7 ms·

Aneurysm

167 points by Vigier 11y ago

jacquesm 11y ago
"All the skills that I slowly and painfully acquired to become an aneurysm surgeon have been rendered obsolete by technological change. Instead of open surgery, a catheter and wire is passed through a needle in the patient’s groin into the femoral artery and fed upwards into the aneurysm by a radiology doctor–not a neurosurgeon–and the aneurysm is blocked off from the inside rather than clipped off from the outside." Wow. That's a most un-expected way of fixing things in the brain! This subject never ceases to interest me because both my parents have had aneurysms, my dad died of them (he had three over the course of several years), my mom recovered (she had one which got clipped exactly as described in the article), both had paralysis effects, and both were heavy smokers. Incredible how reading that story affected me, worse than any movie I've ever watched.
- bhaumik 11y ago
  If you're interested reading more personal encounters like this, I highly recommend "When the Air Hits Your Brain". It follows the author's journey from resident to experienced neursurgeon with a wisecrack sense of humor and greusome detail. I finished it in premed days when I was looking for an candid story of becoming a neurosurgen. Definitely kept me fascinated. *http://www.amazon.com/When-Air-Hits-Your-Brain/dp/0393330494 http://www.amazon.com/When-Air-Hits-Your-Brain/dp/0393330494
vinceguidry 11y ago
I have the book this passage was excerpted from. It is phenomenal. Highly recommended. One chapter has him visiting a Ukrainian neurosurgery clinic not long after independence, and somehow getting involved in a titanic bureaucratic struggle. Utterly fascinating.
- petercooper 11y ago
  Yes, I just want to second how spectacular this book is. Certainly the best I've read in the past year. Well, I say read, I listened to the audiobook ;-) (the narrator is amazing so it was very enjoyable). It really opened my eyes to what it means to be a high flying surgeon and how to deal with both the psychology and aftereffects of risk taking.
wumbernang 11y ago
Comedy timing for me. My father was taken into hospital 4 hours ago after collapsing and turns out he's got a brain bleed. They stuck him in a CT straight away and are now doing a lumbar puncture to see if there is any blood in the spinal fluid. They don't know what has precisely happened but they suspect an aneurysm that went undetected. The mortality rate of this event is 50% in 30 days. He's had a long history of hypertension and a couple of surgeries to clean out arteries in his neck. Not sure why I'm sitting here on HN but it was taking my mind off things. Fail :( Anyway, moral of the story: Don't smoke and dint eat piles of shit; it'll get you one day. Edit: Ordered the book as well now like an idiot. Scary tale when you're close to it but I find comfort in knowing things rather than ignorance. Thanks for posting this.
- plq 11y ago
  God, so sorry to hear that. There's no "Fail :(" here, please don't think like that. You're just trying to cope with this stuff. It's the most humane thing to do, and you know what, you need to stay strong for your family and for that your mind needs such breaks from time to time.
  - wumbernang 11y ago
    Thanks for the uplift; appreciated.
- mrbill 11y ago
  May your dad have as good an aftermath as my friend has.
  - wumbernang 11y ago
    Indeed. Thanks for the kind words. Glad your friend got through it. Terribly traumatic but a good outcome looking at your other post. Happy to know someone who got through it against the odds.
- ars 11y ago
  How is he?
pgrote 11y ago
Wonderfully told. Thanks for posting it.
mrbill 11y ago
Just sent this link to a friend of mine who suffered from a full-bleed aneurysm a few years ago. She was lucky enough to be out in public when it happened, and got to a hospital in time for surgery (couldn't do the noninvasive method described in the excerpt). Two weeks later they sent her home! It was amazing. Doctors told her that "Fifty percent of people who have one never make it to the hospital, fifty percent of those never make it home." She's had some personality changes (to be expected with such a traumatic brain injury), but nothing horrible, and I'm amazed at modern medical science. One of the hardest parts (emotionally, for her) was me helping her shave her head after she got home; they'd had to do part of it anyway for the surgery, and two weeks in the hospital hadn't done what was left any good as it was matted and beyond fixing. Shave a bit, let her cry, shave a bit, let her cry... until it was all done.
rudolf0 11y ago
Very well-written. The suspense was absolutely killing me as well.
- branchless 11y ago
  I nearly crumbled under the opposing pull of reading each word of excellent prose vs skipping to the end to find the result. Thank goodness I went into programming and not brain surgery!
  - lmitchell 11y ago
    I on the other hand almost just stopped reading - I absolutely hate sad stories and I was sure it was going to be so sad :( I'm so glad I finished it though, it was incredible to read and I want to read the rest of the book very badly now.
