Monday, September 20, 2010

The First Step is Admitting You Have a Problem

On Friday, I went down to Mass General for "Preadmission Testing". For some reason that sounds like I need to come to terms with something before they'll let me in the hospital. Or, that they needed to do some poking and prodding to make sure I'm ready to say something.

That probing mostly involved documenting my medical history (again), talking to an anesthesiologist, and having various tests performed -- an EKG, blood pressure reading, weight check, blood work, cup filling, and chest x-ray. All pretty uneventful. Or, at least I have no results yet which make those tests eventful. Though I do always find peeing in a cup kind of exilerating. There's that moment when you have to pull the cup away just in the nick of time. It requires split-second timing and steady hands. Don't want to underfill. Don't want to overfill. Don't want to spill. What a rush.

So now that I've been through that testing, I'm ready to admit something -- I'm pretty damn terrified. I'm not saying I don't remain optimistic, and my brave face isn't all facade. But with the clock ticking down to a week from today, reality is definitely sinking in.

I've had the luxury of time. 40 years. But mostly the past three months. I've had time to contemplate what's happening to me, what's happening to my family, to make plans, to take action. But, of course, it always comes down to the wire.

It's also somewhat akin to getting married or having a baby. A lot of energy is put into the preparation for and anticipation of an event. As if the event is the thing that needs the most attention. Not to anger the bridezilla and/or What to Expect When You're Expecting set. The preparation for the event is important. But the work, the real work, comes after. Getting married is easy. Having a baby is relatively easy. Being a successful spouse and parent -- that's damn hard.

On September 27th, I will hopefully be divorced from/deliver a 4 cm giant aneurysm. What comes after, no one knows. On paper it's 1-2 days in the Neurological Intensive Care Unit (the other NICU), then 2-3 days on the regular neuro floor. Recovery? Maybe 6-8 weeks at home. But those are all rough estimates.

On Friday we met with the surgeon one more time before the day, which was good because it cemented the fact that we think he's "the guy". Even when he seemed to think my surgery was scheduled for today. That would have been funny, if it turned out I had less than the week I thought I had. Or that he wasn't available on the 27th. Downright hilarious.

We talked a bit more about the surgery, though there's a ton that's up in the air. And plenty that I don't really care to know until after the fact. I do now know where my scar will be -- right top front, mostly "above the hairline" -- that means less and less every year. I may end up with other scars as well, on my neck and leg; if a bypass is required, they'll take a vessel from my leg and run it from my carotid artery to my brain. Hopefully, on the inside. I'm a little unclear why exactly my leg doesn't need that blood vessel, but he didn't say anything about taking the whole leg. So I'll trust he knows what he's talking about.

I also may have [another] hole in my groin; they'll most likely do another angiogram to make sure blood is flowing to all the places it should be (and none of the places it shouldn't), before putting me completely back together. Makes sense.

Aside from the simple fact that it's brain surgery, the complicated thing(s) about my aneurysm (have I mentioned it's "giant"?) is the clotting and calcification which have formed over time. That means there's a fair amount to get through (aside from my skull and my brain). And that the aneurysm can't simply be clipped and drained. I guess smaller, more fluid ones are accommodating like that -- they'll just collapse. But he'll need to maneuver around and take it apart piece by piece. That's actually best case. The other possibility is that the clotted portions and/or the calcification may have glommed on to smaller blood vessels in my brain. And tearing those while removing the pieces would be bad. Bleeding and/or stroke kind of bad. Fairly localized, which is good. But still the bad side of good.

So if he finds a lot glomming, he would perform the bypass. The idea is that by running the major artery around the aneurysm, they can then remove it without needing to worry about what's stuck to it. Problem there is that he'd need to intentionally cut off the flow of blood to my brain while that was taking place. Pretty much guaranteeing a stroke.

Thus the terror. But, looking on the bright side...hold on. I know I've got it here somewhere...right, there it is: I'm young and otherwise healthy. I've been told that a number of times. So that's nice. Kind of like being carded while buying a bottle of wine at the grocery store. Turning 40 did not make me feel young. Taking merely adequate care of my body through less than moderate exercise and a remotely nutritious diet haven't made me feel healthy. But when it comes to having major surgery, I'm "young and healthy". So I've got that going for me.

Also on the bright side, there aren't any pain receptors in your skull or brain. So if it turns out the only incision is in my head, the pain shouldn't be too bad.

Concerns, for my doctor, me, and for my family, are on neurological damage and the D-word. I'm certainly trying not to focus on that (gotta accentuate the positive), but I have to consider it. It would be unrealistic and somewhat irresponsible to not account for the Dark Side while making my preparations. Got my Will. Got my Living Will. Still need to work on letters to the boys (there's absolutely no generic form to fill out there). Wrapping up/handing off/documenting projects at work (in case I'm unable to do them afterward or need the help of Past Ken to teach Future Ken how to do things). Come to think of it, I should write myself a letter. Then again, I suppose in some ways this blog is that letter.

Really, on the whole, the preparations have been good. I had a great visit with my family in New Jersey. I've had quality time with my family here. I got to see Wyatt off to kindergarten and Gus off to nursery school. Jamie and I have had nights out in New York and on a Maine lake. I have three Happy Hours scheduled for this week. I'm writing here as much as time will allow. So I'm covering my bases, I'm preparing. I'm trying to fulfill my tangible obligations, let my loved ones know how much they mean to me, and get some personal fulfillment to boot. But I'll never be "ready".

Because I know the hard work comes after next Monday, for me and others.


  1. You never cease to amaze me Ken. We're here for you and your family. -Shane, Jill and Phoebe

  2. DAMN you're a good writer.

    Get better, you.

  3. To hell with political correctness - I'm lighting a candle for you. God Bless.

  4. Ken - I just heard from Sue D. about what you've been going through, and am stunned. I'm so sorry that you and your family have had to face this. I can't imagine what it's been like--although, as Julie notes above, you are still very good at expressing what you mean through writing.

    My thoughts are with you as you go into surgery this week. I hope that everything goes perfectly. Sending you and yours my best wishes, hope, and love - ("Gail") Haruko Yamauchi

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