Stents & Socks

FYI: These posts are half typed and half using the terrific keyboard dictation feature.

My family is the type that can find humorous moments during the darkest of times. Some may call that inappropriate, others may call it a coping mechanism. In our case, I believe it is the latter.

Like when we were at my grandfather’s funeral in an outside room waiting for the service to begin. My mom was using some Binaca Breath Spray, which was very popular at that time. However, she didn’t have the spray in the correct direction and instead of spraying inside her mouth…the spray went all over her cheek. My sisters and I saw it as it happened and we all got the giggles.

When my father almost died from a ruptured intestine, my sisters and mom and I spent over night in the hospital waiting room. To pass the time we counted ceiling tiles. Then when we knew he survived the surgery, we needed to stop at a store to get “supplies” to go to a hotel. Things like saline solutions for contact lenses…underwear, etc. We were so tired it was like a very slow march of zombies. As we caught the reflection of ourselves the glass of a display case…we got horribly silly. Awake for 24-hours was not. a good look.

After my father passed away many years later, my mom and I made our first public appearance at our church’s Maundy Thursday service. Mom wasn’t looking forward to all the sympathy faces and comments of expression from people, so our plan was to arrive late and sit in the back, but there were no seats available, so we had to sit closer to the front. One of us sang something “off” in one of the hymns and we got the uncontrollable giggles. As we were both trying to hide our giggles, the obvious shaking of our shoulders probably made it seem we were both crying…and that WOULD have been appropriate since my dad has just passed. Nope…we were giggling.

Well, long story short….I think my family of angels (dad, mom, and both sisters) had some fun with me on Wednesday after I was admitted to the hospital for my latest brain procedure: inserting a flow diverter/stent inside my existing stent.

After checking in and walking down to the radiology department, I felt something hitting the back of my knee/calf. My rain jacket wasn’t long enough to hit that area and I couldn’t figure it out. Turns out it was something INSIDE my pant leg – a SOCK that hung on in the wash apparently. I’m still shocked I didn’t notice it before leaving the house, in the car, or the walk from the parking lot to the hospital

I couldn’t believe it. Too funny and something my family would do. I promptly extricated the offending sock from my pant leg and handed it off to Dave where it kept it for safe keeping. It surely helped lighten the mood.

I’ve been to this area of the hospital many times and I was SO glad that Dave was allowed to come in with me this time. We arrived promptly at 11:45 and proceeded to the pre-op area where I was asked more questions and prepared for ROUND 4 on my original, biggest brain aneurysm.

As usual, the staff at Maine Medical Center were top notch. Highly attentive, hard working, and kind. I met with part of the team that would be assisting with my stent placement and we made sure to mention I had a history of becoming quite nauseous. They promptly ordered up a nausea patch and gave me pill as well. I can happily say both were highly successful.

Part of my team was Jack, who is a PA and Dave and I were happy to see him. He has attended our brain aneurysm support group many times in the past and I was happy to see a friendly face. He explained the procedure to us again and that he was very confident we’d get it all done today which helped ease my anxiety. And I was anxious….more in previous days than today. Having a stent placed inside of another stent wasn’t something I had heard a lot about it.

IV’s were set up, my groin area was shaved, I gave Dave a kiss, and off I went to the endovascular radiology suite. It’s a bright and busy area with a fantastic team of technicians. I was quickly put under and my next memory is of waiting up in the PACU (Post Anesthesia Care Unit.) recovery area hearing Dr. Ecker’s voice saying the procedure went very well. I guess Dave saw me briefly when they were moving me there, but I don’t remember

Afterwards I had to lay flat for two hours to avoid any issues with the groin incision site. Then another two hours in recovery. During the wait, my main nurse was able to take a much-needed 30 minute break. Elaine was filling in for her. While reading up on my case, she noticed I worked at Johnny’s and mentioned how much she “loved their magazine”. It gave me great pleasure to tell her I was the one responsible for the layout. She said she’d tell people she met the person who does the catalog.

