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The Daily Whim

The Daily Whim

Wed. Jul 21, 2010

Brain Matters

Since I met my dear wife, she has been through the medical wringer a few times. A hysterectomy, a cervical fusion, a shattered wrist, the later removal of the metal placed in her wrist, not to mention a hospitalization or two for her Crohn’s disease. And I get to play Nurse Ratched and/or Nurse Bruno (as well as “hairstylist” when she broke her wrist). Meanwhile, I’ve been The Healthy One for the fifteen years I’ve known her. But I always told her, someday, payback is gonna be hell.

And the payback has arrived.

I’ll try to keep this short, but I do want to cut to the moral of the story so you don’t miss it: DO NOT ignore the signals your body sends you, and do not hesitate to get your butt to the hospital when those signals are screaming. Alternately, you could roll the dice using Jim’s method (which I assume he has since abandoned).

We’ve all slept on a body part in an awkward position and awoken to that dead numb feeling … we say “it’s asleep.” Well, Saturday after a nap, I woke up, and my right arm was “asleep.” But it didn’t graduate to that pins & needles sensation that signals it’s “waking up.” I could control its movement, but I had maybe 20% of the normal sensation and feeling. And as I was wondering when it was going to wake up, I also noticed that the right side of my face had a similar numbness.

Had I slept that hard? Well, yes, I was tired. And I did wake up on my right side. But after about an hour with zero progress, I realized this was not your normal sleepy body part experience. I’d been talking to Susan about this all along, and I finally decided she needed to take me to the ER to get checked out.

It’s Saturday night. A big city ER. This should be fun.

Though I’d felt no numbness in my right leg, while negotiating my way to the car I realized my balance was off. And by the time I got to the admit desk at the ER, my tongue was feeling a little thick. I listed off my symptoms, and it was somewhat disturbing to see how quickly they hopped. Within about three minutes of entering the ER waiting area, I was being wheeled off to the CT scan room.

For the first 24 hours, they had me in the hospital equivalent of a holding cell. There were no rooms at the Hotel Piedmont, they were full up. And when the hospital is full, folks who come into the ER and need admitting are sent to the euphemistically named “Express Admission Center.” I was put in a tiny 8×10-ish room with a big sliding glass door, and they slapped a biotelemetry pack on me. All night long the uber-efficient nurse woke me up every hour on the hour to check my blood pressure and temperature.

Because when you’re in the hospital, you need your rest, ya know?

During the day they took my vitals every three hours or so (???), and shipped me off to get an ultrasound of my carotids, an echocardiogram, a chest X-Ray, and took several pints of my blood for testing.

The neurologist came by and said the CT scan did not show the stroke, but there was an “abnormality,” which he quickly corrected to a “finding.” However, it was on the right side of my brain, not the left, where signs of this stroke would be found. Apparently some unknown time ago I had a “silent stroke“ (no symptoms). But it was going to take an MRI to track down my current symptoms. Which were beginning to lessen in intensity.

But the MRI machine was backed up, and it would likely be Monday before I could be scheduled. So it looked like another night in the holding cell at Hotel Piedmont.

Then about 8 Sunday night, they finally told me they were moving me up to a regular room. I’m primarily concerned with getting there soon enough to get dinner (they don’t feed you much or often in the holding cell). And, my, how the meal service has changed since I was last in a hospital. I got a three page menu (which included breakfast, served all day), and I could pick up the phone and order at any time between 6am and 10pm. Delivered within about 30 minutes by a waiter/waitress in a black uniform. It was like hotel room service! Very nice, and the food was above average in quality.

But they still have this obsession with making sure you get absolutely no REM sleep. Every hour they come in to slap the blood pressure cuff on my arm and pop a thermometer in my mouth. In fact, I wake up when I hear the nurse coming into my room at 3:30am … pushing a set of scales. Really? You want me to get out of bed so you can weigh my sleepy ass at 3:30am? Do you not think I would weight the same at, oh, I don’t know, 8am after I wake up? And, again, during daylight hours vital signs are read every three hours or so. It’s absolutely perverse.

After a nice breakfast of french toast Monday morning, I finally get sent off for not one but two MRIs. They pump me full of contrast and I spend about an hour in that deafening tube.

