Head Games

It is clear that middle age is upon me.  I turned 50 earlier this year and, I must say, it's all gone to hell in the last 30 days.  I was what I thought a vibrant sort of guy.   The gym, yoga, boot camp class, treadmill, weight lifting, worked a full schedule, got up early, took fish oil/B complex/multi vitamin/aspirin, ate well, didn't smoke, drinks only occasionally, and had a (fairly) good attitude.  Umm yeah.  All of that has been placed on the back burner. 

Three or so weeks ago, the headache, eye pain, and neck ache began along with a droopy left eye.  My first thought was stroke.  But the diagnosis was Horner's Syndrome.  I'd never heard of it.  After that, the quest was to find the cause for the Horner's.  One of my two neurologists sent me for a CT scan of the brain, neck and chest which returned a startling discovery -- bilateral dissected carotid arteries.  And that was one week ago today.  Critical.  Cardiovascular surgeon was placed on hold pending my further assessment.  "You need to return to the hospital and check yourself in immediately."  The risk for stroke was high.  I spent last weekend in the hospital with LoverBoy right next to me on a cot.  I have determined that hospitals are not for resting and recouperating.  They are noisy, busy, interruptive, repeatedly answering the same questions, and listening to crazy patients in the rooms next door.  I had eight or ten doctors visit me in my room.  Excellent care and nursing staff. 

Let's talk about the cause for the dissection of the arteries for a minute.....I have no definitive idea why mine happened.  Yoga?  Gym?  Weight lifting?  Twisting my neck wrong?  The list of possibilities is long and includes: 

• Neck extension during hair-washing at a beauty parlor
• Chiropractic manipulation of the neck
• Whiplash injuries
• Blunt trauma to the neck
• Extreme neck extension during yoga
• Painting a ceiling
• Coughing, vomiting and sneezing
• Neck extension while receiving mouth-to-mouth during cardiopulmonary resuscitation (CPR)

I left the hospital shooting myself in the stomach twice daily with Lovenox, a blood thinner.  This medication was accompanied by the world famous and widely prescribed "rat poison" Coumadin/Warfarin.  As soon as the Coumadin was at the proper level of thinning my blood, I would terminate the Lovenox shots.  That happened yesterday.  My blood is thin enough, but not too thin, now they say.  This Coumadin regimen will continue for the next six months -- Blood draws to check the levels every few days or a week, maybe up to a month.  I will repeat the CT scan then.  The cardiovascular surgeon fully expects that the dissection of the carotids will have healed itself by then.  I had no idea!  That was a small piece of good news in this whole mess.  I had anticipated dealing with it for the remainder of my life.  I've also visited with a Neuro Opthamologist -- a Canadian-born woman of great education and knowledge in Horner's Syndrome and the dissection.  She told me my eye was in perfect medical health, nothing to worry about there.  She discussed my condition with huge amounts of experience and made me feel much better about my prognosis. 

While I was in the hospital, they discovered a 70% blockage in my celiac artery.  Because one thing isn't enough....right?!  I was having no symptoms and had no idea it was there.  They said it could have been there a very long time, possibly even from birth.  But they'd like to do an ultrasound on it to measure the blood flow and track it again in six months to see if the occlusion/blockage has gotten worse or not.  So I had the ultrasound yesterday.  Brad, the technician, was amazing and offered me all kinds of information and medical information -- I love that stuff.  BUT, since I had the test, guess what.....I now have symptoms in the very spot where the celiac artery lies.  Just below the xiphoid process, which is on the center line just below your rib cage.  It has hurt since I left the test yesterday.  It kept me awake for about an hour in the night.  Lawdy.  Lawdy.  Lawdy.  So back to see my primary care doctor this afternoon.  Surgery is the fix for the celiac artery issue.  I can't wait. 

