The Case of the Bi-polar Shunt

This is so dumb it's almost comical... My shunt was adjusted 19 days ago. It seemed to be a pretty good setting until last Tuesday when my shunt started draining WAY too much spinal fluid for whatever reason. And it hasn't stopped.

I prefer over draining CSF to not draining enough because if I'm over draining, I can lay down flat for a few hours allowing my CSF to build back up again and the pain goes away completely! ... until I stand up again. Sometimes I can be up for more than an hour, but it'll hurt. The other extreme of having too much fluid is much more difficult to manage and almost always requires brain surgery. Laying down makes it worse (because it's not draining enough and keep building up pressure).

So back to this over draining shunt... The pressure setting can be adjusted up or down because it's a magnetically programmable shunt. They use a magnet tool over the top of the shunt valve to change the pressure setting making it more difficult (for over draining) or easier (for under draining) for the CSF to find a healthy balance.

The PA tried to adjust my shunt for over an hour yesterday (it should only take minute or two plus an X-ray to confirm the setting). And therein lies the problem: my shunt valve is stuck. They couldn't get it to move. They just got a new adjustment machine and we'll try it again today, but really?!!

And here are the options moving forward...
(1) the new tool adjusts my shunt up several settings without any problems and then we just watch and wait to see if it's a good setting.
(2) the tool doesn't work and we decide to try and stick it out until my next appt Dec 19 and make plans from there (to operate or not to operate... that is the question).
(3) replace this shunt now if we deem it broken.

I'm not in a TON of pain and would rather deal with this for a few months than jump into yet another surgery. But if this valve can't stop over draining so badly, then we'll have to do something about it.

And as always, thank you for your prayers!

Warning: RANT ahead...

A day in the life of a person with hydrocephalus... my shunt was adjusted Friday morning. Yesterday wasn't perfect, but it was better than the day before! Today is worse, but not as bad as it was before the shunt was adjusted. Most neurosurgeons believe that it takes several days and weeks for the brain to adjust to a new pressure setting. It's been my limited experience (two programmable shunts in college and two since June) that my brain gets used to a new setting within a few days. But sure, I'll wait the obligatory two to four weeks. I have nothing better to do.

This is something hundreds of thousands of families in the USA alone deal with every day for the lifetime of the individual with hydrocephalus. And really, we're the ones who are truly blessed with first world technology!

I truly miss the almost 13 years that this wasn't a problem for me. And I hope and pray that neurosurgical technology will get better in my lifetime and it will allow a neurosurgeon to remove the scar tissue blocking the natural flow of CSF through the brain. Our current technology is only 65ish years old and we've come a LONG way! It isn't impossible and I'm grateful for the efforts of the Hydrocephalus Association in helping raise awareness, education, and donations to help find a CURE for this condition.

Help the cause! Donate!!

Day in the Life...

A day in the life of a person with hydrocephalus... my shunt was adjusted Friday morning. Yesterday wasn't perfect, but it was better than the day before! Today is worse, but not as bad as it was before the shunt was adjusted. Most neurosurgeons believe that it takes several days and weeks for the brain to adjust to a new pressure setting. It's been my limited experience (two programmable shunts in college and two since June) that my brain gets used to a new setting within a few days. But sure, I'll wait the obligatory two to four weeks. I have nothing better to do.

This is something hundreds of thousands of families in the USA alone deal with every day for the lifetime of the individual with hydrocephalus. And really, we're the ones who are truly blessed with first world technology!

I truly miss the almost 13 years that this wasn't a problem for me. And I hope and pray that neurosurgical technology will get better in my lifetime and it will allow a neurosurgeon to remove the scar tissue blocking the natural flow of CSF through the brain. Our current technology is only 65ish years old and we've come a LONG way! It isn't impossible and I'm grateful for the efforts of the Hydrocephalus Association in helping raise awareness, education, and donations to help find a CURE for this condition.

www.hydroassoc.org

Headache free?!!! Whaaaaat??!!???!!?

It's been 24 hrs with my new shunt pressure setting and so far so good! I woke up PAIN-FREE until I moved my head and then the pain shot through my whole body. But as long as I kept my head still, I didn't have ANY pain. As soon as I stood up, the sharp pain subsided and I had a productive morning! And now, my head is just starting to ache and I'm exhausted, but hello! That's a completely different story than the one I've lived with since April. Here's to my brain continuing to adjust to the new setting and the pain going away 24-7!

