Category: Hospital

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.

Pre-Operative Appointment

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Because my original coiling was an emergency situation due to my brain aneurysm rupturing, I didn’t get to “experience” Maine Medical Center’s Pre-operative department. They may not have been that extensive back in 2006 either. But, I have to say it’s a terrific group. I didn’t really know what to expect.

I knew they were taking blood, but beyond that, I didn’t know if my Doc had ordered other tests or procedures to be run. They did draw some blood and took my vitals, the nurses gave me instructions and directions, and we had an extensive anesthesia interview. I met with four different ladies during the visit which lasted almost two hours.

Pat Richards, one of the Dr’s/nurse, even went above and beyond the call of duty and tried to get to the bottom of a lingering medication issue I haven’t been able to get straight answers on. She realized it was stressing me out and took it upon herself to find the answers for me. I really, really appreciated her doing that. She didn’t have to, but I knew she’d have the proper authority and medical explanation and terminology that I didn’t.

They were all very well-informed and presented us with several more brochures on what to expect, where to go and what to do before, during and after any surgery. In 2006, we weren’t given any such information before, during or after, so I think they’ve come a long way in educating the patients and their caregivers. There still was no info on aneurysms though, so we’re hoping down the road, we can help change that.

Even though it meant a separate trip down to Portland for us (an hour or so away), Dave and I both felt going through all of this on a day different from the surgery day was very nice. I didn’t have to deal with answering a ton of questions, giving blood and signing forms an hour before the surgery. I’ll get there, meet with the anesthesiologist and the Dr. and I’m on my way. I’ll be drugged…Dave will have the tough part of waiting.

I was very pleased with the level of care by Maine Med when I was there for 20 days back in 2006 and I continue to be impressed with their improvement and care for their patients.  Let’s hope I feel the same way on March 17th!

Angiogram and Results

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I had my four-year aneurysm check-up angiogram yesterday. Had to be at Maine Medical Center at 9:15, so we left the house around 7:45. I couldn’t eat or drink anything so, of course, today I woke up with a horribly dry and sore throat. Figures. Despite an earlier weather report of snow showers, it was just cold and sunny, so we had good traveling weather.

Dave and I arrived at Maine Med right on time and were quickly whisked into the radiology patient recovery area where I was promptly told to strip out of everything and put on the lovely johnny gown. Oh, they’re so attractive. The wonderfully funny nurse, John, arranged to get me a water swab so I could at least wet my dry throat.

I was hooked up to an IV and blood pressure and oxygen monitor then taken into the operating room. As I was wheeled in, I heard some amazing music being played. They had on the Rat Pack station from Pandora Radio. LOVED it! It was around 10:00 when I started to be prepped for the procedure to sounds of Tony Bennet and Frank Sinatra belting out standards.

I was moved onto the narrow table surrounded on one side by large monitors. Arm guards were positioned to keep my arms on the table and out of the way and I was hooked up to multiple sensors as well as a strap place over my forehead to keep me from moving my head. My groin was shaved and I was introduced to at least four or five different radiologist, including Bernie, who was my “bartender” with the meds. I didn’t go with any med prior to being wheeled in and I REALLY regretted that when the Dr. began inserting the catheter. The worst pain I’ve had at the beginning of an angio. Next time, I ask for meds, and more meds….and some meds too. OUCH!

I’m not sure how long the actual procedure took. I DID get some meds when I was experiencing the pain, so I was a tad groggy. Had to take deep breaths and hold them on many occasions for pictures to be taken. So I was awake for the whole thing. One injection of dye was almost painful in my head and part of my tongue felt a little numb, but it didn’t last long.

Once the procedure was done, I was unhooked from all of the sensors and one of the radiologist had to hold strong pressure on my incision area on my groin. We chatted about Buffalo weather and the Bills. It helped pass the time of having a stranger hold your groin! LOL

At around 11:00, I was wheeled back into the recovery area. Dave wasn’t there, but one of the nurses said that Dr. Ecker  had spoken to Dave “at length”. Uh, oh…that didn’t sound promising! And I thought when Dave came around the corner, he looked pale.

