! Will email you guys as soon as I can and let you know how it went.
                                      Hugs to you all!
                                      Cherry/Cincinnati



                                      At 09:20 AM 11/4/2002 -0800, you wrote:

                                      Cherry,

                                      My thoughts and prayers are with you today, honey.  Let us know when you can how your surgery went.  Take good care of yourself!

                                      Hugs, Valerie



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                                    • CrabbyWithPTC@aol.com
                                      Cherry, I asked around in the larger forum and what was said was that an ICP monitor can be clipped to the shunt valve and monitored. When finished, the valve
                                      Message 18 of 26 , Nov 5, 2002
                                        Cherry,

                                        I asked around in the larger forum and what was said was that an ICP monitor can be clipped to the shunt valve and monitored. When finished, the valve is then replaced back onto the shunt and the shunt takes over again. However, there is a higher risk of infection with this being done so please be careful. Good luck and let us know how everything turns out.

                                                     E


                                        In a message dated 11/4/02 2:42:24 PM Pacific Standard Time, ccubbage@... writes:


                                        Dear E,
                                        Thanks for the encouragement and the helpful information. After reading about Ken and what he is going through - I am almost ready to back out of this. Poor guy - he has really been through it.  I'm so glad you have seen some improvement!
                                        I will be so glad when it is this time tomorrow night and the waiting and anticipation is over.
                                        Thanks again for your help!
                                        Cherry


                                      • Cherry Cubbage
                                        Thanks E! I am leaving in about 45 minutes for the hospital. Will email you guys as soon as I am home and let you know how things turned out. Meanwhile , you
                                        Message 19 of 26 , Nov 5, 2002

                                          Thanks E!
                                          I am leaving in about 45 minutes for the hospital.   Will email you guys as soon as I am home and let you know how things turned out. Meanwhile , you take care of you and thanks for all the help!
                                          Cherry




                                          At 05:00 AM 11/5/2002 -0500, you wrote:
                                          Cherry,

                                          I asked around in the larger forum and what was said was that an ICP monitor can be clipped to the shunt valve and monitored. When finished, the valve is then replaced back onto the shunt and the shunt takes over again. However, there is a higher risk of infection with this being done so please be careful. Good luck and let us know how everything turns out.

                                                       E


                                          In a message dated 11/4/02 2:42:24 PM Pacific Standard Time, ccubbage@... writes:


                                          Dear E,
                                          Thanks for the encouragement and the helpful information. After reading about Ken and what he is going through - I am almost ready to back out of this. Poor guy - he has really been through it.  I'm so glad you have seen some improvement!
                                          I will be so glad when it is this time tomorrow night and the waiting and anticipation is over.
                                          Thanks again for your help!
                                          Cherry



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                                        • Cherry Cubbage
                                          Valerie and E Just thought I would let you know that I am back home tonight. My surgery was canceled. My Nsg had another surgery prior to mine that went much
                                          Message 20 of 26 , Nov 5, 2002
                                            Valerie and E 
                                            Just thought I would let you know that I am back home tonight. My surgery was canceled.  My Nsg  had another surgery prior to mine that went much longer than he expected.  After waiting al;most 5 hours -  I finally heard that he had cancelled mine because he was nowhere near finished with the other surgery.'
                                            To say the least - I am not happy! Now I have to go through this all over again and I have no idea when it will be. His office is supposed to let me know something tomorrow.  Hopefully it will be on Thursday - but who knows.
                                            Anyway - thanks for your thoughts and prayers!  They were much appreciated!
                                            Cherry



                                            At 09:20 AM 11/4/2002 -0800, you wrote:

                                            Cherry,

                                            My thoughts and prayers are with you today, honey.  Let us know when you can how your surgery went.  Take good care of yourself!

                                            Hugs, Valerie



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                                          • CrabbyWithPTC@aol.com
                                            Cherry, I m sorry to read that your monitoring was cancelled. Hopefully, it will be rescheduled soon. I know what you mean about disappointment. Just when you
                                            Message 21 of 26 , Nov 6, 2002
                                              Cherry,

                                              I'm sorry to read that your monitoring was cancelled. Hopefully, it will be rescheduled soon. I know what you mean about disappointment. Just when you get the nerve and the psyche to do it something happens. It might have been for the best, though. Let us know about your new appointment.

