Trip 1

My Summary

Josh and I made our first trip to Denver for treatment on October 8-11 2007.

Arrived in town on Oct 8th to meet with Dr. Reed before the actual procedure.. He took a movie (I'm a star!) of inside my mouth and down my throat, which involved me "singing" and hitting the high notes! Such a fun first little visit. It was very interesting to see the inside of my throat and my punching bag and how the larynx opens and closes.

Arrived at the hospital early in the morning on the 9th. Went to the pre-op area where the nurses added a push pin for Sacramento on their wall of patients. Lot's of questions from me, and very patient answers from everyone! Did all the "pre-op" stuff like hook me up to the IV, took blood, filled out paperwork, met with the anesthesiologist, etc. Dr. Yakes stopped by to answer any lingering questions I had before going in.

There was a little girl, probably about 8-10 years old, from Mexico in the room next to me. She also had a facial AVM. She walked by my room and I saw that she was holding her hand up to her face. I was so sad for her! The size of her AVM was pretty comparable to the size mine is now and I can only imagine how difficult it was for her to live with that. Kids are mean at that age. Not because they are mean spirited, but because they are kids. I am sure that she gets teased and probably walks around with her hand up to shield her face from onlookers regularly. I was so glad that she was here getting treatment for this and hope that one day she won't have any reason to hide her face.

I had to do an MRI first, which was probably one of my biggest worries for the day. I'm super clausterphobic in those things! They gave me some Valium to help, and honestly I did very well if I do say so myself. Just closed my eyes, pretended I was NOT all locked up in prison, and tried to relax. The constant and rhythmic noise even eventually lulled me to sleep a little towards the end!

I went directly from there to the OR (or whatever the room is called where they do the embolizations) for the angio & embo. Super nice anesthesiologist! I had warned them before hand that I am sensitive and have a history of waking up nauseous and being very sick to the point of preventing me from leaving the hospital. But they put together a super cocktail for me and did their best to promise I wouldn't have that reaction.

Woke up and felt no side effects from the anesthia! Yay! I was so excited that I felt "good" that I really couldn't even focus on anything else! My face was swollen, but not huge. After waiting the necessary amount of time to lay flat due to the angio, I ate some pudding and jello, and drank some cranberry juice, and then I was outa there! We went back to the hotel and just went to sleep.

We stayed at the hotel all day on Wednesday and just slept and watched TV. I felt pretty good, just a little weak and sore. On Thursday we were ready to fly home. The swelling and bruising had really set in by then, and I definately looked like someone who had just had surgery. Luckily we were able to use this as an excuse to get "blue passes" on Southwest and preboard the plane ensuring a front row seat, and then we were on our way home!

Continue to Trip 2

Medical Mumbo Jumbo!

Indication: Extensive facial arteriovenous malformation, large mass lesions in the submandibular area and left facial area and tongue. Severe pain syndrome. Pulsatile tinnitus.

Report of Operation

Operation: Head, neck, and cerebral arteriogram procedure; repair of lingual and right anterior chin AVM repair procedure.

Complications: None (yay!)

Estimated Blood Loss: Less than 5 ml.

Operation Notes: ...Utilizing a micropuncture set, access to the right common femoral artery was achieved and a 4-French Terumo Glidecatheter was advanced over a wire from the right common femoral artery to the right external iliac artery, right common iliac artery, abdominal aorta, thoracic aorta, aortic arch, right innominate artery, aright subclavian artery, right vertebral artery, right common carotid artery, right internal carotid artery, right external carotid artery, right facial artery, right lingual artery, right internal maxillary artery, left common carotid artery, left internal carotid artery, left external carotid artery, left facial artery, left lingual artery, left internal maxillary artery, left ascending pharyngeal artery.

Arteriograms were performed of all these branches showing no evidence of intracranial pathology. There is extensive supply to the AVM involving the lingual area, submandibular area, and left facial area. Supply from all branches of the right external carotid artery as well as the left branches external carotid artery are noted to supply this AVM. Branches from the ophthalmic artery on the left with additional branches from the cavernous carotid as well as the petrous carotid are seen coursing forward to supply AVM in the left facial area. Giant venous outflow is also identified, which is also very unique in this lesion.

At this point, utilizing a 21 gauge needle, access to the malformation in the lingual area along the midline was performed and contrast injected, angiogram performed and the study reviewed, and a total of 5 ml of ethanol was utilized to treat that compartment. A second compartment was then accessed percutaneously in the anterior right chin area and contrast injected, angiogram performed and the study reviewed, and one 12 mm diameter, thirteen 10 mm diameter, and four 6 mm diameter fibered nester coils, followed by 5 ml of ethanol were utilized to treat this compartment. Control angiogram demonstrated occlusion of both compartments post embolization.