Post-Op Follow Up Appointment

Here’s what I know 5 days later:

•I’ll be on Plavix and Aspirin for at least 3 months.
•The coiling will possibly be scheduled for the end of April. Probably the 20th or the 27th. Dr. Ecker leaves for Finland for three weeks in May to study with a top surgeon there and he wants to make sure he has a follow-up appointment with me before he leaves.
•He doesn’t feel the dizziness and acid reflux are a result of the stenting. I’m checking into one more medication issue with my reg. Dr. now that what I’m experiencing isn’t a common after-effect of stenting. He almost felt it might be from being taken OFF the prozac because of its complication with Plavix.
•The Dr. said if I’m still having dizzy issues at the end of the week to give him a call and he’d order up another CT Scan.
•He said, once I’m not dizzy (LOL), I can have a drink or two. Yippee!! I have some Guinness waiting in the fridge for me to have my delayed St Patrick’s Day drink when the time comes.
•He performed the usual balance and vision tests on me. Had to walk in a straight line forwards and backwards and follow the number of fingers he’s holding up, etc. I passed, even though I did lose my balance briefly and had to grab his leg for support. Ooops! Was that inappropriate? His leg was closer than Dave’s was. LOL
•I’ll still have to continue to take the 4 propholactic antibiotics before every dental visit. Probably the rest of
my life.

I love his confidence with what he does. It really rubs off. I asked him so many questions about things I could and shouldn’t be doing like gardening or soaking in the tub. He basically said, unless something occurs, continue with my life as I lived it prior to the stent insertion. I think he deals with a LOT of elderly people so having a younger person he can joke with and encourage to live my life and enjoy it, is probably
a nice change.

He showed us the images taken during my procedure and pointed out the stent. It sure is an odd shaped artery, but the
stent opens up the walls very, very well. Dr. Ecker seemed to think coiling wouldn’t be an issue at all now. He did start to try coiling during the procedure last week, but during that process the lower part of the artery “shut down”, meaning I had a vasospam and he had to inject me with some Nitroglycerin. In looking at the notes Dr. Kwan reported after my initial coiling in 2006, the same thing happened in that surgery too, so I guess it’s a really good thing it happens on the table, that’s for sure.

Dr. Ecker was also VERY pleased to see the vascular arterial structure on the right side of my brain and all around
the aneurysms looked very good. So, I was happy he was happy.

Dave and I discussed any symptoms to look for in the next few days, but Dr. Ecker was quick to point out that the first 6 hours after the procedure then the next 24 hours were the most critical and he felt I was doing very well. Tell my head, throat, bruises and dizziness that! I got no sleep last night because of this new acid reflux crap along with a dandy headache, so I ended up sitting up in the wing back chair all night. Which I’m sure just does wonders for my neck and my back. I just popped two pills to help with the headache I’ve had all day.

The Rest of The Story

Now that I’m feeling a little more human today, I’ll elaborate on the brain procedure from Wednesday.

We got there about 15 minutes earlier than we were supposed be. We were told no later than 10:00. The procedure was supposed to start 11:30.

We waited in the surgery waiting room for over 1 1/2 hours. I hate waiting…I’ve BEEN waiting for months now to get this darn thing over with. I didn’t really need this last hour or so of waiting. It wasn’t like I had to be anywhere, but it was still very frustrating to see people who arrive later than us go in first. Apparently there was a mixup behind the scenes as the pre-op nurses were very apologetic and we rushed quite quickly though the pre-op procedure.

We met the anesthesiologist and answered lots of questions, then I was wheeled down the radiology department. Down the long, flower-painted, cool, corridor. I DID remember that hallway during my first coiling in 2006, which was amazing, because I was pretty out of it due to the rupture. It must had had an impact, or I thought I was imaging it.

My vitals were taken and we were parked outside of the radiology operating room. Dr. Ecker appeared and we chatted. I also had to sign several consent forms, one of which was for the Neurofrom Micro Delievery Stent, just in case coiling wasn’t working and he needed to deploy it.

I kissed Dave and off I went. I had several IV’s in already, but they had to hook me up to several monitors once I was on the narrow table. The arm guards were raised and they began giving me oxygen. Immediately after that, they said they were going to start putting me under. I felt VERY sleepy and that’s the last thing I remember.

