Category: Doctor

The stream

Kick The Can

Published on by heiditea3 Comments

Well, after meeting with my neurosurgeon this morning we have decided to kick the can for another year on the blood remnant in my large brain aneurysm. Yes, it’s there, but it doesn’t pose any immediate risk at the moment – they think.

Options currently presented are:

  1. Do nothing and observe with periodic angiograms/MRA’s.
  2. Insert more coils (I have 20 already) into the aneurysm in hopes no more blood gets in.
  3. Block off the affected artery and see if the blood flow reverses.
  4. Place the relatively new Pipeline™ Embolization Device INSIDE the existing stent that was place in the artery in 2011.

Here is how we’re addressing each option:

Watch & Wait: Simply monitor the remnant with periodic angiograms and/or MRA’s. Then if it appears it IS growing and more blood is getting back into the aneurysm, THEN we act. It could do nothing for 10 years, or it could double in size by next year.

More Coils: I already have 20 coils and a stent that is supposed to be blocking blood getting into the brain aneurysm. Obviously, they’re not doing their job as hoped and expected.

Sacrifice the artery where the aneurysm is & reverse blood flow: This procedure will require doing a balloon occlusion test first to determine if my vascular system can handle the blood flow being shut off. IF the balloon test is successful, then I would be a candidate for having that “diseased” part of my artery completely filled with coils and the blood flow would reverse. I’m still trying to understand how it all works.

The Pipeline inserted inside existing stent: The doctor had done some research and this specific procedure has only been done ONCE, at least in the U.S. that he is aware of. Not exactly a glowing recommendation. Even one of the most renowned neurosurgeon’s in the country has shied away from doing it.

It’s pretty safe to say we have ruled out options 2 and 4. Adding more coils doesn’t seem like a more durable option at this point and even though the Pipeline has been used VERY successfully throughout the entire country, including here in Maine by my doctor, the lack of data and positive feedback on inserting one into an existing stent doesn’t bode well for its use in my specific situation. I’d rather not be a test subject unless all other options have been exhausted.

So, we’re going to do a combo of 1 and 3. Well…at least #1 at this point.

Blood Supply To The Brain

I’ll have an angiogram next Spring AND have the balloon occlusion test done at the same time. There are four main arteries supplying blood to your brain. In most people, there are links between these four arteries that allow for one of the arteries to be blocked without significantly affecting the amount of blood reaching the brain. The balloon occlusion test is usually done if there is an abnormality (in my case, an aneurysm) in one of the four main arteries. It is a way to see whether one artery can be temporarily or permanently blocked without significantly affecting the level of blood in your brain. An X-ray and a special dye are used to create images of your arteries and a small balloon, which when inflated will temporarily block your artery. Sounds scary, but if you’re on the table in the hospital already, they simply deflate the balloon if you’re unable to handle it.

The angiogram will allow us to see if the remnant has grown in a year and we’ll have the balloon test done and that will determine, should I NEED to treat the remnant, that blocking the artery and reversing the blood flow is a good option. If I’m unable to handle the test, then that’s another option off the table.

There is another potential, more invasive option, but I’m not even going to go there yet. We’ll wait a year, see if the remnant has gotten any bigger, and DOES need treatment, before we address it further.

So, I’ll continue to eat better, try to get more exercise, and reduce stress……the last one will be the hardest I think. Kick the can….

 

 

Checkup Scheduled

Published on by heiditeaLeave a comment

My angiogram to check on my aneurysms has been scheduled for February 18th. Of course, I’ll be nervous the day of the procedure hoping that all goes well and all looks good.

Thankfully the angiograms at Maine Med aren’t the all day events like they used to be. They have improved the tools & procedure and you no longer have to lay completely still and flat for hours and hours afterwards. There still is a significant recovery period, but nothing like it used to be.

However, I’ve had so many angiograms since 2006 that the initial puncture is quite painful due to scar tissue in those exact spots I think. I usually ask for extra meds as a result.

I have to get some labs done next week. Been there…done that!

Film At 11

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I’ve seen many videos and demonstrations online showing graphics of brain aneurysm operations and medical personnel discussing procedures, treatments and causes of brain aneurysms, but the video below is by far the most educational one I’ve seen to date.

