My dad has a teleconference with his surgeon in a few days (he lives 5 hours from the city so that's why they're having a teleconference) and he said I can make a list of questions to ask the doctor. I was wondering what questions you would all recommend? We're now unsure whether he'll be getting clipping or coiling but I think they may be leaning towards coiling now instead whereas at the start, we thought it would be clipping.
It's a 5mm aneurysm that has previously bled then clotted and he also has a blocked carotid artery. With this in mind, what questions would you suggest I ask?
I’d be happy that they are going for coiling as clipping can be very dangerous. I would ask about the risks of treatment versus the risk of rupture. And also the expected recovery time once he’s had the coiling. Sometimes it can be months for recovery. And I’d also ask about the risks of the angiogram as this procedure itself can be risky. I guess I’d want to know whether there is an option to monitor instead of having the treatment. I’m not sure of your dad’s exact circumstances so I’m not sure if treatment is definitely necessary for him. It’s such a scary time and I’m glad you’re dad has got you to ask questions for him. The main thing is to ask as many questions as you need to to make sure that you and your dad both feel comfortable with what’s happening. Most of the neurosurgery experts can be really good and understanding while others have been in their job for a very long time and they forget how scary these things can be for patients and their families. Where is the surgery taking place and why are you teleconferencing and not seeing the doc in person?
hi sg! i would ask the risks and the risk of a clot being thrown from the blocked carotid, will they clear the blockage first? Also why are they leaning towards coiling? Dont ask risks if it frightens you more, i am not a big fan of stats- i beat the odds every time, tc
Depending on age, physical conditions in general, the size and location of your aneurysm you might have many (or just one) options of treatment. In the last 4 years there have been new developments and better treatments. The options are clipping, coiling, or other endovascular treatments (pipeline, glues, stents). Depending on the specialist that you talk to they are going to sell their services and sometimes that one might not be in your best interest, and may be there is another option that is better. Please check the videos at this link:
I would ask why do not consider Pipeline embolization devise? It seems that this new technology works better in the long run than coiling, because sometimes with coiling the problem reapears because the coils get compacted.
I agree with all opinions above, and I would like to add one thing that made my recovery so fast (besides thinking positive and having family around of course). If he goes through the surgery, make him play lots of logic games right after. I did sudoku , trapped mouse, snakes and apples (free from magma mobile), and probably 20 more. I also made a choice of movies, once I was out of icu and in post stroke unit with tv, i picked a movie with complicated plot, to make my brain recreate those connections. In 2011 I chose Inception, right now they probably play Interstellar.
Good luck and keep us posted.
And personally if I had time to research, find this group and write down questions prior - I would want My doctor or his office to have a plan B of resources in my area. Doctors don’t want to give out too much information and always try to keep us calm which is very important. But I was a Girl Scout with siblings in the Scouts, we raised horses and took the Always be Prepared to be part of our genetic make up. I need to know there are preparations for Plan B. Also support for family if any, some training available to them to understand aneurysms (though BAF can make one pretty literate in the field) and how best to help in the recovery process.
Thanks for all those suggestions, I've added a few questions to my list now.
DB, the reason for the teleconference is because my parents live 5 hours away from the city and he was only recently discharged from the hospital so he can't make another trip back up there until it's surgery time as it wears him out too much.
Moltroub, I did have a look at the treatment options and questions to ask on the baf site but thankyou for the other links, they're good.
Theashka, thanks for the brain game suggestions! Dad's not a smartphone/tablet user but there's still the old fashioned crosswords etc he likes to do.
Thankyou to all, have read each of your posts carefully and added all of your suggestions.
Summer Girl, you mentioned that your Dad is having teleconference with his doctor. Has he had more than one opinion - at least 3 neurosurgeons to weigh in with their opinions. It makes a huge difference and there is always more to learn than from one person. It would be wonderful if you can be in on the teleconference as well - more ears hearing information always help. Good Luck. ChillyGirl
My understanding (from an Aaron Cohen webinar) is that the type of procedure recommended to you might be dictated by the facility the doctor operates from. That is, the doctor you see is limited by the facility he works out of. Not every hospital can do all possible treatments. So a question I would ask the doctor is, "What viable procedures for my condition are not treatment options now due to facility/training limitations of the surgery facility you work through?" That should give you some insight into what's being recommended, and might help guide how you go about seeking a second opinion (look for facilities that can handle a procedure that might be more advisable for your particular aneurysm).
Chillygirl, thanks for the suggestion. My dad's results were sent off to a board of neurosurgeons to decide what to do because he also has a blocked right carotid artery. I'm not sure how many were in the board but at least that means there was more than one surgeon deciding the best move.
Anna, I'm pretty sure all procedures are options at the hospital my dad will be going to. But I will definitely put that question on my list, thankyou.
Something else that's come up... they are thinking of operating on the blocked carotid artery first because they want the brain to be getting as much blood circulating as possible when they operate on the aneurysm. But a neuroligist had previously told dad he would think they would operate on the aneurysm first as fixing the carotid may make too much of an impact on the aneurysm from the wider pathway of blood now being able to flow through. Has anyone else been in this situation or heard of something similar? And which did they fix first?
SummerGirl, My husband had a ruptured aneurysm much different circumstances but I wanted you to know a carotid artery was severely blocked as well. This was discovered during the angiogram.
He underwent cerebral angiogram with coil embolization of ruptured anterior communicating artery aneurysm. He also had angioplasty of the right carotid artery at the same time. Fortunately he is doing very well back to his normal routine. He did have another angiogram at the 6 month mark with more coiling this was expected (just an overnight stay at the hospital). He will have one more angiogram at the one year mark to check on everything. Hope this helps. I found the videos and info on the BAF site very helpful and it is good to see what others have experience but remember each patient is unique, there are so many variables. I am hoping that you have some excellent doctors; approachable, able to explain things so you all can understand (in laymen's terms as it is all new to us!), who listen and address your concerns and of course competent and whom your family can feel at ease and trust! My thoughts and prayers for your family and Father.
Cheryl that's so good to hear your story! Thanks for sharing that with me. My dad has since talked to the surgeon and now they're not sure if they'll even operate on the aneurysm because it's in a difficult spot. The surgeon said it's in a hard to reach area and the operation risk may be too high. He's off to have an angiogram so they can get a better look at the aneurysm. It's frustrating not being able to have a clear and easy operation choice but hopefully we'll get answers soon.