Sunday, August 01, 2010

Semicolon

I've been asked a few times, "Why Semicolon? Is that what you're calling it?" I've also been asked, "Can I see it?" So I figured I'd kill two birds with one stone.

Mostly, I chose this website because of all my stalled efforts to write consistently, this is the blog I've headed to most over the years (maybe I'll link to others at some point). And my description of the semicolon (above) holds up well for what I'm going through right now. Plus, if I really push the metaphor more literally, the thing looks slightly (very slightly) like a semicolon. You can judge for yourself down below. But I'm not calling it "the semicolon". I don't really call it much of anything. Here, I suppose it's "the thing". But in casual conversation, it's just "my aneurysm" or "my brain" or "my head". We did try to name it at first. "Annie" popped out quite naturally, but that felt a little cutesy. To my kids, it's "the bubble". That simply felt like a palatable word. (And I suppose it makes me "Bubble Boy".)

Some co-workers came up with the name Rizzo (for aneuRizzm). Not sure if it's Rizzo from Grease, M*A*S*H, or Midnight Cowboy. Perhaps a combination of the three -- a rough-and-tumble, though partially-crippled, broad who runs an Army motor pool.

But no name has stuck.

As for seeing it, a few have already and now you all can. I'll start with the first glimpse I had, from my MRI. In case anyone's particularly MRI savvy, I've flipped the image around to show the thing more apparently on the right side of my head. The way the scans work, pictures are mirrored (click to see it larger):


Can you tell what doesn't belong? The two white things at the top are my eyes (they're supposed to be there). The circled areas are highlights made by my doctor to emphasize the two important bits -- the aneurysm itself (dark) and the edema/swelling (light). The former created the latter. The latter created my seizures/episodes/tickles (I'll get to that).

Next up was my Cat scan (CT):


Not as dramatic, but it shows bone where it's supposed to be as well as where it isn't. So you can see how some calcification has formed to wall off the aneurysm from the rest of my head.

Next up was the angiogram. That's where they went into my arteries and took pictures of blood flow:


What's most significant here is how relatively small a portion of the thing still has blood flowing through it. The rest is clotted.

I also have a rotating animation from the angiogram, which is kind of fun to watch, though admittedly confusing, because it really does make it look like the aneurysm is on my left side. I really have to confirm that with someone before there's any cutting.

video

Last but certainly not least is the 3D computer rendering of the aneurysm (put your glasses on now). Best I can make out, I actually have a squid in my head; but I am not a medical professional, nor have I ever played one on TV:


So those are the gory details. All of that shown, not much is new. It's been two weeks, these images and more are in the hands of doctors from Maine to Boston to Texas, and I'm awaiting second opinions.

I did have a sleep-deprived EEG this past week, required due to some limited continuation of my seizures. The test showed nothing out of the ordinary. Meaning, I don't seem to have any odd brain activity beyond the periodic mild seizures and my fascination with Dyson Air Multiplier technology (would you seriously pay $300 for a fan?). I did have the dosage on my anti-seizure meds upped a little, but I'm still clear to drive. I was very glad about that, because having my license taken away would have made all of this feel more like a disability, despite feeling fine.

The appointment with this neurologist (as opposed to the neurosurgeon) was also extremely elucidating for me in terms of appreciating my seizures and what actually happens in my brain when I have them. First of all, I came to understand what a seizure truly is: a sudden surge of electricity in the brain. Even more importantly, that my seizures would be characterized as "Simple Partial Seizures" in that they only affect a portion of my brain, I retain consciousness, I remember the events themselves, and my internal surge protector is able to shut down the problem quickly. I'm fortunate in some ways since there isn't a lot of mystery around what's causing the episodes, but there is still a desire to prevent them, since a continuation could result in more complex and less localized symptoms (e.g. convulsions, loss of consciousness).

The doctor said that my symptoms (such as the forgotten song or movie quote that pop into my head) are the aneurysm "tickling" a memory. It's felt somewhere between deja vu and a premonition. But it may have simply been the recollection of a specific time and place. Given that the song was from Elvis Costello and the quote from Star Trek: The Next Generation, it could be back 20 years, to college. That's when I bought my first Elvis Costello album (the very economical Get Happy -- 20 tracks for $2.99 on vinyl). Around the same time, I began the ritual of visiting my friend Dan every Saturday night, to watch the latest episode of ST: TNG while he handed out ping-pong paddles to grad students (work-study). It was very exclusive.

Additionally, in looking at my scans, the neurologist said that my brain has been very "accommodating" to my aneurysm (cordoning off some space, otherwise building around it). Which takes me back to my original question -- what to name it. It's this thing. But it's very much at home now. It's part of my brain. It has access to my innermost innermost. How do you put a name on that?

I don't want to make it so personable I'll miss it if and/when it's gone. I also don't want to create a menace I'll resent every minute it remains in my head. It's probably best not to personify it at all. But that's hard when it's a source of such great conflict. It is a villain, trying to kill me. It is nature, indifferent to the consequences of its actions. But it also turns out to have been a companion, riding shotgun, for one of the most significant decades of my life (marriage, parenthood, home ownership, career change). How can I not imbue it with some level of humanity and/or intent?

This from a man who often buys the dented box at the front of the store shelf, sympathizing with the dejection it must feel having been passed up repeatedly for pristine boxes behind it.

So I don't think I'll be naming the thing; just taking it along for the ride.