A Cerebral Angiography.. also called a Cerebral Angiogram.. is an invasive procedure performed in Radiology, in which a doctor inserts a long catheter through the artery in your groin. The doctor snakes the catheter through your system, with the help of a camera on a screen, until it reaches the destination artery in your neck where he then sprays dyes that show bad blood vessels in the brain. My process went something like this:
I was greeted by the staff who was going to be in the room during my procedure. They were available to answer any questions I had. A nurse came to my paralyzed side and then asked me for my name and birthday. She began to explain the procedure and then read the release forms that I needed to sign in order for the doctor to begin. She proceeded to tell me a 5-minute-long list of scary side effects, some being seizure, loss of limb(s), stroke, a coma, paralysis and death… I had already experienced two of these things earlier from the AVM rupturing.. she then informed me that these are rare symptoms and only happened at a rate of 1 in 100 patients.. I smiled and laughed while I told her my AVM was already something I had experienced that is rare, what have I got to lose now… I signed scribbles with my somewhat paralyzed arm in three different places. I was then moved from my bed to a table similar to the one in an operating room. Its hard and flat and cold. All male staff exited the room while the female staff placed monitors all over me. One notified me that she was then going to inspect my groin area to find the artery that they will be using.. The nurse only uncovered the area that she needed, and was very careful to keep my privates, private.. She told me the next steps she needed to perform… which was me receiving a fresh close shave followed by a minute long orange-colored-ice-cold-freezing-rub of the antiseptic on the location over the artery.
I knew the show was about to begin because the Doctor and entire staff of about 8 people walked in and went straight to prepping their tools. I took the option of having 2 pre-warmed blankets placed on me because I was shivering from the cold. I take advantage of warmth when I can have it. A huge hanging 20-inch square grey plate, covered in plastic, was set in place by machine just an inch or two above my nose. From what I could now see, the room was actually really cool looking now that my mind was off the freezing temperature. The room was huge, bright and white, and there were tracks on the ceiling so that different machines could move. The staff was full of smiles while they moved two floating 40-inch flat screens to my left side and placed this Wall-E looking X-Ray machine behind my head. I began to be tucked in with the blankets and my head was placed in a stabilizer to help it stay still and in place during the procedure. I asked the doctor about the side effects that worried me and he reassured me that I had more chances not experiencing them.. We spent a minute going over the procedure one more time and I said to him, “Side effects or not this is probably something that you would WANT to have done.” I felt ready to go and I couldn’t stop smiling.. they probably thought I was on narcotics for the pain I had been feeling from the hemiparesis but.. I was just plain excited.
I feel safe in hospitals. I feel like no matter what, I will be taken care of if something happened. Especially when I’m surrounded by such a sweet staff, some young, some old, who all are so professional and sure of themselves and the job they have to carry out.
Everyone stood in their places while the Doctor told me that I would feel a stinging for a few seconds while he injected the anesthesia to the site. I replied and said “ok” causally because normally the stinging is never as strong as they say.. but he was not kidding. I gritted my teeth and groaned painfully for a good 10 seconds while I felt like acid was being poured on the right side of my groin, near the crease of my leg.. THAT SHIT WAS PAINFUL, I’m sorry for cursing, please excuse my french.. a few seconds later I felt this numbed thumping, something warm started to run down the crevices of my groin in pulses, which was obviously blood from the artery, and then I felt something that was weirdly snaking through my heart. I was calmly eyeballing around the room and at the doctor while the staff worked.. Just at the things I could see without moving my head or body.. Although the flat screens were in view, I was way too chicken to look over to them, I knew that I would be able to see what was going on and the catheter that the doctor was currently snaking through my insides on that screen.. so.. I thought it would be best to refrain from viewing it. The doctor began to tell me that in a few minutes the entire staff was going to leave the room, he would be injecting a series of dyes from another room and while they were being injected, I would feel a warming sensation in the areas of my brain that they were focusing on. He told me that it was extremely important to remain very still and to not move during the entire procedure. I again replied with a casual ‘Ok’ and a smile. He asked me if I was still doing ok while they took the Wall-E-looking X-Ray contraption, that I will now call Wall-E, and placed it near the left side of my head. As soon as it was set into position, the staff left the room and the first set of injections began.
The doctor notified me that he was going to do 1 test spray in the first area and asked again if I felt ok.. I said Yes, clenched my jaw and let my lips relax open, just in case, so that I wouldn’t move anything due to pain while they took the photos, I then got to experience the warming sensation in the first area, which was the top left side of my head down to around my left eye. It wasn’t bad! It just felt like a semi-hot tea was being poured on my skin and eye. The sensation made its way down to my cheek bone.. It was actually relaxing. I received two more sprays that had the same feeling, just stronger, but I was ok. No pain experienced. The photos were good and the staff came back in to set me up for the next area… the back of the brain.