This shunt is working too hard!

After two weeks of my shunt overdraining CSF (feels like you've changed elevation and your head fills with pressure but never "pops" and you get the worst headache you can possibly imagine and horrible nausea and vomiting EVERY time you sit or stand up), I'm finally allowed to get it adjusted! They'll use a tool that sits on top of the skin above the pressure valve (top right of my head... not the same in the picture) and the magnets in the tool device adjusts the shunt setting a bit higher so that my intracranial pressure has to be higher before it drains any CSF.

I told my nurse and dr two days after surgery that I was still overdraining, but they said I needed to wait a month before changing the setting. I stuck it out for 16 days, but it's getting a ton WORSE, not better.

Hopefully this adjustment will be all I need. At least we know that the shunt is not clogged (how three of my shunts have failed) because it's still moving CSF. This means we can play with the settings to make this work.

HOORAY for Shunt Adjustments!

After two weeks of my shunt overdraining CSF (feels like you've changed elevation and your head fills with pressure but never "pops" and you get the worst headache you can possibly imagine and horrible nausea and vomiting EVERY time you sit or stand up), I'm finally allowed to get it adjusted! They'll use a tool that sits on top of the skin above the pressure valve (top right of my head... not the same in the picture) and the magnets in the tool device adjusts the shunt setting a bit higher so that my intracranial pressure has to be higher before it drains any CSF.

I told my nurse and dr two days after surgery that I was still overdraining, but they said I needed to wait a month before changing the setting. I stuck it out for 16 days, but it's getting a ton WORSE, not better.

Hopefully this adjustment will be all I need. At least we know that the shunt is not clogged (how three of my shunts have failed) because it's still moving CSF. This means we can play with the settings to make this work.

My family

I 💕 my cute family!

Collect life-threatening illnesses

Wow. Wow. Wow. Wow. I've ALWAYS loved Scotty Hamilton, but this man just nailed my thoughts exactly! We're all going to fall. That's life. Enduring life WELL looks like picking ourselves back up, brushing off the fall, and starting over again. Sometimes this is easier said than done, I know. Believe me! I know!! But wallowing in self-pity isn't helpful and in my case, it literally makes the pain worse. If you need a pity party, set a timer and when it goes off, move on with life! Get up. You've GOT this!

Friends bonding with brain surgeries...

 TRUTH

My darling friend Catherine Hughes had her shunt revised yesterday in Phoenix and I had my revision done on Wednesday. We were playing the "who feels the crapiest" picture game and that's when we realized we had more in common in this picture than just a new shunt. We're both icing our incisions. And that tells the story of our post-op lives more than anything, I think. 🤕In the  In the 

Hospital Day 11

After losing so many battles this last week, it was all I could do to stay somewhat sane yesterday. I just wanted to go home and be with my babies. We'd been at the hospital eight days longer than anticipated and I was DONE! This quote so perfectly summed up my emotions. And physically, yesterday was the absolute most painful day of this ordeal since headaches started April 24th. A CT showed that my brain is swollen, I had air pockets hroughout my brain, and some intraventricular bleeding. All of those things can add up to a pretty craptastic headache, but they aren't necessarily unusual. I had he same thing happen in June, but not the revision is August. But things calmed down and I had a GREAT night and get to be discharged today with as needed follow up over the next several days, weeks, and months. But just to catch you up, here's what I been doing...

On Wednesday, Oct 12th, I came to the UofU hospital because my six-week old shunt was failing. We assumed my shunt had clogged and wasn't draining as much CSF as it should have been. The surgery would've lasted 15 minutes to replace the broken shunt and I would have been discharged the next day.

But the shunt wasn't clogged. It was obvious, though, that the shunt pressure valve setting wasn't allowing enough CSF to drain, so I still needed surgical intervention. And instead to using whatever random shunt and set it to whatever random pressure setting, we decided to run some intracranial pressure tests for a week to see the pressure at which my brain is happiest so that if I had to be shunted again, we'd know exactly what would work best.

