Chris Russell image

Chris Russell

Chris: Demystifying brain surgery - Aneurysm Survivor

Words tend to fascinate journalists. Take aneurysm for example (from Greek: aneurysma, "dilation", from aneurynein, "to dilate") a localized, blood-filled balloon-like bulge in the wall of a blood vessel.

It was not a word I was completely familiar with when my GP read it out.

It was an incidental finding from an MRI scan taken as an option after a cycling accident “just to make sure there was nothing broken” which had not been spotted. “Why not?” I said to the MRI option, “I pay enough in medical cover.”

As someone who was not born in hospital (as it wasn’t yet common practice for a normal pregnancy in Wembley, UK, 1958) the MRI and a confirming CT Angiogram were forays into unfamiliar territory.

The places you visit when other people are sick.

I was torn between assuring myself that the word was not associated with the bike accident – which of course might lend weight to my wife’s argument that cycling was too dangerous a sport for someone of my distinguished looks – and trying to recall just what an aneurysm was.

Mine was a 7-8mm bubble on the side of an artery in my brain. A little time-bomb with a 1% chance per year of detonating. Rupture I was told, brought with it a 40% chance of death and 60% chance of worse outcomes.

My wife and I visit the specialist together and he explains two ways of treating a brain aneurysm both involving surgery which he underscores is “playing with fire” just in case the words “brain surgery” don’t conjure enough gravity.

The first involves a hole in the skull through which a clip is placed on the aneurysm to block it off from the adjoining artery. The second, a catheter going up through a leg artery to deposit a “nest” of platinum coils in the aneurysm which prevent blood flow into the aneurysm. Both have a 97-98% success rate – which sounds a lot better to me than the rupture alternative.

My wife’s question about the best place in the world to have an aneurysm treated is responded with an unequivocal: “If I or my wife had one, I would have it treated in Adelaide,” from the specialist.

A consistent answer we received was that Adelaide has some of the best medical equipment in the world, enough size to support specialists and not too much to create overcrowding – at least not if you have private medical cover. Around this time we began to let others know – boss, colleagues, family.

How do I feel? Well without any symptoms, I feel pretty lucky. A 40% chance of death or worse, vs 98% success rate sounds good to me. And I’ve only discovered it by chance – the time bomb could have continued ticking with no sound and me in complete ignorance.

I’ve always been a “glass half full” person so for me it was just another sign that Bilbo’s recollection of Gandalf’s tales of the “unexpected luck of widow’s sons” was spot on.

A full brain angiogram was conducted while I was awake – something I hadn’t been expecting but it held no fears - a local anaesthetic in my groin with a catheter releasing dye in my neck, as multiple Xrays are thrown onto an impressive TV screen.

There it is. A fatish bubble (not traditional balloon shape) which the radiographer is convinced could be treated with coils – although probably also requiring a “stent” or small tube to be left in the artery to guarantee blood supply.

Surgery via the skull sounds more daunting and with greater short-term impact but with more long-term certainty and less ongoing monitoring/impact.

Assuming surgeon Dr Amal Abou-Hamden is able to clip close to the artery leaving no exposed aneurysm, it is likely to return me to full activity – including cycling. There are standard risks, from infection to the possibility of stroke if blood supply through the artery were to be cut.

I was blessed with a maternal grandmother who always exuded a calming: “if you can’t change something why worry about it” attitude and a scientific schooling which allows me to place trust in logic and statistics.

Although my wife is keen to resolve matters urgently, a date is set about 6 weeks off for craniotomy and clipping. I choose Calvary Wakefield Hospital, Dr Amal Abou-Hamden flagging it has one more bell & whistle with surgical equipment – which is on order for the RAH but not yet delivered.

Bravery? Calm? No, it was a mixture of trust in the medical system and those who had advised us and my grandmother’s focus – and I had a sense that if I remained focused on the day to day, it would help those around me to do the same.

It certainly didn’t feel like bravery when they put on the silly backless blue hospital gown, white blood pressure stockings and orange non-slip socks before wheeling me away from amused and concerned family to the operating theatre.

The anaesthetist goes to work and I wake 4-5 hours later in the high dependency unit – what I imagine Cony Island with a medical theme to be like. Lights, the machine which goes “beep” (actually several of them), action, constant checks and noise all around.

Clearly they have prescribed stimulus for rapid recovery rather than calm. And they know what they are doing as in a short space of time I’m alleged to have told my wife “bad luck about the life insurance.”

I’m holding regular conversations with people about interesting things like the date, Tony Abbott, my name, birth date, holding up three fingers on my left hand and how many people with beers I could get in my room to watch the Crows win.

Within 24 hours the physiotherapist has taken me for a walk, mostly unassisted, along an adjacent corridor. All the staff at Wakefield seem to have taken “cheery” training and some, “101 comedy” which helps – especially as it doesn’t hurt to laugh.

It’s great to have a nurse who introduces herself by saying: “I had the same operation you did with the same doctor 18 weeks ago and I’ve been back at work for 12 weeks.”

Even better to be sent home less than five days after the operation to a good night’s sleep in my own bed. Within a week I’ve been for a walk or two around the block, dropped back into the hospital, called in at the office and written this.

Although banned from driving and cycling for a bit, about the only normal thing I am not doing within a week is any cardio fitness.

A post-op angiogram has Dr Abou-Hamden and radiographer claiming a "perfect" result.

It’s not as though it’s brain surgery or anything!

PS: Since then I rode 100km in the Amy Gillet ride matching my 2014 time and 140km in the 2016 Tour Down Under community ride.

Chris Russell is Strategic Adviser with the Local Government Association of SA

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