I began to wonder why someone would ask every few minutes if I was still doing ok or feeling any pain.. I always replied nicely, it didn’t bother me at all. It was their job to make sure I was alert and well. I really appreciated it though. The older tech moved Wall-E and my bed into another position and explained that the next set would be of the back of my brain. He explained that patients have reported that these sets of warming sensations feel similar to whiplash, but to do my best to not move my head for any reason. A minute later, the doctor explained where the dyes were going and I again clenched my jaw. This set felt like I was standing way too close to a space heater. My skin underneath my hair and on the back of my neck heated in up 2 seconds from warm to like it had just been sunburned. The sensation goes away completely no more than 10 seconds after the doctor alerted that he was going to begin the photos. When the staff is in the side room and the pictures begin, the machine makes this audible clicking, similar to when you cock a gun to load it.. but much faster.. It was like 20-30 clicks within 10 seconds and it would still click just a few more times after I no longer felt warmth.
The next few set of sprays were HANDS DOWN THE ABSOLUTE COOLEST THING I HAVE EVER EXPERIENCED. The same process went on a few more times and these injections were felt in the top of the skull, and middle of my face around the cheek and eye bones. These weren’t painful, just hot and tingly with the warmth radiating from the inside of the skull to the skin.. The interesting thing about these sets were that with each spray, the veins on my eyeballs seemed like they were gradually filled with bright light and it was like you could see them on the eyeball and eye lid. It was incredible. I muttered an ‘OOOOO!’ through my jaw and slightly smiled while the dyes were injected.. I wanted to laugh because I felt like such a goofball, but, I didn’t want to mess up the x-rays and move.. I sat there and thought about how God takes the sometimes uncomfortable experiences we face and shows you the beauty in them. Wall-E was moved to another area of my skull and I saw how my skull was showing as a real-time x-ray on one of the flat screens, it was cool to see, and also noticed that I have a large head..The next set was the same tea heat but this time the room was filled with gorgeous, fireflies and sparks that came from the corners of my eyes and filled the room for a beautiful 3 seconds.. Ricardo loved this because it’s very similar to the sparks you see when the operator of a mini-truck that is driving and bagged (on air suspension) lowers the ride height to intentionally drop the frame of the vehicle on the pavement, so that the truck will ‘drag’ and create these sparks by using the frame, steel, or titanium pieces that are intentionally mounted on the vehicle to create this effect.
As soon as the doctor walked in I told him how cool those last scans were and he chuckled, everyone continued to work and one of the nurses told me she was glad I enjoyed it. The doctor explained that this would be my last set of injections, and that I would be done. He worked and quickly stepped out of the room while I smiled and clenched my jaw.. I was happy that I would be leaving the freezing room sooner than I thought.. For the final time I was reminded to hold very still while I suddenly felt pure burning pain shoot through the back of my neck, through my brain, sending burning sensations through my right eye ball which then radiated through the entire right side of my face.. making me groan loudly in pain, tear up and blink several times. The doctor asked if I was ok and said that this was the last injection. I braced myself and prepared for more pain. The second injection had the same effect but this time it went through my right eye and shot stinging pain across my forehead to my right ear making it feel like I was bleeding from it.. but thankfully I was not.. as soon as the staff came into the room I let out an ‘OW.’ The Doctor said I was finished, and I let out a sigh of relief.
I still couldn’t feel anything but I noticed the doctor quickly removing everything from the area he was working in. When he was done the rest of the staff cleaned up and got me ready for the last step. This was where I experienced the most pain. The amount of pressure that must be applied to an artery that has just been stabbed.. is awful. The pain is felt deep in the tissue and if its not done right it could bleed out underneath the skin, creating more problems for me. For 20 minutes, a tech held tons of necessary pressure to the artery in my groin while I looked over and noticed a slideshow of the pictures they had just captured. He explained that I would have to lie flat for the next 6 hours, and that I would not be allowed to move or elevate my bed while the artery healed.. I said “sure thing” and quickly asked if he could show me the ones with the bleeds and to my surprise they showed me. It didn’t look good.
He explained that all of the black tangles we were viewing on the screen, were the bad veins and arteries.. and they were showing where the bleeds were currently happening inside of my brain. It was a huge, tangled mess of highways and worms and knots and black dots covering a very large area of the left side of my brain. The female nurse came over to place bandages on my groin and while she did that, tears began to form in my eyes.. and like always, I set the blood pressure and heart rate monitors off.. I took a few deep breaths while she handed me a tissue and asked if I needed anything, so I asked for another warm blanket.. It gave me a minute I needed to collect myself because I hate it when anyone other than Ricardo tries to comfort me when I am upset.. I was then moved back to my bed and was wheeled to the double doors with the ok from the doctor to be taken back to my room. Each staff member smiled and each gave a genuine Good Luck to me before the doors to the hall way opened up… Ricardo and my Dad, who now had my older sister, were all standing there.
I wasn’t going to have the opportunity to cry about what I just saw for another couple of hours.