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The Daily Whim

The Daily Whim

Fri. Aug 13, 2010

Brain Matters, Part 2

I suppose it’s time for an update to my Brain Matters. When we last left off, I was just home from the hospital after having a minor stroke, with a referral to a neurosurgeon regarding the aneurysm they found.

Since Dr. Daniel Barrow is the chief of neurosurgery at Emory, it takes some time to get in to see him. But Susan & I met with him on Wednesday, Aug. 11. He reviewed my files and imaging, and spent about half an hour with us going over the basic “patient education” that is needed in a case like mine. Luckily I’d been doing my research, so his words served as confirmation and clarification of what I already had learned.

And the take away from the talk is that he does not yet have enough information to make a judgement or recommendation. One more test is required. Via angiogram (inserting a catheter into my groin and threading it up to my head to insert dye) they will be able to get higher resolution 3D images of my aneurysm, which will allow them to make a better call on how to repair it.

So I’m scheduled to have that procedure as an outpatient on Aug. 26. After that, I’m hoping things will move swiftly towards a resolution. There’s three options, depending on what they find.

One, wait and watch it through regular testing. This option is highly unlikely to be chosen, as my aneurysm is in a really bad place, if it bursts or leaks.

Two, an option nicknamed “coiling.” They again insert a catheter in your groin, and thread it all the way up right next to the neck of the aneurysm. They then pack the aneurysm with tiny platinum coils, which promote coagulation and push the blood out. This option is possible, but [a] Dr. barrow said the location is not one usually conducive to coiling, and [b] my amateur evaluation of my existing imaging is that the neck of the aneurysm is too big to keep the coils in.

Option three is to cut open my thick skull, and place a titanium clip directly on the aneurysm to close off any potential blood flow into it. The good news is that the aneurysm is relatively accessible, and doesn’t require too much dissection and jiggering with my brain. If I had to bet money, I’d place it on this option.

But the choice can’t be made until after the angiogram imaging is done and evaluated. So that’s the next step.

On another note, I got the bill for my 64 hour stay at Piedmont Hospital. I’d told Susan it had to top 30 grand, and I pretty well nailed it: $30,414. Nearly $18,000 of that was for MRIs, MRAs, and CT scans.

But here’s the kicker. I later get a letter from my insurance company, in which they dictate the “allowable amount” for those services is $7,938.00 (about $900 of that is my co-pay). That’s right, they told the hospital they will pay 26% of the original bill, and that will just have to do.

I’m glad I don’t have to run my business that way, or I’d be out of business.

But, at some level, that health care pricing battle is not my problem, and not my fight to wage. I got excellent care, and I will gladly pay whatever is determined to be my share. And I know the next hospital stay will make that bill look like buying a pack of gum. But this is one of those situations where money truly is not the object.

So, in summary, I remain a very lucky guy. I have some minor numbness remaining in my thumb and forefinger on my right hand, but otherwise have recovered from the stroke. Plus I’ve met the guy who will be handling my brains, and he’s a hugely impressive fellow.

But as Tom Petty said, the waiting is the hardest part.


Peanut Gallery

1  Jim wrote:

Ah. The accessing of the femoral artery. As you know, I just had that and always had an icky feeling about it. But the drugs the give you to relax you before they access your femoral artery are wonderful. Don’t get gypped. (Am I allowed to use the word “gypped”?)

Good luck! I’ll be thinking of you.

Comment by Jim · 08/13/2010 09:53 PM
2  Reid wrote:

Yeah, I’ve never been too keen on that whole “accessing of the femoral artery” deal. That’s also a downside to the coiling choice; not only is the coiling done that way, but you have to have an angiogram every 6 months or so for the first couple of years to ensure the coils are holding.

As for the drugs, since they have me scheduled to show up at Dawn:30, I’m likely to enter pre-op shouting “Versed and warm blankets for everyone!”

3  KC wrote:

1. Isn’t all this waiting dangerous?
2. I hope Dr. Barrow has big hands. He will need big hands to handle all that brain.
3. Don’t get me started on medical billing. I file claims for two dental offices, neither of which will accept preferred provider status or usual and customary allowances. I do, however, see the “allowed” amounts on the EOBs. We’d have to run a very fast revolving door to work for the pittance most insurers consider “reasonable”. That’s IF they don’t deny the claim all together. Hmph.
4. Get well, damnit!

Comment by KC · 08/13/2010 10:56 PM
4  Reid wrote:

1. Getting out of bed in the morning is dangerous. Getting out of bed with an aneurysm is only marginally more dangerous.

2. He said he would be using a microscope, if it comes to surgery, which would indicate my brain is too small to even see with the naked eye.

3. I’m not fighting that war, but everything I have seen related to price, both while uninsured and while insured, is absolutely insane.

4. Working on it, ma’am.

5  LadyNiniane wrote:

Catching back up with your exploits after a lot of time spent wandering around in the Midwest…

Holy crap!

Having had a friend go through some of the same stuff recently, you can bet that I am paying closer attention to things inside my own body. We’re all reaching that point in the calendar when we simply cannot say, “No! Go away!” any more.

Lady Niniane

6  Paul Scheele wrote:

It’s not that I’m not a praying man, Reid, but my prayers (good or bad), somehow, never get to God’s ears; accordingly, I’ve enlisted the help of some who can seemingly claim theirs do, on your behalf, and I’ll tell them to remember you again, especially, on August 25/26…

You’ve dodged a broken neck before, and something tells me, it ain’t your time, quite yet. Buck up, buckaroo…

7  Reid wrote:

Thanks, Paul, I gladly accept prayers and kind thoughts from any direction. And I don’t think it’s “my time” either.

I had several pints of blood drawn last week for testing prior to this weeks angiogram. And while there, the doctor met with me. It’s been determined that long term high blood pressure was the likely cause of the stroke, and when the doctor read the nurse’s BP readings … he acted like he didn’t believe them. I guess he didn’t see how they could have become so “normal” so quickly. So he checked them himself, the old fashioned way … and got the very same numbers: 130/82.

Got the results of the blood tests back, and my cholesterol (which they’d said was high when I was in the hospital) is well below 200 (166). Sodium levels? Middle of the normal range. And in three weeks I’ve lost 5 of the 15 pounds I need to lose.

So, by the numbers, I’m fairly healthy, for a nearly 52 year old guy. All that remains is to correct the tiniest defect: a 6.5mm x 4.5mm sac of cells filled with blood … which happens to be very unfortunately located.

But it’s hard not to be optimistic when the folks helping you include one of the best neurosurgeons in the country, one of the best wives a man could have, a very supportive family, and lots of friends who care.

I repeat, I’m truly a very lucky guy.

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