From R.B.

June 14 th, 2005 was a typical business day for me. I was working with my business partner at a client site, conducting a presentation. At about 2:30 PM, with no prior symptoms, I suddenly became dizzy, and within about three seconds lost consciousness. Although I only remember brief instances what took place during the next several hours, the gaps have been filled in for my by my friends and family.

Since the client site was in West Seattle, I was taken to Swedish Medical Center/First Hill in downtown Seattle. Within five hours of the onset of my symptoms, my condition was diagnosed as a cerebral aneurysm that had ruptured, causing a subarachnoid hemorrhage allowing blood to enter the fluid spaces surrounding the brain. Within another four hours, my ruptured aneurysm had been treated through the use of the non-surgical procedure called endovascular coiling, and I began my recovery.

I spent the next seven days in the Intensive Care unit at Swedish Medical Center recovering from the effects of the bleeding. During that time, I had some problems with fluid buildup around the heart and lungs, and some instances of a condition called vasospasm, which is common after a cerebral hemorrhage. After seven days in Intensive Care, I spent two more days in the general care unit, and was then discharged on June 23 rd. My recovery at home was rapid, and on July 5 th, I returned to work part-time, resuming full time work the following week. Within four weeks of the rupture, I had resumed all other normal activities, including driving and exercising.

I have come to fully appreciate how atypical my experience has been. Cerebral aneurysm ruptures are often fatal, and those who survive can be left with long-term stroke-like symptoms. In my case, my recovery was rapid and complete, and now, two months later, I have absolutely no noticeable effects from the rupture or from the treatment. I’m back to 100% of the mental and physical condition I was in before the onset.

There are several factors, and people, that contributed significantly to my successful recovery. The most notable are:

• Getting treatment as soon as symptoms appeared.

  Since the only symptom I experienced was loss of consciousness, there was no question I had a serious problem, so I was transported to a hospital immediately. Others with this condition might experience symptoms that would allow them to postpone admission to a hospital for days, increasing the chance of a stroke or of permanent brain damage.

• Being admitted to a hospital that can provide the best possible neurological care.

  The Neurological Unit of the Swedish Medical Center, in my opinion, is the best. My primary neurologist, Dr. Ryder Gwinn, oversaw the excellent care I was given, and as conditions arose during my recovery in Intensive Care, he insured they were rapidly diagnosed and treated and never allowed to become unmanageable. I trusted Dr. Gwinn and the other doctors and staff completely, and this trust eliminated any anxiety I might otherwise have had about my health.

• Being admitted to a hospital that can provide the most advanced technology.

  Possibly the single, most critical factor in my unusually good recovery was that fact that Swedish has on staff an Interventional Neuroradiologist who is skilled in the use of the endovascular coiling procedure.

  Dr. Philip Vogelzang did a superb job of locating and assessing my aneurysm. More importantly, he explained treatment options and his recommendation (coiling) to my family in such an upbeat and optimistic manner that they felt very comfortable following his recommendation. I’m very thankful that they did, and I attribute much of my rapid recovery to the fact that with Dr. Vogelzang’s skill in the placement of the coils, my aneurysm was fully occluded, and there was no need for surgery. Results of Dr. Philip Vogelzang’s treatment of my aneurysm can be seen here [Case 4].

In summary, I must say that I am profoundly grateful to Swedish Medical Center, to the doctors and staff that treated me, and in particular to Dr. Vogelzang and Dr. Gwinn. They provided the best care that I could have possibly received, and I owe them my survival and the resumption of my good health. These are priceless.

R.B.

From CJH

9-11-99 was one of those horrendous days that stay fixed in one's memory, so 9-11 now has two very significant meanings for me and my family. One of those memories I share in sadness with the nation, the other memory is one of rejoicing that I have a memory at all. I consider myself blessed to have been living in Seattle that day in 1999 when I had a cerebral aneurysm rupture.

My husband and I were watching the Mariners on TV that night, (eating homemade hamburgers and depressed about another baseball loss). Suddenly, with no warning, I felt a flush that seemed to spread throughout my body. I put my hamburger down and went to our bedroom to remove clothes, thinking the heat just under my skin was from clothing that was too tight. But by the time I got to the bedroom, my head began to feel like it was going to split open. Also the light hurt my eyes. I called out to my husband to call 9-1-1...something was definitely wrong. But we had no idea what.

The emergency techs came quickly. By the time they arrived I was laying atop the covers with not a stitch on, because I was so hot, but shivering. My head hurt, my eyes did not want to see the light, so I kept them shut (but opened them long enough to notice that my Grandma had been right when she said the EMTs are always good looking). Apparently I was not frightened because I joked with them. I vomited a time or two and then they put me on the stretcher and got me in the ambulance. My husband rode with me to Ballard Swedish Emergency. I remember very little of that time there. I remember only alot of darkness. (They turned the lights low because I told them how the light was hurting me.) Also I remember a light, warm blanket and the gentle touch of everyone who was around me. My husband, who is also my best friend, was with me non-stop. I know that was the greatest help in making me feel unafraid. I guess I was out of it enough to have no worries. He did the worrying for both of us.

A CAT scan made it clear that there was some cerebral bleeding so they packed me up in another ambulance and sent us to Swedish "on the hill." (The rest of that night and the next day, is mostly a blank for me, but I have heard the second hand stories.) At that point, my husband called my sister to come and sit with him and to help him make a decision about what was to be done. The neurologist team told them that this was a cerebral aneurysm that had partly ruptured but stopped. They could do one of three things. 1) Leave it be, it may not rupture again; 2) clip the artery near the aneurysm to isolate it; or 3) a relatively new procedure could be performed which would place Guglielmi Coils inside the aneurysm so it could heal over. My husband asked the Neurological Team leader what he would do, if it was his wife. He said he would choose the coils because Dr. Philip Vogelzang, who would perform the procedure was very well qualified and since we were at Swedish where care of patients with neurological emergencies has a reputation for being the best, he was confident in recommending the Coils.

I don't remember any of the operation, but they say I was fully awake. My husband and sister tell me that it took a long time and when they wheeled me out, one of the doctors asked me, pointing to my husband, "who is that?" When I answered without hesitation, my husband stopped holding his breath. I felt so good that I was ready to climb off the gurney onto the bed without help. But that was a false feeling of well being. As it turned out, I was in intensive care a day or two, being watched for vasospasms and any other complications.

I spent a total of 11 days there at Swedish with wonderful care from the whole staff. The pain from having blood in my body where it was not designed to be, kept me on pain medication for that time and even at home for some time afterwards. But in general, I recuperated physically very well. I think my psychological health was the harder thing to deal with. Event the thought of having a hamburger, made me dissolve into tears. I found it very difficult to believe that I would not have another aneurysm and that this time it would rupture and I would die, just like that. As time went on and everyone made it clear to me how rare it was to survive a cerebral aneurysm, I became even more skeptical that I actually would.

With the Guglielmi Coils there is no outward evidence of the healing process. A tiny little incision in the groin area healed quickly and I had nothing to show that this had even happened to me. I went up to Swedish to say thanks to the nurses and I obtained copies of the x-rays of my brain before and after the Coil placement. As the weeks went by, I began to believe that I was really a survivor. After the sixth month angiogram, to check how the aneurysm was doing, my husband and I both celebrated our success with a hamburger.