September is National Brain Aneurysm Awareness Month

Hey, look, it’s September, and that means, once again, that it’s Brain Aneurysm Awareness Month!

In much the same way that Thanksgiving and Christmas have become occasions for annual reposts over at the animals’ blog, it seems that one post in September is going to be dedicated to revisiting The Event. This year, rather than just link back to all the original posts (although I’m still doing that too), I thought I would reproduce the first of the Event posts in its entirety, since that’s the one that includes most of the helpful tips about what to look for and what to do (and, uh, what not to do) should aneurysm troubles come your way. Read on for more!


Thursday 11/7/2019: Emergency Room & ICU

So November 7th, 2019, was the day I could have died three different ways before breakfast.

It started out like an ordinary Thursday, with the feeding the cats and the dog and the drinking the coffee and the checking the emails and the working on the book and all that stuff. But then around 8:45am, while I was using the, ah, facilities*, I had a sudden, severe attack of vertigo. Not the head rush kind of vertigo where you’re a little dizzy for a few seconds after standing up quickly, but a kind of room-darkening, can’t straighten up, somebody’s-squeezing-you-in-a-giant-fist vertigo that I’ve never experienced before and hope to never experience again. This lasted for what seemed like a few minutes, though it may have been a few seconds. After it ended I was left with a cold sweat and a strange new sort of ache across the back of my head and into my shoulders. Denial not being just a river in Egypt, the first thing I thought was:

Me: “Maybe I’ll skip the Bowflex today.”

I progressed from there to thinking that maybe I should make an appointment with my doctor to thinking maybe I should call 911, just in case something really bad was happening**. I went into the bedroom to let the dog out into the backyard and then got dressed, because of course I couldn’t call 911 while I was in my robe and pajamas. (Pro tip: Don’t do this. This is silly. Whatever you’re wearing, the paramedics will have seen it before, and when you get to the hospital they’re just going to undress you anyway.) Then I went to get the phone from the kitchen, which, as has since been pointed out to me several times, was not the nearest phone to where I was. But it is the phone I use most often. So that’s the one I went to. (What can I say? I obviously wasn’t thinking very clearly at this point.)

On the way to the kitchen I suddenly got a severe headache in the top of my head, as if someone had dropped an anvil on me. It’s funny when it happens to Wile E. Coyote, less so when it happens to you. I still managed to make it to the phone, but I couldn’t seem to get it to dial 911. So obviously the phone was defective. I then proceeded to the living room to get a different phone which would, presumably, work better.

Not long after that, I woke up on the living room floor with the phone next to me, in the approximately 18 inch gap between the sofa and the extremely hard, heavy, and pointy-cornered coffee table.

table
The space where I took a nap for a while.

Upon waking up I discovered that I had vomited on the sofa and the nice clean clothes I had put on for 911 (told you getting dressed was silly). It was now 9:13am according to the clock on the mantel. So the three ways I could have already been dead at this point were:

  • I could have just not woken up.
  • I could have cracked my skull on the coffee table.
  • I could have aspirated the vomit after throwing up while unconscious.

Miraculously, none of that had happened. I managed to pick up the phone, which still didn’t seem to me to be working properly, even though it was. I didn’t realize I had successfully dialed 911 until I heard a faint tinny voice frantically saying “Hello? Hello?” Remembering that I needed to hold the phone to my ear and mouth instead of carrying it around like a banana, I managed to give 911 my address and followed their instructions to unlock the front door, get my cell phone, and put away the pets—well, one pet, anyway; I found Chaplin and got him into the cat room. Lulu was still out back, and I couldn’t find Charlee. That was all right, though, as there was zero chance Charlee would come out from under the sofa or wherever she was hiding while strange people were in the house. Such as paramedics.

Said paramedics arrived before I was even finished talking to the 911 dispatcher. I went out to meet them but they steered me back into the house for a brief chat and evaluation. I described what had happened and they asked a few questions. I only really recall one of them.

Paramedic: “Did you throw up?”
Me: “I think so, but I don’t remember.”
Paramedic: “Well, it smells like you did.”

Since I had in fact thrown up on myself, that smell followed me around for a while.

