Apr 14, 2014

Concussions, a Lesion and 2 Aneurysms oh my!

This week I had a stay in hospital for a couple of days because of 2 aneurysms found in a recent CT scan. The experience has left many friends and family with questions as to why I was there and what is in store for the future of my noggin. Though I shared some quick updates while I was in the hospital, I wasn't able to share many details or answer any questions. So this post is for all of the folks who care to know the full story...not so easily squeezed into a facebook update. ;)

To understand the present I will start with a quick recap of the history of issues with my head due to many concussions and a wonky pituitary. The pituitary problem was discovered about 15 years ago when I was suffering all kinds of weird symptoms that had my doctor concerned I may have MS, so she had me booked for an MRI. The first MRI showed there was nothing wrong with my grey matter so MS was not the cause, but they made me come back next day for another as they had seen something else they wanted to focus on. The second MRI showed something wrong with my pituitary gland but the neurologist wasn't sure if it was a lesion or tumour, so I was booked for another six months later to see if there was any growth of the spot.

Once I knew the concern was my pituitary I did some research on what the heck that gland actually does, and when I found out it controls all the hormones in my body I decided being on birth control pills, which play with your hormones to prevent pregnancy, probably wasn't a good idea so I stopped taking them. This alone caused many of my symptoms to subside and things got better. After the 3rd MRI showed it was not a tumour on my pituitary, it was determined that the lesion was not a threat to me (certainly not worth the risk of surgery to do anything about it) and I would have to live with it. Stress causes it to flame up a bit which wreaks a little havoc on me, but self awareness and stress management helped me get along just fine once I understood what was going on in my head and its impacts on my body overall.

The tales of the many blows to my head are a whole post on their own (and really these stories are funnier told in person with all of my dramatic gesturing heheh), but one of the worst was the last one almost 7 years ago while we were on strike. I was trying to get Sasha to sleep in my arms as this was back in the days she still needed naps, and I sat down in my camping chair, which unfortunatly was placed too close to the corner of a large concrete planter. When I sat down the back of my head coned right on the corner of the planter causing those around me to say "it sounds like your head just cracked open!". Sometime between then and now I found I had actually cracked my skull a bit that day!

I still have post concussive issues, but like the pituitary problem, once I know what is wrong and how to manage it I'm able to live with it. What else can one do?

Towards the end of February I started having a whole new feeling in my head I wasn't used to. And a few days later I had an explosive pain in the centre of my head that almost debilitated me. It happened while giving a presentation with my fellow PAC members to our school board, who are planning to cut the inner city funding to our community school that helps children in so many working poor families in our neighbourhood. Anyone who knows me is aware of my passion for strong neighbourhood public schools for all, and having my daughters school face negative consequences made the fight to protect them even more personal. Sasha has friends that would be hungry at school if not for our breakfast and lunch program, and who would struggle so much without the extra staff and supports our school is able to offer with the inner city funding. The changes are scary for people we care about, so even though I have experience speaking to the board, this time was actually a bit stressful I suppose. And that stress, on top of months that have had me stressed from work instability, financial worry, trying to juggle too many volunteer hats and falling behind on my list of tasks led to the sudden tension spasm explosion in my mind.

Thankfully, I have learned it was not a genuine bursting, or I might not be around to tell this tale. Clearly I AM still here, so you already know this story has a happy ending. :)

Because of my history of cronic head pain for whatever reason, once we were done with our presentation I simply went home. I skipped the Co-op Board meeting I was supposed to go to next and went to bed early. Figured I should take it easy like any other time my head is suffering. After a while I noticed that weird throbbing that was unfamiliar to me was not going anywhere and had become fairly intense, so I finally went to the doctor to make sure this new sensation was documented.

She was concerned about the explosive pain I had which is often a sign of stroke, and told me she was gonna send me for a CT scan to find out what might have caused it. The scan was scheduled for about 3 weeks later, so I figured if the medical world wasn't too concerned about rushing me in, and I was still functioning ok after so long, it was likely no big deal. Continue with taking it easy, skip a meeting here and a social event there and all should be good.

