Also, i never actually contacted anyone stating it was a second opinion. I went to each one with my cd’s and reports (uploaded) and requested a consultation and spoke to each surgeon as if he were the first. I wanted to hear their thoughts without the influence of another opinion. I don’t think it matters as they are all professional and take these matters very seriously, but that was my approach. I didn’t just want confirmation, i wanted to consider each one of them as if it were an interview and keep my options open. I believe it worked for me. Im fully confident in the surgeon i chose. After all I’ve been through, and with him as the surgeon who got me through it, he has my complete trust. I hope you find the same.
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I went to a neurologist in the city of Victoria BC. He told me he would keep checking on the aneurysm but neglected to. That is why I had a rupture. If he would have checked up something could have been done. My lesson is always get a send opinion if you are not sure. I live in Canada, but I can tell you that Dr. Haw at Vancouver General is awesome!
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That’s great advice. My doc is at Hopkins. Just curious. Did the opinions differ? I find that prospect so unsettling. Thank you
Yes and no. All three felt the treatment for my particular would be the same (unanimous on flow diversion). One recommended a repeat MRA in a year. The other two wanted a CT scan for improved imaging study (I believe either of these surgeons were a good choice for me). Upon learning I had a contrast allergy, the surgeon I ultimately chose wanted to dive straight into an angiogram (gold standard for viewing aneurysms) in the hopes that it would be one time exposure and if all looked good, I could go to annual MRAs. In my case, he didn’t like what he saw so surgery was scheduled within a month. His actions proved warranted and a long story follows - I’ll spare you the details.
Please do not let that scare you. I believe I read you have a 3mm aneurysm. I recall Johns Hopkins telling me they tend to recommend repairs at around 4.2mm and up, so watch and wait is likely consistent with that mindset. Mine appeared 4.9mm on an MRA, was 6.1mm on the angiogram, and he saw that the artery was clearly diseased. This was my unique situation. MANY people are able to watch and wait. Just make sure that if that is your choice of actions, you keep on schedule. And most importantly, talk to several surgeons and ask as many questions of them, and us, as you want.
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That’s very helpful info.
I had a brain Angiogram on 9/23/22. After that I was told I could wait and watch… I broke out in terrible hives a few days later. They don’t think it was the contrast, but I know it was. I then went for allergy testing to rule out food and environment, all negative, so I’m going with contract allergy. CT contrast is iodinated. I don’t have any problem with the MRI/MRA contrast.
Thank you again.
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Glad you had the angiogram. As far as I know, that’s the best protocol for a truly informed opinion, so your surgeon has been thorough. That’s always a great comfort. Best of luck.
Thanks!!
Could you tell me which doctor you saw at John Hopkins please.
Dr Christopher Jackson. But while he did my initial consultation, his assessment was that I would be an endovascular repair so I’d move under someone else if that were the case. I THINK his name was Dr Caplan but I’m not 100% sure (I never met him). I can look for my notes tomorrow.
UPDATE:
Can’t find my notes, but I’m fairly sure it was as I indicated above. Dr Jackson’s focus was on open repair (craniotomy) while Dr Caplan specialized in endovascular.
ALSO, I’ve heard great things from more than one person about Judy Huang. You may want to look into her and check if her skillset would be applicable to your issue.
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Hi @Mabh212 – I had a ruptured 18mm x 14mm aneurysm with SAH on my left side January this year (2024) and incidentally found a smaller 6mm x 4mm unruptured one on the other right side. I found out from one of the nurses post-op/in recovery that my Doc is one of few neurosurgeons that do both endovascular and cerebrovascular – he could do the coil/stent, if appropriate, but could also do the craniotomy if determined to be the only path. He is not at Hopkins, but if you are willing to travel to Metro DC area for Hopkins, he is in the Washington DC area. This is his profile Rocco Armonda, MD (medstarhealth.org) and I just stumbled upon this article about his expertise Inside American battlefield surgeon’s quest to help in Ukraine - ABC News (go.com) In the context of surviving the SAH, I was fortunate to “get” him once I was transferred to Washington Hospital Center.
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Thank you so much for your replies and insight. I will research these doctors and methods they would use on the 2 arterial aneuryms. Deeply appreciate your response.
Mary Anne
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That’s interesting as I thought they all could do both procedures. Learn something new every day. My Neurosurgeon is also an ex military surgeon and does both, I wonder if that’s the reason.
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Yeah, I guess the military-trained neurosurgeons have to “make do” out there in the field and have no time to be looking for another specialist to show up.
I’m unsure if neurosurgeons go out into the field. I know mine was stationed on Oahu at Tripler where I was born! How’s that for coincidence? Tripler historically gets a lot of military personnel who have been wounded in action. I know when she first came into ICU I was trying to get out of bed. The nurse was confused when I hollered out “officer on deck”
. She’d come in at the far doors from my bed but you could feel and see the difference immediately from my perspective. My RN had to tell me it was my neurosurgeon so I could just stay in the bed. She had started working at WFBH three weeks before I ruptured coming straight from Tripler. She runs a tight ship.
Mine does both as well.
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[quote=“Moltroub, post:37, topic:16276”]
I’m unsure if neurosurgeons go out into the field.
[/quote] - sorry - I meant not Stateside, so at a hospital like in this scenario: Inside American battlefield surgeon's quest to help in Ukraine - ABC News
Thanks! Tripler was very busy when Japan bombed Oahu. It was used during Korea, Vietnam etc after the military personnel were stabilized enough to get home, although some were taken to a hospital in Germany. I’ve never seen Dr. Q-W’s ribbons so I don’t know if she was in the thick of things and I’ve never asked.
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