Three days ago, we all pow-wowed and decided to take a look in the brain. The pediatric neurosurgeon who performed the last surgery I had in college that kept me brain-surgery-free for 13 years (and based on my shunt history, y'all understand why that 13 years was such a big ol' deal) came to assist my adult neurosurgeon during my surgery. Unfortunately, there is a bunch of scar tissue behind the hole made 13 years ago that is preventing the CSF a natural passageway of flow. My basilar artery is also behind my third ventricle and one nick of that vein and the surgery would have been over with a quickness.

Soooo, using the ICP data we collected last week, I was given a new shunt that we're hoping will last a lot longer than the last five.

The shunt was initially working great for several hours after surgery, but by Friday morning, we knew something was wrong. Thankfully it's an easy fix. They used an external magnetic device to adjust the pressure setting and I can also slow the flow of CSF by laying down flat. This will need more fine tuning, but I can do that on an out patient basis.

Soooo ... Buh-bye hospital! I'm coming home!!!

Hospital Day 10

#hydrocephalus #ETVshuntCombo #brainSurgeryRecovery

I stayed in the hospital a day longer than planned to help get some semblance of control on my pain. Yesterday was seriously one of the most painful days (physically and emotionally) since all of this began in April. And the resident in charge Wednesday night/Thursday morning kept telling me that my surgery was complication-free and that I was exaggerating my headache pain. He said Tylenol (500mg) was more than I needed for my imagined pain.

Obviously, this resident and I had some issues yesterday. Again, it goes back to what I've been saying since April: YOU are the expert with your body. YOU know it better than anyone else. When something is feeling "off," be aware and be your own advocate even when every dr questions your sanity.

And sure enough, yesterday's CT results showed that my brain is swollen, it's filled with pockets of air, and I have some intraventricular bleeding. All of that adds up to a ridiculously awful headache that took all of Thursday and most of last night to begin to get on top of the pain. Thursday was a really rough day. Like, seriously one of the worst (in regards to pain and emotion) these last several months.

Again, thank you for your prayers! Each of your pleas on my behalf to our Father in Heaven is blessing me and our family with strength, courage, and determination to get through another day.

Scar Tissue and Brain Surgery

I just got back to my room. The external ventricular drain that I've had all week was removed. According to my husband's report, the neurosurgeons (my adult nsg & the pediatric nsg who did my original ETV 13 years ago) said that my ETV was still wide open with possible scarring further down, but they felt it was too dangerous to proceed past my basilar artery to remove anything. And I'm totally okay with their assessment and treatment plan. Kinda sucks, but there it is.

And alllll the data we collected this last week with the external ventricular drain (EVD) that was measuring my intracranial pressures helped us find a shunt that will work better (read: LONGER) than all my previous shunts. I now have a Codman Hakim valve with an antisiphone device that will provide a wider range of pressure options.

They will keep me overnight and get a CT in the morning. If all looks good and pain is well-managed I can go home tomorrow afternoon.

shunt ETV combo

Eeeek!!! I've been BEGGING for this surgery since May 21 and now it's on the OR schedule for tomorrow! Woohoo!!!! And I'm POSITIVE everything is working out because of your prayers and faith! I have the most wonderful friends and family! 💕

13 years ago TODAY (I thought it was on the 10th, , I was discharged from Primary Children's Medical Center after Dr Brockmeyer did my ETV (poked a hole at the base of my third ventricle to allow CSF to flow throughout my brain and body compensating to changes in pressure naturally). And Dr MacDonald is going to have Dr Brockmeyer help make that hole wider, thus allowing more CSF to drain through the fenestration.

And now I need a nap because I've been WAY more excited and this externalized ventricular drain can't handle it. We'll keep you updated!

UofU Hospital Stay Day 6

#Hydrocephalus #ItsOnlyBrainSurgery #HydroStrong#WeveGotThis #ShuntETVCombo

last Wednesday's surgery was just the first surgery I needed while I'm here at the UofU. Neurosurgeon's tend to want answers when a patient's shunts fail so quickly. So I have this extraventricular drain (EVD) draining my excess fluid just like a shunt would, but I get to see my spinal fluid in a little bag on my IV stand. It's equal parts really cool and really gross. The EVD measures how much CSF I drain throughout the day and night and also my internal intracranial pressures. The idea is that this will allow my neurosurgeon to choose a shunt and setting that will more closely match what my brain actually needs.

But having an external catheter increases the risk of infection a MILLION times more than giving the patient a shunt and closing the inside of the brain with stitches. This means that I'm limited to two visitors at a time and they all need to be over the age of 14. In other words, this really stinks for me and my kids!! Thank heavens for FaceTime and Skype.

