Category: Doctor

3-Year Checkup Results…Sort Of

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I turned 62-years old on December 22nd. How did I celebrate? Well, we had a fantastic dinner in Portland, then I had an MRA next door in Scarborough. Not how everyone would want to celebrate, but it is what it is. That just happened to be the time and date they had available for the MRA, so I took it.

I wasn’t nervous regarding the MRA itself, other than remaining still during the painless, but noisy procedure, it’s always the impending results where the scanxiety comes in to play.

Usually there is a period of waiting before finding out the results, but in this case, the results were posted to the hospital’s online portal the following morning. I wasn’t expecting to see them so soon. There was good news, and potentially some bad news.

The good news is that no new brain aneurysms were detected. That IS good news because with two previous aneurysms, I am already susceptible to develop more.

The bad news may NOT be bad news, but I don’t know that yet. The wording in the report said there is “a 4 mm focus of flow related enhancement” somewhere along the coiled aneurysm. When the doctor’s office called the next day, they said Dr. Ecker said he couldn’t tell if that finding was “real or not” and it appeared he was leaning towards my having a cerebral angiogram to confirm or deny that finding.

What IS discerning about the 4 mm area of focus is that after my last scan in 2022, the older remnant area of concern where blood was getting back into the neck of my coiled aneurysm, was almost completely gone. So, this is a NEW area of concern. And if it is truly a new out-pouching of blood along the aneurysm, it certainly developed quickly.

Images from before flow-diverter stent and after (Dec. 2022)

We’re hoping to speak to the doctor via TeleHealth, so we don’t have to drive 60 miles just to spend 15 minutes with him, but we DO want to see the images and discuss it with him. I’m hoping that conversation happens sooner rather than later and an angiogram can be scheduled fairly quickly. I want to know if this is “real or not”. If it’s just a blip on the MRA scan, then great, nothing to worry about. If it IS a new remnant, the next course of action could be very complicated as there are already 20 coils and two stents trying to stop this bugger from killing me.

I will update you all when I know more. I’m trying not to be overly reactive, but it certainly is concerning news…until I learn it’s NOT concerning news. Happy birthday to me!

I shared my story (up to this point) on the MaineBA.org website if you’re new to my blog and would like the condensed version of my story.

MY STORY

See You in Three Years

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I first met Dr. Ecker on December 3rd, 2010. In all that time and the different medical procedures we have been through, I don’t believe I have ever hugged him. Yesterday I broke that patient/doctor barrier and gave him a very warm, tight embrace.

Twelve years ago, he picked up my aneurysm story where Dr. Kwan left off four years prior. Aneurysm #1 ruptured in 2006 and is the problem child. Even after 16 initial coils, blood was getting back into the aneurysm. Dr. Ecker has been trying to improve the situation and produce favorable results with several attempts. Two stents and 4 more coils later, we might be at a turning point in our professional relationship with this pesky bugger.

As noted in my previous post, I was thrilled and emotional to hear how well the flow-diverting stent deployed back in April was doing. I certainly was relieved, but until I saw the images and spoke to him in his office after he had a chance to review everything again, I still wasn’t celebrating to the point of calling it “done”.

Seeing the images yesterday was remarkable! The areas where blood was previously getting into the neck of the aneurysm had almost disappeared and the artery where the flow-diverting stent was placed inside the older stent had conformed to the shape of the artery. This is EXACTLY what the hope was. Success!

Because this particular procedure, placing a stent inside another stent, is not a common practice, Dr. Ecker felt a follow-up MRA in three years would be best and I agree. Although we’re all thrilled to see how it’s taking shape after 7 months, giving it sufficient time for healing was recommended. THEN if it continues to look good, we’ll look at it every five years.

Below are a few photos I took of my images on the doctor’s computer screen. They aren’t the best, but I tried to indicate where things are for my readers. The two images placed side-by-side were backwards on his screen showing the AFTER image first, then the BEFORE image after it, so I had to cut them apart, flip them and I tried to keep them around the same size for scale. Hopefully, you’ll get the idea. And yes, I DO know I should have added another “m” for the size of my aneurysm. Don’t @ me. It took me a long time to get these images right and I’m too tired and busy to change them. 🙂

Raw image comparing the aneurysm and artery prior to flow diverter deployment and after
Indicating the location and size (approx. 1/2” in diameter) of the aneurysm, which is currently filled with 20 coils (not visible).
LEFT: Showing the area of blood that has been developing over a period of years into an aneurysm already susceptible to rupture. RIGHT: Now showing a reduction in size of the bloody area and a clearly defined artery.
RIGHT: Showing the relative location of the flow diverter placed within the older stent in the artery.

