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Therese Atkins with a help of a shunt, her journey without Physical and occupational therapy, living a normal life with the symptoms associated with normal pressure of hydrocephalus.

For Therese, her condition started a while back about six years ago December 20 th , 2016, she visited the Bellin Health Physical Medicine Neuro Consultant, for severe pain in her head, the attending physician Dr. Brian A Knapp, evaluated her and his diagnosis was that she suffered from Cerebrovascular Accident due to Thrombosis of left Anterior Cerebral Artery. Therese is a patient of Hydrocephalus, before recently I did not know what that is much less knowing my wife is a patient of this illness. However I have taken the liberty to research its meaning, Hydrocephalus is the buildup of too much cerebrospinal fluid in the brain. Normally, this fluid cushions your brain. When you have too much, though, it puts harmful pressure on your brain.

THERESE MEDICAL HISTORY OVERVIEW

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THERESE MEDICAL HISTORY

T H E R E S E

Your best chance at winning is to be alert

I n this chapter I call overview I will tell you some things that are helpful to ensure that your patient enjoys a normal life, however, those are not my beliefs but the observation of living with someone who has Hydrocephalus, in that case, this patient happens to be my wife of fifty years, with the help of the shunt Therese was able to enjoy a normal life of course as normal as could be. The first thing you should do is schedule regular ongoing checkups, if I had not called in to schedule a six-month checkup with the doctor that performed her surgery, doubles to say she would not have been seen and this report which I have seen fit to post to you would be futile. Below is a report of the attending physician.

OVERVIEW

Nathan Zwagerman, MD Therese Atkins is a very pleasant 76-year-old woman with a history of ACA stroke with residual fourth ventricular IVH, underwent EVD placement followed by a VP shunt placement by me. I last saw her back in November and her imaging was stable. She has no new complaints. She is otherwise in her usual state of health. She has no new imaging to review. In summation, Ms. Atkins is a very pleasant woman who presents today for a follow-up evaluation. At this point, we had a long discussion regarding the natural history of this as well as the options of treatment with continued observation versus intervention. At this point, we will plan on keeping her on continued conservative management. We will plan on getting her back to see us on a p.r.n. basis. In the meantime, if she has any questions, comments, or concerns, she can contact our office, but otherwise, we will see her back as needed.

QUESTION AUTHORITY

After reading the doctor’s note above I am sure that you believe what you had just read, well let's put the record straight I am writing this to help enlighten the subject of shunting in general, I do not fabricate, discriminate, or lie to the contrary. Therese has not uttered a word of speech for six years to me or anyone for that matter, most assuredly any communication on her behalf is being done by myself, however, this is not about me so when I tell you that the statement made above which states that and I quote, we will plan on keeping her on continued conservative versus management, is news to me nothing has been said to me about that except it being written in the doctor note and place in Therese health chart. Therese is a pleasant woman indeed today at her follow-up evaluation there has not been any long or short discussion regarding the natural history of the shunt placement in Therese's head and no option of treatment offered to her by the attending physician, what is written above is all smoking mirrors probably an oversight on the part of the doctor or the communication never took place at all. But to be in the loop you will need regular, ongoing checkups for the patient scheduled, to be honest even at these late stages Therese is still awaiting the information promised by the physician, about the option of treatment schedule promised. CAUTION: Do not rely simply on the fact that everything will be done as it supposes to be for the benefit of treating your patient these words were imputed into Therese's chart but not carried out even at this time and she is well into her tenth month.

Check Your Chart Make sure you comprehend the conversation regarding what is being done to the patient with the attending physician, check your health chart, In my case, I don’t know what the doctor mean when he wrote she can follow up on a p.r.n basis, we never discuss that, but nevertheless it is written in her chart below is the information imputed into Therese chart, once again I believe it must be an oversight on the part of the attending physician. You saw NATHAN T ZWAGERMAN, MD on Wednesday, July 20, 2022. The following issues were addressed: Postsurgical presence of cerebrospinal fluid drainage device and IVH (intraventricular hemorrhage ATTENDING PHYSICIAN: Nathan Zwagerman, MD Therese Atkins is a very pleasant 75-year-old woman with a history of ACA stroke with residual fourth ventricular IVH, underwent EVD placement followed by a Certas valve by myself. Postoperatively, she had uncomplicated course. She is otherwise doing relatively well. At this point, she can follow up with me on a p.r.n. basis. .

FAMILY EMOTIONAL FACTORS

Firstly have regular check-ups with the neurosurgeon this will help ensure that the shunt is working correctly, and progress is on track freeing you to live a normal lifestyle. Hydrocephalus requires long-term follow-up care so it is important to have regular check-ups, Therese attending physician dismiss her after the first follow-up without scheduling future care, the neurosurgeon needs to monitor your patient progress and make a test for any changes that may indicate that there is a shunt malfunction. After the patient's discharge, there will be a transition back to your health care team, and attending medical check-ups is recommended, Physical and occupational therapy may speed the recovery and further enhance the patient's health, since this is all about Therese you need to know that Therese had her share of therapy done at home by a private company, after the completion of the schedule seven visit her therapy is being done by me her husband. I have cared for her those last six years and now well into her tenth month of living with a shunt, so many strange and unusual happenings with Therese prompt me to record her daily life, seeing such signs as walking difficulties, poor bladder control, and progressive dementia, all of this can be slowed down given the proper care, that being said brings me to the most important weapon you will have in this venture it is emotional support. EMOTIONAL SUPPORT : Whether you know it or not if you are caring for someone with hydrocephalus you are not alone there is an institution that you can reach out to for help, but the most important is the family emotional factors for you and the family must be considered that is why sharing the responsibilities is recommended and needed. Regular feelings with your doctor will help them provide the best professional guidance for you, while the help of relatives and friends or other professional help may be necessary for moral support and what is best for the patient to accomplish this goal. Therese is gradually showing signs of loss of interest in our quality time together, she rather spends most of her time sleeping, She is having difficulties moving her right leg when walking, Therese's shunt is placed on the right side of her head. i will be updating this blog four months from today. PLEASE RETURN HERE JANUARY 2023

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THERESE MEDICAL HISTORY