I am 49 years old and live alone. On April 26, 2013, I was getting ready for bed. I had just set my alarm clock, and the next thing I knew I was waking up on the floor, very weak. I pulled myself up onto the bed, and called 911. I was probably unconscious for a minute or two, based on the clock. My strength returned, and I was able to get myself into the stretcher when the ambulance arrived.
After various tests, I was told I had a ruptured brain aneurysm. The aneurysm was 3mm in size. I was taken to a stroke center, and a surgeon was called to operate (coiling). The first couple days afterwards I was very tired, and slept the whole time except when meals were brought. I also had an extremely stiff neck, to the point where sitting up was a big chore. But that went away in a couple days. I gradually was able to stay awake more. I browsed the web on my phone, and even kept my boss up to date on my condition and talked to my elderly father (who lives in another state) by phone. I remained in the ICU for two weeks, then was moved to a regular hospital room for another 6 days before I was discharged.
There had been a problem with my upper leg where the surgery was done from. The blood had kept flowing and may leg was bruised so bad it looked like it had been crushed. The doctors had to do a small procedure to stop the blood flow and bruising. So I had to walk with a cane at first. But that rapidly improved. I was used to walking about 6 miles a day before my surgery. I got rid of my cane within a few days, and was walking a mile or two (though slowly) within a couple weeks. Although the keppra I was on made me tired, it seemed my brain was functioning fine other than that. I enjoyed listening to music, and even working doing some electronics stuff (a hobby). I was not allowed to drive, but was able to work remotely from home, and soon was working almost full-time.
The doctor was having me slowly taper off the keppra. Right about the time I got to the end of my taper (late June), it seems the problems started. I started getting a bunch of anxiety. When I was allowed to drive and started going into work, if someone else was talking anywhere nearby it was impossible for me to concentrate. I started having issues with insomnia and depression as well. I do have a past history of multiple depression episodes, though I had not had one since 2001 (when I was permanently put on a low dose of prozac). I assumed that the anxiety and insomnia were just part of the depressions I have had in the past. I did not do any research on brain aneurysms other than what the doctor told me, since that was in the past and I didn't want to scare myself anymore. I instead concentrated on learning to control depression and anxiety. But insomnia was still a problem, so my PCP doctor prescribed 0.5mg of klonopin at bedtime in August (I had taken this drug for a short period years earlier while starting on prozac).
The klonopin helped with sleep for a few weeks, but then started to lose effectiveness. In addition, I started getting a lot of anxiety in the late afternoons, sometimes almost to the point of panic attacks, and my depression worsened. I couldn't figure out why I kept getting worse. I did some research online, and eventually realized that had become addicted to the klonopin, and was having inter-dose withdrawal symptoms. I did quite a bit of research to learn how to taper off. With my doctor's approval, I began tapering off the klonopin 1/4 of my dose per month in mid-November. The anxiety would be worse when I made a dose cut. But as time went on, the anxiety was definitely lessening, and I was also able to think more clearly (something the klonopin was affecting as well). I completed my klonopin taper in mid-February. Though the insomnia and anxiety got worse for a while after that, I was able to tolerate it, and my thinking was clearer and less depression.
Since the aneurysm was treated, I had 2 CT scans and an MRI scan at several month intervals as per my surgeon's schedule. The last was in October. My surgeon said he was happy with each scan. He said he wanted to see me again in March, to schedule an angiogram, which he called the "gold standard" at around a year since the surgery.
This brings me to my first question. I saw my surgeon last week. He said two things that greatly disturbed me. First, in addition to an angiogram, the doctor said I needed to be prepared for some additional coiling if necessary based on the angiogram. Per my surgeon, there are risks of serious complications from this procedure (several percent). However, he said if I didn't allow for more coiling I would have a several percent risk of another bleed per year, and that would be extremely serious (possibly fatal). I asked him what he thought the chance was that I would in fact need coiling again, and he said he refused to speculate on that. I am curious if anyone else has been in this situation before (facing possible additional coiling). I wonder why he thinks I may need this. Maybe he is seeing something on the scans but does not want to alarm me?
The second thing that disturbed me brings me to my second question, which has to do with the anxiety, depression, and difficulty concentrating. I assumed these were psychological issues, especially given my past history of anxiety and depression. Another thing that makes me think that they are psychological instead of organic is the fact that they wax and wane over time. I'll have days where I sleep normally and am able to concentrate pretty much like my "old self" and with very little depression. On bad days though, I still sometimes sleep only an hour or two at night, have difficulty concentrating, and experience significant depression symptoms. My surgeon said he thought that was due to the aneurysm itself, despite the way the symptoms wax and wane. Assuming it is in fact the effects of the aneurysm itself, what mechanism causes the waxing and waning of symptoms? The thing that really disturbs me is that he said the anxiety and depression are likely caused by the aneurysm, and that they "may or may not" improve with time. He mentioned that I am "only" a year out, so its to hard to tell what will happen.
Based on needing surgery again next month, and the fact that my symptoms may not be just psychological, I am now doing more research on ruptured aneurysms online. That is why I have decided to join this support group. I look forward to giving and receiving answers and support here.
Frank