Today's story requires a brief recap of previous events. I have talked about this to death, but it is a necessary preface. Car accident, subdural hematoma, back to work, real job, growing taller, blah, blah. All was going well.
In June, almost two years after the accident, I had a stroke. Specifically, a hemorrhagic stroke caused by a subarachnoid hemorrhage, which is bleeding into the gooey bits between the brain and skull. Essentially, arteries rupture, which cause bleeding, which causes pressure, which hurts like a son of a bitch.
In my case, it started out as a dull headache that I was perfectly willing to ignore. I get headaches all the time, so I got used to paying little attention to them. Most can be ignore with simple distractions. Some require drugs. This one went from 0 to 100 in a few seconds. Ignoring it was not an option. The good news is that I immediately knew the stabbing in my brain was a direct result of all my previous brain troubles.
One of the worst aspects of a hemorrhagic stroke, aside from having the stroke itself, is that it is almost always misdiagnosed. When they happen spontaneously, people go to the hospital and doctors mostly assume it is something else. The main symptom is a headache, which could be almost anything. Ischemic strokes have different symptoms, and since ER doctors see them far more than hemorrhagic strokes, their natural inclination is to only think about a stroke when faced with ischemic symptoms. The delay in treatment is what gives hemorrhagic strokes a high mortality rate. I had no idea I was having a stroke at the time, but I knew the explosion in my brain was directly connected to having my skull cut open, and the doctors could easily access my medical records. Instead of wasting time trying to figure out what it was, they went straight to work treating it.
I can't speak for anyone else, but one thing I know for sure is that after having a craniotomy, I never want to have another one for as long as I live. I would never go so far as to say I would rather die than have more brain surgery, but I would go to extreme lengths to prevent anyone from cutting open my skull again. The funny thing is, when my arteries were exploding and it felt like Roman senators had confused my brain with Julius Caesar, I would have happily let anyone with a medical degree slice me open.
Fortunately, the treatment was less severe. They gave me drugs to lower my blood pressure, drugs to prevent that part of my brain from dying, drugs to keep me from freaking out, drugs to keep my lunch in my stomach and, my personal favorite, drugs to knock me out as much as possible while still keeping me conscious. Apparently, losing consciousness greatly reduces the survival rate.
Fully loaded, they strapped on the ECG to check my heart. It has something to do with too much adrenaline pumping through the system. I never had a heart attack, but the tests showed a cardiac arrhythmia and ST elevations. This is another reason hemorrhagic strokes are often misdiagnosed. On paper, the ST elevations look just like a heart attack and doctors often waste time concentrating on the wrong organ.
The CT scan showed the doctors what they already suspected. Generally speaking, when your brain is bleeding, you have a few treatment options. Most surgeons go straight to cutting people open. They say that is the best long term solution, especially with aneurysms. But I never had an aneurysm. This is where doctors having the ability to access my medical records really came in handy. Most subarachnoid hemorrhages are caused by aneurysms. As such, most doctors would assume that is the cause. Had I been in the United States, they probably would have cut my skull open only to discover a surprising lack of aneurysms. Since the Chinese doctors knew my history, they knew it was a result of past trauma. People like to complain about lack of patient privacy in China, but I think it is terribly convenient that a doctor in one hospital can find patient information from another hospital's computer. The system can be abused, and a celebrity's medical records can get leaked to the tabloids, but it also saves lives.
With cutting me open completely unnecessary, they went with interventional radiology. That might sound like something that causes cancer, but even a simple x-ray is more radioactive than what they did to me. They jammed a catheter in my thigh and used a digital subtraction angiography to make their way up my femoral artery. Once in place, they used a balloon to cut off the artery's blood supply in a procedure called embolization.
I find it more than a little impressive that they can move a wire from your leg into your brain without causing any additional damage. The alarming part is that it is all done while you are wide awake. A subdural hematoma is deadlier than a stroke, and the treatment is more destructive, but for me, the stroke treatment was worse. I was not fully conscious until days after the hematoma. I only had to deal with the aftermath. I was fully conscious before, during and after the stroke. The hematoma was not painful at all, until everything was healing. I felt the stroke every step of the way. I was asleep when they put all the wires and tubes inside my body after the craniotomy. I was wide awake when they plugged me in after the stroke. That might be one of the reasons they gave me benzodiazepines.
When I woke up after the craniotomy, there were compression stockings on my legs to prevent deep vein thrombosis. I had no idea what they were and what had happened to my legs. This time, I watched them wrap up my legs and knew why they were doing it, which is far less alarming. Unfortunately, I was also wide awake when they inserted the Foley catheter. That was unpleasant.
The day after they embolized the hemorrhage, they moved on from CT to MRI. As it was explained to me, the CT scan is more useful immediately after a stroke while the MRI is much better after 24 hours. Overall, I prefer the MRI. It is a more comfortable scan and the pictures look a lot better to my untrained eye. I'm certainly not a doctor, but I have seen a lot of pictures of my brain at this point.
I was in the hospital for a week after the craniotomy, mostly because they wanted to make sure I could survive. Most people who die do so just before or soon after the surgery. Since they never cut me open for the embolization, they let me go home after a few days. The odds of dying dropped dramatically with each passing hour.
After the craniotomy, they gave me a long list of possible long term side effects. One of the effects that I mostly ignored was the possibility of having a stroke. That was something to worry about in the future, like Alzheimer's. I mostly worried about having a seizure, which never happened. Now, I have a shorter list, but I don't much care for any of the options. I could easily develop an aneurysm in the next six months, or at least have more artery troubles. There is a pretty good chance I will have another stroke, and I am at risk for hydrocephalus, which just sounds horrifying.
The long term side effects are pretty much the same as after the craniotomy; fatigue, anxiety, mood disturbances, PTSD, various cognitive impairments. And, of course, headaches. I don't know if my personality is changing, but I definitely know about fatigue. I get exhausted just eating lunch. The fatigue is worse than anything else.
It took a year after the craniotomy to get my first real job. Not because of the scar on my head. That is easy enough to cover. I could not work for a year because I got tired too easily. Now, I am faced with the same situation. I can barely walk to the kitchen, but I know that will pass. It takes some hard work to go from napping all day to performing at my highest level, but I know from experience that it can be done. Two years ago, I was told that my career was over. All the experts are telling me the same thing all over again. I proved them wrong once. I don't see any reason not to prove them wrong again. Hopefully in less than a year.
The first thing people outside of the hospital always ask me is if I am paralyzed on one side of my body. That would definitely end my career, but that is a different type of stroke. An ischemic stroke is basically when a blood clot cuts off the blood supply and kills a small part of your brain. That can easily lead to paralysis and/or speech impairment, depending on the location. I had a hemorrhagic stroke, which is too much blood and does not generally leave a dead zone in your brain. I have the full use of all my limbs and can speak properly, or at least as properly as I did before. The only thing wrong with my brain is als5fhga7sk.
NB, someone else's brain.
Hopefully, two other people.
