This is Normal.......Really!

We had a little scare with Gianna's shunt over the past couple of days.  I noticed the areas around the shunt incision and beside the valve (the place that sticks out the farthest on her head) became swollen with fluid.  The fluid filled areas are soft when you touch them (kind of like poking a water bed) but pretty large.  Everything I've read about signs of a shunt failure or infection have "swelling or redness around the shunt site" at the top of the list.  We'd pretty much convinced ourselves that was the case and that we were in for an ER visit, a shunt drain or revision, and another hospitalization for Gianna. 
So needless to say I was surprised when Dr. Pittman took one look at Gianna today, said she looked great, and that the fluid build-up is not uncommon for the type of shunt valve she has (a medium pressure valve) and with her being so young and so small still.   I was even more surprised when he said that what we need to do is press very firmly on the shunt valve 25-20 times, 2 to 3 times per day to "prime the pump" and release the fluid.  I still don't even feel entirely comfortable laying Gianna on her head on the side with the shunt, but he showed me how to hold her head press on the valve like the piece of hardware that it is.  Yikes!!  Well, it looks like this is just part of the process of learning what normal life is with Gianna.  A head full of fluid and pressing on her shunt like I'm priming the lawnmower is apparently perfectly normal and nothing to worry about!  I was really happy with the good news of course, but could have done without the pressing-on-the-shunt part! 

Here's a picture of Gianna yesterday.  I dressed her up with a bow for her First Steps evaluation.  :-) First Steps is Kentucky's Early Intervention program, and provides therapies to kids age 0-3.  We knew about the program because Angelo uses it for Speech Therapy (and is completely in love with his speech therapist, by the way!  I swear he's not learning his colors on purpose so she will keep visiting him.  He says everything is pink....but that's another story).  The evaluators were wonderful - they stayed for about an hour getting to know her and asking lots of detailed questions about her development.  She's considered at-risk due to her diagnoses, even though she's still too little to participate in some of the therapies.  She'll start off with a service called Developmental Intervention.  The therapist will keep a close eye on her development and whether or not she is meeting milestones (like rolling over, interacting, etc.), and will also teach us things we can do at home to support her development.  Again, this is another service that I'm really thankful KY has available for children!