The sad truth

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Brain Aneurysm Recovery continues…: Overcoming Fear-Be Inspired

For most brain aneurysm survivors, the real challenge does not begin until healing is complete. I think the same applies to any serious illness that one might have been faced with. When I was in the hospital, my goal was to get out so I could be with my family. I missed my little children the most.

The entire time I was in South Africa, it seemed like my days were full. After discharge from the hospital, I was with the physiotherapy 3 times per week for 2 weeks while at the same time seeing different kinds of specialists to try and bring my blood pressure to at least a high or normal level. My blood pressure was still considered severely high despite being on moderate to high doses of several blood pressure medications.

The day came, however, when I was considered stable enough to return to the US under the special care of a nephrologist. That was the day that my fears begun. You see, I have always been the kind of a person who is always looking forward to change, always looking for new challenges, and willing to take risks but all of a sudden I found myself numbed by own fears existing in this self-imposed bubble. How could I be afraid of living and dying at the same time? I could not lay down and sleep peacefully without letting go of the feeling that…I might not wake up again. It was better for me to live in the moment than to face tomorrow. I recall that Monday morning in mid-September when we went to the health center at the Embassy to talk about my medical clearance and travel plans. Everything was evolved around “what can happen.” Every decision was made to ensure my safety was made a priority. The airline was chosen intentionally, the doctor had been notified and an appointment was in place upon my arrival to Dallas.  All this preparation acted as a catalyst to my self-imposed fears.

During my last appointment with the neurosurgeon in South Africa, he told me that I was one of the lucky cases he had dealt with. He said that statistics show that about 70% of people who suffer a ruptured brain aneurysm die within 72hours, and the remaining 30%, more than half of them wish they were dead. He then added that I should not limit myself on a “quality lifestyle” but rather enjoy every day to the fullest. One thing he emphasized on is the significance of the mighty power of God that surpasses all human understanding. The doctor’s words from that conversation have remained my main source of motivation. I no longer search for a role model to inspire me. I am turning myself into a role model to inspire others and let them know that if I survived, they too can survive.

For the first 6 months following my return to the US, I could not sleep well at night without taking a sleep aide. My nights were longer than my days. It seemed like my mind become alive at night held hostage and fully manipulated by my own fears. I was afraid of dying…again.

 I was afraid of talking to people due to my slow reaction times. It took some time to regain self-confidence.

I was afraid of not being able to return to work. I have always been independent and having that insecurity meant vulnerability and basically living at the mercy of others.

I was afraid of flying and high altitudes. What if I suffered a re-bleeding or another one? Basically, I was afraid of dying.

I was afraid of my kids growing up without a mother. As I was going through my healing process, I experienced a stage where I was bargaining with God to keep me healthy and long enough to raise my kids to an age where they would be independent and stable. Once in a while my oldest son always goes back to that time when he woke up only to find a stranger in the house telling him that she was there to take care of him and his baby sister until daddy who was with mommy in the hospital returned. He recalls traveling to South Africa to be near mommy while she received treatment in the hospital. Then he recalls the day he came to the hospital to see me and celebrate my birthday. After all that, he asks if I will ever leave him and his sister with strangers again. Sad indeed. I know God is with us.

I had to find an effective way to deal with my self-imposed fears. That is why I started being an active member on the brain aneurysm foundation Facebook page, started this blog, written a book which is due to be released end of this month, and started plans to form a support group in the Dallas area. I have become a doer not a talker.

The complexity of the Brain

About a week ago, I was going through my medical records of when I was first admitted to the hospital following the rupture of my aneurysm. Something caught my attention that has led me to a new conversation… or perhaps just digging deeper into the complexity of life. This was on my neuro checks at the section where they had to record my level of consciousness. At one point, it was indicated that I was unconscious and the other times, it was indicated that I was semi-conscious. It got me thinking…what is the difference/relationship between brain and mind, alert and conscious? Does the brain control the mind? If you are alert, can we assume that you are also conscious?

