This Guy Was Planning On Cutting My Head Open
20 June 2004
My mom has already told the story of myruptured aneurysm from her perception elsewhere on this site.Though some of this may be repetitious I have been encouraged totell the story from my view.
September 18, 2002 was a Wednesday. I had missedtwo days of work that week with flu like symptoms, somethingunusual for me. I work in the engineering department of a localcompany and really enjoy my job. It was around 6:00 AM and as Iprepared to get into the shower my mind was on the day ahead andall I had to do. Suddenly, with no warning I experienced the mostintense pain of my life. It was as if a knife had been driventhrough the center of my forehead, my knees buckled but I did notcollapse, and for a few seconds I had tunnel vision with a paleorange aura surrounding. For a brief instance the thought ofaneurysm flashed through my mind. My wife had worked with a guy whohad died from one and in the back of my mind I had a slight fear ofthem. I knew little about them except that they struck withoutwarning and were generally fatal. I disregarded this idea veryquickly and then considered stroke, as the symptoms seemed to fitmy grandmother's descriptions of her stroke. I just as quicklyabandoned this idea and decided it was just a bad headache, theworst I had ever had. I seem to recall that at this point I gave upon the idea of a shower and went looking for painkillers. All Icould find was aspirin, and I remember grabbing a handful, probably5, and swallowing them, not a good idea for someone with a rupturedaneurysm I was to later learn. I knew that I could not make it towork and called my boss and left a message on his voice mail that Iwould not be in. My 17 year old daughter and 11 year old son were at home at this time, my wife already having left for work.According to my daughter I told her that I was going to lay down awhile and then left her to get my son off to school, fortunately,she was home from school that day.
My next memory is that of my daughter speaking to someone on the phone next to my bed. She hung up the phone and then told me that I was "going to the doctor". She is quiet athletic and, very easily it seemed, pulled my 6.0' 230 lb. frame out of bedand headed me to the door in the manner of a bar room bouncer expelling a drunk. I had no desire to go to the doctor and felt it unnecessary. Yet, I didn't have the energy to argue with her, andbesides I though, "they'll give me something for the pain", whichwas still unbearable.
Our family doctor practices in a hospital about 10miles away and that was where we headed. The ride there was terrible. I seemed to feel every bump and crack in the road and the sun was especially intense and I frequently shielded my eyes withmy hand. My daughter dropped me at the door of the emergency room and left to park the car. I told the receptionist my complaint,along with my insurance and other vital information. I was shown to a room and within a few minutes some guy came in, the first malenurse I had ever met. He checked my blood pressure, pulse,temperature, and questioned me closely about my complaint. The nurse left and returned very shortly with the doctor, I was actually surprised that he was seeing me so quickly. The doctor questioned me in detail about my headache, how it had come on,where it was located and asked me to rate the pain on a scale of1-10, with 10 being the worst pain I had ever had. I told him it was a 15, right off his scale. He spoke with the nurse, who left,and then told me he was sending me for a CAT scan. I thought this unnecessary and told him so; he ignored me and continued. Telling me that it was possible the CAT scan would not detect anything in which case he would have to do a spinal tap. I knew what a spinal tap was and I was in no mood to have some guy stab me in the back with a needle and again told him so. The doctor reassured me thatmost people said his spinal taps, "were not too bad". Before Icould argue further the nurse returned with a wheelchair and I wastaken for a CAT scan.
