Ruth is a day-tripper, whose hobbies are playing bridge, shopping, and going out to lunch with her friends. But in the last six months of 2004 through March 2005, Ruth was unable to do any of those activities. "I don't remember much of that time," she said, summing up those lost months.

Ruth's symptoms began early in 2004 and included shuffling her feet and occasional forgetfulness, both of which her husband of 50 years, Billy, attributed to aging. The more immediate issue for Ruth was a severe knee problem that required surgery. But the surgical procedure had to be repeated within 10 days. It was a turning point in Ruth's life, said Billy. "She was heavily medicated and in a lot of pain after the surgery," he began. "She seemed ‘out of it' during that whole period, but we thought it was because of the medication."

Billy brought Ruth home but in the ensuing months there was no noticeable improvement in her condition. She needed help transferring from the bed to her wheelchair, from the wheelchair to the toilet. Her memory got worse. She became incontinent. It seemed to Billy that she was getting worse, not better, until one morning in December 2004 when she was "totally disoriented," he said. That scare resulted in a trip to the hospital, many tests, and ultimately, a suspicion of NPH. It was the first time Billy had heard of the disease, defined for him by the doctor in layman's terms as ‘water on the brain.' With further testing, NPH was confirmed and Ruth was to be sent home until January when the surgical placement of the shunt system, including the CODMAN® Programmable Valve, would be performed.

But while Ruth was being evaluated, Billy had his own health scare, resulting in a hospitalization and surgery for him – and a recovery that didn't allow him to do any lifting or other chores for up to eight weeks. With Ruth not yet walking, it would be impossible for her to come home. She was discharged instead to a nursing care facility.

"She was not cognizant of much while there," said Billy. "She recognized me after some prodding, but she was fuzzy on recognizing our children," their son and two daughters. It was heartbreaking for the entire family.

In January, Ruth was brought from the facility to the hospital for the shunt surgery. "They told me what would be happening, but it was all Greek to me," Ruth remembered. Because of Billy's continuing recovery, after the shunt surgery Ruth was transferred back to the nursing care facility. "When I came back, the nursing assistant said as soon as she saw me she knew something was very different, that I was aware of things and paid attention." Ruth's recovery began.

"She was alert and asked about everybody," Billy said. The day after his recovery restrictions were lifted Billy brought Ruth home, and she continues to make "steady progress," he said happily. Ruth's only problem, she said, is from the knee that continues to trouble her. Otherwise, added Billy, "She can get out and go, she drives now. She has come a long way."

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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