From what the Dr. told me later on, he did try for some time to insert the coils into the bulging wall of the aneurysm, but was unsuccessful in getting the coils to stay in the aneurysm because of the width of the aneurysm remnant. So the stent was deployed over the mouth of the entire aneurysm. That particular annie is at the top of very angled, loopy part of my artery. The Dr. kept saying it was a “diseased” artery, but it wasn’t physically ill, just very oddly shaped and according to the Dr. the stent fit in it perfectly. He seem very pleased with how well the stent worked in that odd shaped artery.

As I was being unhooked, but still on the OR table, Dr. Ecker went to speak to Dave and in trying to explain things to Dave, he eventually ended up taking Dave directly into the OR where I was still on the table showing him the images of where the stent was placed. Something DID occur on the table and the Dr. did have to inject something. We’re still not sure what term he used. It MAY have been a vasospam, not sure. I was pretty impressed, as was Dave, that the Dr. took Dave right into the OR to show him. I like that he does that.

The next thing I remember was being yelled at to wake up. I was in recovery. Dr. Ecker was right there and told me he had to employ the stent. I was quite ticked…only because that meant I had to go through all of this AGAIN and start the wait AGAIN for more work. Ugh.

I had a breathing tube inserted for the surgery and removed afterwards, but it made my throat VERY sore. I wasn’t hungry and had a pretty good head ache. There were two neuro patients in the larger recovery room. We both should have been transferred up to the 608 ward. I was NOT looking forward to that room due to previous experiences there in 2006, so I was quite pleased that they didn’t have any beds up there and that we would be spending the night in the recovery room. There were very few of us and would be much quieter.

Under the care of Erin, Hank, Darcy and Gil, a quite night soon became a rough one. Dave left at about 9 or so. He assisted me a great deal, so I don’t think the nurses minded him being there. In fact, when he left, Erin said my husband “is a real sweetheart”. I said I agreed and that I was very lucky. As soon as he left, the rest of the night and next day just went down hill.

The head pain became worse and different levels of pain meds just weren’t working. So we kept ramping up the pain meeds, then I finally got physically sick about 3 times over a 6 hour period. Morphine doesn’t like me. It’s not fun to throw up in the first place, but to do it after you’ve had brain surgery and a breathing tube stuck down your throat…it was VERY unpleasant and painful and took so, so much out of me, not to mentioned how tired and numb I felt. It was not a good night or morning.

About 4 or 5 hours after I got out of surgery, I THEN realized I had a catheter. I never even realized I had it attached/on. They did remove it, but I was unable to pee on my own. They did a bladder scan and found I was full, so another catheter was inserted. A few hours later it was removed. Still nothing on my own however.

I saw Dr. Ecker a little bit before 7 the next morning. He was concerned about my pain and about throwing up, so he ordered up a CT scan and within 20 minutes I was over in radiology again getting scanned to make sure everything was okay with the stent.

Once they got the news that it looked good, I was moved to a semi-private room on the 6th floor. They had made up all of the release forms before I left recovery so all I had to do before I could be discharged was pee on my own. Talk about pressure!! Two tries…nothing. They did 2 different bladder scans and were getting ready to put in ANOTHER catheter, when I finally went on my own. Yippee!! I’m outta here!

My head was still not feeling very well, I was weak and wobbly, but at least the nausea was done. They tried a patch used for motion sickness and that finally seemed to do the trick. I had eaten a little bit, but not much. Swallowing anything other than water was a little painful still and I was very afraid of choking on food as I knew that would hurt my head tremendously.

We left the hospital. I had my Guinness shirt on in honor of St. Patrick’s Day and we stopped at McDonalds for shamrock shakes. Unfortunately, the activity flashing by the car and riding in the car in general upset my head and stomach a little bit, so I didn’t have much of it until I got home later. I just wanted to get home to my own bed.

I called my mom when I got home, took two tylenol and went to bed. I slept until 9 then woke up and drank more water and tea. It has been difficult finding exactly what position I’m comfortable in. Laying flatter feels good some times, by sitting up does too. Confusing.