My neurosurgeon is still trying to decide what to do for my second surgery. He can use this EVD data to choose a shunt that works better for me, or, he can choose to involve one of the pediatric Neurosurgeon's just down the hill at Primary Children's Medical Center and have them take a look at my endoscopic third ventriculostomy (ETV, the hole they made at the bottom of my third ventricle in 2003 that made me shunt-free for almost 13 years). We really rEaLlY want Dr Brockmeyer (the nsg who did my ETV) to take a look and make the fenestration wider or to remove any scar tissue building up down stream that is preventing enough CSF to drain. Whichever route he chooses, this surgery won't happen until Wednesday or Friday, at the earliest.

In the meantime, this EVD prevents me from moving around or sitting or standing without help from my nurse because the drain has to be level to my inner ear or else I over drain with a quickness and risk possible slit-ventricle syndrome or intracranial hemorrhaging. This has been quite the adventure, that's for sure!

Thank you for sending me funny jokes and memes. It's helping the time go faster. I've been sleeping better than I have since April. My nurses are all freaking AMAZING!! I love that i get to have surgery here. I mean, it totally stinks that I have to do this, but the nurses and staff here are working hard to keep me happy, pain-free, and distracted by the weight of this trial. It will be over soon.

Middle of the Night Education

4:00 am and I'm sitting here in my hospital room wide awake helping a nursing student understand intracranial pressures and the physics behind extra-ventricular drains using the one coming out of my head as the example and teaching tool. And, as it usually happens, I'm the one learning the most.

External Ventricular Drain

Happy Birthday James!

  

It's this little guy's sixth birthday. My heart has broken a bunch of times this week knowing that I could possibly miss James's big day because of my brain not being fabulous! And now I'm quarantined in a part of the hospital that doesn't allow kids under the age of 14 to visit. I wish the timing could have been better, but the sooner we get my brain figured out, the better momma I can be for my kiddos and especially for this birthday boy! 

Thank heavens for Skype! I got to participate with my family for James's birthday! We did blowing out the candles and opening presents together. That was fabulous and makes my heart happy! Thank you to everyone who brought treats and presents to James and the kids today! He said he felt very special all day long. Happy birthday James! Love you!!!!😘

Intracranial Pressure

So this happened today. My six-week old shunt wasn't helping my brain lately which meant one of two things: (1) there was a blockage somewhere the shunt system preventing enough spinal fluid to drain, or (2) the pressure setting for the shunt was too high or too low and over/underdraining my CSF. Either problem requires brain surgery. Again. For those of you keeping track, this was my third surgery since June and my seventh overall.

And as it turns out, the shunt was overdraining which is crazy because I totally thought it felt like it wasn't draining enough.

The plan was that if the shunt was clogged, they'd simply ("simply" for brain surgery??) revise the shunt system and is be on my way just like the surgeries in June and August. But since it was a problem with the pressure, we decided to use an external ventricular drain (basically like a shunt, but on the outside on my brain). I'll have this EVD for a few days as we use it to try to figure out the pressure at which my internal CSF pressure feels best.

In the meantime, Glen and I are experimenting with the physics behind it all. It doesn't take much to entertain us these days. And yes, the fluid you see in this video is my cerebral spinal fluid. Totally gross, but oddly very interesting!

13th ETV Anniversary

In other news, today is the 13th anniversary of the endoscopic third ventriculostomy procedure that kept me shunt-free for 12.5 years. I'm pretty dang emotional about that. We don't know why it's not working or why my CSF isn't getting absorbed in the brain. Regardless, it's a pretty bitter-sweet day for me now that I'm shunt-dependent and that these shunts keep failing.

We finally got home a few minutes ago from the UofU ER. I couldn't stay on top of my pain levels and had to get help. They were incredibly nice and accommodating and listened to both of us very carefully. This was probably the best experience I've ever had at a urgent or emergent care facility. My symptoms (craaaazy bad headache, nausea and vomiting, double vision) and the scans confirmed to everyone that the surgery scheduled for Wednesday is the best next step. So they gave me meds to keep me as comfortable as possible until then.

