Category: Hospital

That Little Voice

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It’s funny…for the most part, I rarely think about my small unruptured aneurysm on a daily basis. I know it’s there, but I don’t know yet if it has grown in the year since it was discovered or if there are any issues with the larger one that ruptured. I’ll find that out when I go for an angiogram sometime in June AFTER our trip to England & Scotland.

However, with my impending gallbladder surgery FINALLY happening this Friday, that little annoying voice in the back of my head that reminds me of the aneurysms has reared its ugly head. Not that I’m overly anxious or nervous about the gallbladder surgery, but it still is surgery…I’ll still be put under anesthesia and I’ll be having things inserted and an actual organ removed from my body. Things “could” happen….that little voice says.

After yelling at that voice to leave me alone, it’s a simple procedure, and it has NOTHING to do with you for a change, it finally does quiet down. I’ve been treated very well at Maine Medical Center and I liked the surgeon and her staff, so I have no qualms about the procedure itself. I’ve survived a ruptured brain aneurysm, a stenting and recoiling, so this should be a walk in the park, right? I hope so.

I don’t want to think about those darn aneurysms again until I have to. So you just listen to me little voice…this has nothing to do with you and those pesky brain aneurysms. Silence!

The Coiling (Part 2)

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I realized Monday evening (two days before the coiling) that I was more nervous about this procedure than I was expecting to be. Not sure why, but I was. Perhaps it was a foreshadowing of the events yet to come and the amount of time I had to wait to get into the darn operating room. Lots of delays and one of my poor sisters Dori, who was flying into Maine to be with me, had two flights delayed and missed seeing me before I went into the OR.

The coiling procedure itself went very well. Dr. Ecker was able to get five more coils into that remnant area on the original aneurysm that had ruptured in 2006. So I now have a total of 20 coils in that one annie. He said the stent that was implanted last month was very secure and he feels the coils will stay secure behind it.

We had planned all along to get some good 3D images of the original aneurysm and the other new smaller one for comparison during future checkups. So after the coiling procedure was completed, he inserted quite a large amount of contrast dye. More than normal I suppose.

As the dye was injected I had an “episode” where my pupils dilated and my blood pressure shot up to 280. I still don’t know what they did to correct the situation….and I’m not sure I want to know just yet, but it was a serious situation because they’re weren’t sure what caused it. I wasn’t aware I have had any issues with the contrast dye in the past and he was concerned I had had another rupture or bleed somewhere. I was immediately taken to get a CT scan for further review and it showed I did not have a bleed, but they were concerned what caused it.

Unfortunately, for my family, the scare it gave the Dr. created a scare with them. He came out to speak to them between the coiling and the CT scan, so he wasn’t sure I was okay just yet. Which scared my sister, sister-in-law and husband a great, great deal. I’m so sorry they had to go through that.

Apparently the Dr. was also concerned about getting me to come out of the anesthesia, but obviously they did. Because of the chaos that occurred at the end of the procedure, he decided to get me right to ICU and that he’d come back later and remove the sheath in my groin then. I was taken to ICU and apparently was quite chatty that first hour when Dori and Dave came in to see me. The only thing I remember is that my throat was killing me because of the breathing tube used during the procedure. I didn’t recall any of these conversations the next morning. LOL

At around 8:00 in the evening, Dr. Ecker stopped by SCU3 to remove the sheath in my groin that’s inserted to allow the micro catheter and coils to be entered smoothly into the artery up to the brain. I was given the option of having him insert the angio seal/plug into the puncture site in the artery (without any anesthesia) and only have to lay flat for 2 hours or having him simply apply pressure for 15 minutes to stop the bleeding, then I’d have to lay flat for 4 hours. Because I’ve had the angio seal/plug inserted once before without any anesthesia and it hurt like hell, I opted to have him apply pressure and have to lay flat for 4 hours….It wasn’t like I had anywhere to go. I was going to be in bed all night anyway. I’m sure he wasn’t happy with that decision, but he relented.