My groin area, where coils and stent were inserted, isn’t nearly as sore as it has been in the past, so that’s nice. They did use the angio seal plug this time so I think that helps a great deal. I have some special instructions and directions to follow with the plug, which is different than not having one, but I’m glad I don’t have to deal with too much pain down there. The head pain is enough.

I’m trying to get up every few hours and walk around to keep things moving. And we have some good meals waiting for us in the freeze for later.

My follow-up with Dr. Ecker is scheduled for Monday. I have a list of questions started. I’m supposed to now stay on Plavix and Aspirin, but I don’t know how long yet. I’m also going to have to find out what a good replacement for Prosac is since it has a drug interaction with Plavix. Goody.

At this point I still don’t know WHEN he’ll attempt to do the additional coils through the stent. The stent should keep the coils in the aneurysm now, but he likes to give the stent time to adhere completely to the width and shape of the artery before attempting the coiling in case they move the stent. It’s still a little touchy right now as far as it moving, or dislodging something that could cause issues. I’ll be taking it easy.

Dave, as usual, was wonderful through all of this. We both kept our senses of humor and he sat with me as much as he could, even feeding me chicken noodle soup when I couldn’t sit up in bed in recovery. Unfortunately, with all of the sitting in one spot he did in waiting rooms, he threw his back out! LOL We’re in great shape.

The sun is shining, we saw geese on the stream for the first time this morning, and I’m alive. Trying not to complain. Trying.

At Home with New Metal

I’m home. it has been a tough 24 hours. Surgery didn’t go as planned. he was unable to insert additional coils successfully, so he inserted a spanking new Neuroform Microdelivery Stent across the base of the aneurysm and we’ll have to go back in in six or so weeks to insert the coils. The neck of the access area was too wide and the coils wouldn’t stay in.

It was a horrible night. lots of head pain then horribly sick to stomach. Two catheters later, then transferred from recovery room to semi-private room on the neuro floor this morning. I had to pee on my own before they would discharge me…talk about pressure, but I FINALLY did we left hospital around 3:30 or so. Promptly fell into bed when got home and slept soundly until 9.

I’m still feeling lousy, but not sick anymore and very glad to be home. I’m ticked i’ll have to go back and do this all again, but it is what it is. I’m alive. The drs. and nurses, as usual were fantastic. Just amazing care.

Thank you for all your prayers.

Things To Do This Week

Yes, this week has finally come.

Wednesday (16th) I will have more coils added to my brain aneurysm after it was discovered in January that the 16 platinum coils that were inserted back in 2006
when it ruptured were either compacting or the aneurysm was growing and blood was flowing back into it. Since it’s an aneurysm that has already ruptured
once, everyone felt it was important to get this taken care of sooner rather than later.

The 2nd smaller aneurysm will be monitored. Right now there doesn’t appear to be a risk of rupture with that one, so it’s a wait-and-see-what-it-does kind of a mode. It may never grow or need any treatment…or it may grow or rupture. Who knows! Ah, the lovely, complicated, wonderful brain!

The hope is that they’ll do the coiling, I’ll be in ICU possibly just overnight, and I’ll be released to go home the following day (St. Patrick’s Day!). And if all goes well, that should be the case.

I have a small collection of things to take with me to the hospital on Wednesday. My “Get-Better-Bear” Care Bear my sister sent me in 2006, my comfy clothes for the ride back home, and I’m taking my iPad with me to keep me occupied. I have synced up an entire season of The Dick Van Dyke show on NetFlix as well as some podcasts. I know I won’t get any sleep in the hospital…they truly aren’t restful, but they treat you VERY well at Maine Medical Center. I had 20 days in the hospital in 2006 to witness that.

I’m told I may be very tired for some time (possibly weeks) after the procedure and may have a headache after the coiling. I know my groin will be sore. If you’re not familiar with endovascular coiling, here is good explanation. It’s ironic to have brain surgery and your groin to be the incision, but that’s one of the beauties of having coiling verses the far more invasive and dangerous
clipping
, where they open the skull and perform open brain surgery.

It’s still a procedure on your brain, however and one that is not without complications. I’m confident with my Dr. that he’ll do what needs to be done and do it well. I only plan to take four days off work.

I know I’m lucky and I’m blessed with each day I wake up Dave and our kitties. May the luck of the Irish be with me this week!