Yeah my Codman has the anti siphon feature. And 20cm is the highest setting it goes to. I just had another appointment with my neurosurgeon this past week. Again he seems to think that my body may need a higher pressure.

I only started having symptoms for about 2 months when my lumbar puncture was done. So he thinks my pressure might need to be on the high end. He just adjusted the valve to a 16 now. He only wants to go a notch at a time but says I may very well need it fully opened at 20.

He says everyone builds CSF / pressure at different rates. Any idea on how long it takes to go up one notch? Even though I'm set at 16 I may still be low until the pressure builds up.

I do feel like I'm getting a little better but it's happening so slow so it's hard to tell. But we are pretty sure at this point that we are adjusting in the right direction now. I have had any headaches in weeks.

So again, any idea on how fast the body would produce enough CSF to raise 1 setting. I'm 32 years old. Pretty healthy other than this.

If you are over draining and need a higher setting, you are not going to ever make enough csf to raise the pressure (visualize over draining, you can't catch up without slowing the draining, aka raising the opening pressure on the valve!!). A person makes about the same amount of csf daily (avg adult makes bit over 500ml/day, completely replaces csf in use more than 3x a day). Yes, people can take a while to adjust to new settings but that's more a factor of compliance, my daughter takes longer than many but if the setting is too high, we figure that out quickly. Your surgeon is being careful but maybe too careful given the details, two notches should be ok or less time between adjustments. It sounds like you need to ask what the plan is if your right setting is anywhere above 20cm. My daughter's pressure issues are probably not the same situation as yours as she is still a growing child shunted as a baby and did not have any obstructions in her ventricles. Kids' pressures change as they grow and most don't need lots of adjustments, those who do need adjustments usually stabilize by 8-12yo.