What you really wanted to know about brain aneurysms but were afraid to ask

There’s a lot of actual scientific info out there about hemorrhagic strokes for anyone with a working web browser; but based on a sample of my acquaintance, the stuff that everyone REALLY wants to know goes unasked and even more unanswered online. So here’s the straight dope on brain bleeds from one exceptionally stupid but unbelievably lucky survivor.

Does a subarachnoid hemorrhage hurt?

Maybe an 8 on a scale of 1 – 10, right behind the eyes. (I’m not saying 10 on principle to give myself some headroom; and I’ve only had a 9 “hope to die” pain once in my life, this wasn’t it.)

In the months before the aneurysm burst though, I had a long series of almost continuous bad headaches — which may or may not have been connected to the event! — and in hindsight I wonder if perhaps this oddly enough helped me because I was so used to stabbing pain in the headmeats. I think if you suddenly and without any warning experienced pain like that, most people would be flooded with adrenaline and stress hormones that would make a brain bleed much worse; but I was pretty calm (and exceptionally stupid, let me reiterate) about the whole thing.

When did you know you’d had a brain aneurysm?

Not till two and a half days later, in the ER. l thought I had super bad food poisoning for the first couple days, and just did what anyone would do in that case: laid in bed trying to drink water and take aspirin (which luckily I puked right up, cause aspirin thins the blood and thus is one of the worst things you can do for any kind of hemorrhage… although puking isn’t so wonderful in these cases either).

In hindsight it occurs to me that perhaps my dreamy two-day slide in and out of consciousness alone was, you know, not a sign of high intelligence. So here’s my public service announcement, kids: if you EVER pass out suddenly, go straight to the ER and get checked out instead of laying in bed trying to nibble saltines!

Did they vacuum up the blood in your brain during surgery?

Do people think they have tiny little shopvacs for brains or what? My aneurysm was on a bifurcation point of the middle cerebral artery, which you can find on this picture — pretty deep in there, right? — and the blood (a couple Tablespoons worth) had spread out pretty good by the time they operated. The brain is as soft as tofu and all convoluted, not suitable for vacuuming.

Does brain surgery hurt?

Not at all. The part that hurt the most was having a big-ass catheter called a central line inserted into an artery in my neck by someone who had never done it before.

Do you set off the metal detector at the airport?

Nope. I have two clips in my head (aneurysm burst twice), and I think maybe some screws from the craniotomy… but they’re tiny and made out of titanium, so I’ve never had a problem.

Did you think you could die?

Never occurred to me that I would not get 100% better. The rule of thumb seems to me that the higher your odds of going out, the less they mention it to you. So if your doctor is telling you that your cholesterol is a little elevated and you could die… the risk is purely theoretical. But if everyone is super cheerful and keeps assuring you that everything will be OK, you might want to make sure your will is up to date. I had no real idea of the odds until 2 weeks after my surgery when I finally spoke to the lead neurosurgeon.

Did you see god or get religion?

Nope, although I really wanted to. In fact one of my relatives came to pray over me and declared in prayer that I had promised to become a Christian if I got better — I did no such thing, I can assure you — and I almost blurted out, “You think your god doesn’t know you’re lying?” The closest I got to a Higher Power was lying there in the hospital for a week with nothing but science and the love of others to sustain me.

Do you have a bad-ass scar?

Yes but it doesn’t photograph well because it’s pale and about an inch back from my hairline. Ask me in person and I’ll show it to you.

How much does brain surgery cost?

$300,000 más o menos. Did I mention I was unemployed and had no health insurance when all this went down? I avoided bankruptcy almost entirely due to the charity of Stanford Hospitals — in addition to avoiding actual death and disability by their hard work.

Have you had any personality or sensory changes?

I might not be the best judge of this one, but I think not. Certainly I seem to have avoided the “gross neural deficit” that afflicts 35% of aneurysm patients.

Did you do something that made an aneurysm happen? Did you have any warning? Did you do anything that improved your outcome? Are you likely to have another one? Does it count as a pre-existing condition?

Don’t know, don’t know, don’t know, don’t know, and don’t know. I was quite amazed at how little they know about the whole thing… but part of it unfortunately is that so few hemorrhagic stroke sufferers seem to make a full recovery. Plus you can’t efficiently screen people for aneurysms before they burst… so the only way you can find out is the hard way.

Have your priorities in life changed? Are you less prone to do startups for instance?

Ummmm… that’s probably a whole separate blog post.