In Biology, we are told that the brain is part of the tangible and visible world of the body. You can see it and you can feel it. The mind, however, is the part of the invisible, transcendent world of thought, feeling, imagination, and attitude. In other words, the mind is the devil’s right hand. It is responsible for all the negativity, laziness, restlessness, doubtfulness…etc. The mind cannot manipulate the brain but the brain can manipulate the mind by what we commonly refer to as intuition. Intuition can only be successful at influencing the brain if the person if fully conscious.

From the healthcare standpoint, to be alert, you only need to be awake and responsive. To be conscious, you need to be: alert, attentive, able to follow commands and be aware of your surroundings.

Doctor Jacob Sage, a neurologist and one of the well-known bloggers, defines conscious as nothing more than the ability of our brain to acquire information (which is the state of being awake)  AND all the content that the information contains AND the ability to get all that information into and out of memory. The key word is “ALL”. If you have all that, you are conscious of the blue sky and the red sun. Nothing more is needed to be conscious of that beautiful sky.

The Complete Headache Chart

How well do you know your headaches? Here is a complete list of the different types of headaches.

The Complete Headache Chart

Allergy Headaches

Symptoms: Generalized headache; nasal congestion; watery eyes

Precipitating Factors: Seasonal allergens, such as pollen, molds. Allergies to food are not usually a factor.

Treatment: Antihistamine medication; topical, nasal cortisone related sprays; or desensitization injections

Prevention: No

Aneurysm

Symptoms: May mimic frequent migraine or cluster headaches, caused by balloon-like weakness or bulge in blood-vessel wall. May rupture (stroke) or allow blood to leak slowly resulting in a sudden, unbearable headache, double vision, rigid neck. The individual rapidly becomes unconscious.

Precipitating Factors: Congenital tendency; extreme hypertension

Treatment: If aneurysm is discovered early, treat with surgery.

Prevention: Keep blood pressure under control to prevent.

Arthritis Headaches

Symptoms: Pain at the back of head or neck which intensifies on movement. It is caused by inflammation of the blood vessels of the head or bony changes in the structures of the neck.

Precipitating Factors: Cause of pain is unknown

Treatment: Anti-inflammatory drugs, muscle relaxants

Prevention: None

Caffeine-Withdrawal Headaches

Symptoms: Throbbing headache caused by rebound dilation of the blood vessels, occurring multiple days after consumption of large quantities of caffeine.

Precipitating Factors: Caffeine

Treatment: Treat by terminating caffeine consumption in extreme cases.

Prevention: Avoiding excess use of caffeine

Chronic Daily Headaches

Symptoms: Refers to a broad range of headache disorders occurring more than 15 days a month; two categories are determined by duration of the headache (less than four hours and more than four hours).

Precipitating Factors: Typically evolve from transformed migraine. Although not related to chronic tension-type headache, they can evolve from episodic tension-type headache. Can be associated with medication overuse.

Treatment: Depending on the type of CHD, different treatment options exist. It is important to limit analgesic use.

Prevention: Based on diagnosis of headache, how long they last, and the number experienced per month.

Cluster Headaches

Symptoms: Excruciating pain in the vicinity of the eye; tearing of the eye; nose congestion; and flushing of the face. Pain frequently develops during sleep and may last for several hours. Attacks occur every day for weeks, or even months, then disappears for up to a year. Eighty percent of cluster patients are male, most between the ages of 20 and 50.

Precipitating Factors: Alcoholic beverages; excessive smoking

Treatment: Oxygen; ergotamine; sumatriptan; or intranasal application of local anesthetic agent

Prevention: Use of steroids; ergotamine; calcium channel blockers; and lithium

Depression and Headaches

Symptoms: People with painful organic diseased tend to become depressed.

Precipitating Factors: Causes can originate from a wide variety of complaints that can be categorized as physical, emotional, and psychic.

Treatment: The presence of depression is often subtle and the diagnosis is frequently missed. Depression is a wide spread affliction that can be treated, but first it must be unmasked.