At this point the paramedics walked me down to the ambulance and off we went. Within a few minutes my phone rang; a neighbor had seen the ambulance and alerted our friends around the corner and one of them was calling to check on me. I didn’t manage to pick up the call, but I did manage to call them back from the ambulance. (Technology!) We had a brief conversation that went something like this:

Friend #1: “Are you okay?”
Me: “I’m with the paramedics.”
Friend #1: “Are. You. Okay.”
Me: “They said my vitals are good.”
Friend #1: “All right. Do you need me to call anyone?”
Me: “Can you call Lulu into the house? She’s out in the yard.”
Friend #1: “All right. Can I call anyone else?”
Me: “Can you call Lulu into the house?”
Friend #1 (pause): “Okay.”

Needless to say my friend also called my wife. Good judgment there.

After this my recollections of Thursday get kind of murky. I don’t think I opened my eyes for more than a minute for the entire rest of the day, and I only remember bits and pieces of events and conversations, like this:

Me (to paramedic in ambulance): “I hate to make a fuss.”

If the paramedic answered me, I don’t remember it. I did wake up briefly when we got to the hospital and I was unloaded from the ambulance; I remember seeing the sign for Emergency. Some time later I realized I was actually in the emergency room and people were talking to me, or trying to. I managed to answer one question from a doctor:

Doctor: “Have you ever had anything like this before?”
Me: “I had an anxiety attack once.”
Doctor: “This isn’t that.”

I remember hearing someone say that my wife had arrived, and I remember hearing the doctor tell her that I was very sick and not stable to transport. I have been informed that I told the ER doctor that this wasn’t the worst headache I’d ever had. (I am prepared to revise that statement.) I have also been informed that I apparently really, really had to pee. I vaguely recall being given one of those urinals you can use in bed, but I didn’t have much luck with it and eventually they had to catheterize me, and according to my wife they had to do it in a hurry because I kept trying to get out of bed to go find the bathroom, and obviously nobody was going to let that happen. (They would have catheterized me eventually anyway, given what was going on, but the rushed nature of the insertion came back to bite me, as you will see later.)

At some point someone said or I had heard enough discussion to figure out that I had a ruptured cerebral aneurysm. Much later, I discovered, from reading the ER notes in my hospital file—which I had to pick up so it could be entered into the system at my primary care clinic—that I had been graded a three on a subarachnoid hemorrhage evaluation scale. The notes don’t specify which scale was used but I suspect it was the Hunt and Hess grading system, which I found online during one of my many searches on all the new terminology I learned over the course of last November. This scale includes both evaluation criteria and a rough estimate of the patient’s chances of survival:

HuntAndHess
Never tell me the odds.

Spoiler alert: I survived. Most of that day is pretty much a big grey smear across my memory, though; I don’t remember being catheterized, or all the blood work they drew, or being taken for CAT scans, or being admitted to the hospital and brought to ICU. But that’s probably for the best.

* Toilets: Killing people basically since they were invented.
** It was.


The links to the original six-part series appear below. If you got here, you already either read or skipped over Part One, but still, for the sake of completeness, a link to Part One is included, because it would look kind of funny to just start with Part Two, right? I mean, after all, it’s not like this is “Star Wars” and we’re kicking things off with Episode IV.

The Event, Part One

The Event, Part Two

The Event, Part Three

The Event, Part Four

The Event, Part Five

The Event, Part Six

Part Two is mostly concerned with the surgical intervention to treat the aneurysm with platinum coils, while the remainder cover my hospital stay, from cycling through various departments to finally getting discharged and going home. It has a fairly happy ending, but a lot of times this sort of thing doesn’t. One thing you can do to help your odds if it happens to you: Don’t bother getting dressed before you call 911.

16 thoughts on “September is National Brain Aneurysm Awareness Month

  1. I am ever so amazed that it was all working out for your well being, James. You indeed are a living miracle and a blessing to all who read your story, and learn from it. Thank you for documenting it so well.
    Health care these days is SO much more able to deal with these things…when I was working in Neuro rehab, we would get survivors of aneurysms there, but they were often very permanently compromised, neurologically, such as when someone has a major debilitating stroke, and they would end up in long term care if they even survived.

    Way back in 2011 or 12…I had a brain CT scan, for a mother of all headaches so that I was almost nonfunctional from the pain, but thankfully it was negative for anything like an tumor or an aneurysm…it was Mono. (Triggered by a flu shot – Go figure!)