I'm 50.  I have already outlived several adults in my family who died in their 40s.  My own father had two heart attacks just a year or so ahead of my current age.  He eventually died at 62 from Lou Gehrig's Disease.  Both grandfathers died in their 60s, or barely 70.  No men in my immediate family have lived past 70.  This crap plays heavy games in my head.  I think about it.  I wonder about it.  I mean, I feel in some ways like I'm just getting started in my life.  Happy, (was) healthy, eating nicely, enjoying things.  But now I wonder.  Who knows what tomorrow will bring. Let's just say that I'm more than thankful for insurance. Oh yeah, and one more thing, I'm supposed to be working at a real live job somewhere in the middle of this whole mess. 

I Think I'll Live For Now

Take a good close look above.  That's what not one, but both, of my carotid arteries apparently looks like.  At the top of the carotid, just at the base of where the carotid enters the skull.  The above scenario is not good.  It allows for lessened blood flow and it also poses high risk for blood clots or complete obstruction causing a stroke.  Or if a clot was allowed to form and then move into the brain....well, let's not talk about that. 

You'll remember my earlier troubles and the diagnoses of Horner's Syndrome a few weeks back.  One of the many reasons for Horner's to develop is, indeed, a dissection of the carotid arteries.  I had hopes for a lesser-impactful, happier shall we say, reason.  Last Thursday and Friday, we had our entire condominium returned to hardwood floors.  There were four workers here, the entire place was in disarray and sawdust, and the workers headed home after finishing a beautiful job.  I went to Portland Providence Medical Center for my CT scan of the brain, neck and chest.  I headed home and began helping clean the condo and putting things back in place.  And the neurologist called.  "I'm advising you to return to the Emergency Room immediately..."  What?  Huh?  I feel good.  Can't I wait until tomorrow?  Or Monday when my doctor's office opens?  Before long, two more doctors had called with the same recommendation.....return to the ER at once.  You are running a high risk of stroke.  Now, I had not been too worried about this whole thing until right at that point.  I had been optimistic and pretty upbeat.  But suddenly I'm on the internet reading about emergency surgery to put in a stent.  And he said it was both sides.  And that it was significant.  You can read about the whole affair over at LoverBoy's site here.  So I showered and headed back to the hospital fully expecting emergency surgery.  I found out later from the Cardiovascular Surgeon that he had been alerted and was ready for me in the operating room.  I had very few symptoms.  And my Horner's Syndrome symptoms from a few weeks ago had improved and were actually almost gone.  The doctor's began coming in and you know how that goes.  I answered the same medical questions ad nausea for three days repeatedly.  They agreed that the surgery was not necessary at this point.  I began blood thinning medication to reduce the chance of clots.  One of the thinners is an injection that I'm giving to myself.  The other is the world-famous Coumadin, or Warfarin.  It is powerful and has to be monitored many times a week to start with.  I'll have my blood drawn 2-3 times a week and they make adjustments to the medication -- they don't want the blood to thick or too thin.  Huge risks of bleeding...externally or internally. 

My conversation with my new friend the Cardiovascular Surgeon was really a good one.  Don't tell anyone, but he likes me.  He told me so.  He said that he enjoys being around guys like me who are positive, energetic, go to the gym, eat right, don't smoke and take an active role in their health care.  And he went on to say that he fully expects that my dissection will repair itself over the next six months. Wow.  Really?  I guess I thought that I would be on blood thinners for the remainder of my life.  But the doc says no.  Repeat CT scan in six months to check it out again.  I think the tears in my eyes alerted him to how happy I was simply to be alive.  And to hear his good news made it just that much better.  He patted me on the knee as he walked out. 

So I'm home this morning.  Getting ready to shoot myself in the stomach with the needle of blood thinning meds.  No weight lifting.  Super easy, no running, on the treadmill.  And no work this week until the blood thinners have a chance to get up to speed and evened out.  I'm nervous.  I keep thinking of those two carotid arteries which are each of our lifelines to being alive.  It makes me super nervous.  I think of my family history and how I've already outlived several men in my family.  And how my father had two heart attacks at my age.  It's unsettling and I have a hard time shaking the thoughts.  But I am alive.  And I have the best pooch and husband in the world.  And the friends!  The friends!  Facebook, texts, voice mails and emails clearly indicate that I have a group of the world's most amazing friends.  And I thank you.  From the bottom of my heart, I thank you.  Oh, here I go again crying.  I've gotta go.