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Dr. Bob
Dr. Bob, Neurologist (MD)
Category: Neurology
Satisfied Customers: 5330
Experience:  Neurology & Int Medicine (US Trained): 20 yrs experience
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I have hydrocephalus with a Vp shunt. I started my day very

Customer Question

I have hydrocephalus with a Vp shunt. I started my day very normal. I was just released from the hospital yesterday when I was in another town. I have a history of Hodgkin's lymphoma. Remission x 23 years. I also may have breast cancer. High blood pressure,
hypothyroidism. Well between morning and now I have developed a very bad shunt headache and (even though I have worn glasses for thirty years due a horrible astigmatism. So I haven't been able to see near or far. So that was how I started my day. Now, twelve
hours later, I can't see up close unless I take my glasses off and I see double in the distance with my glasses. While I don't want to look a gift horse in the mouth but I have learned that drastic changes like that usually aren't good. Should I go back to
the hospital?
Submitted: 2 years ago.
Category: Neurology
Expert:  Dr. Bob replied 2 years ago.
Why were you in the hospital? What sort of testing did they do?
Customer: replied 2 years ago.
I went into the er for help with my shunt. I was in extreme pain and I had heard flying could mess with things. I had flown cross country twice in five days. They determined my settings are still there. I am at 20 and that's as far as you can go. However I'm still a little high on the pressure gage. They did a shunt series and a ct of my head. They took blood and urine. They said everything was fine, but to have my vision change a complete 180 in a matter of a couple hours is strange and scary.
Expert:  Dr. Bob replied 2 years ago.
I agree that this is worrisome given your history. Did anyone look at your retinas?
Customer: replied 2 years ago.
A little. The problem is that my optic nerves don't go willy until my pressure gets super high I.e. 50 or 60.
Expert:  Dr. Bob replied 2 years ago.
Did your CT show any problems?
Customer: replied 2 years ago.
No, but there again,Mitch usually doesn't.
Let me give a short example of my crazy body. When I had Hodgkin's they couldn't find it. Ct, blood , X-ray,n everything was fine so I was misdiagnosed and sent to an ENT. He accidentally found it because he ran an Mir .
So, because I always present as fine,marring one symptom. My blood pressure rises as the pain in my head increases.
Customer: replied 2 years ago.
Oh p.s. I forgot that I haven't been able to move quickly and I'm extremely unstable. I have unstable before but not quite like this. I am just recovering from a 4 day insomnia situation. Last night I slept for the first time in days.
Expert:  Dr. Bob replied 2 years ago.
Well, having hydrocephalus does not make one immune to other types of headaches. :-)
While a shunt headache would make sense, it certainly is possible that you could be having a migraine headache, which can last for days to weeks and result in visual disturbances.
A compound headache involving features of both types of headaches could also occur.
Either way, when the vision is potentially at risk, the blurring and double vision need to be further investigated. Can you get in to see an ophthalmologist soon, or even better a neuro-ophthalmologist?
Customer: replied 2 years ago.
Not soon. It would be at least a monyh
Customer: replied 2 years ago.
P.s. I am not affected by sound or light. It's literally a shunt ache but with accompanied weakness, , and an unstable walk.
Expert:  Dr. Bob replied 2 years ago.
Wow. That's too long, in my opinion. The only mitigating factor would be if the vision returns to normal (or your baseline) intermittently. But it sounds like you have multiple reasons to go back to the hospital...bad headache, high blood pressure, visual changes, dysequilibrium and insomnia. Any one of these alone can justify an ER or Urgent Care visit.
Customer: replied 2 years ago.
Just typing is difficult. It feels like I have moments when everything goes dark and then the light comes back. The vision is just creepy. Now my vision is bad. Close up/faraway whatever. Glasses, no glasses. It's a pain.
Expert:  Dr. Bob replied 2 years ago.
I'm sorry to hear this...it must be very distressing. And I am worried for you, to tell the truth. I would suggest you have this evaluated by a doctor right away, before things get worse. A good ER doctor will know what to do. They can even call in an ophthalmologist to evaluate you right away. If you have an academic medical center nearby, they have eye doctors on staff, and on call, at all times!
Customer: replied 2 years ago.
Ok so back to the er. Should I call the squad? I think we both know I can't drive. I can call a cab, but only if it's safe. Not to sound overly dramatic.
Customer: replied 2 years ago.
Would the possibility of having breast cancer play a part in my vision?
Expert:  Dr. Bob replied 2 years ago.
If your condition is not progressing (i.e. is stable) and the cab can get you there tonight, that would make sense. If things are progressing or your vision is changing rapidly (and a cab is a long wait), you would want to have a family member take you or call 911.
Having breast cancer is not likely to play a part in this. If you had metastatic disease it should have shown up on CT (thought MRI is a better imaging modality for this.)
Customer: replied 2 years ago.
Well a cab would be at least an hour and I don't have family here. So the squad it is. Thanks for all your help!
Expert:  Dr. Bob replied 2 years ago.
You're welcome. Hope all works out for the best for you.
Expert:  Dr. Bob replied 2 years ago.
Hi Julie,
How are you feeling today? Did you go into the ER? Were you evaluated?
If so, what did they find?
Let me know if you have any follow up information or questions.
Regards,
Doctor-Bob
Customer: replied 2 years ago.
I did go to the er. They have admitted me and They are going to review my shunt and I'm seeing a Neuroopthamologist. So we will see. Thanks.
Expert:  Dr. Bob replied 2 years ago.
That's great. It sounds like you are getting the care you need. Hope all goes well.
Expert:  Dr. Bob replied 2 years ago.
Hi Julie,
How are you feeling today? Are you out of the hospital?
Let me know if you have any additional questions. I would be glad to help further.
If not, a positive rating would be much appreciated.
Thanks,
Doctor-Bob