Dissection

In the dark of night, at the age of forty-one, I should have been nestled in my husband’s arms, listening for my daughter’s even breathing in the next room. Instead, I lay on my bed, very still, eyes tight, my face pressed to the sheet, thoughts focused on just continuing to breathe. I had never felt such pain. I could hardly lift my head off the mattress. A repetitive, rushing sound echoed through my ears with every heartbeat.

Whoosh. Whoosh. Whoosh.

Sliding to the floor and crawling to the bathroom, I urinated then threw up. Breathing shallow and rapid, hands and lips tingling, head in agony, the room spun. My husband, Bob, on the cold tile floor, cradled my shivering body with his arms as I leaned heavily against his chest between bouts of sickness.

My moment has come, I thought. Funny how difficult it is to imagine a medical emergency before it happens. I always thought mine would involve crushing chest pain or a hard lump in the breast. I never imagined it would be my head.


Back in bed, I held my afflicted head in my hands, trying to block out the pain, noise, and fear and fighting to think only of my nine-year-old daughter, Lily.

I can’t be sick. I will not be sick. I refuse to be sick.

Wanting desperately to go anywhere but the hospital, I was terrified that I would never come home.

Please don’t take me to the hospital.

In the emergency room, the doctor’s expression changed from an unconcerned smile as we explained I had an excruciating headache, to a look of gravity when I added there was a whooshing noise in my head. A day of tests—brain MRI, carotid ultrasound, blood tests, and X-rays produced no answers. Then, the neurologist came in.

“I’m afraid the noise in your head indicates that you probably have a venous malformation in your brain. If so, it will require surgery.” A venous malformation is a congenital problem that can cause bleeding.

I know I should have felt relieved to have an answer, but instead, I felt angry. I did not want to hear his words. Until this moment, everyone had been smiling and hopeful. All of the tests had been negative. This doctor was serious and unwavering and was telling me I needed brain surgery.

Brain surgery—something most of us never think we will need. Brains are taken for granted. I could not imagine having brain surgery.

I needed one last test—an arteriogram—in which the artery in my groin would be punctured, a catheter inserted and threaded up through my aorta and into my brain arteries, where dye would be squirted while we all watched it on television.

The test had risks—bleeding, paralysis, death. The neuroradiologist came in with a consent form, assuring me that none of his patients had ever suffered any of these problems. Signing the form, I wondered whether the statistical probabilities were against me.

On the way to radiology, the breeze in the hallway blew through my hospital gown and the thin blanket covering me as I lay on a stretcher, the pain and noise in my head constant. Two male technicians wheeled me into a cold operating room where everything was stainless steel. They moved trays of utensils onto tables laid with white sheets. The table was hard, lights bright.

I tried to joke so they would like me and fight hard for my life. We talked about line dancing, Girl Scouts, local restaurants. They allowed me to sit up even though I was supposed to lie down. One said the neuroradiologist did not think this test would show anything. What did that mean? Should I even have this test?

The doctor injected my groin six times with a local anesthetic. Then he prepared to pierce the artery with a catheter. Having my groin punctured was just like it sounds—someone stabs you hard with a sharp instrument. I endured several stabbings before it was successful.

Once the catheter made its journey from groin to brain, dye was intermittently injected. Each time, I felt a rush of hot, prickling nerve endings dancing on a section of my face. Finally, the rush came to an area in the back of my head.

“You are touching exactly where the pain comes from,” I said.

“You mean I’m making it hurt more?” asked the doctor.

“No, you are touching the very spot exactly.”

The neuroradiologist took pictures from every possible angle in that area of my brain and found what we were all looking for—the vertebral artery was dissected or torn. The noise in my head was caused by swelling in the artery, which was so bad that the blood almost couldn’t get through. Every time the blood tried to force its way through the almost occluded artery, it made a whooshing sound.

Vertebral artery dissection was a better diagnosis because the treatment did not include brain surgery. Given time, the artery should heal itself. However, because blood was having such a hard time getting through the swollen artery, I was in danger of having a stroke.

Being in danger is a frightening thing. My head overflowed with images of the worst-case scenario—paralysis, blindness, my family living on without me. Yet, being obsessed with the unthinkable showed that my brain was still functioning.

The doctors discharged me after one night in the hospital with few instructions: pain medication and bed rest as needed, activity around the house as tolerated, call the office for an appointment.

For weeks, the pain and noise were unrelenting. Nights were worse, as the pain inexplicably intensified, at times making me frantic. Bob fixed cool washcloths for my head, rubbed my back, distracted me, and enfolded me in his arms.

Over three months, the noise in my head gradually disappeared, but I was left with frequent intense headaches. Headaches interfered with my activity and commitments. I kept trying but, at times, had a feeling of suspension, of holding my breath and waiting for my life to get back to normal.

Sometimes, not knowing the extent of your limitations is a good thing. But, eventually, a time comes when it is better to acknowledge the truth—that you are, in fact, altered. At the end of two years, I finally understood that I had suffered a permanent loss. Although my body looked the same, pieces were missing.