Dr. Jack came by to check on me and talk about the procedure. He said the flow diverter placement went very well and there were no issues. Also gave me a brief cognitive exam and was pleased. I was finally able to eat something. I ordered up an egg salad sandwich that hit the spot and didn’t cause any nausea, thankfully.

My throat was very sore and my voice was raspy due to the intubation/breathing tube they inserted during the procedure. I didn’t have much pain, just discomfort at this point. As expected, the groin and head were the main offenders.

Even though Dave was allowed in the hospital, he was not allowed back to see my in the PACU. So, I called him on my cell phone. By the time I was transferred up to a room on the sixth floor neuro ward, it was 8pm and visiting hours were over. So, I wasn’t able to see Dave again that day. He ended up driving back home. I called him several times in the evening.

This area of the hospital was once very familiar to me. I spent almost 20 days here after my ruptured brain aneurysm in 2006. It was called the 608 ward back in the day. It was not my favorite place. Noisy, chaotic, and crowded. Since a remodel a few years ago, is it now a quieter, less chaotic place with private room and strong sliding doors. I felt like I was in a the Plaza compared to those days.

Once I got settled in and introduced to the crew assigned to my corner room, Brittany and J.J. I was starting to feel some pain. I ordered up a hot black tea with a Tylenol chaser. As long as the Tylenol took care of the job, I did not need the stronger pain meds that were offered.

The tea really hit the spot, but the caffeine may not have been the best choice at 8:30 in the evening. In addition to the offering of tea, the lovely compression wraps were also slapped onto my lower legs to help alleviate the development of any clots and keep the circulation flowing. I have a love hate relationship with these things. I know they’re needed, but they make sleeping difficult as the wraps expand like blood pressure cuffs every 30 seconds and they’re wired up to the end of the bed, so some movement is restrictive. I’m a side sleeper and they just weren’t playing nice.

I was still hooked up to one IV pumping fluids into my body, but hydration wasn’t an issue today. So, at some point during the night, due to my successful urination visits, the nurse removed that IV. It felt great to have the arm free again.

I had a surprise visitor at 9pm — Dr. Ecker! I never saw him prior to going under in the operating room but I did remember hearing his voice afterwards. He and Dr. Jack both went to speak with Dave after the procedure which I know Dave really appreciated. The docs mentioned it was a good decision to have the procedure done after getting in there and really seeing what was going on. Dr. Ecker explained to me again that he felt everything went very well, BUT that we’d discuss it in more detail on our follow up in two weeks. I will also be having an angriogram in 6th months to make sure everything has healed as it should. It was great to see him and I appreciated him coming to check on me at that hour. It was his birthday today as well.

My discomfort in the bed continued and I got very little sleep overnight. Brittany was terrific and I had some pudding early in the morning for my next round of Tylenol. They performed neuro checks every four hours. With the usual “what’s your name”, “where are you”, “smile for me”, “stick out your tongue”, “raise your arms”, “touch your nose” and some strength test with my arms and feet. I passed them all with flying colors. I even got the date right after midnight.

Sometime after 3am, I was able to finally sleep, but then was awakened at 4:30 to go down for a CT scan. I knew they were going to do the CT scan, but wasn’t expecting it quite that early. They had a wheelchair all ready for me and I was whisked down for the scan and 10 minutes later I was back in the room on the 5th floor.

I was wobbly on my feet and there were some sensations visually that were bothering me. Then right after the scan, I got an ocular migraine. Thankfully it lasted the usual 30 minutes and didn’t develop into something more. Perhaps the contrast die from the CT scan triggered it..or it was just…you know…my brain was fiddled with earlier the previous day.

As dawn broke, there was a shift change on the floor and I was introduced to Kellie. Then things started to happen in rapid succession. I called Dave and he was already in the car driving down to visit me for the opening of visiting hours at 8am. I ordered up a tasty breakfast of cinnamon French toast, diced pears, orange juice and hot tea which tasted like coffee. Boooo….