Dr. Ecker came in shortly after Dave and informed me there did appear to be problems with the coiling in the aneurysm so something would have to be done, but that he’d discuss that with us at the follow-up appointment on Monday. Then he divulged a 2nd, smaller aneurysm was discovered above the initial aneurysm. This one was about 3 mm (1/8″). My original one was 11 mm (1/2″). This was shocking. If I had one in 2006 for my last angiogram, wouldn’t they have said something about it? If it wasn’t there, then it’s not a good sign that one has developed in such a relatively short span of 2 years. The Dr. had told Dave that this smaller annie had a wide neck too and it might not be a good candidate for coiling.

So, not only do I not know what’s going to happen to the original annie (Or Big Annie), but I don’t know what’s going to happen, if anything, with this new little discovery (I’ll call her Little Annie)

I know Dr. Ecker had mentioned possibly adding more coils to Big Annie, which isn’t that highly unusual, and it’s far less dangerous because it’s not a rupture, but he had also mentioned clipping, which means a craniotomy and that’s a far more invasion process that involves removing part of the skull and having open brain surgery. But that’s with the original annie. Now this 2nd one comes into play. Goody.

I have been introduced and read storiesabout many people who have multiple aneurysms and my own cousin is living with two un-ruptured aneurysms that they’re simply monitoring, which might be the case for me with Little Annie. So, it’s not that highly unusual for people to have multiple aneurysms and the positive take on this is that I KNOW it’s there and we can do something (hopefully) before it ruptures unlike last time.

My fear is not the surgery at this point…it’s the outcome and having complications during the procedure that would require a longer recovery period or prevent me from doing my job or driving. I was VERY lucky with my previous rupture that I was not dealt with life-altering deficits – which could have easily happened and could still happen. I have a lot of faith and trust in Dr. Ecker and excellent staff at Maine Med. They were fantastic to me in 2006 and I know they’ll take good care of me
this time…for whatever I’m going to be dealt with. I’m still very, VERY thankful that Dr. Ecker is here in Maine and we don’t have to travel to Boston.

I wish Dave didn’t have to go through more crap with aneurysms. He has been such an angel and powerhouse during all of this. I’m sorry he has to “suffer” as well.

MRA Results and New Doctor

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Today I met the new aneurysm doctor here in Maine, Dr. Ecker, and got the results back on the MRA of my annie.

Dr. Ecker is a real straight shooter and got straight to the point: The MRA showed a slight recanalization of the coiling in the aneurysm. That was a term Dave and I had
never heard, so Dr. Ecker took us to his office, showed us the MRA results and drew us a diagram on what was showing up on the MRA and what his concern was.

I’ll try to explain it without drawing it! Basically, either the aneurysm has slightly grown, or the coils have contracted and it has allowed some blood to flow into the aneurysm through the neck of the aneurysm. His words were that I had a “recanalization of the neck”. Of course, I was initially shaken. My fear has always been they’d discover another annie, not having an issue with my existing one, so this was a
surprise to say the least.

He wants me to have an angiogram now.mDr. Ecker said it wasn’t an emergency situation, so we’re waiting until January, after the holidays for that. He does the angiograms, he also does coiling and clipping operations. I’m thrilled he’s here in the state of Maine. He also appears to have experience with the by-pass surgery I’ve just recently read about.

Right now, there is no course of action until after he see the arteries and coiling on the angiogram. Right now, all of the things he mentioned were “if this….”, or “if that….”, so we need to see the results of the angriogram. Dave has done a lot of research online since we got home and is discovering it’s not that highly UNcommon for this to happen. Usually the recanalization occurs within the first two years after the coiling, so this is kind of unusual, but I feel confident Dr. Ecker will give us the best course of action. He’d either have to go in and insert more coils, which I’ve read several people have had to do on the message board, there’s a possibility I could have to have it clipped, which is a more serious operation, or he’d insert a stent inserted to block off the flow off blood there. Again…he can’t tell for certain what needs to be done until we do the angiogram.

He studied in Buffalo, was in the service as a medical surgeon in Japan, and after listening to an emergency call he took in his office while we were there, someone I would want fighting for me on the operating table. The risk factor for recoiling isn’t as extensive as my first coiling because it wouldn’t be because of a ruptured aneurysm and I’d be home from the hospital on the same day. The same risk factor would hold true
for the clipping, although it’s far more invasive and would probably require a long hospital stay.

I’m doing okay. Still processing this information. But I’ve always known I could be at risk, so we’ll just deal with what God deals me, when he deals it. I’m feeling good now, the Dr. didn’t feel it needed immediate attention, so we’ll cross that bridge when we get to it, right?