Hi Miffy,

Clumsiness and loss of gross motor skills is a big red flag for my child, pressure is too high or the shunt is temporarily obstructed. Eye problems are something I really pay attention to, and glasses are on the horizen, but the sudden changes are not minor symptoms even tho' they are very transient episodes for her (have had four revisions, two years this month since the last one but this summer had issue that luckily resolved so shunt failure is always in the back of our minds). But it is hard when these failures are happening in slow motion, least determining which is a problem and what is within the child's normal. I understand about not wanting to do testing sometimes, it can be more traumatic for the child with little to show.One kind of less invasive testing we do every 6-9 months for our almost 8 year old is get her eyes checked out, where they dilate the eyes and look at the optic nerve and do some extra neuro checks. The surgeons at our hospital put more value in checking eyes than shuntograms (see a good ophthalmologist or better a neuro-ophthalmologist to best catch neuro issues). Consider how often your child has had imaging, that is another check on things if the child still is has some compliance (imaging is not conclusive for determining shunt failures for our child and that can become a problem for some kids shunted as infants). Be honest with the surgeon that his approach has unsettled you, he should be able to dial it down ok. Catching over and under draining has made our life more difficult as one learns on one's child, I think it has made a huge difference in our child's quality of life that we've not settled for really poor shunt settings/configurations.