Established April 15, 1995
University of West Georgia Disclaimer
Left to right: my husband Randy, me, my step-son
Jeff, my daughter Kate,
son-in-law Andrew and my son Kevin taken while we were on a cruise
together
recently. Randy and I took 11 members of our family to England in
2005!
Maggie
Randy, Sophie and Don
The top photo is emblematic of my life: family is and always has been my joy. My second delight is my profession of Physical Therapy, in which I have practiced as a neuro specialist for many years. In March 2007 I accepted a position at our local community college to teach PT assistants. My husband is a retired periodontist, who now is a computer specialist. My love for my profession is contagious: one of my daughters is a PT too, and her sister is a 4th year med student at the Medical University of South Carolina in Charleston, where my life was saved. One of my sons is a PT Assistant and now an Occupational Therapist (he went to MUSC, too), and he is married to an OT Assistant! Another son and one of my sons-in-law are involved in restoring historic homes in Charleston. One of Randy's sons is a computer engineer in Ithaca, NY; the other is a senior in business at Emory. My other son-in-law is a sea captain, and he is the daddy of my 2 darling grandchildren, Nathan and Rachel, who live near us and are very much a part of our lives. We are very fortunate that 5 of our six children live within 2 hours drive. And I am more fortunate than so many to still be alive after suffering a brain aneurysm and subarachnoid hemorrhage, to still be able to practice in my profession, and most of all to be with my husband and family whom I love without end.
29 September 2007
Hello-- my name is Maggie. I am 57 years old, married and the mother of 4 adult children and 2 adult step-sons. I suffered a ruptured aneurysm in the right internal carotid artery in my brain on June 29th, 2007. It was not repaired via craniotomy and a titanium clip until the evening of July 3rd. A very traumatic four and one-half days trying to find a physician who would actually BELIEVE what I knew: that I had a ruptured aneurysm.
I think it might be important to relate that four years ago I encountered intermittent diplopia (double vision) and some unexplained vertigo (dizziness) for about four months. I had a complete neurological workup including an MRI and MRA of the brain, an ENG (electronystagmography), multiple blood tests looking for markers for mysasthenia gravis, and of course neuro testing by the physician. Nothing could be found, and the symptoms disappeared as mysteriously as they came. Starting in February this year, the intermittent double vision returned. Having had all the neuro-work four years ago, I chose to try to ignore it and wait for it to disappear. It was found later that the aneurysm was resting on top of the oculomotor nerve of my right eye, undoubtedly the cause of the double vision.
Part of my frustration, beyond the fear that the rupture would extend and I would be rendered severely brain-damaged or dead, was that I have spent 35 years in a career in Physical Therapy, and my specialization has been neurology and brain injury! So on the morning of Friday June 29th, when I heard/felt the most astounding "pop" deep in my brain, following instantaneously with the most CATACLYSMIC headache and excruciating "nerve" pain while trying to turn my head or turn my spine with any movement, I knew EXACTLY what had happened. Coincidently, the fire alarm at the college where I teach Physical Therapy went off about 30 seconds after I felt the explosion in my head. We had a class of 35 high school students involved in a Summer Academy for health care professions in the building at the time, and I was visiting with their parents. Amazingly, I was able to stagger outside and asked some students to get off the only bench outdoors and told my colleagues (who are all nurse educators) to call an ambulance as I had a ruptured vessel in my brain.
My recollection is that not much happened for a little while because of the commotion, and even THEY could not believe I knew what I was talking about. Everyone kept saying, "Are you sure it wasn't the fire alarm going off?" Finally my closest associate got the keys to my car and my purse and she drove me to the hospital which was only five minutes away. Sounds fortunate, but it wasn't.
I could not sit up because of the horrendous pain. My friend got a wheelchair and under my direction INSISTED that I be seen immediately. They took my blood pressure (150/90, which was fairly unremarkable considering the degree of pain I was enduring) and heard my description of what had happened and I was immediately sent for a CT scan of the brain. It was negative for any signs of bleeding.