Back in my room, it isn’t long before my attending physician comes by to tell me [1] all of yesterday’s tests had been clean, my heart enzymes are normal, my echo was normal, carotids are clear, chest X-Ray is negative, my blood sugar is normal, etc., and [2] radiology had called up after their preliminary look at my MRI results. They see what could be an aneurysm. And now they want to do another test.

My mind is saying “each time you test me you find something new that’s wrong, so y’all can stop helping me now, before I wind up dead.” But I’m shuffled off again to the CT scan room, this time with an injection of a contrast solution that, well, was quite a rush. Or a flush, to be more exact.

But it’s too late in the day for the neurologist to get the “final rendering” of this latest test, so it’s another night at the Hotel Piedmont. My symptoms are about 70% gone, but Reid is getting very antsy now. Bad news plus confinement points me towards “Cornered Rat Syndrome.” But I’m trying to be calm. And the level of care from both my wife and the staff at Piedmont (4 South, not the holding cell in EAC) leaves me lacking a target to lash out at, other than The Fates.

But Tuesday morning shortly after I wake up, my attending physician comes by to inform me the neurology team is looking at the CT scan now, and they’re hoping to have a plan one way or another by noon. An hour or so later she comes back to say she’s preparing my discharge papers, but I can’t leave until I see the neurologist.

Hours later (pace, tap foot, pace), the neurologist comes by. The MRI shows I most definitely had a minor stroke, and the enhanced CT scan shows a 6mm x 4.5mm aneurysm right at the first branch of the main artery entering the right lobe of my brain. It’s a “berry” aneurysm, and it is small.

He tells me there’s only one place in town that deals with my problem. So I am referred to a doctor who is Chief of the Neurosurgery Department at Emory (he hired Sanjay Gupta), and chairman of the Neurosurgery Department at Emory Medical School. His specialty? Repairing unruptured aneurysms.

I am sent home, with a prescription for aspirin and one other drug, which in combination will thin my blood a bit to deal with the possibility of a stroke recurrence. I have some lifestyle changes to make, both in terms of diet and my level of fitness. I could stand to lose 15-20 pounds ( to near Jim level).

And I’m alive. My symptoms are 90% gone. I saw my niece yesterday and my granddaughter today. I napped in my own bed (hey, you’ve got to get back up on that horse). And I will soon have probably the top guy in the southeast looking into my brain.

Things could be one whole hell of a lot worse.

For example, I could have ignored my symptoms, hoping I’d wake up in the morning feeling better (see Jim: “Again, I wake up alive. I still don’t realize the importance of this.”). I could have a wife who cracked under the successive pressure of bad news upon bad news, instead of the resolute rock she was. I could live in a “one neurologist town” with a mediocre hospital, instead of having the best care for which one could hope.

Most importantly, I could have not had this minor stroke at all (or ignored the symptoms, which were minor enough they might have gone away over the course of a few days), and found out about this aneurysm only when it burst, putting me at imminent risk of death.

So, especially to those of you who are my age peers (slightly below or above 50), I say pay attention to what your body tells you. Nay, screams at you. Don’t go into denial … “strokes? they happen to other people, I’m healthy!” Go to the hospital and get checked out.

That trip may save your life. Twice.


Peanut Gallery

1  Kevin Lawver wrote:

That had to be scary – and I’m glad the prognosis isn’t nearly as bad as it could have been. Good luck in the rest of the process getting it taken care of!

2  ruminator wrote:

I’m glad you’re OK. That was scary… and it was a damned-fine telling of the story.

3  Reid wrote:

It was a scary couple of days, but I want to emphasize … I’m fine. I had about as minor a stroke as you can have, with symptoms now 90% gone. I’m in the best hands I could be in, between my wife and my neurosurgeon.

I’m just a lucky guy!

4  Wizard of Draws wrote:

Holy shit Dude! Hang in there and if there’s anything you or the Missus needs, a cartoon or whatnot, let me know ASAP.

5  Susan wrote:

I am so glad he’s home as well as our 4 feline children! Thanks to Alex, Sarah, Cecily, LeeAnn, Danny, Caroli, Melissa and all that have had Reid in prayer and thought. It was needed, felt and most appreciated. I have every confidence this will be a story that we tell at times of needed inspiration and can say we came out the other side whole. For us “whole” is with the other at our side.

