Innovations in Neurosurgery
The 74th Reunion and AGM of the Nurses&pos; League was held on Saturday 24th September 2011.
The morning presentation on innovations in neurosurgery was given by a nurse consultant in the field of neurosurgery and also a mother with very up to date experience
The Nurse Consultant who started training in 1976 moved towards Neurosurgery as her speciality. It was hard for nurses to break into this field but now they have clinics with their own caseload.
They do not consider themselves &pos;mini doctors&pos; but maxi nurses’!
Their strength lies in following the parents and patient on their journey from diagnosis to treatment and through to aftercare, also supporting the extended family The family are informed and included in all discussions and the decision making process.
It is very important to appreciate the anxiety, exhaustion and loss of control, which they feel.
She went on to outline some conditions still familiar to us all. There have been major developments in the progress of treatment and surgery in this area. Hydrocephalus is still treated by the insertion of a ‘shunt’ that is still a situation prey to blockage and infection.
In some situations ventricular washout has been performed on babies in utero weighing less than 1 kilo via a ventriculostomy and cauterization of the choroid plexus to limit the production of cerebrospinal fluid.
In the USA the MOMS trial is in progress for children with diagnosed spin bifida; surgery is performed on the developing foetus at around 22weeks gestation; the baby then continues to grow to full term, preventing further damage to the surrounding tissues from the amniotic fluid. Early results from the trial are promising, with improved leg movement and a reduction in the risk of hydrocephalus. However, there is an increased risk of premature birth.
Two sets of conjoined twins (craniopagus) have been successfully treated and cared for. Surgery is best performed in small steps as she explained &pos;Slow and safe is better than quick and spectacular&pos;
Surgical treatment for epilepsy can be very successful in reducing or stopping seizures. The patients are carefully selected and thoroughly assessed before surgery can take place.
For the treatment of some conditions such as craniosynostosis a frame is sometimes fitted onto the face, allowing distraction of the face forwards, over a period of weeks; other children requiring major cervical spinal surgery have placement of a fixed Halo vest jacket that the patient wears for 3 months following surgery, to allow the cervical bones to heal.
These patients go home and are able to live a reasonably normal life. The support of the community nursing service is invaluable during this time.
Mother’s Experience
A mother spoke simply and very movingly about the 15 years following the birth of their first child.
Very soon after her arrival her mother became concerned that there was something wrong.
Initial visits to the doctor proved very unhelpful and she was dismissed as an over anxious mother despite the baby&pos;s copious vomiting.
At 6 weeks it was finally acknowledged that there was a problem, the baby&pos;s head circumference had increased from 25th to 98th centile.
A diagnosis of hydrocephalus was made caused by the presence of multiple brain tumours.
At that time the parents were offered the choice of two hospitals for referral, &pos; We chose GOS. We didn’t know why then but we do now!
We received unfailing support both practical and emotional at all times&pos;.
On voicing a concern of her daughter&pos;s condition, a nurse came, listened and looked and action was taken at once.
During the course of the first 3 years surgery was performed for insertion of shunts 9 times. Over the 15 years this brave young lady has undergone 45 operations.
There are still considerable problems and they never know what each day might bring but this family is united and strong with a younger son who is 11.
There was a photograph of a very attractive teenager very proudly wearing her smart red school uniform!
Article by LizzieY on Sunday 8th of January 2012 10:45:20 AM |
