Trip 5

My Summary

June 3-5 2008

Josh was able to get some time off and came with me again. So far he has been able to make every other trip with me. As much as I love everyone else, it is still always the best when he is with me. While everyone takes very good care of me (cause really, who better to care for you than one of your 3 moms?!?) I still feel the most secure and relaxed with my Joshua!

We met a really nice lady on the plane. She was previously a nurse and now works for a pharmaceutical company, traveling and talking with doctors and health care workers. She was interested in what was going on with me and my ugly lip wound, and we talked the entire flight to Pheonix.

Arrived in Denver grabbed lunch, and explored downtown a little. Found a fun little park in the middle of the city and just sat enjoying the sun for a while. We were able to get in early to see Dr. Reed. Because of my swollen lip, the wound, and the potential for bleeding we didn't really do an exam. He just kinda checked things out from a distance but did perscribe me an antiobiotic since my lip was infected again...for the third time!

Went to Swedish the next morning and met an entire new group of nurses. All super nice. (It's like a stepford hospital but without any of the bad stuff!) One nurse seriously looked just like my girlfriend Kim that I took tons of classes with at SJSU...and her name was Kim! How crazy is that?

Dr. Yakes came in to chat with me before the treatment since I was still super freaked out about my lip and it bleeding while I was in the OR (if you read my blog, it details that I was all out of sorts at this point about my lip and the scary bleeds and such.) I of course came off as a control freak when I was basically telling him how to do his job! I even told the anesthesiologist to be careful when they intubated me...like they wouldn't have anyways!!!I can't help it! I like to be in control. Dr Yakes is totally the best though and wasn't the least bit offended or annoyed with me. Or at least he didn't show it! He just tried to calm me down a little and remind me that he would be there in case anything happened and he would take care of me! Seriously, I'm a little too paranoid sometimes!

Also, this trip was the last time I would see Andy, one of Dr Yakes PA's. She moved on to another job that she loves. She was always very nice and helpful, and I'm sure all of Dr. Yakes patients will miss her!

The treatment went well. He did focus on my lip which cause HUGE swelling by the next day. I wish I had a picture cause it was crazy! Steph came to visit us that night at the hotel and brought McDonald's milkshakes, fries, and pies! (It's always some yummy dessert when we get together!) Since I was already on a LOA from work, I didn't have to worry about recovering quickly and was able to just relax at home and start my HBOT treatments!

Continue to Trip 6

Medical Mumbo Jumbo

Indication: Massive anterior face and left face AVM, pain and swelling symptoms.

Report of Operation

Operation: Bilateral facial and head and neck arteriogram procedure; repair of anterior chin malformation; repair of lower lip vascular malformation repair procedure; repair of left facial vascular malformation repair procedure.

Complications: None

Estimated Blood Loss: Less than 5 ml.

Operation Notes: ...Utilizing a micropuncture set, access to the right common femoral artery is achieved and a 4- French Terumo glidecatheter is 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, left common carotid artery, left internal carotid artery, left external carotid artery, left facial artery, left ascending pharyngeal artery, left internal maxillary artery, right innominate artery, right common carotid artery, right internal carotid artery, right external carotid artery, right facial artery, right internal maxillary artery, right subclavian artery, right vertebral artery. Arteriograms are performed of all these branches demonstrating extensive AVM in the left facial area, land lower left chin region.

At this point direct puncture was performed in the lower lip area of the AVM, contrast was injected, angiogram performed and the study reviewed. A total of 2 ml of ethanol with a 50% mixture of contrast was utilized to treat that compartment.

A second area of malformation was then accessed in the lower right lip area with a 23 gauge needle, contrast injected, angiogram performed and the study reviewed. A total of 1 ml of ethanol with a 50% mixture of contrast was utilized to treat that compartment.

A third area of the malformation was accessed in the lower lip area with a 23 gauge needle, contrast injected, angiogram performed and the study reviewed. A total of 2.5 ml of ethanol was utilized to treat that compartment.

A fourth area of malformation was accessed percutaneously in the left lower lip area, contrast injected, angiogram performed and study reviewed. A total of 1.5 ml of ethanol with a 50% mixture of contrast was utilized to treat that compartment.

A fifth area of malformation was accessed percutaneously in the left lateral lower lip area, contrast injected, angiogram performed and study reviewed. A total of 2.5 ml of ethanol with a 50% mixture of contrast was utilized to treat that compartment.

A sixth and final compartment was accessed percutaneously in the left facial area with a 23 gauge needle into the lesion, contrast injected, angiogram performed and study reviewed. A total of 1 ml of ethanol was utilized to treat that compartment.

At this point control angiograms were performed on all six compartments thrombosis. Arteriogram of the right internal maxillary artery shows significant AVM reduction in anterior chin, lower lip and left facial region. The procedure was then terminated.