                                                           E


                                              In a message dated 11/5/02 5:55:53 PM Pacific Standard Time, ccubbage@... writes:


                                              Valerie and E 
                                              Just thought I would let you know that I am back home tonight. My surgery was canceled.  My Nsg  had another surgery prior to mine that went much longer than he expected.  After waiting al;most 5 hours -  I finally heard that he had cancelled mine because he was nowhere near finished with the other surgery.'
                                              To say the least - I am not happy! Now I have to go through this all over again and I have no idea when it will be. His office is supposed to let me know something tomorrow.  Hopefully it will be on Thursday - but who knows.
                                              Anyway - thanks for your thoughts and prayers!  They were much appreciated!
                                              Cherry


                                            • Valerie Fisher
                                              Cherry, Oh my, I m so sorry! Hang in there and let us know when you are scheduled! My prayers are with you. Now try to de-stress!lol Hugs, Valerie ... Do
                                              Message 22 of 26 , Nov 6, 2002

                                                Cherry,

                                                Oh my, I'm so sorry!  Hang in there and let us know when you are scheduled!  My prayers are with you.  Now try to de-stress!lol

                                                Hugs, Valerie



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                                              • Cherry Cubbage
                                                Hi Valerie, Just talked to the Dr s office - HAD TO call them myself = kept waiting and waiting for them to call me. They told me that he was booked solid
                                                Message 23 of 26 , Nov 6, 2002

                                                  Hi Valerie,

                                                  Just talked to the Dr's office - HAD TO call them myself = kept waiting and waiting for them to call me.  They told me that he was booked solid through December and she was going to have to sit down with him sometime today  and see when he could work me in!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
                                                  She is hoping it will be either the 12th or 19th of Nov.  Gee - like my headaches are nothing to them!
                                                  On top of it all - my husband was laid off of his job  on Monday.    So - I will try to de stress - but I not going to get my hopes up too high!
                                                  Thanks for your prayers! you are a sweetie!
                                                  Cherry


                                                  At 09:03 AM 11/6/2002 -0800, you wrote:

                                                  Cherry,

                                                  Oh my, I'm so sorry!  Hang in there and let us know when you are scheduled!  My prayers are with you.  Now try to de-stress!lol

                                                  Hugs, Valerie



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                                                • Amanda
                                                  Cherry- Thinking of you. I m sorry about your hubby. I know it seems like when it rains it pours. *BIG HUGS* and chocolate sent your way. Amanda (*has anyone
                                                  Message 24 of 26 , Nov 6, 2002
                                                    Cherry-
                                                    Thinking of you. I'm sorry about your hubby. I know it seems like when it rains it pours.
                                                    *BIG HUGS* and chocolate sent your way.
                                                    Amanda
                                                    (*has anyone heard from ken???*)
                                                     
                                                    -------Original Message-------
                                                     
                                                    Date: Wednesday, November 06, 2002 01:42:42 PM
                                                    Subject: Re: [ptc] Cherry..
                                                     

                                                    Hi Valerie,

                                                    Just talked to the Dr's office - HAD TO call them myself = kept waiting and waiting for them to call me.  They told me that he was booked solid through December and she was going to have to sit down with him sometime today  and see when he could work me in!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
                                                    She is hoping it will be either the 12th or 19th of Nov.  Gee - like my headaches are nothing to them!
                                                    On top of it all - my husband was laid off of his job  on Monday.    So - I will try to de stress - but I not going to get my hopes up too high!
                                                    Thanks for your prayers! you are a sweetie!
                                                    Cherry


                                                    At 09:03 AM 11/6/2002 -0800, you wrote:

                                                    Cherry,

                                                    Oh my, I'm so sorry!  Hang in there and let us know when you are scheduled!  My prayers are with you.  Now try to de-stress!lol

                                                    Hugs, Valerie



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                                                  • Amanda
                                                    Cherry- No surgery AND no chocolate???? Ok, that s just WRONG! I m sending you TWO boxes of chocolate Amanda ... From: ptc@yahoogroups.com Date: Wednesday,
                                                    Message 25 of 26 , Nov 6, 2002
                                                      Cherry-
                                                      No surgery AND no chocolate????
                                                      Ok, that's just WRONG!
                                                      I'm sending you TWO boxes of chocolate 
                                                      Amanda
                                                       
