Hydrocephelus Brain Shunt infected

[LL4Walter]

Hi, My 69 year old Dad has stage 4 Lung nsc cancer that he has been battling for over 2 years with good results from first Tarceva, then Chemo and prior to that radiation to mets to his brain. He is an otherwise healthy, robust, nonsmoking person. Last month he started experiencing problems walking, nausea and headaches. He was referred to a Neurologist who recommended a Shunt to help regulate the fluid in his brain. It has been a nightmare ever since. Infection after infection back in and out of the hospital due to Bacterial infections he got either during or after surgery. The Neurologists assistant refers to a possible non optimal working shunt - Antibiotics were given while he was in the hospital but not when he went home. Within 7 days he was back in ER convulsing, 103 temp and I thought he was dying-I stayed in the hospital with him for days thinking it was the end. ... 24 - 36 hours of antibiotics, he is comfortable, watching golf on television and knows every golfers name. So on & on it goes. It seems they are testing the fluids from his shunt daily - which does not seem that sanitary either. Its just so awful to see my Dad getting his *** kicked by bacteria from this stupid shunt. So here is my question...The Doctor at the Hospital in Los Angeles CA now say we have 3 options : 1) Take him home to die of infection instead of cancer 2) Remove Shunt entirely and replace it. 3) Option 2 plus do chemo through his spine to help kill any remaining bacteria. I am not a fan of this facility so would be open to other suggestions for a 2nd opinion. Unfortunately he is in the hospital now so it would be a big deal to switch but if it would give us better options and care-we will. I don't know a lot but his WBC is 3 today - and was as high as 17 when he was acute at ER check in. He has great insurance and medicare too-My poor Mom doesn't know what to do...What do you think?

[LL4Walter]

Dr, Thank you for the reply. My Dad ended up doing Option 3, so I am glad to see that was a good choice. He seems to be doing well and is currently with an external drain to make sure the fluids are draining properly and testing for any growing cultures which all three have come back negative. He also received some anti-bac shots into the (old shunt) to quicken the process. They will decide this week if they need to replace the old shunt but it looks like they will. I plan on taking your good advice and asking our DR for a second opinion from another Neurologist. Do you think it would be ok to take him home for a few days to get some fresh air and be in his own bed? Today is Tuesday and the earliest they would do the shunt revision is Monday. I ask this because He really wants to go home and my heart breaks when he asks me. He is able to walk all over the hospital with a walker & assistance, has control of his bowels etc and I'm just scared the spark he has left will burn out if he doesn't get a break. The Dr's say its fine since we have 24/7 professional caregivers and if he needs to come back to hospital for any shots or tests he can do so as an outpatient procedure. His house is immaculate and way cleaner than any hospital ;)) just don't want to make a mistake. My Mom is hesitant....I think its just easier for her when he is in the hospital-which is another Therapy session I will need soon ;)) Thank you kindly, LL4Walter

[Dr. Kokil Mathur]

Hi!
I am sorry but it’s really difficult to give an advice on net. In general the immunity of cancer patients is low. So any infection should be treated rigorously. However, yes, any invasive procedure, be it a shunt or an epidural injection or a intravenous line can act as source of infection due to low immunity.
So following this line of thinking, option 3 is the best. You could also discuss your father’s case with another specialist. One way to do this is ask the specialist to call in an expert for a second opinion. Take care!

The medical advice given should not be considered a substitute for medical care provided by a doctor who can examine you. The advice may not be completely correct for you as the doctor cannot examine you and does not know your complete medical history. Hence this reply to your post should only be considered as a guiding line and you must consult your doctor at the earliest for your medical problem.