I went for the scan on Tuesday afternoon (5 1/2 wks after the explosion in my head). Tuesday evening after Sasha was in bed I got a call from my doctor. The scan had found 2 aneurysms in my head and she was going to speak to a neurosurgeon in the morning to see what should be done! I spent that evening reading up on brain aneurysms to find that there are many procedures used to deal with them depending on where they are located in the brain, and not all procedures require surgery. Got a little freaked out at the range of recovery times, and also from scary consequences of aneurysms bursting which significantly reduce your chance of survival, and if you survive increases your chances of permanent brain damage.

I fell asleep that night thanking my body for breathing.

By lunch time the next day I called her and said I wanted to know what was going on, and it turned out the neurosurgeon she had been trying to reach was out of town til Friday. She called me right back after she contacted another at VGH who wanted me to go to the ER right away and get admitted so they could assess the situation. Kinda scared me that things were moving so fast now.

Finally settled into my temporary bed. A room with three walls,
one made of glass. I could watch the nurses at their station in the
reflection. Not very interesting, but helped me know I wasn't alone.
It was 6 hours from the time I got there to the time I was actually in a bed on the 5th floor for neurology patients. The first night I was watched like a hawk by my nurse, and was awoken every hour with the same routine: check my blood pressure, shine bright light in my eyes to make my pupils dilate, take my temperature, ask me questions like 'what's your name, where are you, whats the date', and run me through a series of tasks to check my motor skills. All these things are done to make sure I haven't suffered any neuro damage. I also wasn't allowed any food or drink so I was ready if I needed to be rushed off to surgery at any time.

A room with a view. Kept hoping to see my buddy land an
ambulance on the helipad, but the only chopper that landed
came while I was having a test done so I missed the action!
The hourly check ups continued throughout the next day, whenever I wasn't being wheeled away for a test that would help the neurosurgeons prepare a plan of action.

The day started with an xray to make sure heart and lungs looked ok for surgery. Then I had a walk about with the physiotherapist who would help me in recovery after any potential surgery. At lunchtime I was taken for an MRI. A little while later I went for the Cerebral Angiogram...this one made me nervous. Well, really it was the waiver I had to sign before going in acknowledging that I might have a stroke during the procedure that made me nervous. Ummm. Wasn't I in the hospital to prevent having a stroke?!

Once they had me on the table I started trembling and even weeping a little as the fear started kicking in. Apparently they get this reaction a lot. When they offered me something to help me relax I said 'hell ya!' in my head, but my imporing head nod and puppy dog eyes got the point across equally well. Once they gave me something to relax we moved right along.

The angiogram was one I've never had before and some have asked me what it is, so here is my summary of what was a pretty intense experience. They insert a catheter into an artery in the groin area which goes up to the arteries in your neck and uses a special dye and camera to take pictures of the blood flow in the blood vessels of the head and neck. I watched the show going on inside my veins on a giant monitor right beside of me (seriously large, the screen was almost as long as my body!) They warn you when the dye is going into each of the arteries in your neck that you will feel "some heat and some discomfort as it passes through" which translates into "there will be hot flames shooting through your head and when it goes through your eyeballs prepare for searing pain" - or maybe that's just my experience. But they were right when they told me the sensation would pass quickly, it did. And an hour and a half later the whole thing was done. Phew.

After all the tests were done it was a waiting game for the neurosurgery team to decide what, if any, treatment would be required to deal with my aneurysms. I was anxious to know which procedure would be done so I could start wrapping my head around the possible recovery time which could be anywhere from a week to over a year depending on how it goes. The neurosurgeon didn't visit me til later in the evening, and then he told me they had determined no surgical procedures would be required. Yahoo!

They had not found any evidence of a rupture, and after comparing my current scans to ones done in the past, it seems the aneurysms had been there quite a while. One from waaay back, and the second seen on the scan after my last conscussion. So I had in fact been living with these things for many years, which is quite common. You can live with an aneurysm and have no symptoms or problems ever. It's only dangerous if they rupture or are in a place in your brain where you could die or suffer brain damage if they rupture.