    Enjoy every new day, they are all gifts to us, aren’t they?!

    Liked by 4 people

    1. Yeah, an old (well, from 2002 … it’s thirty-seven, it’s not old) article in the Times about rupture cerebral aneurysms described them as “spectacularly fatal” and while that’s not quite as true as it used to be, they remain nothing you want …

      Like

  2. “I have been informed that I told the ER doctor that this wasn’t the worst headache I’d ever had. (I am prepared to revise that statement.)” Hah, you think?! 😂

    I love the chuckles and the lighter tone but jees, what you went through was terrifying and you came pretty close to the edge. Not living-on-the-wild-side kind of edge either.

    I know I’ve read your account of The Event before, but reading this all here really does hit home and it’s a good reminder for a lot of things – don’t go ready for calling emergency services (my mother got dressed and tried to straighten her hair before I took her in for what turned out to be a heart attack), the phone you want for 911/999 is the nearest one not the most used one, and when you pass out make sure it’s not near any hard or sharp surfaces! I face planted the bathroom door handle a couple of weeks ago and realised belatedly that I could have lost an eye. The situation you were in had much more severe potential consequences of course and I am very grateful to whoever is pulling the strings ‘up there’ that you came through the other side okay.

    The symptoms you had do sound similar to what happened to me, even though mine wasn’t an aneurysm (I don’t think, anyway). My head just nearly exploded. Not that it’s documented in my medical records because I couldn’t get the help I needed but never mind. “Nearly had her head explode due to too much fluid” wasn’t really something I wanted on there anywhere. It’s startling in a weird and sometimes underwhelming way when you come near to death. Almost like it didn’t happen to you or it wasn’t that big a deal. Maybe it’s just that it doesn’t sink in, or we can distract ourselves from it or joke it off, I don’t know. That’s me, anyway. I don’t know if it felt and feels different for you?

    Anyway, thank you for writing this all up for new and pre-existing readers. Your experience and the information you present is priceless to share. Many people will know roughly what things like a heart attack, stroke or aneurysm are or how they present, and yet if it actually happens, so few realise that’s what it is. Those delays and debates over whether to seek emergency help can cost someone their life. It sounds like toilets can also cost someone their life – Thanks for that link, which I was stupid enough to click. Now I’m going to be worried that a black widow spider is going to be under the toilet seat. I feel bad for Godfrey The Hunchback though; murdered by a clever villain who took up position beneath the toilet somehow and shoved a sword up Hunchback’s bum, a wound that took several days to actually kill him.

    Thank you again for your efforts & for so openly sharing your experience with us all. Stay well & away from hospital!

    Caz xxxx

    Liked by 1 person

    1. I remember your post about passing out and hitting your head and I was concerned that it might have been something like what happened to me. I’m very glad it wasn’t an aneurysm, although it’s terrible that you couldn’t get proper care afterwards. I got pretty lucky with my care in that an excellent neurosurgeon from Scripps, which is my primary care clinic, happened to be on duty at the hospital. (The hospital has fairly poor ratings on Yelp ― yes, they rate hospitals on Yelp, apparently ― but I have few complaints.)

      A lot of people in the aneurysm group I belong to on Facebook report survivors’ guilt from knowing so many people don’t make it with this condition. I don’t have that, but I do have days where I’m weirdly anxious for no apparent reason, and other times when things don’t seem quite real, as in, am I really still here? But those feelings pass. I’m pretty good at not thinking about things, I guess. 🤔 Anyway like I’ve said in that group, quoting the old Wallflowers song “One Headlight” ― “Man I ain’t changed, but I know I ain’t the same”.

      There were plenty of interesting toilet-related deaths at that link, weren’t there? If we were including fictional ones, we might add what happened to Tywin Lannister, when he said the wrong thing to the wrong crossbow-toting person while he (Tywin) was sitting on the commode …

      Liked by 1 person

    1. I’m sorry to hear about your uncle! Once it happened to me, my family and I started becoming aware of more occurrences both to well-known people in the news (like Grant Imahara of “Mythbusters”) and among friends and acquaintances, and the stories reinforce just exactly how lucky I was to have the outcome I did.

      Liked by 1 person

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