The Next Chapter

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Yesterday was my 12th cerebral angiogram in 16 years. That’s a lot of images, a lot of stress, many procedures, successes, and even failures. Brain aneurysms don’t care what else is going on your life…they show up whether it’s snowing or not.

It was snow that greeted Dave and I yesterday morning as we were up before the sun rose to hit the road to Portland, a 60 mile drive south. Thankfully, we drove out of the snow about a quarter of the way there as a driving rain greeted us at the door of Maine Medical Center.

When multiple members of the hospital staff remember you from previous visits over the years, that should never be a good thing, but it is what it is in my case. I supposed it’s a comfort to see familiar faces who know my story.

Down in radiology, I was prepped for the procedure, hooked up to an IV, and answered everyone’s questions. Dr. Ecker came in to greet me and indicated he was excited to see how the flow diverter he deployed back in April was doing. Well…yes, I was too! He even opened up the images from the procedure on the computer in the prep area to view them with me and Jack, the PA, who has assisted Dr. Ecker with several of my other angiograms. Again…they know me here.

The procedure itself went very well. No issues and no pain or major discomfort. I was a good girl and didn’t move this time as some lovely classical music accompanied the staff in the endovascular suite.

While still on the table and hooked up to everything, Dr. Ecker said that things looked great, then he said “What Eddie Kwan started 16 years ago, ends today!”. Dr. Eddie Kwan was the doctor who performed the original coiling on my ruptured brain aneurysm in 2006 with 16 coils.

“What Eddie Kwan started 16 years ago, ends today!”

Dr. Robert Ecker

At first, hearing those words brought tremendous relief and joy, then I saw the last 16 years flash before my eyes in a rapid succession of images…the fear when it ruptured, the loss of my husbands niece, the loss of my sister…my second brain aneurysm, the clipping, the recoiling, the stents…all of it in a millisecond of memories and feelings indelibly etched into my heart, brain, and soul.

20 coils, 1 clip, 1 stent, and 1 flow diverter

After that wonderful declaration by the doctor, a few more images were taken to get a good look at everything else then the doctors left and went to speak with Dave in the waiting room. While the rest of the staff were busily performing their post-procedure routines and unhooking things and cleaning me up, the tears started to unexpectedly flow.

My arms were still hooked up to things and down at my side within the arm guards, so one of the nurses touchingly came and dabbed the tears away from my eyes and face with a tissue for me. They were very comforting, in what was quite a personal and emotional moment for me, and I’m very thankful.

Dave was very surprised and concerned to see tears in my eyes when he joined me in the post-op area about an hour and a half from last seeing me. I assured him they were tears of joy, but he also knew why it was emotional for me because he has been with me through it all.

I was glad to learn what I heard from Dr. Ecker in the radiology suite matched up with what he told Dave seeing how I was a little drugged at the time. The flow diverter (pipeline) did it’s job. It adhered nicely inside the old stent and had paused the flow of blood from getting back into the neck of the aneurysm. He said it was “Done” and I wouldn’t need to go back for five years and it would just be the less invasive MRA scan next time.

The images that were taken yesterday will need to be closely looked at again just to make sure there isn’t anything else we should be concerned about, but during the doctor’s first look on the table, things looked good and it was a great report. I’ll have another follow-up in his office in December.

I pray this is a start of a new chapter in my life where I don’t have to worry about this damn aneurysm anymore. The rest is up to me…live life better and take better care of myself. I am lucky to be here at all.

I am so grateful, thankful, and blessed for the improved medical advancements in treating brain aneurysms and the skilled hands of Dr. Ecker and his stellar care over the last 10+ years. He knows what I’ve been through.

Two Fun Side Notes: Stephanie, my nurse in the pre & post care area is a Buffalo Bills fan and shared photos of her dogs dressed in Bills attire. What are the odds that two Bills fan, in Patriots country, run into each other in the hospital? Then I ran into Sara, our former brain aneurysm support group facilitator on our way out of the hospital. It was great to see her face. Again…they know me here. 🙂

Angiogram’s R’ Us

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I’ve been scheduled to have my follow-up angiogram in a couple of weeks. It’s to check that the stent (flow diverter) we placed in April is doing well. Then it dawned on me that it’s not only to check on the stent, but to also check to see if it is preventing more blood from getting into the aneurysm.

One would hope that a stent placed inside of another stent would finally do the trick, but with this particular aneurysm, you just never know. It has been a thorn in my side, or a thorn in my brain for 16 years.

Let the scanxiety begin!