                                                      -------Original Message-------
                                                       
                                                      Date: Wednesday, November 06, 2002 05:27:19 PM
                                                      Subject: Re: [ptc] Cherry..
                                                       
                                                      Thanks Amanda,
                                                      It's funny that you *sent*chocolates.  All I wanted to do last night was come home and eat as much chocolate as i could!! But my daughter had found my hidden stash and eaten it all!! Boy was I PO'd!!! No surgery and then no chocolate!!
                                                      Cherry





                                                      At 03:41 PM 11/6/2002 -0500, you wrote:
                                                      Cherry-
                                                      Thinking of you. I'm sorry about your hubby. I know it seems like when it rains it pours.
                                                      *BIG HUGS* and chocolate sent your way.
                                                      Amanda
                                                      (*has anyone heard from ken???*)
                                                       
                                                      -------Original Message-------
                                                       
                                                      From: ptc@yahoogroups.com
                                                      Date: Wednesday, November 06, 2002 01:42:42 PM
                                                      To: ptc@yahoogroups.com
                                                      Subject: Re: [ptc] Cherry..
                                                       

                                                      Hi Valerie,

                                                      Just talked to the Dr's office - HAD TO call them myself = kept waiting and waiting for them to call me.  They told me that he was booked solid through December and she was going to have to sit down with him sometime today  and see when he could work me in!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
                                                      She is hoping it will be either the 12th or 19th of Nov.  Gee - like my headaches are nothing to them!
                                                      On top of it all - my husband was laid off of his job  on Monday.    So - I will try to de stress - but I not going to get my hopes up too high!
                                                      Thanks for your prayers! you are a sweetie!
                                                      Cherry


                                                      At 09:03 AM 11/6/2002 -0800, you wrote:

                                                      Cherry,

                                                      Oh my, I'm so sorry!  Hang in there and let us know when you are scheduled!  My prayers are with you.  Now try to de-stress!lol

                                                      Hugs, Valerie



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                                                    • Cherry Cubbage
                                                      Thanks Amanda, It s funny that you *sent*chocolates. All I wanted to do last night was come home and eat as much chocolate as i could!! But my daughter had
                                                      Message 26 of 26 , Nov 6, 2002
                                                        Thanks Amanda,
                                                        It's funny that you *sent*chocolates.  All I wanted to do last night was come home and eat as much chocolate as i could!! But my daughter had found my hidden stash and eaten it all!! Boy was I PO'd!!! No surgery and then no chocolate!!
                                                        Cherry





                                                        At 03:41 PM 11/6/2002 -0500, you wrote:
                                                        Cherry-
                                                        Thinking of you. I'm sorry about your hubby. I know it seems like when it rains it pours.
                                                        *BIG HUGS* and chocolate sent your way.
                                                        Amanda
                                                        (*has anyone heard from ken???*)
                                                         
                                                        -------Original Message-------
                                                         
                                                        From: ptc@yahoogroups.com
                                                        Date: Wednesday, November 06, 2002 01:42:42 PM
                                                        To: ptc@yahoogroups.com
                                                        Subject: Re: [ptc] Cherry..
                                                         

                                                        Hi Valerie,

                                                        Just talked to the Dr's office - HAD TO call them myself = kept waiting and waiting for them to call me.  They told me that he was booked solid through December and she was going to have to sit down with him sometime today  and see when he could work me in!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
                                                        She is hoping it will be either the 12th or 19th of Nov.  Gee - like my headaches are nothing to them!
                                                        On top of it all - my husband was laid off of his job  on Monday.    So - I will try to de stress - but I not going to get my hopes up too high!
                                                        Thanks for your prayers! you are a sweetie!
                                                        Cherry


                                                        At 09:03 AM 11/6/2002 -0800, you wrote:

                                                        Cherry,

                                                        Oh my, I'm so sorry!  Hang in there and let us know when you are scheduled!  My prayers are with you.  Now try to de-stress!lol

                                                        Hugs, Valerie



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