When I was returned to the emergency department Iwas taken to a different room, much larger, with more equipment,and many more people. I told the male nurse about my daughter andasked him to let her know what was going on. Within a few minutesthe doctor had returned and told me that the CAT scan had disclosedblood on my brain and that it could be an aneurysm. All right, Ithough, no spinal tap! Before I could consider my perceived goodfortune further the doctor told me that I was being transferred toSaint Anthony's hospital in Rockford Illinois. "Why", I asked?Because that is the closest hospital with a neurosurgeon he toldme. Though I understood what an aneurysm and a neurosurgeon were,apparently I was not grasping the significance of what the doctorwas telling me as I suddenly had a new concern. How are you goingto transfer me? "By helicopter", he told me. I have known manyfixed wing aircraft pilots, including my father, and hold a degreein Mechanical Design. Both the pilots I have known and my owntraining have told me the same thing, avoid helicopters, they havetoo many moving parts and complex systems along with theaerodynamic characteristics of a rock. At once I began expressingthese concerns to the doctor, who apparently did not have the timeor desire to listen to my dissertation on the relative safety ofhelicopter travel. I seem to recall him saying, "you won't survivea ambulance ride", and then told me they would give me somethingfor the pain and left the room. For some reason his comment had noeffect on me and I did not give real consideration to the thoughtthat there was something seriously wrong with me. As far as I wasconcerned this was all a waste of time and money.
The male nurse returned and told me that he wascontacting my wife at work and wanted to know how he should tellher. What did he mean, how should he tell her? Just tell her, sheknew I was going to the emergency room, I just didn't understandwhat all the fuss was about. My mom arrived about this time and Irepeated to her what the doctor had told me. The male nurse came inand said he had my wife on the phone and my mom went to talk withher. Then one of my sister-in-laws and a brother arrived. Why hadthey both stopped by I wondered? By this time I was starting tothink that perhaps I should be checked but did not really thinkthat there was anything wrong with me and all this was not reallynecessary. I was to later learn that the doctor had concerns aboutmy ability to make the trip that were not especially hopeful.
The helicopter arrived. I had by this time resignedmyself to making the flight to Rockford, as everyone seemed sodetermined that I do. Still, I did share with the pilot a few of mythoughts on his preferred method of flight, which he accepted ingood humor. As it turned out I knew one of the flight nurses; sheis the sister of a friend of mine and we talked as they loaded meon board the helicopter. Despite my misgivings, I found thehelicopter interesting and actually enjoyed the ride, sleeping fora part of it. We landed in the yard, as the ER entrance wasundergoing construction and an ambulance transported me to thedoor. I was actually a little embarrassed at all this effort as Ifelt that all I had was just a headache.
It is at this point that my memories become fuzzyand fragmentary, and the sequence of events, I'm afraid, is foreverlost. I remember meeting the surgeon, Doctor Todd Alexander, nearthe door. He introduced himself, examined the papers that hadaccompanied me and told me he would talk with me in my room. Atthis point I thought that I had gone directly to my room, but fromwhat I have been told by others that is not the case. I may havegone and had another CAT scan, I'm not really sure. I do have somevery clear memories about the angiogram I was given that day, whichwas a new experience in pain. A small incision is made in your leg,near the groin and a catheter threaded through into the artery. Acontrasting dye is then injected into the arteries surrounding yourbrain, which will enhance the arteries on a x-ray type device andreveal aneurysms. Before injecting the dye the doctor told me thatmy head would feel hot. Hot does not come close to describing it.It's as if you are being burned alive from the inside out. I'mcertain that this is what it's like to be inside a microwave oven.During my stay in the hospital I underwent two of theseprocedures.
Enroute back to my room I remember that we beginpicking up relatives, my wife, children, mother, bothers, and asister-in-law. We passed the hospital priest whom I recognized;though I had not seen him for around 20 years. He would stop in myroom a little later and talk. I arrived in my room in theneuro-intensive care unit and may have fallen asleep for a fewminutes, I'm not sure. The doctor arrived as promised and beganexplaining the aneurysm to me, and the surgery he was proposing tocorrect it. It was at this point that I finally grasped thesignificance of what was happening to me. This guy was planning oncutting my head open.