We are SO blessed to have each of you in our life! Love you all and now I'm going to sleep.... 😴💤

Emergency Department for Pain Management

My brain didn't want to wait until my surgery on Wednesday. The pain got psycho crazy this afternoon and I kept dry heaving. So I finally called "uncle" and decided to let the drs at the UofU hospital help me manage the pain. The Dr is trying his best, but we all know CSF pressure headaches really won't go away without surgical intervention. At least the nausea has calmed down. Sheesh. Hydrocephalus is dumb.

Peacefully Enduring

It helps when you have an amazing support network who fill your cup with strength, courage, and determination. I'm blessed to have all of you in my life!

Recovery Day 36

EDIT: surgery is scheduled for Wednesday, Oct 12

I met with my neurosurgeon this afternoon for my post-op appointment and it turned into a pre-op appointment. My "new" shunt got old really fast and isn't working correctly. We just aren't positive WHY it isn't working...

(1) The shunt system might be clogged somewhere in the valve itself or in the catheters. My neurosurgeon will know when he inspects the shunt system in the OR. If it's clogged, I'll get a new shunt and be on my way praying that we can wait a little longer before that shunt fails.

--OR--

(2) The shunt system might just be at the wrong setting preventing enough CSF to drain. If this is the case, then I'll wake up in post op with an external ventricular drain (EVD) coming out of my noggin and it will stay there anywhere from 2-10 days while we try to figure out the pressure setting that gives me the least amount of pain. Once we have that number, my neurosurgeon will "install" a shunt with that pressure and then I'll be good to go!

So... yeah. We don't have a surgery date yet thanks to the initial insurance red tape we have to cut through, but it better be soon because these headaches are getting pretty psycho. It's most likely surgery will be this Wednesday, but I'll let you all know soon. Sheesh.

Awesome Husband

Homecoming football game last night for Copper Hills High School. The cheerleaders roped their vice principal, Mr. Varga, into doing something he hasn't done in yEaRs and the students LOVED it! What a goof! Haha!! The students should challenge him to a hand stand contest at the next game because he'd totally win! But really... I love the student body at CHHS!! They have a TON of school spirit and really show up for their teams! #MyHusbandIsAwesome #GrizzCheer #Copperhillshigh

I love my momma!

My parents left early this morning to drive back to California. Mom got here August 29 and my dad drove into town this last Sunday. He took the kids to a bagillion places these last few days and mom, of course, spent these last several weeks entertaining the kids and keeping our house running smoothly while I rested and recovered from brain surgery #6. Mom helped me make 18 freezer meals and snacks the other day. I just wish there was a way to replicate her laundry skills. I seriously have the best parents ever and am grateful that they get to go home to get some much-needed R&R time!

I'm so incredibly grateful for your continued prayers. When I say I've felt every. single. one. please understand that I'm not just saying that because it's the nice thing to say. I am VERY sincere in recognizing the strength and courage I've received because of your faith. #grandparentsareawesome#hydrocephalus #itsashuntlife #strengthcouragedetermination #faithheals

SHYMA

Truth. I was diagnosed at the start of my sophomore year at BYU and I know dozens and dozens of hydrocephalus friends who were diagnosed as a young or middle-aged adult. 

My symptoms: dizziness and taking really long naps. I didn't have headaches until I received my first shunt. Read my story HERE.

It IS Brain Surgery!

When I received the results for my very first MRI of my brain, the doctor at the BYU Health Center told me I'd just have to take a pill every day for the rest of my life. I remember thinking, "Meh, that's not that too bad!" And then I met with a neurosurgeon and he gave me a completely different treatment plan that required brain surgery. Another appt with another neurosurgeon also recommended brain surgery... immediately. urgently. post haste. My life has never been the same, since.

On another note, thank heavens they can do SOMEthing instead of letting my CSF kill me. I mean really. Hooray for modern technology!! I just wish it was a little bit better and more reliable...

Normal Pressure Hydrocephalus

Normal Pressure Hydrocephalus

This is a BIG deal. So many chronologically-enhanced individuals with Alzheimer's and dimentia actually have NPH. Learn the signs!


Normal Pressure #Hydrocephalus can look like Alzheimer's or dementia - but it is TREATABLE! #MakeWaves and spread the word! #HAM2016

Vision Improving After Shunt Revision

I'm wearing my contacts today! It's the first time since May!! My vision is finally improving after this summer's brain drama. Woohoo!!!

