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Aloha Friday

What A Pain In The Brain

It has been brought to my attention - by my Self - that I haven't really blogged about Rob's branial-cranial sitchyation, which is so weird, because I tell you every damn thing else that happens to me. (You're going, "We know, we know...") So, having gotten permission from Hubs Himself, I'm going to give it to you here in timeline fashion, as that's the easiest way for me to remember it all, and I may yet get it wrong because the days have blent together in me' noggin. But here goes:

October 29, 2011: While the girls and are camping out with the Girl Scouts, Rob stays home with Jack and endures probably the worst migraine of his adult life. (He used to get them badly as a kid, and has had a few here and there, but none like this.) Nausea, vomiting, sensitivity to light and sound, the whole bit. Classic migraine. Pain scale: 10.

October 30, 2011: We return home. Headache still present. Rob simpers that complaining to me about having a headache is similar to (example I can't remember, but unfair, basically, because I suffer from them frequently and badly myself), to which I reply that he is free to complain away, if it helps, as I sympathize.

Halloween: A better day, but we skip trick-or-treating (kids being disciplined) and do some shopping, during which headache worsens. We cut trip short and go home to medicate Rob.

November 1-2: Migraine present, but not vomiting, at least. Rob goes to work but comes home early both days, in pain.

November 3:  Headache persists and is so bad, again, that we go to ER. Doc takes history, gives Dilaudin, Phenergan, and Benadryl. Relief is immediate. Eventually, he is released and sent home.

November 4: My BFF, Dr. Lisa, inquires about Rob's visit to the ER and headache status. She insists symptoms are not normal and that he should NOT be at work but in hospital instead. Trusting her instincts, I inform Rob of this. He immediately comes home. We head back to ER. They perform CT scan and bloodwork. Labs appear normal, but CT pictures show evidence of TIA's, transient ischemic attacks, aka "mini-strokes." Hi, I freak. We are told they will contact NMCP (Naval Medical Center Portsmouth) to get his Neuro appointment bumped up ASAP. He is released.

November 5-6: Headache persists. Because of mini-stroke scare, I cancel my camping training trip for Girl Scouts to stay home with Rob, who is miserable.

November 7: Headache very bad. Stressed and anxious about TIAs (both past and possible current/future), I call civilian ER and implore them to call NMCP to move up the Neuro appointment. They inform me that 11/30 is earliest available as they have already done so, and to return if symptoms worsen or new ones appear.

November 8: Bad, bad headache. We return to civilian ER for treatment. ER doc once again takes history from onset of headache on 29 Oct and performs an exam. Finds right side neurological deficit, including weakness in hand and low/no reflexes in leg. I implore him to repeat CT scan, to see if there are changes (new mini-strokes?) since Friday's scan. He agrees. CT performed. New spots are noted but not ruled in or out as TIAs. Because of right-side weaknesses, he is transported by ambulance to NMCP and admitted to hospital. I go home, pack kids and food for co-op cooking classes, and drop them off at friend Jenny From the Block's house before heading to NMCP. I find him dozing and in the company of - surprise! - three male roommates, which means I will not, as expected, be spending the night with him. Sad. Neuro does rounds, checks on Rob. Says no food or drink until MRI is done in morning, which sucks because he's starving. Neuro orders pain and sleep meds by IV.  BP still high. I'm kicked out after 10 PM, more than two hours past visiting hours, over the protests of his friendly roommates.

November 9: In NMCP, Rob gets MRI of soft tissue, MRI of hard tissue, MRA (basically, an MRI of the vasculature). TIAs not necessarily confirmed, but not ruled out, either. Diagnosed with benign cavernous angioma, a tumor that's (correct me if I'm wrong) a tight cluster of blood vessels in the back left area of his cerebellum. "Benign" does not mean "not harmful," just "not cancerous." Bleeding could occur, which could cause blindness, kidney, pancreatic issues, and death, among other fun things, so there is much cause for concern. MRI is still needed for thoracic and cervical spine, to see if there are more tumors, as Von Hippel-Lindau disease is now suspected. It is decided to release him that evening and do the MRI on outpatient basis (scheduled for 21 November), keeping Neuro appointment for 30 November. Released with script for compazine only, for migraines.

November 10-11: Headache persists, possible migraine, not helped by Compazine at all. Extremely, worrisomely sleepy. Gets time off work (thank God) and sleeps most of time.

November 12-13: Rob okay, mas o menos, but again very sleepy. Sleeps most of weekend.

November 14: Migraine up to an 8-9. Two doses of compazine don't help. Recommended to take to ER by ??? (someone one of us called, but I was so tired, I can't remember who now), but again, I was too tired, I did not feel comfortable to drive. So, Rob takes an Ambien in order to sleep through the pain, and goes to sleep. Me too.

November 15: Migraine persists. New symptoms: Hyperesthesia, in that the pizza boxes I bought from 7-11 for the kids' dinner and hand over to Rob so I can drive are almost dropped, from the sensation of burning heat. I take them back; they are not at all hot. Not anywhere on the box, despite his protests that they are. Also, later in ER, tingling and numbness along jawline, from middle of ear to center of chin.

So, Immediately following my breast cancer gene appointment (see previous post), decision is made to return to civilian ER for migraine relief, after all-day suffering. Compazine not effective, at all, ever, so Dr. Melanie orders stoppage. What? You didn't know I was an MD? Me neither. We head to ER, which is unusually full. A long wait is promised. I decide to page the NMCP on-call neurologist, to see if we can't get a new migraine treatment med prescribed while we wait. In the meantime, Rob is called back to the exam room in short order, but waits a long time to see the doc. Finally, kids and I are allowed back, just as he is getting hooked up to IV saline drip. We wait another long time, during which NMCP Neuro returns my call, pissily asking what he can do for me THIS time and complaining that I am abusing the call-back privilege. I state that we have, in the meantime, gone to the ER for pain relief, that his primary care is NOT available in the off hours, and so therefore I should do what instead?! Neuro says, "Come see me at 0800 tomorrow so we can get a management plan in place until his upcoming appointments." Yay! Agrees that compazine should be discontinued (see?) and that we (he) should seek pain relief from ER doc until morning.

ER Doc then visits, takes history of this issue (from Oct 29-present) and proceeds to examine Rob. Agrees that compazine should be discontinued and new med prescribed, but upon hearing that we have an appointment the following morning with NMCP Neuro, tends toward providing immediate comfort and letting the Neuro make future medical decisions. Nurse eventually administers Dilaudid for pain, Phenergan for nausea, and more saline for dehydration. Observation ensues. Pain level goes from 9 to 2 quickly. YAYYYYYYYY. Doc decides to give another half-dose of Dilaudid to bring it down further, observe for 10 more minutes, and release Rob. We go home, Rob high as a kite and happy about it.

November 16: 0800 appointment with Neuro. Will update when possible.

Thank you to all of you who have been thinking of Rob and us, praying and sending good thoughts our way. We appreciate each and every one of you. I won't be sleeping tonight, as the kids and Rob have to get up in ~3 hours to get to NMCP on time for Neuro appointment, and I don't want to oversleep. Feel free to entertain me with lovely comments! ;)