At the time of my "bleed", I was 39 years old. I work fulltime in the clerical field for a public utility and had no serious medical events prior to my bleed. My only diagnosed history of hypertension was during pregnancy (third and last pregnancies 1986 & 1990). Following my bleed, I was placed on Procardia XL and have had three follow-up angiograms, all clear with the exception of reduced blood flow on my left side due to the nick that occurred during a secondary coiling exploration in 1999. All lags that I consider deficits are reported to be (by others my age) more a sign of aging than a residual of the aneurysm. :-) Officially, I am deficit-free. The purpose of my narrative is to offer my shunt story for consideration by all who care to read it.
Living Shunt (and pain) Free . . .
8 September 2002
Revision: 9 May 2004
In April 1999, I suffered a "bleed" of a Basilar Tip Aneurysm in my Vertebral Artery. Please forgive me if the following is not exactly correct medical language. I'm a clerk. :) My bleed was "coiled" at UC Davis Medical Center - Sacramento, CA by a wonderful team of doctors. My only complaint is that I can't recall any of their names, nor the name of the On-Call Doc at Sutter-Amador Hospital (Jackson, CA) who received me into the Emergency Room at 1AM and had me medi-flighted to UCD (demanding Kaiser approval and threatening to send me to UCD without it) where I would get the best care. I firmly believe that my life today is owed to the fast action of all concerned. No criticism against Kaiser is intended here. Following that night, my care has been a priority and continues to be so (apparently, once you've reached the other side of a bleed, you're given a bit more special attention. :) Kaiser was wonderful and continues to be so. I'm just thankful that that nameless On-Call Doc didn't wait through the delays and insisted on getting me to UCD. I also owe my life to my husband who was there, recognized that something was terribly wrong with me and called 911. I have no memory of that first 48 hours.
I wanted to write my story because of my cerebral-abdominal shunt, installed at UCD (reportedly a standard practice) during my reparation (coiling) procedure. From April 1999 to February 2000, I lived in daily, constant abdominal pain. At first, I thought the pain to be temporary. By September, when I went to UCSF for additional coiling surgery, I thought my pain was "normal". During the procedure, the surgeon nicked an artery in my brain (not uncommon, so I hear) and I was kept overnight for observation. During evening rounds, a team came to check on me and one of the "students?"stayed behind and asked me questions about my shunt. Until then, I had been told that shunt-related pain was virtually unheard of. She told me that many shunt patients cannot walk or speak, so that statement was a bit subjective. I had also been told that I would have to keep my shunt for the rest of my life. She told me that, in Europe, shunt-placement is often a temporary measure. Hearing my story of months of abdominal pain, this doctor encouraged me to "push" for my shunt to be examined for possible removal.
I began complaining (about my pain) to my Neurosurgeon who was stumped. He tested me for appendicitis and I.B.S. and even performed surgery to relocate my shunt. They were about to send me in for exploratory abdominal surgery when my husband called the Head of Neurosurgery and demanded a second opinion. Although the second surgeon was also stumped, my husband and I continued to complain until my Doctor (now the head of the Neurosurgical Department) agreed that I could actually be experiencing pain related to my shunt. My doctor came to us and said that there was a remote chance that I had a low-grade infection in my brain fluid, which when released into my abdomen, caused pain as my body tried to fight it. They plainly stated that they didn't think that such a thing could cause the level of pain that I was experiencing and cautioned that, if I did have an infection, they would have to replace my shunt, give me antibiotics and then replace my shunt again to ensure that my brain fluid was not re-infected. All of this risk with no guarantee that my pain would be diminished at all.
I asked the surgeon if, during this process, they could test me to see if I could live without my shunt. He agreed that they could cap my shunt and see how I did. He asked me not to get my hopes up as most shunt patients were shunt-dependent and stayed that way.
I was admitted into the hospital on February 12 and my shunt was removed at my neck, tested and capped. I didn't need the surgeon to tell me that I had an infection or that I would be able to live without my shunt. From the minute I awoke from surgery, I felt wonderful! The surgeon confirmed that my shunt was barely "dripping" at all and had me watched closely for 24 hours. I recall lying there feeling "healthy" for the first time in months, fearing the headache that would foretell the need to reinstall my shunt. The headache never came! On Valentine's Day, they removed my shunt and I was up within an hour . . . making my bed in the NICU (if you ever want to scare NICU nurses, just start moving around your room. :))
Now, five years after my aneurysm . . . I'm completely okay. I was told that prior to about 1994, they had no way to repair my type of "bleed" and that I would have died within 24 hours. Today, I'm fine! I owe my life to those wonderful surgeons and the pioneer of the coiling procedure! As of my last (and final, which makes me a bit nervous) angiogram (nearly two years ago) my coil was still in place and my aneurysm was still occluded, and I have no deficits.
I owe my everyday happiness to that wonderful Neuro-Intern who gave me great advice. My reminder to you . . . medicine is an Art. A wonderful, miraculous Art, but an art all the same. Push for what you need and thank them when they get it right. They're doing the best that they can.
Discussion, comments, or questions: April Hughes
© Copyright 2002 April Hughes
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