Tuesday, August 28, 2012

Cracking the Coconut

Remarkable times we live in, eh? Very infrequently in this on-demand, instant streaming, real-time world must we resort to deferred gratification, which is why I felt so compelled to compile this assortment of images after receiving a copy of my ER Catscan of a few weeks ago. When I made my request from the radiology library, they reminded me I also had a scan on file from November 2010, and I realized my brain scan trading card collection was incomplete and just had to order it. I had scans from prior my surgeries, scans following my aneurysmectomy and cranioplasty, but nothing from between the time of my craniectomy and the subsequent artificial "bone flap" replacement. Given how much the jellyfish has affected my life, I've paid relatively little attention to its tank, even though (seizure aside) my healing skull is probably the thing I'm most conscious of above my neck. I continue to have mild headaches (which I'm told are normal), as well as an awareness of clicking sounds at times, especially when I wiggle my ears. That too is a relatively normal part of the healing process as the tectonic plates of my cranium fuse. That process is made slightly more difficult by the fact that bone is mending with plastic. Mostly for my own curiosity and at times disgust, I've assembled the following images, which offer a timeline of the ins and outs of my head. I've added captions for the blog itself, but they probably won't come across if you receive an e-mail of this entry. Remember, left and right are reversed in the scans:
My first CT, from 7/9/10. My skull is intact, and my brain is relatively "unremarkable" (so said the report), aside from the giant aneurysm lurking outside the reach of this particular scan section.
11/24/10, post surgery. You can see the glint of clips holding the arteries and a fairly significant missing piece of noggin. This scan actually provided the measurements used to fabricate my artificial piece of cranium.

10/31/10. By far the most disturbing picture I found. At first, I honestly thought someone had PhotoShopped it with a warping tool. And to think people didn't run away screaming.
Early November 2010. A complete tonic to the previous picture and a reminder of the beautifully-decorated helmet I had to wear whenever out of bed (Did I mention I was missing part of my skull?)

8/7/12. The shine is still the arterial clips. My skull's a bit rounder, but you can see (on, the left, which is the right) that it's not perfectly healed.
cool scars.
8/28/12. None of these are of my good side, if I even have one,but it's settling in.

 I hope you enjoyed this trip down Memory Lane by way of Cerebral Cortex Junction. Putting this together actually gave me the first chance to share some of my scans with the kids. Of course, Gus now keeps asking to see my brain. I've assured him there's only one person I trust to do that.

Wednesday, August 15, 2012

What is Sick?

 First off, I appreciate everyone's good wishes regarding last week's event, including the fact that those  wishes often came in the form of, "Enough already!" outrage. It's nice to know everyone else is is as tired of my drama as we are.

This afternoon I did have a good seizure-follow-up appointment with my neurologist, which helped clarify the nature and origin of my electrical malfunction – he felt it was merely an indicator of ongoing healing in my brain (i.e. a reaction to scarring caused by my surgery and stroke). He was also fairly confident that the increase in my anti-seizure medication has a good chance of preventing future events. He reassured us that additional seizures would be unlikely to cause permanent damage and that if they were to occur in my sleep (as last week's did), there would be little or no need for emergent medical intervention (though Jamie did the right thing by calling an ambulance, since it was a new development for me). Over all, he wasn't able to offer much that was definitive, aside from confirming that the CAT scan taken in the ER did not show any new damage or bleeding. Mostly, he cemented the fact that the brain remains a mystery, even for someone who specializes in studying it. That's one of the reasons I've always enjoyed him as a doctor. For instance, he was genuinely tickled today when I recounted that my left arm shakes reflexively when I rub my left eye."I guess there's some kind of connection there," he said, adjusting the bow tie he always wears.

As much as I'm glad to have some level of clearance to return to my status quo, it's also been hard not to ponder the meaning of any change in my condition, going so far as waking myself during the night, only to then offer consolatory amazement at my consciousness, as if that awareness alone could stave off future attacks.

It has been frightening for the past week, being reminded of illness or weakness or however one wants to do describe my condition. While my kids know more about aneurysms and strokes than I'd prefer, it's generally easiest to say I "was sick" (past tense) in answer to questions about why I'm so slow and need a cane. It's still strange for me to think of the aneurysm and stroke as an illness or ongoing condition (and have not felt it's been a degenerative condition for quite some time). They feel like historic events or waves which swept me up and deposited me in my current state. In the ER -- when relaying my medical history -- the nurses often said I'd previously suffered a CVA (cerebrovascular accident). It's an odd term but fitting -- like I was hit by a bus. My hemipalegia, muscle spasms, and seizures are merely after effects of that accident, some horrible mistake.

So the good news is that for now I remain stable. This turn of events may put my return to driving on hold for at least three months, but the adjustment to my medication should represent adequate intervention for continuing progress. There's no need for me to curb my return to work (now fulltime in the office) or slow physical efforts. Onward and slowly, carefully upward.

Tuesday, August 07, 2012

A False Sense of Security

The title of this entry is inspired by how much we had settled into the "new normal" of our lives, including the ability to go to sleep each night with relative lack of worry. For me that was in part a gift of nearly 2 years passing without much incident, health wise. Also, what I consider part of the "WTF?"reaction to trauma. As much as I somewhat believe life hands you only what you can handle, and that there are good lessons to learn from challenges, there is also part of me that believed– or at least wants to believe – that misery begets a certain amount of immunity. Life's unfair, but it's nice to think there is some balancing act at work.

When I went to bed last night, I had no reason to suspect that I would not wake up in my own bed. All things considered, I've been feeling fine. As it turned out, when my eyes opened this morning, I was in an ambulance headed to the Emergency Room. While I had experienced seizures early in my health crisis, they were mild and manifested themselves as a sense of déjà vu and anxiety. In actuality, those seizures helped save my life, since without them I would never have received the MRI which identified my aneurysm. While I was immediately put on anti-seizure meds, my neurologist believed they were caused by the physical interaction of my aneurysm with the rest of my brain.  my surgery supported that hypothesis, since I hadn't had a conscious seizure since. Early this morning, however, I experienced what I would consider a much more traditional seizure. Often in the morning – when waking – I have some spasms on my left side, caused by my yawns'neural misfires. At first, Jamie thought my thrashing today was just that. Once she realized I was struggling to breathe a bit, she called 9-1-1 (for me) and her mother (to watch the kids). Though the EMTs arrived quickly, she did have time to get me on the floor and start CPR. In retrospect, that may have not been necessary, but it's a good reminder of  lessons learned long ago – that chest compressions should be performed to the beat of the Bee Gees' "Staying Alive" and that you cannot perform proper CPR while someone is lying on a mattress (which she recalled from Michael Jackson's death).

So the important thing is that despite the trauma of the way she was awakened and the fact that Wyatt unfortunately entered our bedroom while the paramedics were working on me, I was and am no worse for the wear. I did bite my tongue in a few places as well as Jamie's fingers while she was trying to unlock my jaw, my left shoulder hurts a bit from its standard slight dislocation and the fact that Jaime pulled me off the bed using my left arm. I also lost patches of hair from my legs, arms, and chest where EKG leads were attached at the hospital. They did a quick Cat Scan which thankfully showed nothing new and  took some blood work, which should show whether my anti-seizure medication is dosed to low. For now, they have increased it slightly. I'll see my neurologist next week and see if he thinks any more action need be taken. There's nothing anyone can point to as an obvious cause. Recently, I have not been more stressed or exerting myself more. I had been told previously that even mild seizures could lead to stronger ones. So maybe if I had been having them in my sleep.... I am certainly hoping that the extra thousand milligrams of medication today at least allow me to wake in the same place I slumber.