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23 March 2009
I am a 43 year old lady, originally from the UK but living in Hong Kong with my husband and two teenage children. I had been having unexplained left upper quadrant abdominal pain and other symptoms for quite some time. Last October, on a flight from San Francisco to Hong Kong after spending a holiday in the USA, I experienced pain, numbness and nearly passed out twice. I was given oxygen during the flight. I went to hospital with a suspected pulmonary embolism. Luckily that was ruled out, but my CT scan showed a 1.5 cm aneurysm at the bifurcation of my splenic artery. By comparison to an AAA it seems small but the splenic artery is only 3mm wide so that puts it in better perspective. At that time, I received so many contradicting opinions from doctors. I was quoted all sorts of rupture statistics and it seemed that nobody really knew anything about this type of aneurysm. I saw three surgeons and repeated the CT scan and they all said that the location of the aneurysm meant that splenectomy was the only surgical treatment. I was told I could also choose to just live with the risk of rupture and repeat scans every 3 months. The pain was still bothering me and I was convinced that it was from the aneurysm. Not a single day went by without me fearing rupture and it felt like I was carrying a timebomb. I finally decided to go ahead with the splenectomy and scheduled it for February 2009. Having scheduled the surgery, I contacted Violet Jones whose narrative was posted on this site and she suggested that I try to find a surgeon affiliated with our university hospital for another opinion with a view to saving my spleen. The fact that I still have my spleen today is all thanks to Violet and her advice.
I found a professor of vascular surgery through the Hong Kong University's Medical School and went to see him. He reviewed my scans and agreed that since the aneurysm was symptomatic it would make sense to have it surgically removed. He said one option was to try embolization but I felt that the risks were too great given the position of the SAA and my spleen may not be preserved. He agreed that splenectomy would be the usual surgical choice but that he could try to save my spleen by taking a vein from my leg and grafting it to replace the damaged artery but considering the position of the SAA there was a strong chance they would have to remove my spleen during the operation. I recieved pre-splenectomy immunization as a protective measure. I felt confident that the professor was the most highly qualified person to carry out the surgery and his team was probably the only one in Hong Kong skilled enough to attempt it.
I underwent the surgery on March 11th 2009, and not only did the professor preserve my spleen but he managed to reconnect the ends of the artery without the need for a graft. He said my pain was most likely due to the fact that the SAA was pulsating and that it was quite a large aneurysm. In the recovery room, one of the nurses from the OT told me it was like a large perfectly round marble. I have a very large incision right across my abdomen but am healing beautifully and the relief that the timebomb has gone is incredible. The nagging pain has gone, telling me that it was definitely the SAA causing my symptoms.
I learned a lot through this experience. I learned that it is important to meet people who have been through similar situations and that you have to be your own advocate. If I hadn't 'met' Violet and subsequently asked the professor to try and save my spleen, I would have lost a perfectly good organ and have been unnecessarily at risk of sepsis. Being a teacher, exposed to sickness all year round, having such an important part of my immune system intact is important to me. I know people can live without their spleens (my daughter lost hers at 9 years old due to a blood disorder and she takes penicillin every day) but I felt strongly about not giving it up without a fight.
Update:04 September 2009
Almost six months have passed since my surgery and I am glad to say that I have pretty well made a full recovery. The only minor deficit I have is numbness across a large part of my abdomen due to the severing of the nerves. I am told there is about a 50% chance of them growing back. Right now you could stick a needle through my belly and I wouldn't feel anything. The best thing is that the pain has totally gone so I'm now positive that it was caused by the aneurysm. I travelled with my hubby and kids to visit my mother in England in June for two weeks but at the end of July she was diagnosed with primary liver cancer. Sadly, she deteriorated at a rate we could have never imagined and died two weeks after diagnosis on August 18th. Luckily I flew back to the UK in time to see her again for two days before she passed away. She was 72. Overall, this has been a tough year with a lot of medical stuff going on. My 13 year old daughter will have an MRI this coming Monday to investigate a tumour on her tibia bone that will hopefully turn out to be benign. I'm confident things will improve in the last few months of the year. My best wishes to everyone in this wonderful family.
© Copyright 2009 Wendy Lau
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