Joann: Grandma is Back!

For five years, Joann, 71, a fiercely independent and active grandmother from Delaware was slowing down and her quality of life was diminishing, as she unknowingly suffered from normal pressure hydrocephalus (NPH), a little-known neurological condition that affects about 375,000 people in the U.S.1 NPH can be mistaken for old age, but may also be misidentified as Alzheimer's or Parkinson's disease because the symptoms are so similar.

Joann's NPH can be traced back to 2003 when she started to have difficulty walking. She walked as if her feet were glued to the ground and would suffer frequent falls, even though she was walking with a cane. She then developed bladder control problems and though she didn't realize it at the time, her mind wasn't as sharp as it used to be. She and her family just thought all her problems were simply age related and there was little they could do to stop or slow down her deteriorating condition. Joann worried that one day she would have to live in a nursing home.

That all changed when a neurologist performed an MRI that showed Joann had enlarged ventricles in the brain due to an excess buildup of cerebral spinal fluid -- a clinical sign of NPH. This excess fluid typically leads to three primary symptoms: cloudy thinking or memory loss, a distinctive shuffling gait and urinary urgency or incontinence. All symptoms Joann had been experiencing, to one degree or another, over five years.

A neurosurgeon then performed more tests and confirmed that Joann did indeed have NPH and that her symptoms could potentially be improved or even reversed with treatment. Joann had never heard of NPH before, but once she discussed the risks and benefits of treatment with her doctor, she opted for shunt surgery with the CODMAN® HAKIM® Programmable Shunt in March 2008.

In the procedure, a shunt, a thin, tube-like device, is implanted underneath the scalp to drain excess fluid from the head to the abdomen where it is absorbed safely into the bloodstream. After implantation, the shunt settings may need to be adjusted periodically because removing too much or too little fluid can be problematic. The newer programmable shunt technology used in the CODMAN HAKIM® Programmable Shunt allows doctors to painlessly and quickly adjust the settings using a magnetic device held over where the shunt was placed. In the past, changing a shunt setting required further surgery.

Joann's procedure was a success. Her balance and bladder control problems improved and she no longer needs a cane. "Only a few days after the surgery my granddaughter said to me, 'Grandma you're walking straight!'" recalled the grandmother of four teenagers. "If I had known about NPH I would have sought help sooner."

Joann is back to socializing with friends and driving too, making special trips to see her son Robert, 40, and her four grandchildren.

1 Hydrocephalus Association

While most experts say that approximately 375,000 people have NPH, estimates have ranged from about 200,000 to 750,000 cases of NPH. Hospital discharge data shows that only about 11,500 cases a year are currently diagnosed and treated with surgical implantation of a shunt. Since NPH is often mistaken for other conditions, most cases of NPH go unreported and many are left untreated. Only a specialist can properly diagnose NPH. Surgery is not for everyone. There are potential risks and complications; recovery may take time.

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