Headache and Fever after tethered cord release

jmjdj · 07-05-2012, 07:14 PM

My son is 12 years old and had his 2nd tethered cord release on June 15th. Last night he began running a fever that has stayed around 102 since 2 a.m. and complains of a bad headache.

I took him to the regular doctor today to rule out any kind of common infections (ears, throat, upper respiratory, etc.) and they couldn't find anything.

His incision looks great. It's not red, puffy, leaky, etc. In fact he only has a couple of stitches left.

My concern is that he is a carrier of MRSA with the most recent diagnosis being last June when he had abdominal surgery.

Is it possible for him to get a csf leak or infection this far post op? Tomorrow makes 3 weeks since the surgery. What would you anticipate they will check for?

I called his neurosurgeon (we are 2.5 hours away) and they said if his fever doesn't go away to be there at 10 in the morning. However, I am very impatient and even more so when I'm worried.

Any info will be appreciated.

thehipcrip · 07-05-2012, 08:02 PM

I'm sorry to say that from my personal experience, yes, it is possible that he's developed a CSF leak. The good news is that his incision is dry, which dramatically limits or even eliminates the opportunity for bacteria to enter through the incision and cause an infection. I'm not sure how/if being a MRSA carrier might affect a CSF leak.

Even though he's lucid, not vomiting or complaining of a stiff neck, it's possible that the doc will want to rule out infection in the CNS (such as bacterial meningitis) based the high fever and headache alone.

I realize that saying this to a parent whose kid has had multiple neurosurgeries is like telling an ant to ignore the crumb in front of him, but try not to worry tonight. I'd keep him lying flat just in case it is a CSF leak. If his fever gets worse and/or he develops any of the symptoms mentioned above, take him directly to your local ER.

I'll be holding him, and you, in my thoughts. Please update us on how he's doing.

jmjdj · 07-05-2012, 09:01 PM

Thank you for your response. After 19 surgeries, I am pretty good about not being too much of an alarmist but I also like to have an idea of what we are getting into. I always feel like if I know the worst and it's not that then we are in good shape! Sounds bad I know, but it makes it easier to be prepared.

Thank you also for your prayers!

SCI-Nurse · 07-06-2012, 12:21 AM

a fever is a sign of something urgent to address, especially after a surgery and the surgeon should be concerned about this presentation.

pbr

thehipcrip · 07-06-2012, 02:02 PM

Quote:

Originally Posted by jmjdj

I always feel like if I know the worst and it's not that then we are in good shape! Sounds bad I know, but it makes it easier to be prepared.

Nope, doesn't sound bad to me because I'm the same way. Adopted an "Expect the worst and be pleasantly surprised if things turn out different!" outlook a long time ago. `~lol~

jmjdj · 07-06-2012, 11:23 PM

I took him to see the NP at his neurosurgeon's office today (which is 2.5 hours from home). He all but lied to her about how bad he was feeling and she seemed to not listen to me when I was telling her the facts (amount of fever, how he reported his pain on a scale of 1 to 10, etc.) He does this when he thinks that the truth will land him in the hospital. After 19 surgeries and some complications, he has it figured out. Told me she thinks he has a UTI...which is a possibility but that is information they could've given me on the phone yesterday and I could've had a culture done locally.

He has a neurogenic bladder and had it augmented last June. He has a stoma made from bowel tissue so a culture always shows e-coli.

She told us he didn't look as bad as she expected so I should watch him really close and let them know if he gets worse. When we were there he told her his headache was a 1...by the time we got in the car it was a 5. Once we got home it's back up to a 6-7 level.

I'm a little frustrated because he is only with me for the weekend because he has to spend the month of July with his dad. I don't think they take good enough care of him and there is nothing I can do. Really wish they would've done a little more but it's out of my control. She wouldn't even order the urine culture. Told us to go back to our regular doctor for it. So I drove him back home and had it done. We will see what it turns up....

SCI-Nurse · 07-07-2012, 09:38 AM

I am sorry for your frustration. Yes a NP in a neurosurgery office won't order a UA and culture unfortunately - too specialized to do that. Even though you drove all that way to the neurosurgeon, it is probably good that they saw your son in person.

So to move forward, I hope you are getting the urinalysis and urine culture and sensitivities completed. Based on his symptoms, the provider will order an antibiotic while waiting on the cx results.

In regards to your caregiver relationship with your son, you may want to address this separately with some psychosocial intervention or to relieve yourself of some of the caregiver duties. As a mother I know how difficult it is when you understand the intricate details of his care and know what is best and your son is 12 years old and does not understand the results of his decisions. The reality is that you have only so much in your control and so much not in your control. The key is to find a balance between for you and your son.

best wishes and keep us posted.

pbr

07-05-2012, 07:14 PM	#1
jmjdj Junior Member Join Date: Jul 2012 Posts: 3	Headache and Fever after tethered cord release My son is 12 years old and had his 2nd tethered cord release on June 15th. Last night he began running a fever that has stayed around 102 since 2 a.m. and complains of a bad headache. I took him to the regular doctor today to rule out any kind of common infections (ears, throat, upper respiratory, etc.) and they couldn't find anything. His incision looks great. It's not red, puffy, leaky, etc. In fact he only has a couple of stitches left. My concern is that he is a carrier of MRSA with the most recent diagnosis being last June when he had abdominal surgery. Is it possible for him to get a csf leak or infection this far post op? Tomorrow makes 3 weeks since the surgery. What would you anticipate they will check for? I called his neurosurgeon (we are 2.5 hours away) and they said if his fever doesn't go away to be there at 10 in the morning. However, I am very impatient and even more so when I'm worried. Any info will be appreciated.

