What I Learned When I Almost Died - Chris Licht [22]
Exactly twelve hours earlier, at 5:45 A.M., we had been fifteen minutes from airtime. Who knew when I’d get to do another show.
Dr. Deshmukh began by saying the arteries within my brain looked fine. None of the scans—and I’d had three by now—had found the characteristic signs of an aneurysm.
“That,” he said, “doesn’t make me feel any better.”
There was no doubt I had a subarachnoid hemorrhage. And the blood had to have come from somewhere. It wasn’t fiction.
“I am still very nervous about you,” he said. “I am concerned you have an aneurysm that’s not detected. In a week, it may show up. If and when we find it, we go in and get it.”
Sometimes, it can even take three cerebral angiograms to locate the weak point in the arterial system. Clearly, I would be at George Washington for a while. If nothing were found during a second angio, Dr. Deshmukh said, maybe I could go home in two weeks.
Two weeks.
Lots of patients are hospitalized for their ailments far longer, but two weeks seemed an eternity to someone who had never been in a hospital. My headaches would last even longer, Dr. Deshmukh said, until the runaway blood was absorbed back into my system.
He did not go into detail about what “go in and get it” meant, but there are two common ways. One involves an interior journey very much like the cerebral angiogram. A catheter is pushed through the patient’s arteries, this time all the way to the scene of the crime. A coil of wire—thinner than a strand of hair—is pushed through the catheter and jammed into the balloon of the aneurysm. That fills it and seals it off from the artery, eliminating the weak spot through which blood has escaped.
Sometimes, though, the balloon is so tiny no coil can fit inside. Or sometimes its neck is so wide any coil shoved inside will fall back out, dropping into the main bloodstream, where it could lead to a stroke. In those cases, the second type of fix is used: brain surgery.
Dr. Deshmukh felt I was a candidate for number two, but he kept that to himself. He hadn’t found an aneurysm, which probably meant mine was really, really small and coiling would probably not be possible. Instead, when he found the microscopic assailant, he would go in through the skull and pinch off the aneurysm with a titanium clip. It’s not as awful or dangerous as it sounds, he says. Surgery is more invasive than going the interior route, yes, but getting rid of aneurysms this way has been done for half a century.
If I had known brain surgery was in my future, however, I wouldn’t have felt better that it had been done for half a century.
Dr. Deshmukh could not close off the aneurysm by either means, of course, if he could not find it. For now, he was calling a halt to the hunt. He does not like to do cerebral angiograms one after another in a constant quest for the aneurysm. For one thing, the procedure itself has risk. And in the immediate aftermath of a rupture, the body can camouflage the scene, and it can take several days for things to settle and the aneurysm become easier to see. Because he hadn’t seen mine after the first angio, there was a chance it was being obscured in just this way. It made little sense to search again so soon. He would do a second cerebral angiogram a week from today.
Until then, we had to be alert for any neurological sign that the aneurysm, wherever it was, was rupturing a second time. The odds of that were not great and they diminished each day, but the threat was real. He did not say this either, but Dr. Deshmukh has had patients who survive the initial rupture, are safely ensconced in the intensive care unit, and then suffer new bleeding and die before they can get to surgery.
In other words, patients who were in precisely my situation.
My ignorance was my happiness.
But maybe it wasn’t an aneurysm, the doctor went on. In about 15 percent of cases, no definitive