ggreer 11y ago
If you've read Marsh's Do No Harm and you're interested in more stories like it, I strongly recommend When the Air Hits Your Brain: Tales from Neurosurgery[1]. Its author-surgeon (Frank Vertosick) lacks much of the compassion shown by Marsh, but the stories cover his failures more than successes. I find failures and mistakes more interesting, as there are countless ways in which an operation can go wrong, but only one way it can succeed. Though sometimes morbid, the cases are always fascinating. 1. http://www.amazon.com/When-Air-Hits-Your-Brain-ebook/dp/B006WOFB5C/ http://www.amazon.com/When-Air-Hits-Your-Brain-ebook/dp/B006...
- shenanigoat 11y ago
  Absolutely. That is a fantastic book. I gave a copy to my neurosurgeon as well (meningioma resection, benign).
shenanigoat 11y ago
It bugs me so much that the huge font, single word title is a typo.
justifier 11y ago
" I rarely clip aneurysms now. All the skills that I slowly and painfully acquired to become an aneurysm surgeon have been rendered obsolete by technological change. Although neurosurgery is no longer what it once was, the neurosurgeon’s loss has been the patient’s gain. " so nice to read this many of the entrenched remain so through superstition at the loss of progress, but to read someone speak highly of a practice that rendered a section of their skill set obsolete is heartening i have family who work in trauma and they condescendingly balk at my excitement over new medical technology: https://www.youtube.com/watch?v=aA-H0L3eEo0#t=3m14s https://www.youtube.com/watch?v=aA-H0L3eEo0#t=3m14s https://www.youtube.com/watch?v=8X69_42Mj-g#t=14m17s https://www.youtube.com/watch?v=8X69_42Mj-g#t=14m17s personally, i look forward to bones: https://www.youtube.com/watch?v=02Or-Hx3yqc https://www.youtube.com/watch?v=02Or-Hx3yqc
madaxe_again 11y ago
Lovely piece, shame whoever posted it can't spell - stonking great big title reads "aneursym", rather than "aneurysm".
- mVChr 11y ago
  And the URL :/
branchless 11y ago
I felt so nervous reading that I actually felt a little ill. How people do these jobs I cannot know. Yet somebody has to. Amazing.
gregpilling 11y ago
My son had surgery for 3 aneurysms 5 years ago. At 8am he was a normal 6 year old boy, going with his mom to LA Fitness. Then at 8:30 I got a call that he couldn't get up off the floor. An MRI showed 3 golf ball sized aneurysms, and they put him in a helicopter from Tucson to Phoenix, about 100 miles apart. I was pretty crippled by fibromyalgia at the time, my wife was 7 months pregnant, and they wouldn't let us fly with him. We cried driving two hours to learn if our kid lived or not. They used superglue to plug the fistula at Barrow's in Phoenix Arizona, they went up through the leg. http://www.thebarrow.org/index.htm http://www.thebarrow.org/index.htm Amazingly, he was walking again within 4 days and home within 7 days. I have a friend that had the same surgery 5 years before; she was there for months recovering from the clip method. My son was ok for 4 1/2 years, but for unknown reasons he had another brain issue in December that caused temporary paralysis for a few hours. They went spelunking again and found nothing. They did decide that the 5 year old repair had healed perfectly. Dr. Cameron McDougall the surgeon was just beaming with happiness when he told us that. My kid is doing well, he is pretty smart. He attends the hardest charter school in Arizona, BASIS. He is 11 years old, and I am his angel investor (Total investment about $500) in his website http://legimon.com http://legimon.com which is his version of Pokemon. Total revenue so far is $282.00 and about $40 in profit for some t-shirts. He was quite amazed when I told him how long he would have to scrub toilets at McDonalds to make that much money. We then had an hour long discussion about trademark law; he knew more than I did. He has been doing all the wordpress and photoshop work lately, and he works about 3 hours a day on it, everyday for the last three years. He has developed 400 characters and tells me that he is not stopping until he passes Pokemon's 700+.. He has planned out the app, the Xbox game, the VR headset upgrade for gokart racing, and the theme park. I couldn't be more proud of him. I keep a photo of him in the hospital taken right after they used a cordless drill to put a hole in his skull. He looks like corpse, his head is half shaved, his spine is twisted sideways and the drain from his skull is a bright orange. I use it when I am having a bad day at work, as a reminder of what a bad day really is. Ask me anything.
- kayoone 11y ago
  I don't have anything to ask, just wanted to say that this is an amazing story. Can't imagine going through that with a kid of mine and him doing so well now makes me happy for you guys! All the best to you and your family.
gonzo 11y ago
They chased stroke the night I was in the ER. CT of head, spinal tap, etc. Turns out, different kind of aneurysm. Ascending aortic dissection. Different repair (Dacron tube replaces the first 4" of my aorta.)

