Meet Dave (My trip
to Sheffield)
Today I took a rather
large step towards getting my AVM (Dave) dealt with as I had my
consultation with the lovely staff at the Royal Hallamshire Hospital
in Sheffield which is the specialist hospital in the UK for
Stereotactic Radiosurgery or Gamma Knife as its also called.
Gamma Knife is
essentially targeted radiation to shrink the AVM into something
resembling scar tissue over a couple of years, which if sucessful
should stop my pesky AVM from bleeding again.
From the website they
have it described as:
“The
Gamma-Knife is not a knife in the conventional sense, but uses a
focused array of intersecting beams of gamma radiation to treat
lesions within the brain. The technique was invented by
a Swedishneurosurgeon, Professor
Lars Leksell and
provides an alternative method of treatment for a number of
conditions, for which open neurosurgery may be either not practicable
or carry a high risk of complications.
Within the
central body of the Gamma Knife there is an array of separate
cobalt sources (201
in the 4C model) (192 in the Perfexion Model) and each of these
produces a fine beam of gamma radiation. The sources are evenly
distributed over the surface of the hemispherical source core so that
each beam is directed at a common focal spot at the centre. The
resultant intensity of radiation at the focus is extremely high
whilst the intensity only a short distance from the focus is very
low. This enables a high dose of radiation to be delivered to
the abnormal tissues whilst sparing the adjacent healthy brain
tissue.”
The
machine looks something like this
As
well as seeing the hospital I also got to meet my consultant Mr
Yianni who seemed a thoroughly pleasant chap and very helpful in
answering my questions and queries which turned out to be few due to
the extensive research I have carried out around the subject
(thankyou Internet!)
The
treatment which should hopefully occur within a month (finally!)
seems fairly painless with the exception of the metal frame that will
be screwed into my head which will look a little bit like this
Mr
Yianni also answered some questions on the size and location of my
AVM which I had previously had been a little bit in the dark about!
Turns out as I thought its located in my Occipital lobe (but had also
affected my other brain areas due to the size of my bleed) and is
around 3cm or so in size, which is good in the sense that the larger
it is the worse it is. I also got to see the images from my angiogram
that had taken place in December, which I had seen in real time
whilst the procedure was under way (seeing the inside of your brain
in real time is WEIRD!) but had not the chance since!
To
explain the picture a little, the large snake like bit is a “feeding
artery” and the large black blob is the Nidus of the AVM, which is
basically the nasty tangled bits that cause all the problems!
Above is the inside of my bloody brain, or rather an X-ray showing "Dave" in all of his tangled glory, the evil little shitbag.
Gamma
knife is the safest way of removing an AVM, but like any procedure
involving the big pink mass of flesh it involves risks which they
outlined to me. The benefits obviously massively outweigh the risks,
as to leave it untreated would essentially be a case of when it would
re-bleed rather than if
it would re-bleed
The
main risks involve having an angiogram before my gamma knife
procedure, which leaves me at risk of a stroke during the angiogram.
An angiogram is basically where they insert a tube into my groin
(into an artery) and then inject a dye which is then carried into the
brain and gives them a much better picture of the blood vessels
inside which they see through an X-Ray.
A
better explanation is:
“An
angiogram or arteriogram is an X-ray test that uses dye to
demonstrate the arteries. Arteries are invisible to X-ray so the only
way they can be seen is by filling them with dye. The correct name
for the dye is 'contrast', and it is the iodine it contains that is
visible on X-ray.”
Its
a little uncomfortable, but no biggie! There is some strange
sensations as the dye gets injected (like a reverse shot) as the
warmth spreads through the blood vessels, which is a little strange
but not too bad. The worst part is afterwards as you have to stay
still for 4 hours whilst the wound closes up.
The
other risk is that the gamma knife could cause further damage to my
occipital lobe, which as I discovered today is still far from
recovered. I had thought my peripheral vision was pretty well
recovered, or maybe I had just got used to it being poor, but as I
discovered when they did a visual field test its still pretty bad.
The Consultant could not put an exact percentage chance of It getting
worse, but said it was fairly likely but that it should also return
to normal (Well my new “normal”) after a couple of months, which
I am pretty cool with. Risks and benefits and all that, its worth
being a little bit blind in my peripheral vision if it means the
horrible little bastard gets obliterated!
I
have also chosen to now call my AVM Dave in “honour” of our
current incumbent Prime Minister David Cameron (Prime Minister is a
nice way of saying Grand
Shitbag)
as its much like the current PM in that I really wanna see it gone
ASAP, but unlike Big Dave I will have to wait a little longer to see
it go.
They
estimate around 2 years or so before its properly gone, which they
will confirm through a further Angiogram, which whilst annoying in
the respect that it will still be hanging over me a little bit, its
the safest option!
Even
with that in mind, I am really really really really really looking
forward to getting my life back in my own hands. The consultant
reckons if it all goes well I can return back to work around 2 weeks
or so post gamma which is nice, as much as it sometimes drove me up
the wall I really enjoy working there. And it will bring back
routine, human contact and further cognitive challenges that my life
has severely lacked since this all happened.
I
would be lying if I said I was not a little fearful at going back, as
its the scene of the crime in the sense of that it is where my bleed
occurred.
BUT
and
its a big BUT
As
I have learnt on this journey, fears are there to be confronted and
to challenge you and mainly to be overcame. Its something I look
forward with relish to taking on :)
Thats
about all for now, i'm gonna have me a beer!
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