The doctor went on to explain the possible outcomesand consequences of the surgery. He asked if I had any questions orconcerns. I did have questions, a lot of them. My first was, "do Ihave any options besides surgery"? "Yes", he replied, "you candie". That question settled, my next concern was the late hour,"this guy must be tired", I thought. I questioned him about thisand he assured me that was not a problem, he was, "use to this". AsI do my best work in the morning I apparently assumed that everyoneelse did as well and was not comforted by his answer. Consideringthe circumstances, some of my questions were surprisingly rational.I asked how many of these surgeries he had performed and questionedhim closely on his success rate. Regarding this, he finally gave methe answer I think I needed to hear at the time, though inretrospect I do not believe it was entirely true, "they all lived",he told me.
The surgeon left the room with my family, exceptfor my wife, in tow. My wife spent a few minutes with me and thenleft to join my family talking with the surgeon in the hall. I waslater told that he was explaining the surgery to them in much moredetail than he had given me. Including the odds, which he placed at50-50.
My memories after this are fuzzy at best. I havevague memories of being taken into the operating room. I recall anout of focus, pale green room with no equipment and two figures insurgical garb. I remember the mask for the anesthesia being placedon my face and a voice saying I should be going to sleep. I think Imay have struggled against the mask but am not sure and the voicerepeated again that I should be going to sleep. Then nothing untilI woke the next day.
I awoke in a bright room alone, disorientated andnumb. There were tubes, wires, and electronics everywhere. Irecalled where I was and what had happened and rationalized thatsince I was apparently awake and thinking that the surgery musthave been a success. A nurse soon entered the room and I questionedher. "Yes", she said, "the surgery was a success and I was doinggood". The anesthesiologist stopped in to see me. He startedjoking, saying, "I was pretty strong for a guy who just had brainsurgery". I had no idea what he was talking about but he continuedhis joking and to me it sounded as he and I had had a fist fight. Anurse came in and she apparently noticed my confusion and explainedthat I was aggressive when I came out of the anesthesia. At thistime I could barley move and was a little skeptical about the wholestory they were giving me. My family would later explain that whenthey woke me in the recovery room I became very aggressive and ittook four people to hold me down and restrain me to the bed. I feltterrible about this. The anesthesiologist was only about half mysize and trying to help me and I woke up trying to kick his butt.The nurses and anesthesiologist all laughed about this and told methat it was not uncommon. Still, I felt bad about it.
I was to spend a week in the neuro-intensive careunit and then a week on the regular floor. The nurses and hospitalstaff were great. I understand that I often gave them a hard timeand made some inappropriate comments. Still, they were alwaysgood-humored and very attentive. Most of the nurses, and thesurgeon's assistance Michelle, were RN's or degreed nurses and Iwas amazed at their level of expertise and professionalism. I wouldfind this same level of expertise and professionalism on theregular floor as well. Even the food at this hospital was good andI actually enjoyed it.
During my hospital stay I went through the same ordeals thatmost other aneurysm patients endure, headaches, pain, worry ofvasospasm, weak, and tired. I continued to experience thesesymptoms and others after my discharge from the hospital. It's beensix months since my aneurysm and surgery and I still experienceit's effects, especially fatigue. Still, I get a little better eachday. I hope to return to working soon and plan to form a non-profitorganization to aid other victims of aneurysm and encourageresearch. I welcome e-mail.
Update and Reminder: 22 March 2006
Annual Clipping Day Reminder
For anyone who may not know, March 23rd is the 69th anniversary of the first surgical clipping of a cerebral Aneurysm. It was on this day in 1937 that Doctor Walter Edward Dandy placed a small metal clip, little more than a bent piece of wire, around the neck of an unruptured Aneurysm in his 43-year-old patient. The patient did survive.
Dandy's treatment was considered radical for its day. At that time, it was believed, due to the restricted work area and the rather unstable nature of Aneurysms, that surgery did not offer a solution to Brain Aneurysms. The only available treatment option at this time was bed rest and prayer.
Performing a surgery like this in 1937, without the aid of an operating microscope, or the advanced electronic and imagining devices we have today was quiet a feat. This surgery was actually a footnote in Dandy's long and brilliant career but sixty nice years later, it is still saving lives.