I Love You Honey!

6  larry p wrote:

Glad to here you’re ok. You’re advice regarding not going into denial when something wonky happens is good. Around the age of 41, I started having “digestive” issues when I went out running. It took me a month or so to get around to seeing a doctor and to stop “testing” the digestive issues to see if they were real. Yup, very repeatable. Turns out I had a 90% blockage in a coronary artery. So, it’s best to go to the doc first thing and let them do the tests. While I was out running, doing “reproducibility testing”, I could easily have pulled a Jim Fixx [http://en.wikipedia.org/wiki/Jim_Fixx] and keeled over dead with a heart attack.

Here’s hoping the fixing of your aneurysm works as well as the angioplasty did for me.

7  Al wrote:

Wow, Reid. I was terrified just reading this and can’t imagine how I would have reacted. I’m glad things are looking up and you’re getting good care. It’s remarkable what they can do these days — in a dystopian Metroplis kind of way — but the gadgets themselves are marvelous.

Comment by Al · 07/21/2010 07:57 PM
8  elburro wrote:

Man, aneurysms are scary. You’re lucky in many,many ways, which you already mentioned. They know it’s there and can take care of it. I’m glad you had the symptoms to know you had to get to the ER.

Getting oneself to a doctor can be a somewhat complicated process. Very few people want to go, or want to believe that something could actually be serious. At least for me, it’s normal to say, “I’ll bet it goes away, it’s nothin’”. I’m real good at doing the denial game. However, one time I was watching tv and my chest kept getting tighter and more painful until I couldn’t really ignore it. “Elaine!!” We go to the ER at Northside. My first clue should have been that the reaction at the ER was the opposite of yours, kind of a yawn, ho hum attitude. I finally had to start yelling at them, “I’m having a heart attack, dammit!” 4 hours later, the doctor comes in with the results; “It was gas. You can go home now.” Grrrrr. After that, my denial routine is much harder to overcome. I think your story will have a positive affect on me.

Glad you’re okay and in great hands.

9  Maureen wrote:

Wow! Thank God you had Susan and everyone taking such good care of you! We are keeping you in our prayers through your next “episode”. You write well enough to be published and paid!

10  Reid wrote:

Thanks to everyone for the kind words & wishes, and thanks to Larry & Richard for telling your stories. Back in 2006, I had Susan call 911 and get them to send EMTs because I thought I was having a heart attack. Turned out to be a pretty severe anxiety attack. And though I felt a bit foolish afterwards, I didn’t regret having her make the call. At that moment, it felt like I was dying.

And a little over a year ago, I had another condition pop up (nothing life threatening, but I won’t go into now for various reasons … maybe someday). I reacted to early symptoms, it was caught early, and is being treated successfully to this day.

So, if you might think “Reid, this is all Too Much Information“ to be posting on the web, it’s for a reason. I tell my story, as do Larry & Richard & others, and hopefully anyone who stops by and reads this also has a seed planted in the back of their brain.

And maybe they’ll pay attention if and when their body has something to say. No matter how scary it might feel at that moment. It gets better, if you get checked.

11  Elise wrote:

Whew. I’m glad you’re home, and I’m glad you have access to top notch brain guys. Most of all, I’m glad you took care of business. I hate doctors, and I hate hospitals, but when you gotta, you gotta. I’m so glad you did.

Hope you’re back to “normal” very soon. ;-)

12  Tommy wrote:

Reid,

You are definitely in my thoughts and prayers dude! I am really glad you listened to your body’s cry for help. I go to the doctor regularly and listen to what they say. Early detection is the key to solving most serious health problems. Nip it, nip it, nip it! I will be monitoring you from afar, hoser!

13  Reid wrote:

TL, thanks for stopping by my digital home, hoser! I met my neurosurgeon for the first time this morning, and he wants to do one more big test before we lock in on a strategy to eliminate this aneurysm. But I am indeed lucky that it was found early, as that allows this time to gather more info, and enables a decision in how to proceed.

For most people who have an aneurysm, the only choice is “what do we do now that it has burst.”

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