The physician from the ER then ordered blood tests (presumably to see if I had an infection like meningitis or encephalitis) which were negative. Dr. G. gave the appearance of disbelief regarding everything I told her. She persisted in asking if I had ever had a migraine before. By this time my 35-year-old daughter who is also a physical therapist was at my bedside. I informed Dr G. that I HAD had a migraine 30 years ago while pregnant, but that other than that incident I NEVER have headaches. Nevertheless, Dr. G. persisted in suggesting that this was a migraine. I could not have been more clear about the "pop", the devastating pain and the pain running up and down my spinal cord like an electric shock any time I moved. The nurse brought 2 Percocet. It was three hours until the pain reduced from "10 on a scale of 10" to "7" -- still an incapacitating pain. I was then discharged with a prescription for 10 tablets of Percocet!! My daughter had to abandon her car at the hospital, and drove me an hour to my home.
It was now 8 pm on a Friday evening. My husband is a periodontist, and believed that I knew what had happened. However, after the "non-treatment" at the ER in the town where I work, I was not ready to go to another ER in the town where I live. The pain had gradually reduced to "5 on a scale of 10", where it remained until after the surgery. I took Tylenol because I was afraid to use aspirin or ibuprofen in case of further bleeding in the brain. I monitored my highly volatile blood pressure closely. It was too high (150/95) if I sat up and too low (85/50) when lying down. I only walked to the bathroom. I couldn't even sit to look on the Internet for help.
I called my second daughter, who is a fourth year medical student. She was appalled that I had been discharged and confirmed that I needed a neurologist right away. (An aside: She had had a class with an astounding neurosurgeon Dr. Sunil J. Patel, at the Medical University of South Carolina in Charleston (MUSC). Knowing, of course, my lifelong interest in neurology, she had called me last year to tell me all about his lectures, she had been so impressed with his passion for his field!)
Finally Monday morning (July 2nd) came and my luck began to change for the better! Starting at 7 am I called every neurologist in the area, all of whom I have worked with during the past 14 years I have lived here. Several were out of town (holiday week) but thankfully Dr. Harvinder Kohli was able to fit me in. When he heard the description of my symptoms, he assured me that I was undoubtedly correct in my diagnosis. Another CT scan was negative. But the lumbar puncture he performed was classically a dirty yellowish-pink color, indicating bleeding in the subarachnoid space. He said he had been a resident with the same neurosurgeon, Dr. Patel, at the MUSC where my daughter is a student and that Dr. Kohli the neurologist and Dr. Patel the neurosurgeon were friends! While I waited, he called Dr Patel and arranged for Dr. Patel to meet me at the MUSC, 2 hours from home.
My husband drove me (lying on the seat) to the hospital, where my med student daughter was released from her afternoon in surgery to be with me. A CT angiography of the brain revealed the aneurysm, which was 6.6 mm (after having leaked, of course) and in a very fortunate location: in the right internal carotid artery BEFORE it enters the Circle of Willis, a squarish network of arteries that provide blood to the largest portion of the forward brain. Dr. Patel said that the newer endovascular route (threading through the arteries into the brain and inserting a coil into the aneurysm to seal it off) would be less likely to be successful due to the shape of the aneurysm, causing more bleeding. He felt that the more traditionly performed craniotomy and clipping would be safer in my case. I said that it was totally up to him, of course!
I awoke after the surgery almost immediately. The surgeons had not shaved a hair off my head. The hair was controlled with a thick clear gel that took a couple of weeks to wash out of my hair. The nurses kept saying how astonished they were that I was alert, active and talking to them quite naturally. They told me most of their patients were on a ventilator post-operatively. My husband told me later that they said I was "the Poster Child" for neurosurgery, and that I was joking and telling sort of "black" humor, telling my frightened children that "they should avoid elective brain surgery" and so on. Everyone agreed I was in terrible pain but the staff gave me Fentanyl and sedation which killed the pain and caused me not to remember anything of that period. After a couple of days in the Neuro ICU -- which are hazy in memory due to pain meds -- I was transferred to the Neurology floor, and I was discharged home on Monday July 8th. Incredibly, I returned to work (a commute of one hour each way) 3 weeks to the day from my neurosurgery.