Prevention: Physicians can prescribe tricyclic antidepressants, selective serotonin re-uptake inhibitors, or monoamine oxidize inhibitors in the treatment of headaches associated with depression.

Eyestrain Headaches

Symptoms: Usually frontal, bilateral pain directly related to eyestrain. It is a rare cause of headache.

Precipitating Factors: Muscle imbalance; uncorrected vision; astigmatism

Treatment: Correction of vision

Prevention: Correction of vision

Exertional Headaches

Symptoms: Generalized head pain of short duration (minutes to an hour) during or following physical exertion (running, jumping, or sexual intercourse), or passive exertion (sneezing, coughing, moving one’s bowels, etc.)

Precipitating Factors: Ten percent caused by organic diseases (aneurysms, tumors, or blood vessel malformation). Ninety percent are related to migraine or cluster headaches.

Treatment: Cause must be accurately determined. Most commonly treated with aspiring, indomethacin, or propranolol. Extensive testing is necessary to determine the headache cause. Surgery is occasionally indicated to correct the organic disease.

Prevention: Alternative forms of exercise; avoid jarring exercises

Fever Headaches

Symptoms: Generalized head pain that develops with fever and is caused by the swelling of the blood vessels of the head.

Precipitating Factors: Caused by infection

Treatment: Aspirin; acetaminophen; NSAIDs; antibiotics

Prevention: None

Giant Cell Arteritis

Symptoms: A boring, burning, or jabbing pain caused by inflammation of the temporal arteries; pain, often around the ear, when chewing; weight loss; eyesight problems. This rarely affects people under 50.

Precipitating Factors: Cause is unknown. May be due to immune disorder.

Treatment: Steroids after diagnosis; confirmed by biopsy

Prevention: None

Hangover Headaches

Symptoms: Migraine-like symptoms of throbbing pain and nausea, but it is not localized to one side.

Precipitating Factors: Alcohol, which causes dilation and irritation of the blood vessels of the brain and surrounding tissue.

Treatment: Liquids (including broth); consumption of fructose (honey, tomato juice are a good source)

Prevention: Drink alcohol only in moderation

Hunger Headaches

Symptoms: Pain strikes just before mealtime. It is caused by muscle tension, low blood sugar, and rebound dilation of the blood vessels, oversleeping, or missing a meal.

Precipitating Factors: Strenuous dieting or skipping meals

Treatment: Regular, nourishing meals containing adequate protein and complex carbohydrates

Prevention: Regular, nourishing meals containing adequate protein and complex carbohydrates

Hypertension Headaches

Symptoms: Generalized or “hairband” type pain that is most severe in the morning. It diminishes throughout the day.

Precipitating Factors: Severe hypertension: over 200 systolic and 110 diastolic

Treatment: Treat with appropriate blood pressure medication

Prevention: Keep blood pressure under control

Menstrual Headaches

Symptoms: Migraine-type pain that occurs shortly before, during, or immediately after menstruation or at mid-cycle (at time of ovulation).

Precipitating Factors: Variances in estrogen levels

Treatment: At earliest onset of symptoms, treat using biodfeedback, ergotamine, dihydroergotamine, or a 5-HT agonist. Once pain has begun, treatment is identical to migraine without aura.

Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs

Migraine with Aura

Symptoms: Warning signs develop, which may include visual disturbances or numbness in arm or leg. Warning symptoms subside within 30 minutes followed by severe pain.

Precipitating Factors: There is a hereditary component. Other factors include: Certain foods; the Pill or menopausal hormones; excessive hunger; changes in altitude; weather; lights; excessive smoking; and emotional stress.

Treatment: At earliest onset of symptoms, treat using biofeedback, ergotamine, dihydroergotamine, or a 5-HT agonist. Once pain has begun, treat with: ice packs; isometheptene; mucate; combination products containing caffeine; ergotamine; DHE injectable and nasal spray; 5-HT agonists; analgesics or medications, which constrict the blood vessels. Steroids may be helpful for prolonged attacks.

Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs

Migraine without Aura

Symptoms: Severe, one-sided throbbing pain, often accompanied by nausea, vomiting, cold hands, sensitivity to sound and light

Precipitating Factors: There is a hereditary component. Other factors include: Certain foods; the Pill or menopausal hormones; excessive hunger; changes in altitude; weather; lights; excessive smoking; and emotional stress.

Treatment: Ice packs; isometheptene; mucate; combination products containing caffeine; ergotamine; DHE injectable and nasal spray; 5-HT agonists; analgesics or medications, which constrict the blood vessels. Steroids may be helpful for prolonged attacks.

Prevention: Biofeedback; betablockers (propranolol, timolol); anti-convulsant (divalproex sodium); calcium blockers; and NSAIDs

New Daily Persistent Headache

Symptoms: Best described as the rapid development (less than three days) of unrelenting headache. Typically presents in a person with no past history of headache.

Precipitating Factors: Does not evolve from migraine or episodic tension-type headache. It begins as a new headache and may be the result of a viral infection.

Treatment: Can resolve on its own within several months. Other cases persist and are more refractory.

Prevention: Does not respond to traditional options, but anti-seizure medications, Topamax, or Neurontine can be used.

Post-Traumatic Headaches

Symptoms: Localized or generalized pain, can mimic migraine or tension-type headache symptoms. Headaches usually occur on daily basis and are frequently resistant to treatment.

Precipitating Factors: Pain can occur after relatively minor traumas, but the cause of the pain often difficult to diagnose.

Treatment: Possible treatment by use of anti-inflammatory drugs, propranolol, or biofeedback

Prevention: Standard precautions against trauma

Sinus Headaches

Symptoms: Gnawing pain over nasal area, often increasing in severity throughout day. Pain is caused by acute infection, usually with fever, producing blockage of sinus ducts and preventing normal drainage. Sinus headaches are rare. Migraine and cluster headaches are often misdiagnosed as sinus in origin.

Precipitating Factors: Infection, nasal polyps, anatomical deformities, such as deviated septum that blocks the sinus ducts

Treatment: Treat with antibiotics, decongestants, surgical drainage, if necessary

Prevention: None

Temporomandibular Joint (TMJ) Headaches

Symptoms: A muscle-contraction type of pain, sometimes accompanied by a painful “clicking” sound on opening of the jaw. It is an infrequent cause of headache.

Precipitating Factors: Caused by malocclusion (poor bite), stress, and jaw clenching

Treatment: Relaxation, biofeedback, and the use of a bite plate are the most common treatments. In extreme cases, the correction of malocclusion may be necessary

Prevention: Same as treatment

Tension-Type Headaches

Symptoms: Dull, non-throbbing pain, frequently bilateral, associated with tightness of scalp or neck. Degree of severity remains constant.

Precipitating Factors: Emotional stress, hidden depression

Treatment: Rest; aspirin; acetaminophen; ibuprofen; naproxen sodium; combinations of analgesics with caffeine; ice packs; muscle relaxants; antidepressants, if appropriate; biofeedback; psychotherapy; temporary use of stronger prescription analgesics, if necessary.

Prevention: Avoidance of stress; use of biofeedback; relaxation techniques; or antidepressant medication

Tic Douloureux Headaches

Symptoms: Short, jab like pain in trigger areas found in the face around the mouth or jaw; frequency and longevity of pain varies. It is a relatively rare disease of the neural impulses and is more common in women after age 55.

Precipitating Factors: Cause unknown, pain from chewing, cold air, touching face. If under age 55, may result from neurological disease, such as MS.

Treatment: Anticonvulsants and muscle relaxants, neurosurgery

Prevention: None

Tumor Headache

Symptoms: Pain progressively worsens; projectile vomiting; possible visual disturbances speech or personality changes; problems with equilibrium; gait, or coordination; seizures. It is an extremely rare condition.

Precipitating Factors: The cause of tumor is usually unknown.

Treatment: If discovered early, treat with surgery or newer radiological methods.

Prevention: None

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