How I Almost Lost My Husband

How I Almost Lost My Husband

 

            It was a beautiful spring morning in April, 2003.  My husband, Tom, had been struggling with back pain for many years and his neurologist had scheduled him for an MRI.  Tom is incredibly claustrophobic and therefore could not be slid back into the closed MRI machine until the valium had him completely incapacitated.  Since he was out like a light, the good doctor decided at the last minute to have the technician include Tom’s brain in the scan.  He wouldn’t be moving for a while anyways.  The addition was due to some minor extra reflexes in his right leg.  While the procedure is taking place, the receptionist gives me and our 2 year old son, Zach, meal tickets for the hospital cafeteria.  KDMC has pretty good cafeteria food, obviously not what they feed their patients, so off we go.  Zach and I have barely started eating our breakfast when in walks one of the nurses pushing Tom in a wheelchair.  He is still pretty sedated and doesn’t look like he really knows what is going on or where he is.  I thought this strange and wondered why she didn’t just let him wake up more.  I would have come back for him.  It hadn’t even been the 45 minutes they said the scan would take.  She wheels him over and tells me that as soon as he wakes up we are to go immediately up to the neurologist’s office.  When Tom finally is lucid we joke about the doctor having such a bad bedside manner that he probably didn’t have any other patients to see that day and thought he would go ahead and give us Tom’s results since we were already there.  When in doubt, make jokes.

            We arrive in his office waiting room and let the receptionist know we are there.  The doctor comes up to the little hole in the receptionist’s glass window and proceeds to give us the results of the scan.  So much for patient confidentiality, everyone in the very full waiting room heard the news.  Tom had a giant fusiform brain stem aneurysm.  We might have been wrong about the lack of patients for the day, but our view of his doctor’s bedside manner was spot on.  We are stunned at the news.  There we stand in the crowded waiting room, I’m holding Zach.  “What do we do?” we ask the good doctor.  He informs us he has scheduled Tom an appointment at his family physician’s to discuss the matter further, but he wants Tom to be admitted to KDMC pending surgery. 

            From the next appointment we learn that the aneurysm is so large that it wouldn’t make a difference if Tom was in the hospital or not if it ruptured.  There would be no saving him.  It was over an inch in diameter, 2.57cm (100cm = 1m) to be exact.  To give some perspective, most brain aneurysms are measured in millimeters (1000mm = 1m) not centimeters.  This was huge!  Possibly a record.  We begin our quest to find a doctor with the credentials to treat this condition.  We find 3 who are most qualified.  One happens to be at UK Medical Center in Lexington, KY.  Just 1 ½ hours away.  We set up the appointment and the next leg of our journey begins.

            One of my first questions for this next doctor and I try to ask it as un-rudely as possible, is “Why exactly is someone with your training in Kentucky?”   He had completed dual fellowships in neurosurgery and vascular surgery, from Johns Hopkins.  He stated that in Boston he had to wait his turn to get the really interesting cases, in KY he was top dog and got them all.  We could respect that.  He informed us that removing the aneurysm was a bad choice.  Most aneurysms are weak places on an artery wall that balloon out.  They have a “neck” that can be clipped from the outside or blocked from the inside.  This restores the normal shape of the artery and all is well.  Tom’s is different.  His aneurysm is fusiform, meaning it is a weak section of the artery extending all the way around the blood vessel.  Since it is on his brain stem, it cannot be removed.  There are nerves from the brain on their way to the spinal cord that are covering the outside of the aneurysm.  These nerves are fine as hairs and if damaged Tom could need physical therapy to relearn how to talk, eat and walk, he could lose the ability to breathe on his own and end up on a respirator, he might be in a permanent coma or he could die.  None of these are acceptable to an otherwise healthy 40 year old man. 

            Another option is for Tom to do nothing.  There was no way to tell how long the defect had been there, silently lurking.  Oddly enough, it had not caused any symptoms.  His back pain was due to severe arthritis.  It could be a birth defect or it could have formed in the last month.  It could last the rest of Tom’s life without rupturing or it could rupture on the way home.  Again, not a good option considering Tom hopefully had another 40 or 50 years in him. 

            We choose the third option, to close down the artery all together.  First the surgeon performed a myriad of diagnostic tests to know everything he could before he ventured inside Tom’s brain.  To do the procedure, he snaked catheters through Tom’s arteries in his legs all the way up to his brain stem.  He inserted titanium coils into the giant aneurysm in order to block the blood flow and cause it to form a giant blood clot.  The clot would restrict blood flow thereby eliminating the blood pressure that could cause the aneurysm to grow and burst.  The procedure went well and I was able to visit with Tom in the neurosurgical ICU later that day.  He stayed in ICU another 4 days until he was released into a regular hospital room and then sent home.

            Life did not return to normal as the doctors predicted.  Tom intermittently has headaches, blurred or double vision, balance issues, memory loss, and various other side effects from the surgery.  There doesn’t seem to be a rhyme or reason as to which if any side effects he will have from day to day.  But he is still Tom; my wonderful husband and our children’s wonderful father.  He is still the man whom I love and loves me back.   We are grateful for each and everyday.

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