I HAVE noticed I make many more typographical errors in my writing. Intensive editing is necessary! For the first few weeks, I definitely noticed more difficulty with "word-finding": that feeling that the word you are looking for is "right on the tip of your tongue" but you cannot retrieve it. Three months later, that problem appears to be no more nor less than before. My hearing was affected for about two and one-half weeks: my right ear felt full (which it was, with dried blood) and my left ear uncharacteristically was only hearing high tones. It sounded like everyone was speaking as though they had inhaled helium! It was very irritating, especially on the phone. Fortunately that cleared up completely in a few weeks.
I joked with family and friends that since the retraction of the scalp to enter my skull caused nerve damage, that I could now be called officially a "numbskull" and a "sorehead". I was also teased for having a hole in my head (there are three holes, actually) being "cracked", and having "a swelled head"! Unfortunately I AM suffering from a miserable neuropathy of intense, relentless, agonizing itching in my scalp. No amount of scratching relieves it, and I have torn my scalp in places accidentally because I cannot feel how hard I am scratching. Of course the other side of my scalp does not itch at all. Another not-so-good side effect of all this is a thinning of my long naturally curly hair. Thankfully it was very thick prior to the surgery, so it's not too bad. I am hoping it does not all fall out! There is a slight depression just beside the orbit of my right eye where a 1 inch diameter piece of skull was removed to allow access to the brain. It does not appear noticeable unless one looks for it.
I am embarrassed to write of such small residuals when I know so well how fortunate I am. I always wept inside when I would have a new patient with that forbidding diagnosis "SAH": subarachnoid hemorrhage, because I knew the patient would have a long hard road to recovery ahead. And of course, now I am meeting people who are telling me that their mother died of a ruptured aneurysm at age 56, 58, 57....
My own mother died just 2 years after having an abdominal aortic aneurysm (at 65 years) and 3 months after coronary artery bypass at age 67. It was a devastating loss for me and I grieve for others who have written on this site about the shocking death of moms in their mid-to-late 50s. Nowadays we feel so very young even when approaching 60. It is such a devastating and unexpected loss to adult children who are just beginning a new stage of relationship with their parents: friends! My heart goes out to them.
Thank you for this opportunity to write of my experience. I am not certain it will be of value to anyone but myself to have written it, however I VERY much appreciated reading the stories of others who have dealt with ruptured aneurysms and AVM. Many blessings wished to you all, and to the researchers, neurologists, neurosurgeons and their wonderful support staff, I offer my deepest gratitude.
Update: 28 July 2009
I read your updates with great interest and realize that others may be as interested in how I am doing also.,/
One of the most amazing experiences since my aneurysm was traveling to Maui with my husband, Randy, in Feb this year (2009) and taking a ferry from Ka'anapali Beach where we were staying, to the island of Lana'i, where one of our "BA/AVM family", Don Dickensheet and his wife Sofie entertained us for the day. I have included a photo of Randy with Don and Sofie on Lana'i, and one of myself at the Feast at Lele in Lahina, Maui. Don is the one wearing the shirt "Not Dead Yet" -- those of you who have read Don's narratives will have recognized him instantly! (We forgot to take a photo of Don and me together..) What an experience! Lana'i is so different from Maui...hard to believe you could practially swim across from one to the other. Don is simply a tower of strength, and Sofie has to be one of the dearest and most interesting ladies I have ever met. Their home is utterly perfect, with a greenhouse full of vegetable and orchids, (and love birds) and a blooming garden one can find rarely anywhere except Hawai'i. Add a beautiful black lab and one of the hugest tabby cats who is gorgeous. An exquisite luncheon at the golf club, followed by my getting to snorkel in Melehe Bay. (Randy unfortunately was not feeling well enough to go in...) It was one of the bravest things I've ever done...the waves were huge and tossed me out like a piece of flotsam. But the "scenery" down below was not to be compared with anywhere else. We won't forget our day with the Dickensheets and their hospitality. And to think if I had not had that aneurysm, we might never have met them! If you have read Don's narrative and updates and know the horrendous things he has endured, physically and emotionally, you would not believe his level of competence and breadth of ideas. Of course, he is exactly the "rogue" that Randy recognized immediately. I like to think of Don as a modern day pirate-type...tough and brash and a ton of fun...Sofie is so special..kind, giving and filled with life and love.