07-05-2012, 08:02 PM	#2
thehipcrip Senior Member Join Date: Jan 2009 Location: US Virgin Islands Posts: 2,665	I'm sorry to say that from my personal experience, yes, it is possible that he's developed a CSF leak. The good news is that his incision is dry, which dramatically limits or even eliminates the opportunity for bacteria to enter through the incision and cause an infection. I'm not sure how/if being a MRSA carrier might affect a CSF leak. Even though he's lucid, not vomiting or complaining of a stiff neck, it's possible that the doc will want to rule out infection in the CNS (such as bacterial meningitis) based the high fever and headache alone. I realize that saying this to a parent whose kid has had multiple neurosurgeries is like telling an ant to ignore the crumb in front of him, but try not to worry tonight. I'd keep him lying flat just in case it is a CSF leak. If his fever gets worse and/or he develops any of the symptoms mentioned above, take him directly to your local ER. I'll be holding him, and you, in my thoughts. Please update us on how he's doing. __________________ It is easier to find men who will volunteer to die, than to find those who are willing to endure pain with patience. ~Julius Caesar

Thread Tools
Show Printable Version Email this Page
Display Modes
Linear Mode Switch to Hybrid Mode Switch to Threaded Mode

Similar Threads
Thread	Thread Starter	Forum	Replies	Last Post
Experience with tethered cord?	pippi	Tranverse Myelitis, Multiple Sclerosis, Non-traumatic SCI	0	04-05-2008 08:48 AM
tethered cord	lookingup2	Care	3	08-15-2006 11:58 AM
tethered cord	snowwoman03	New SCI	2	11-16-2003 08:50 AM
Pediatric Neurosurgery to Release Tethered Spinal Cord	Max	Health & Science News	0	12-04-2002 11:07 AM
tethered cord	kakkieko	Care	4	09-22-2001 06:26 PM

07-05-2012, 09:01 PM	#3
jmjdj Junior Member Join Date: Jul 2012 Posts: 3	Thank you for your response. After 19 surgeries, I am pretty good about not being too much of an alarmist but I also like to have an idea of what we are getting into. I always feel like if I know the worst and it's not that then we are in good shape! Sounds bad I know, but it makes it easier to be prepared. Thank you also for your prayers!

07-06-2012, 12:21 AM	#4
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	a fever is a sign of something urgent to address, especially after a surgery and the surgeon should be concerned about this presentation. pbr

07-06-2012, 11:23 PM	#6
jmjdj Junior Member Join Date: Jul 2012 Posts: 3	I took him to see the NP at his neurosurgeon's office today (which is 2.5 hours from home). He all but lied to her about how bad he was feeling and she seemed to not listen to me when I was telling her the facts (amount of fever, how he reported his pain on a scale of 1 to 10, etc.) He does this when he thinks that the truth will land him in the hospital. After 19 surgeries and some complications, he has it figured out. Told me she thinks he has a UTI...which is a possibility but that is information they could've given me on the phone yesterday and I could've had a culture done locally. He has a neurogenic bladder and had it augmented last June. He has a stoma made from bowel tissue so a culture always shows e-coli. She told us he didn't look as bad as she expected so I should watch him really close and let them know if he gets worse. When we were there he told her his headache was a 1...by the time we got in the car it was a 5. Once we got home it's back up to a 6-7 level. I'm a little frustrated because he is only with me for the weekend because he has to spend the month of July with his dad. I don't think they take good enough care of him and there is nothing I can do. Really wish they would've done a little more but it's out of my control. She wouldn't even order the urine culture. Told us to go back to our regular doctor for it. So I drove him back home and had it done. We will see what it turns up....

07-07-2012, 09:38 AM	#7
SCI-Nurse Moderator Join Date: Jul 2001 Location: USA Posts: 41,341	I am sorry for your frustration. Yes a NP in a neurosurgery office won't order a UA and culture unfortunately - too specialized to do that. Even though you drove all that way to the neurosurgeon, it is probably good that they saw your son in person. So to move forward, I hope you are getting the urinalysis and urine culture and sensitivities completed. Based on his symptoms, the provider will order an antibiotic while waiting on the cx results. In regards to your caregiver relationship with your son, you may want to address this separately with some psychosocial intervention or to relieve yourself of some of the caregiver duties. As a mother I know how difficult it is when you understand the intricate details of his care and know what is best and your son is 12 years old and does not understand the results of his decisions. The reality is that you have only so much in your control and so much not in your control. The key is to find a balance between for you and your son. best wishes and keep us posted. pbr