Sunday, October 27, 2019

I Can Hear the Ocean From Here

I've catalogued this post as a Medical Update, but I could just as easily filed it under, No News is Good News. For months I've thought about writing but didn't want to do so until I had some answers. So consider this an answer to a question you didn't realize had been asked, knowing it has a pleasant resolution and "fun" pictures of my brain.

It all began in July. I'd gone to Chicago for the Disability: IN disability inclusion conference and woke up one morning with a whooshing in my right ear. It seemed to be synchronized with my heartbeat, which was both distracting and oddly comforting (sometimes it's nice to have concrete evidence that my heart is still beating). A little research put a name to it -- Pulsatile Tinnitus ("standard" Tinnitus is ringing in your ears). I recalled that thirty years earlier, I'd passingly experienced something similar. When it happened, I'd put my ear against my girlfriend's to see if she could also hear the waves crashing on the far off beach of my brain (she could not). Needless to say, that phenomenon did not remain persistent over the months or years. And my perception of it as an invincible nineteen-year-old was not one of concern. It was an oddity, possibly super natural or telepathic in origins. But my forty nine-year-old, extremely vincible self takes serious note of any changes in my brain activity (say, something that falls in the realm of auditory hallucination). Especially since my original, mild seizures eventually manifested themselves with a ringing in my ear, I began to wonder if my aneurysm had started to wave its arms and jump up and down those many years ago. It seemed unlikely, since the seizures had been caused by the mass effect of my giant aneurysm (humble brag), and my 1989 aneurysm should have been quite tiny compared to 2010. Nevertheless, I scheduled a check-in with my neurologist on my return. There wasn't a lot of concern expressed -- only the suggestion that I monitor it and get the wax cleaned out of my ears. A CTA  was scheduled to see if anything new was going on in my head.

Of course, these things take time. Radiology was backed up, there was nothing "emergent" about my condition, and I couldn't get a scan scheduled until the end of September. I was able to fairly quickly get in to see my Primary Care Physician for the wax flush  and reach out to my neurosurgeon in Boston, but that only confirmed the call for a CTA. The whooshing and clicking (yes, sometimes it's a clicking) diminished some or was limited to when I was lying down, but it also evolved into a ringing, at times persistently. I began to wonder if this was the thing I was going to have to just get used to this year (up until then, it had been reflux related to my esophageal surgery). I also began to piece together a timeline of events that pointed to a pharmaceutical cause, not a cerebrovascular. In Chicago, I briefly ran out of Lexapro, which I knew from previous experience caused "brain zaps" as a withdrawal symptom. After some research, I discovered that Tinnitus can also be a Lexapro withdrawal symptom, if not a general side effect of its use. So I tried to just get on with it, doing my annual Aneurysm 5K ride and taking a business trip to Chattanooga. Having survived both, I was ready for my CTA. The technicians didn't run out of the room screaming (always a good sign), and the radiologist's report came back the next day with a definitive, " It ain't pretty up there, but there's nothing new in the last nine years."). All my neurological doctors confirmed that finding, even going so far as to say I can wait five years for another scan (surprisingly, it had been five since my last!). As usual, I learned a few new words:
  • Patent: Open, unobstructed
  • attenuated: weakened or diminished capacity, but not in a concerning or unexpected way
  • Encephalomalacia: the softening or loss of brain tissue after cerebral infarction (i.e stroke)
  • ex-vacuo dilatationventricles can expand when there is loss of brain matter (i.e. Encephalomalacia)
  • Grossly intact: areas of my brain do not show any evident irregularities 
  • cerumen: ear wax (apparently, they didn't get it all)

Learn  pronou
technical term for earwax.
So without further ado, here's a collection of my favorite pics, as well as some quick flip-book videos of the scan "series"):
Brain Cloud
Bobby Pins
Nice blood flow
The missing piece and a shimmer of aneurysm clip
Goalie mask
Head on


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