As it has been nearly four years since my Aneurysm ruptured and I have never updated my original narrative, I though it was time. Perhaps, I should also revise the original, as it was very poorly written, but think I will leave it as a reminder to myself that my thinking processes and abilities have improved. I hope that this update will prove to be better written and more interesting than my original. I tend to be a little long-winded when writing. I will try to be brief and concise but forgive me should I drag things out past the point of interest.
Just over three years ago, I enjoyed a rather nice life. I was married to the same woman for more than 20 years, with two beautiful intelligent children who seemed to be on the road to success. My wife and I owned two homes, along with cars and all the trappings that many seem to consider important to modern life. We both held great jobs, my wife worked for the state of Illinois, and I worked in the engineering department of a local company.
When my Aneurysm struck in September of 2002, it was completely unexpected. I had never suffered a significant illness and I believe that the shock that I was as susceptible to something like this as anyone else was struck me as hard as the Aneurysm itself. The initial months after my surgery were spent waiting for the day that I would pick-up life where I had left off when interrupted.
My surgery actually turned out well and I was spared many of the deficits and impairments that others have suffered. For that, I am thankful but still, I did not emerge from the surgery the same man I was before. My chief complaint, I no longer had the energy and ability to work as I had before. Challenges I had once eagerly looked forward to now seemed overwhelming. I was tired all of the time, experienced headaches, and my thought processes seemed slower. It was as if I had entered the hospital a 41 year old and left a 71 year old. Several months after surgery I did return to work part-time but it seemed too much and, oddly, the work did not hold the same attraction to me as it once did. The long and short of it, I left work and have not returned.
My time now is spent pursuing another passion. As many of you that I have corresponded with know, after my Aneurysm rupture I developed an interest, some might say an obsession, in the history of the clipping surgery, and Doctor Walter Dandy who developed it in 1937. I have spent of fair part of the last couple of years researching and writing about the subject. I have tracked down family members of Dandy and interviewed his surviving residents (students). I also made, what was to me, a pilgrimage to Maryland to attend a dedication ceremony for a professorship in Dandy's name at Johns Hopkins. I had planned this past summer to release a book detailing the first clipping of a Cerebral Aneurysm, but made a decision to delay the publication.
There had arisen an opportunity to obtain much more data regarding the surgery, and Doctor Dandy. I located four additional living former students of Doctor Dandy, and family members of another student. The information and stories they shared with me certainly justified the delay and will help to make the book more interesting and informative.
Since the rupture and surgery, some aspects of my life have tended to take a slight spiral downward. My health is not what it was; I am still fighting to maintain my blood pressure, still experiencing fatigue, and frequent headaches to remind me of the day that everything changed. Still, I know things could have been much worse. Despite this there has been much good in my life. My family is healthy, my brothers who choice to be tested for Aneurysms have been found to be free of them. My children seem to be doing well. My daughter has graduated high school, won an athletic scholarship and is now a third year undergrad. An injury, and knee surgery has sidelined her for this season so she is taking a semester off of school. I am not certain if she will play again but she did realize her dream of playing university level soccer, two years as starting goalie. My son, who was never a serious student, at last seems to be making an effort at school and, I hope, is beginning to pursue seriously some of his talents.
Despite my complaints overall I am better. There are days when I feel near normal, or rather, feel as I use to, since normal, for me, now has a new definition. I continue to research and write and before too long I will release the book. I have been thinking about returning to work part-time, and perhaps even return to school and pursue a second degree.
Like so many others who have told their story on this site the Aneurysm changed my life completely. The person I was is now, for the most part, gone but the Aneurysm is still with me everyday. I have come to terms with the person I have become and made a peace of sorts. My hope is to extract something good from the experience and go on. As I said, it could have been much worse.
© Copyright 2004 Mike Dallas
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