167 points by Vigier 11y ago

"All the skills that I slowly and painfully acquired to become an aneurysm surgeon have been rendered obsolete by technological change. Instead of open surgery, a catheter and wire is passed through a needle in the patient’s groin into the femoral artery and fed upwards into the aneurysm by a radiology doctor–not a neurosurgeon–and the aneurysm is blocked off from the inside rather than clipped off from the outside." Wow. That's a most un-expected way of fixing things in the brain! This subject never ceases to interest me because both my parents have had aneurysms, my dad died of them (he had three over the course of several years), my mom recovered (she had one which got clipped exactly as described in the article), both had paralysis effects, and both were heavy smokers. Incredible how reading that story affected me, worse than any movie I've ever watched.

bhaumik 11y ago
If you're interested reading more personal encounters like this, I highly recommend "When the Air Hits Your Brain". It follows the author's journey from resident to experienced neursurgeon with a wisecrack sense of humor and greusome detail. I finished it in premed days when I was looking for an candid story of becoming a neurosurgen. Definitely kept me fascinated. *http://www.amazon.com/When-Air-Hits-Your-Brain/dp/0393330494 http://www.amazon.com/When-Air-Hits-Your-Brain/dp/0393330494

vinceguidry 11y ago

I have the book this passage was excerpted from. It is phenomenal. Highly recommended. One chapter has him visiting a Ukrainian neurosurgery clinic not long after independence, and somehow getting involved in a titanic bureaucratic struggle. Utterly fascinating.

petercooper 11y ago
Yes, I just want to second how spectacular this book is. Certainly the best I've read in the past year. Well, I say read, I listened to the audiobook ;-) (the narrator is amazing so it was very enjoyable). It really opened my eyes to what it means to be a high flying surgeon and how to deal with both the psychology and aftereffects of risk taking.

wumbernang 11y ago

Comedy timing for me. My father was taken into hospital 4 hours ago after collapsing and turns out he's got a brain bleed. They stuck him in a CT straight away and are now doing a lumbar puncture to see if there is any blood in the spinal fluid. They don't know what has precisely happened but they suspect an aneurysm that went undetected. The mortality rate of this event is 50% in 30 days. He's had a long history of hypertension and a couple of surgeries to clean out arteries in his neck. Not sure why I'm sitting here on HN but it was taking my mind off things. Fail :( Anyway, moral of the story: Don't smoke and dint eat piles of shit; it'll get you one day. Edit: Ordered the book as well now like an idiot. Scary tale when you're close to it but I find comfort in knowing things rather than ignorance. Thanks for posting this.

plq 11y ago
God, so sorry to hear that. There's no "Fail :(" here, please don't think like that. You're just trying to cope with this stuff. It's the most humane thing to do, and you know what, you need to stay strong for your family and for that your mind needs such breaks from time to time.
- wumbernang 11y ago
  Thanks for the uplift; appreciated.
mrbill 11y ago
May your dad have as good an aftermath as my friend has.
- wumbernang 11y ago
  Indeed. Thanks for the kind words. Glad your friend got through it. Terribly traumatic but a good outcome looking at your other post. Happy to know someone who got through it against the odds.
ars 11y ago
How is he?

pgrote 11y ago

Wonderfully told. Thanks for posting it.

mrbill 11y ago

Just sent this link to a friend of mine who suffered from a full-bleed aneurysm a few years ago. She was lucky enough to be out in public when it happened, and got to a hospital in time for surgery (couldn't do the noninvasive method described in the excerpt). Two weeks later they sent her home! It was amazing. Doctors told her that "Fifty percent of people who have one never make it to the hospital, fifty percent of those never make it home." She's had some personality changes (to be expected with such a traumatic brain injury), but nothing horrible, and I'm amazed at modern medical science. One of the hardest parts (emotionally, for her) was me helping her shave her head after she got home; they'd had to do part of it anyway for the surgery, and two weeks in the hospital hadn't done what was left any good as it was matted and beyond fixing. Shave a bit, let her cry, shave a bit, let her cry... until it was all done.

rudolf0 11y ago

Very well-written. The suspense was absolutely killing me as well.

branchless 11y ago
I nearly crumbled under the opposing pull of reading each word of excellent prose vs skipping to the end to find the result. Thank goodness I went into programming and not brain surgery!
- lmitchell 11y ago
  I on the other hand almost just stopped reading - I absolutely hate sad stories and I was sure it was going to be so sad :( I'm so glad I finished it though, it was incredible to read and I want to read the rest of the book very badly now.