The second anniversary of my aneurysm rupture was on June 29th, and like the first, it passed basically unnoticed. I don't know quite why it does not cause the depth of feeling in me that such anniversaries cause in others....but we are all such unique individuals that I do not question it. I still have some rage that is close to the surface when I read or talk to others whose medical issues are disregarded as mine were by the emergency department doctor, Jameela Gator, at Beaufort Memorial Hospital here in South Carolina. After 7 hours in agony, she sent me home with my daughter with a prescription for percocet for my "migraine". (I have never had migraines.) As a practicing physical therapist, I have always been an advocate for those who are trivialized by other healthcare providers. Thankfully, the neurologist with whom I had worked with on Hilton Head Island called the presentation of my aneurysm "classic" (a huge "pop" deep in the brain, followed by a cataclysmal "thunderclap" headache, and "nuchal pain" -- pain down the spinal cord right to the sacrum) and called the chief of neurosurgery (Dr. Sunil J. Patel) at Medical University of SC in Charleston, where I underwent craniotomy and clipping of the aneurysm. In three weeks I was back at work as a college instructor, including a 2 hour commute each day. I taught two courses, one in the Fall and another in the "Spring" session (January through May). At that point I felt that I was not enjoying the teaching as much as I had always enjoyed practicing physical therapy, so I returned to practice at a delightful single therapist clinic in a town next door to Hilton Head Island where I have lived the past 16 years. I am loving the work, as always.
For the most part, I feel like the same person I was before. Per haps because of my amazing good fortune, I do not have the feelings of grief at the anniversary of my aneurysm. I empathize deeply with those of you who have lost a part of yourselves, and those who have lost dear ones, and those who have to struggle to get the care you need. It has been my entire lifetime to work with this miserable situation. Probably the most important thing I do in my practice is VALIDATE my patients' experiences. I am happy to say my eldest daughter (PT) and eldest son (OT) also give their patients receive the same validation. I am so very tired of what I consider to be ignorance on the part of others who tell patients their pain is "all in their head" or that they are "drug-seeking", when all they want is to be able to function without pain! Happily, we are able quite frequently to assist our patients to achieve that goal. It makes life very meaningful. I am grateful I am still here to do my work, and of COURSE, to share the joys and sorrows with my large and interesting family.
The initial side effects of the brain surgery and the damage by the subarachnoid hemorrhage seemed to clear in the first 18 months. My itchy scalp where it was pulled back for the craniotomy continues, but not as severely as before. The thinning of my thick and curly hair has remained to my sadness...they did not remove a hair from my head during the brain surgery! But quite a bit fell out and I am sorry about that. ("Vanity, thy name is woman"!) It is so much less than others' losses that I am uncomfortable even reporting it. But I have been told an update is necessary, so I am updating!
Quite honestly, I think that is all there is to say about my recovery. Happily, I do not have headaches, and the double vision and vertigo I experience 3 years before the rupture, and again 3 months before the rupture have never returned.
I will close this update by saying to you all, that your narratives and updates mean more to me than I can say. I ALWAYS read the updates Jim and Susan send...usually from beginning to end. And I thank God for your successes, weep for your sorrows, and pray for your return to good health, and grieve when one of our family passes from this life to the next. God bless you all.
With much love from Maggie Vitek
Discussion, comments, or questions: Maggie Vitek
© Copyright 2007 Maggie Vitek
All Rights Reserved - Fair Use
acknowledged