What I was NOT prepared for was how incredibly long that sheath is that he pulled out of the puncture site. 14 to 15″ long. I kid you not!! I said “holy crap” when the nurse showed it to me. We turned on American Idol on TV so that helped pass the 15 minutes. My groin was very sore for quite some time and I have a pretty horrific looking bruise beside the site for some reason.

I stayed in the SCU3 (or Special Care Unit) at Maine Medical Center overnight. I didn’t get any sleep and couldn’t eat much except ice cream and sherbet due to my throat. The nurse even crushed some Tylenol into the sherbet for me. That was brilliant!

We also learned after last month that I have issues with Morphine, so I was going to make sure we didn’t do any morphine this time. Amazingly, I truly didn’t need it. My head pain wasn’t so bad that I needed stronger meds. I had the two Tylenols in the evening and two more in the morning. I didn’t feel good, but thankfully I never got sick to my stomach this time and I truthfully feel it’s the morphine. They marked that I was allergic to it, so hopefully I won’t ever go through that again.

Despite the remarkable care and service in SCU3, I didn’t get any sleep during the night. I’ll just say it was a good 8-hour “rest”. I needed the sleep, but there was too much talking, bells, alarms and bustling in the ICU….as it should be. They do an amazing job. I was hooked up to all sorts of monitors and had the leg massage wraps on to keep the blood circulating in my calves to avoid any clotting. I was hooked up from head to toe so just laying on my back was about all I could do for many, many hours.

I was able to eat breakfast the next morning, so that was huge (compared to last time) and I was sitting up in a chair when Dave and Dori arrived giving them a huge surprise.

Dr. Ecker gave me the clear to go home the next day, but another neurologist wanted to make sure there was no neurological reason for my “episode” so they wanted to run an EEG before they released me. I was very tired, had a headache but was functioning as normally as I could at that point.

The EEG took about 20 minutes and they were able to do it right in my EEG-accessible room in ICU so I didn’t have to go anywhere,which was nice. They hooked up electrodes on my head and upper torso. No pain, just makes horrible mess out of your hair. My baseball hat went on immediately afterwards. Results of the EEG came back very quickly and all looked good. I was free to go as soon as the final papers were signed. That took HOURS for some reason, so I never got out of there until 2:30 or 3 in the afternoon. I had been dressed for several hours prior to that. I did get a good lunch though and I know it’s odd to have people released directly from ICU, but it was still a long, long wait. I was very, very tired and hurting at that point and knew we had another hour drive to get back home.

My sister-in-law Nancy offered her home to us so that I could spend some more time with my sister before she flew back home and we headed north. It was nice to spend some time with her and chat and I was grateful she came in for the surgery, even though she had a hell of a time getting to Maine. Nancy agreed to pick her up at the airport and take her back, so I’m also grateful to her for that.

It all worked out in the end. I was wiped out when I got home and the next day. A good day to lay on the couch and watch the royal wedding. I then decided I should remove the bandage from the groin incision and clean that up to avoid any infection or anything. I discovered a pretty horrific looking bruise there. That was new!

I’ll have a follow-up appointment with Dr. Ecker in June.

What This Kind of Looks Like

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Although the diagram below isn’t exact, it’s a decent representation of how things are currently looking in my brain,
with regards to the larger aneurysm.

The one that ruptured in 2006 is approx. 1/2” in diameter. 16 platinum coils were inserted into the aneurysm. Since then, either the aneurysm has grown or the coils have compact resulting in a small pocket of blood to leak back into the aneurysm.

Last week, my neurointerventional radiologist attempted to add more coils to the aneurysm, but was uncomfortable doing that with the current conditions of my arteries and the wide neck of the aneurysm remnant, so a Neuform
Microdelivery Stent was implanted across the neck of the
aneurysm.

The stent will allow more control and easier delivery of coils to the aneurysm, which we will go back and try again
at the end of April.

According to the information I was given the size of the stent is a little less than 1/8” of an inch wide and a little over 3/4” of an inch long. The stent will allow blood to flow through that artery better and keep the artery open and clear for coil implants.

It’s pretty amazing to think of all this “metal” in my head now, but it’s saving my life.

The Rest of The Story

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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.