Hydrocephalus WALK 2016 - Salt Lake City, Utah

Fun at the WALK event last night!

Natalie Geis (kneeling) is a freaking ROCK STAR! Her husband is holding their awesome puppy.
Dr Jody Leavitt (far right) and Dr Jack Walker (on her right).
The other two are friends of Natalie supporting her in her hydrocephalus journey. 

Our cute family! The kids have processed these surgeries very well.
And Glen has been the best kind of husband even though it's been incredibly stressful. 

My fabulously wonderful neighbor, Sandy, is holding Michael as they watch the Life Flight helicopter land in the parking lot. This is the kind of fun that totally wows the kids and grown ups every year at the WALK!

My oldest, Sarah Jane, has been such a trooper and big ol' helper this year!
She's a wonderful blessing in our family!

Complications of Shunt Systems

I'll be giving and receiving hugs tonight at Murray Park at our WALK event! See you there!!

We have GOT to find a cure!!! A shunt is NOT a cure. Yes, it's better than nothing, but a shunt life is stressful and painful. 

An estimated 50% of shunts in the pediatric population fail within the first 2 years. 

Complications of Shunt Systems






THIS is so cool!!! I've watched YouTube videos of the ETV procedure (my last brain surgery in college), but these are actually my friend's ventricles! And just like Jamie, my ETV is still open but it's not enough to keep my CSF balanced well (not too much and not too little). Jamie has a shunt, too. Jamie Wright, thanks so much for sharing!!

That little crease on the right side is the opening into part of my lateral ventricle. The ventricles normally open up and stretch out as the CSF builds up (such as after having my shunt clamped for 6+ hours, as I did here). For whatever reason though my ventricles are stiff and do not enlarge significantly, even when under pressure. That fluffy stuff on the left side is choroid plexus, which produces CSF

Here they have taken the endoscope (camera) down into my third ventricle. You are looking at the floor of the third ventricle, which is where they will make the new opening for CSF to go through.

There are multiple (very small) tools you can use to make the opening in the floor of the third ventricle. He re they are enlarging the opening they made using a small balloon which they carefully pull through the opening to enlarge it. They do this to try to reduce the likelihood of the hole closing or scarring over. 

Here is an after picture showing the hole that was made in the bottom of my third ventricle. This allows CSF to flow from my lateral ventricle into my third ventricle and then directly out into the space around the brain where it is re-absorbed into the blood. This bypasses the cerebral aqueduct which is a common site of obstruction in the flow of CSF (and a common cause of hydrocephalus). In the video you could actually see pulsations as CSF flowed through the new opening. This is normally a good sign that it is working, so it is hard to say why mine ended up not working.

That red structure running along the bottom of the picture was one of my major sources of anxiety over having an ETV. It is the basilar artery which supplies blood to the brain stem. It is rare for it to be damaged during an ETV but you can see how close it is to the opening they made.

Here is another view of the inside of my ventricles. In the video I could tell they were flushing saline into my ventricles to open them up a bit. In the video you can see the ventricular space on the right open up and then collapse back down between flushes. In most cases the ventricles are relatively stretched out from the build up of CSF so that they stay open pretty well on their own.

Roald Dahl and the Curious Shunt

Roald Dahl and the Curious Shunt

In other news... There's a plus side to everything. A silver lining in every bad situation. A hopeful side of a negative experience. The beauty of something that seems gloomy on the outside. So thank you Tracie Charles Wilton for helping me realize that #BrainSurgeryMeansSomeoneElseDoesLaundry
#MyMomIsAwesome

HAM 2016

And THIS is why I'm WALKing to end hydrocephalus. Our fundraising efforts helped create the antimicrobial shunt catheter draining excess CSF from my head to my peritoneal cavity. It's not a cure, but it's keeping me alive! We can do this!!!


This is fabulous!! Vicki Bell and I started the WALK events in Utah in 2007 (it was called TEAM then) to bring awareness of hydrocephalus to our community and to help raise money to fund the education, advocacy, and research efforts of the Hydrocephalus Association. And in 2010 SarahAnn Sowby Whitbeck came on board and has carried on the WALK tradition ever since! I remember the crazy stress in the days leading up to the WALK. And she even fit a TV spot into her schedule. SarahAnn, you're awesome!!!


Hydrocephalus Awareness WALK to Kick Off in Murray