Angiography

January 9 2007

Angiogram of healthy, left side of my brain

The MRI revealed what my problem was and where it was, but the doctors needed a clearer picture of the AVM. They couldn't really decide how to treat it by just looking at a piece of snot on an MRI image. so the next step was a cerebral angiography. this is a really unpleasant procedure, which i was really scared to have done. i had never had any type of invasive procedure done before, especially while still awake and once i had had the angiography explained to me, i just couldn't imagine how i was going to deal with it. being told that they perform twelve of these a day and it is perfectly safe doesn't make it any less icky.

first, i had to shave part of my pubic hair off in preparation. just the part around the femoral artery. this is the big artery in your inner thigh. colin was willing to do that (so was the nurse - no thanks!). while we were in the bathroom shaving my pubes, my dad phoned and i had a whole conversation with him; sitting on the toilet, covered in shaving cream, colin standing by with the razor. it was very surreal and i hope my dad is not reading this ;-) anyway, you shave the night before and get given one of those cool hospital robes that flap open around every naughty body part. suitably attired, i went to bed with the instructions not to drink or eat anything after 12am, not even water. This alone was torture as i usually drink litres of water day and night.

i got woken up early in the morning and was wheeled in a gurney down to the basement/dungeon where they perform the procedure. even just being wheeled around the hospital in the gurney was a new experience for me. it really does look like they show in the movies, but didn't go too well with my nausea. i went in, vibrating with fear. I was in a big white room with a huge bank of TV monitors on my left and large x-ray machines above and on both sides of my head. i felt like a prisoner in a sci-fi movie about to be interrogated. there were about 4 people in the room, speaking in a chinese too complicated for me to understand, adding to the whole sci-fi feeling of the experience. the female radiologist spoke broken english and tried to calm me a bit.

first, they swab your inner thigh with ice-cold, yellow disinfectant. i looked like i had a horrible skin condition. then they inject anaesthesia into the area. of course, the injection hurts like hell. then they are ready to start the procedure. a technician inserted a small catheter into my artery. this catheter is then passed through the whole body, following the artery all the way up to the neck, stopping just behind the ear. the anaesthesia obviously had no effect on the entry point of the catheter because that was still painful. but the most disturbing was when the catheter passed through my stomach and bladder area; i could actually feel this little rubber snake moving through my artery, pushing against the artery walls - ergh! once the catheter was in place in my neck they shot a contrast medium through it, into my brain. this medium follows the path of blood vessels through your brain and shows up on x-rays. oh and it also burns like mad. the whole side of my head started burning from the inside and i could taste the chemical in my mouth. how could this be safe, it didn't feel safe!

once they have shot the contrast medium into your brain, they then take a super-fast series of x-ray images to basically make a map of the veins and capillaries in your brain. when they took the x-ray images i saw crazy lightning flashes projected onto my closed eyelids - who needs drugs when you can just have an angiography. this only took a few minutes and then i could open my eyes and see the pictures they had taken on the bank of TV screens next to me. it didn't seem real, all those bizarre squiggly lines couldn't be mine. that couldn't be inside my head. you feel strangely detached from yourself when you are looking at pictures of the inside of your body. i am not me and those are not pictures of my body; none of this is real.

but the sheer physical experience of the angiography makes everything very real, very quickly. especially as while i was contemplating the images that were not mine they pulled the catheter back out of one side of my neck and pushed it into the other and repeated the whole process. Then they whipped the catheter out of my body and placed a one kilogram sandbag on the wound to stop bleeding. i had to lie on my back with the sandbag in place for four hours. then i had to lie motionless for another four hours after the sandbag had been removed. i was not allowed to move my leg and it was amazingly painful. this is to stop arterial bleeding, which is very dangerous. i hated every minute of it and was a complete baby about the whole thing really, but at least i didn't cry.