My little friends (for you have to embrace these kind of things if you have to live with them) are not under the skull, so if they rupture there is no danger of bleeding on the brain. There is danger of other problems if they rupture, but given their location below my skull, the danger of the surgery is not worth it at this time.

The monitor we watched hourly for
my latest blood pressure reading.
It turns out the biggest problem now is my blood pressure. It has always been 'a touch high' when tested throughout my life, but it seems its no longer in a healthy range. So I will now be taking medication to stabilize my blood pressure as it presents the biggest danger of any ruptures occuring from my aneurysms.

Yay! I get to eat again!
First meal in 2 days.
Once I was given the all clear from the neurosurgeons, the last half a day of my stay was a waiting game for the neurology team to come assess me and give their approval for me to go as well. No significant damage done so I was officially free. The main purpose for my admittance had been to fast track all the tests needed to prepare me for any surgical procedure they thought I might need. If my doctor had booked all these tests it could have been many months to come up with the answers they were able to clarify in only a day or two by having me come through the ER. All worth it in my opinion.

Now that I have a handle on the various types of pain I'm dealing with in my head, and the various impacts they have on my body overall, I know what I need to do to take better care of myself. Primarily, manage my blood pressure and do a better job of managing my stress. The clear cut instruction of "if you need to take anything to relieve pain in your head, you need to stop as much as you can and take it easy until you don't need the pain relief anymore". Also, I tend to wait til I'm in a lot of pain before taking anything to relieve it, and I've been told to not wait so long on that. Pain can cause blood pressure to spike as well. It was also made clear to me that I really don't get headaches like normal people and if not taken seriously the outcome could require more than just a few days off work to recover.

Some things, like work instability, are out of my control. But other things, like my task list from volunteer responsibilities, are within my control. So now I'm reflecting on what I can let go of to give myself more time to take care of me. More quality time and less responsibility. My problem is that I really enjoy being involved in the communities I live and work in...so these are not easy choices for me. How do I stay involved without overdoing it?

Along with the new blood pressure medications, it may alleviate some concern for you to know that my cranium will continue to be monitored over time. I will be referred to a new neurologist who I will see somewhat regularly, and in one year I will go back to VGH to have the same tests done I had while in hospital. Though I am not super keen to do the cerebral angiogram again and hope that won't be necessary!

I've always been a person full of gratitude for the bounty of good in my life, but now that gratitude is seriously overflowing. This experience really solidified that we are surrounded by an amazing community of family, friends and neighbours who fill my life with an ridiculous abundance of happy, and which has always kept me afloat when I start to sink from bouts of depression. I learned a long time ago that friends are the best life preservers you can have. And whatever comes our way we are not alone to face the challenges...that makes stres reduction soooooooooooo much easier! :)

Serious gratitude to all of you that lifted my spirit while I was trying not to be terrified, and for supporting Mark and Sasha by bringing them food, offering to run errands and take care of them, so I never had a worry for them while I worried about myself. Words just can't express how full of gratitude I really am.

I also have to mention my gratitude to all the nurses and staff that took great care of me while I was in for my short stay at Vancouver General Hospital, and my gratitude that as a Canadian I was able to go through all of this medical mayhem over the years without fear of not being able to afford the care I needed. I can't even imagine the stress this would put on families who live in countries that don't provide full health care for all of its citizens. We've got a good thing going in this country - Stop messing with it Harper!!

So there you have it folks. My cranium keeps taking a licking but it hasn't knocked me out yet! I was already doing many things right to take care of myself before this experience, and now my blood pressure has given me something new to work on. It'll be a few more days til my body gets used to being on the new meds so I'm taking it very easy in the next while to adjust to it. But I still have much to do in this life of mine and I will continue to live to the fullest that I can handle every day...while allowing myself to have days doing nothing more often too. That's not going to be as hard for me now as it used to be. ;)

I promise to keep taking good care of myself so I can be around to share hugaroos with all of you for many years to come.
:D xo

1 comment:

Eva Sharell said...

Thank you Kathy, for the detailed account of your hospital adventures. I'm sooo delighted that you will not require surgery and the aneurysms seem to be in as safe a place as possible. Take it easy and get that blood pressure down!
Hugs and best wishes!