Brush with Death - Part 4

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On the same day that the LOML found me, April 29, the hospital team commenced the embolization and early on accidentally ruptured a vessel. They managed to stop the bleeding, but the hemorrhage was worsened. By that time my family was there.

My Boss, Dr. M, was worried, telephoned the hospital and spoke to Adam. Adam said that he did not fully understand what was wrong with me, but did AVM mean anything to her. Dr. M responded that it did. Great excuse for missing a review, don’t you think?

Evie has since written to me:

I think I had to wait a while until the woman doctor came out, or until Dr. L came around to explain to me what an AVM is and what had happened to you. Knowing about it did not help me feel better about it. Dr. L was gravely, and I mean, even for Dr. L, gravely concerned. He seemed to be holding back something. But he did share that your prognosis was unknown and that you were very, very ill.

He also explained that the docs would try to stop the bleeding, which in your case had already stopped from a tamponade effect (pressure from the blood already present restricts more bleeding), and prevent more bleeds by injecting glue into suspected spots. I think that’s what they were doing.

I sat in a plastic chair in the hallway with my head hanging down and my elbows on my knees looking at the floor for a few hours. I was the most depressed than I have been in my lifetime, too depressed to cry or talk. I think Adam and Mom were looking at me and trying to fathom where I was. I felt further away from you than I ever have. Mom asked if there was anything at all she could do to help me. I said no.

I don’t remember what the others might have been talking about, except that your husband filled me in on more details of the day and I remember thinking that he would probably start torturing himself about not finding you sooner. He didn’t deserve that torture, but I didn’t know a way to prevent the eventual thoughts he’d have about it.

The doctor came out again around 9pm or so to say that she was sorry, that she had accidentally punctured another small vessel in your brain trying to get into a tight spot. I tried to stay in my calculating brain understanding what she was saying, as if that ability would be crucial to your survival. I thought she was quite candid about it. So, she said you were being prepped for emergency brain surgery. I just didn’t know what to make of this, but I knew that emergency surgery was never a first choice.

She said there was a chance that we’d be able to see you before surgery and we all went running around the halls to see if we could. I so much wanted to see you and wondered if it would be my last chance to see you alive. I think part of me didn’t want to see you because it would be even more real and upsetting, as if there could be more upsetting. I never did get to see you then.

Dr. W came out and introduced himself and I liked him immediately. He exuded intelligence, warmth and professionalism. He explained your situation, without any trace of condescension, and seemed positive he could really help you. He told us about creating a little window in your skull through which he could work. That’s when I asked if he’d make your skin incision, which I knew would be pretty much from ear to ear, well behind your hairline so the scars wouldn’t show, and he said he would. He wouldn’t give you a prognosis until he got into your brain, but he was pretty positive and highlighted the potential benefit of draining your clot right away to relieve the pressure.

He looked at me probingly and asked if I was your identical twin. Then he said that when things calmed down, I really should have a MRI to rule out AVM in me. A twinge of anxiety flew through me. Then I felt guilty about thinking about myself. (Evie’s MRI was performed later and was normal.) Then I went back to affect-less depression. So Dr. W said the surgery would take about 6 hours and we could all go to a family lounge upstairs to wait.

The lounge was typical, large, no food to be had anywhere, vinyl upholstered furniture and glaring lights. Mom was talking as if to save her life. I think if she stopped talking, she would be having thoughts she couldn’t deal with. About how recently she’d been so angry with you that she had dipped into actual hostility. About how she must now feel guilty about this hostility, that perhaps she was in someway was responsible for your present condition. I just couldn’t listen to her, or your husband, gamely trying to entertain her.

Adam found a little room off the lounge, same cold, sticky furniture, but dark and somewhat muffling of Mom’s prattle. My head hurt so much with worry, I covered myself with my coat, closed my eyes and just though of all the what ifs and how I would deal with them. Mostly I wanted time to pass. It passed slowly.

Around 3am, Dr. W came into the lounge and said your surgery had been a success. He seemed fresh as a daisy, and perhaps on an adrenaline high. He said we’d know more when you woke up the next day, and that we all should try to get some sleep and come back later. Again, he had no prognosis for you, but it seemed to me that you were definitely going to live.

Dr. W had gotten a peek at the AVM and called it ‘formidable’ in size.