ggreer 11y ago

If you've read Marsh's Do No Harm and you're interested in more stories like it, I strongly recommend When the Air Hits Your Brain: Tales from Neurosurgery[1]. Its author-surgeon (Frank Vertosick) lacks much of the compassion shown by Marsh, but the stories cover his failures more than successes. I find failures and mistakes more interesting, as there are countless ways in which an operation can go wrong, but only one way it can succeed. Though sometimes morbid, the cases are always fascinating. 1. http://www.amazon.com/When-Air-Hits-Your-Brain-ebook/dp/B006WOFB5C/ http://www.amazon.com/When-Air-Hits-Your-Brain-ebook/dp/B006...

shenanigoat 11y ago
Absolutely. That is a fantastic book. I gave a copy to my neurosurgeon as well (meningioma resection, benign).

shenanigoat 11y ago

It bugs me so much that the huge font, single word title is a typo.

justifier 11y ago

" I rarely clip aneurysms now. All the skills that I slowly and painfully acquired to become an aneurysm surgeon have been rendered obsolete by technological change. Although neurosurgery is no longer what it once was, the neurosurgeon’s loss has been the patient’s gain. " so nice to read this many of the entrenched remain so through superstition at the loss of progress, but to read someone speak highly of a practice that rendered a section of their skill set obsolete is heartening i have family who work in trauma and they condescendingly balk at my excitement over new medical technology: https://www.youtube.com/watch?v=aA-H0L3eEo0#t=3m14s https://www.youtube.com/watch?v=aA-H0L3eEo0#t=3m14s https://www.youtube.com/watch?v=8X69_42Mj-g#t=14m17s https://www.youtube.com/watch?v=8X69_42Mj-g#t=14m17s personally, i look forward to bones: https://www.youtube.com/watch?v=02Or-Hx3yqc https://www.youtube.com/watch?v=02Or-Hx3yqc

madaxe_again 11y ago

Lovely piece, shame whoever posted it can't spell - stonking great big title reads "aneursym", rather than "aneurysm".

mVChr 11y ago
And the URL :/

branchless 11y ago

I felt so nervous reading that I actually felt a little ill. How people do these jobs I cannot know. Yet somebody has to. Amazing.

gregpilling 11y ago

My son had surgery for 3 aneurysms 5 years ago. At 8am he was a normal 6 year old boy, going with his mom to LA Fitness. Then at 8:30 I got a call that he couldn't get up off the floor. An MRI showed 3 golf ball sized aneurysms, and they put him in a helicopter from Tucson to Phoenix, about 100 miles apart. I was pretty crippled by fibromyalgia at the time, my wife was 7 months pregnant, and they wouldn't let us fly with him. We cried driving two hours to learn if our kid lived or not. They used superglue to plug the fistula at Barrow's in Phoenix Arizona, they went up through the leg. http://www.thebarrow.org/index.htm http://www.thebarrow.org/index.htm Amazingly, he was walking again within 4 days and home within 7 days. I have a friend that had the same surgery 5 years before; she was there for months recovering from the clip method. My son was ok for 4 1/2 years, but for unknown reasons he had another brain issue in December that caused temporary paralysis for a few hours. They went spelunking again and found nothing. They did decide that the 5 year old repair had healed perfectly. Dr. Cameron McDougall the surgeon was just beaming with happiness when he told us that. My kid is doing well, he is pretty smart. He attends the hardest charter school in Arizona, BASIS. He is 11 years old, and I am his angel investor (Total investment about $500) in his website http://legimon.com http://legimon.com which is his version of Pokemon. Total revenue so far is $282.00 and about $40 in profit for some t-shirts. He was quite amazed when I told him how long he would have to scrub toilets at McDonalds to make that much money. We then had an hour long discussion about trademark law; he knew more than I did. He has been doing all the wordpress and photoshop work lately, and he works about 3 hours a day on it, everyday for the last three years. He has developed 400 characters and tells me that he is not stopping until he passes Pokemon's 700+.. He has planned out the app, the Xbox game, the VR headset upgrade for gokart racing, and the theme park. I couldn't be more proud of him. I keep a photo of him in the hospital taken right after they used a cordless drill to put a hole in his skull. He looks like corpse, his head is half shaved, his spine is twisted sideways and the drain from his skull is a bright orange. I use it when I am having a bad day at work, as a reminder of what a bad day really is. Ask me anything.

kayoone 11y ago
I don't have anything to ask, just wanted to say that this is an amazing story. Can't imagine going through that with a kid of mine and him doing so well now makes me happy for you guys! All the best to you and your family.

gonzo 11y ago

They chased stroke the night I was in the ER. CT of head, spinal tap, etc. Turns out, different kind of aneurysm. Ascending aortic dissection. Different repair (Dacron tube replaces the first 4" of my aorta.)