Then Jack came in and gave me even more details of the procedure and to see how I was doing. He drew me a diagram of the anatomy of my aneurysm and to show the funky curves of my arteries. The placement of the new stent fell a little short he said and it may or may not cause some issues later on. I really appreciated him taking the time to explain it all and the drawing he did.

Dr. Jack’s drawing with my text and color embellishments

Then he said the CT scan looked good and all reports back to him via the post-operative staff and the neuro ward crew looked great and that he’d put in the order for discharge. Yay!

The nurse raised the shade in my room. The sun was shining and I was reminded of the bigger, badder world out there as I noticed a window opposite me had a Ukrainian flag and a heart in the window. Yes, I just went through my fourth procedure on this one brain aneurysm, but there were people both sick and healthy around the world in much dyer situations. I am blessed.

I slowly got dressed, Dave went out to pull the car around, and off we went for the hour and a half drive home. The drive pooped me out so we just drove through the drive-thu for a quick meal. I got home, promptly said “Hi” to the kitties and crashed on my own bed for a 3-hour nap. Oh, and I enjoyed a GOOD cup of hot tea.

This is now Friday and I’ve had a slight setback with regards to discomfort, some swelling, and lack of sleep. And now there is abdomen pain I’m dealing with on top of head pain. My groin feels pretty good. Yes, my groin hurts after brain procedures. That’s how they access it.

OH, and when I was being moved from PACU to the Neuro Ward, I discovered I was missing one of the hospital-supplied socks I was given upon entry into pre-op. What was it about socks and this trip? I think it was my family of angels having some fun with me. Well played….well played.

Home Sweet Home

This is old girl is enjoying some quality time with the other old girl. Nice to be back home in my own bed. I don’t quite have the energy to write a full blog post yet. Maybe tonight. #blessed

Date Set

I finally have my date for the flow diverter deployment. Unfortunately for me, it’s not until April 6th. So, I have an entire month to think about it. Goody. Been there, done that.

I am grateful to finally have the date though. Now I can start planning around that date for work and home life and get prepared. One of the benefits of an elective procedure is planning….if I were to wait, the potential of an unexpected emergency situation is much greater.

Let the Plavix and full Aspirin regime commence.

More Brain Bling?

This morning we met with my doctor to discuss the results of my angiogram, his findings, his recommendations, and the next course of action.

FINDINGS:

  • In comparing the most recent angiogram with the angiogram from 2016, there are “significant changes” in the bloody remnant in the neck of the aneurysm.
  • This finding gave my doctor “anxiety that it is at risk” of rupturing in the future again.

RECOMMENDATIONS:

  • Place a flow diverter inside my existing stent to prevent more blood from getting into the neck of the aneurysm.
  • They may insert and expand a balloon first to push back any “tines” from the original stent to allow the new flow diverter to be positioned better.
  • The Surpass flow diverter is a more flexible stent that should adhere better to my “ugly” and “challenging” arterial structure around the aneurysm.
  • It’s an endovascular procedure, so not open head surgery.
  • Bringing in an additional doctor with knowledge of this procedure and flow diverter to assist if need be.

MY DECISION:

  • To go ahead with this procedure here at Maine Med.
  • Will be put on blood thinners (Plavix and full-strength aspirin) the week prior to procedure then remain on both for 6-months after.
  • Procedure could be as early as March.

There is a good video about administering the Surpass flow diverter on this page, although it doesn’t show it being deployed inside another diverter: Surpass Flow Diverter

I was surprised to read on my blog that I’ve been dealing with the stress of this darn remnant for 11 years now. When the re-coil and stent didn’t do the job, the next course of action would be the stent within a stent. If THIS doesn’t work, there is a possibility we could sacrifice that entire section of artery, but I’m counting on it working so let’s not even go there.

Making this decision with Dave by my side gave me a sense of relief. Relief in knowing I’m doing something about it and there is a plan of action. I have great faith in my doctor and his familiarity with my case, my brain, and this particular brain aneurysm for the past 11 years. I know he wouldn’t make a recommendation unless he felt there was a good chance of success. And so far, he hasn’t been wrong.