You may be asking yourself the same question I asked myself, over and over again, as I was transported to the Neurological Intensive Care Unit at Oregon Health Sciences University in Portland. That question was, just what is a subdural hematoma?
I didn't want to rely solely on my own knowledge of the subject, so after all was said and done, I did some research. I did know that our brain is the electronic powerhouse and controller of our bodies, shaped much like the two halves of a walnut. Wrapped around that brain is a tough, protective meningeal membrane called the Arachnoid Mater. Between that membrane and the next one, is a small space, which is the home of bridging blood vessels. The other membrane, the Dura Mater, is the second protective covering for the brain. The hard shell, which is the skull, surrounds the whole mass and gives the brain its final protection.
I turned to the Internet to answer some of the questions I had and found three sources that helped me understand the anatomy of my brain bleed. The first, Wikipedia, was the most helpful and it is the one I will include here. Another one, Medline Plus, from The U.S. National Library of Medicine (NLM) and the National Institute of Health (NIH) just confirmed what Wikipedia said and gave me a little extra insight. The last, A.D.A.M. Medical Encyclopedia, (Pub Med) also a publication of the NLM and the NIH, agreed with the information from the first two.
According to Wikipedia, "a subdural hematoma or subdural hemorrhage is a type of hematoma, a form of traumatic brain injury." In other words, as the result of some sort of injury to the brain, those tiny blood vessels in the space between the two membranes covering the brain rupture and the resulting blood flow attempts to fill that limited space. When that space is filled, it starts compressing on the brain itself. Because it is beneath the Dura Mater, it is called subdural. Intra cranial pressure then begins to rise and as a result, can cause brain tissue damage.
There are two types of subdural hematomas, according to Wikipedia. They are acute and chronic. Of the two, acute is the most life threatening. These are often the result of "high speed acceleration or deceleration injuries...and have a high mortality rate."
"Chronic subdural bleeds develop over a period of weeks, often after minor head trauma." Wikipedia states that these bleeds are common in the elderly, due to atrophy (shrinking) of the brain, which stretches the veins in the subdural space making them fragile and easily broken.
Visitors
On Monday, I had a pleasant surprise when my four daughters came to see me. I was deeply touched. My husband also managed to get an emergency week off work to be there. In many ways, it was like a great family reunion. But it was sad to have to be centered on such grim circumstances.
I don't remember a lot about Monday. Most of it was a blur because of the pain and the meds I was given to treat it. JerriAnne said, "The pain killers...(made) her loopy." Debi said, "You were...in a lot of pain and you wanted to be left alone." My husband said, "I saw that, even with pain meds, she was literally tormented with head pain and just wanted to rest."
The morning of Tuesday, June 18, 2012 brought many changes and emotions to my life. With those changes, I felt unsure of my future. I was angry--"Why me? What have I done to deserve this?" I was afraid--"What can I expect as an outcome of brain surgery? Will I be cognitively or physically impaired? Would I have memory of who I am and what my life had been or was like? And, I was anxious--anxious for my family, anxious for my friends and of course, anxious for myself.
An unthinkable, but predictable phenomenon happened in the afternoon of that Tuesday. I looked around the room, into the eyes of my four daughters who had traveled great distances from their various southwestern homes to be at their mother's bedside, and I didn't know who they were. Dean said to my youngest daughter, Heather, who was holding my hand at my bedside, "She doesn't know who I am." Heather looked at him, with sadness in her eyes and said, "Yeah, mom didn't know me either." As Dean said, I didn't know the man standing near me as my husband--I only knew his name, "Dean." I didn't know where I was. When asked that question, I answered, "Utah," my home for much of my adult life and the state I was born in. I didn't know what day it was or even the month, date or year. It was interesting, however that I knew who was our President. "Obama" was the answer I gave, spoken loud and clear in a low, guttural tone. My doctor and his assistant were concerned. He immediately cleared his surgical schedule and they prepped me for a craniotomy, "Now!" Time was not on my side. The longer we wait, the bigger the bleed will become and the pressure in my brain could do more damage.
I was wheeled out of the room on a gurney. I left my family not knowing whether I was going to have a complete craniotomy, where they remove a sizable portion of the skull to get to the hematoma or drill burr holes and place a drain to accomplish the same goal.
I don't remember going for an MRI on the way to surgery. I don't remember being wheeled into the surgical suite. And, thankfully, I do not remember the surgery.
My heart goes out to my family as they were witnesses to these events. Somewhere in my confused state, I did know I was in good hands. I placed my brain in the hands of a brilliant and competent surgeon. I was in the hands of trained nurses and OR technicians, who knew their job and would perform their duties. And, I was in the hands of my loving Savior, the ultimate healer and physician, who knows my life from beginning to end. He will place His hands upon the surgeons hands and guide him every step of the way.
***Watch for the final chapter, "In Retrospect"...
The Fix
When I awakened, back in my room, I was relieved to find they had only drilled two burr holes in my head. I could feel a drain coming out of the top of my head, and that felt weird. I was pretty groggy from anesthesia, so I wasn't much company for my girls or my husband, but I had many questions.
I knew I had some cognitive issues right away. When I talked, I slurred my words and I had difficulty bringing some words to the front of my brain and ultimately to my tongue. It was a frustrating feeling. I did recognize and know, however, who each one of my daughters was. And I knew "Dean" was my husband. I witnessed the joy that came into their faces as they saw their mom and sweetheart return to her former self.
***Watch for the final chapter, "In Retrospect"...
No comments:
Post a Comment