All of the doctors speak clearly and in a language the typical lay person can understand, but it’s the questions the moderator asks (some from viewers) that are probably THE most asked questions. When we’re at brain aneurysm events, many of those types of questions are asked of us. It was reassuring to know we’re speaking the same language as medical professionals.

It’s an hour long, but well worth it. The main focus of the video is coiling an un-ruptured brain aneurysm and the “what, why, and how” of that procedure, but they go into very good details on other treatments and causes of brain aneurysms. I think anyone out there who is newly diagnosed would find this very useful. It’s produced by Baptist Health hospital in South Florida and their staff members are obviously touting their own facility, which looks very good by the way, so if you’re from Florida…you’re lucky to have such a great team!

Brain Aneurysm Video

I have been through two coilings and now a clipping at Maine Medical Center from 2006, and I believe the Neuroscience Institute staff that MMC has acquired is now one of the top crews on the east coast. They’re highly skilled, diverse surgeons and interventional radiologists who can handle cases that were always sent to Boston. People should no longer question having their brain aneurysm operated on at Maine Med. We are very lucky to have this talented group of individuals and nurses helping our local community.

One Day: Post-Clipping

Published on by heiditea1 Comment

Friday all day was rough. Sick to stomach most of the night until we were able to get it calmed down with drugs. Finally able to eat something and keep it down early Friday morning, but it was only very bland hospital oatmeal and apples sauce. Not a hell of a lot of nourishment, but it stayed down, so that was an accomplishment.

Not able to eat much that requires a lot of chewing due to sore jaw. That was something I wasn’t expecting – cutting the jaw muscle.

Looks like I went 12 rounds with Mike Tyson and he won.

Face is getting a bit more swollen and left eye is starting to close up. Head pain is coming and going. Taking lots of pills, but having trouble getting comfortable in the hospital bed because I have the automatic compression socks on both legs and their wires and weight make it hard to sleep on side. I can only sleep on one side anyway.

The staff in the 608 ward is fantastic as usual. And boy, they have to be a special breed. Two men needed special care in the ware and all the while the older woman next to me was having serious mental issues and cried most of the night and went on and on about how she couldn’t get her coffee until 7 a.m. when breakfast was ordered. Drove me nuts, but nothing I could do about it.

Dr. Ecker visited this morning and did a short exam and said the swelling was completely normal and that he got some great pics of both aneurysms and got all of the 2nd smaller aneurysm with a great clipping job. Love him.

The catheter was taken out at 6 this morning so I now had to get up and walk myself to the bathroom…with a walker. An occupational therapist visited mid-morning and we attempted to go for a walk with my walker, but we didn’t get too far. I was really shaky and just not up for it, as much as I wanted to. With very little food and more drugs in my system, it wasn’t going to happen. She said she’s stop by on Saturday to see how I was doing, so I had my work cut out for me.

Thankfully lunch was coming up and I was feeling good, so I ordered the backed mac and cheese and OH, that was good and hit the spot. Also a fruit cup. All stayed down and in the afternoon Dave and I took a good walk around the floor. Pooped me out, but felt good to get out and up. Had some pretty good head pain today and that required more pain meds.

I had a great dinner…even by hospital standards. Meatloaf and gravy and steamed broccoli and milk. Tasted soooo good and it all stayed down. Dave and I then did 4 laps around the floor, which was great. I felt good, but tired after that and I wasn’t nearly as wobbly as I was this morning. Things were looking up.

Dave, as usual has been my angel getting me GOOD tea from down in the cafeteria instead of the crappy stuff that comes from the kitchen and even some cookies. He stayed overnight in Portland last night and was there very early this morning. I made him go home early because I was tired and it appeared the night nurse tonight wasn’t particularly in the mood for hangers-on who weren’t patients.

Every two to four hours, I’d get my vital statistics taken and they’d do a neurological testing for my vision and balance. I believe I was doing all of those okay. Just needed to get up more. I was still drinking a lot of water which meant I had to get up and go to the bathroom more frequently, which was a pain because I was still hooked up to a few things, an IV tree and vital statistics monitor.

Thankfully, the IV was stopped in the evening, so one less thing hooked up to me.