Friday, April 16, 2010

Don't breathe, don't move

I had brought a stack of research to my Primary Care Physician and asked for a doppler ultrasounds based on the Zamboni criteria. He proscribed it and I went to a hospital to have that done. There were all kinds of strange sounds coming from the ultrasound but I did not see what I wanted to nor did the technician reveal any information. I was worried and on my next visit to my PCP he informed me that the resident radiologist at the hospital had provided a report that my carotid artery, among other misguided results was normal.

I asked for an MRV and brought the protocol with me this time. I handed the protocol to the technician and proceeded to have the all day long scans. Turns out that my PCP ordered MRIs as well as MRV, either way it took hours.

This time, I went to the hospital myself and retrieved the CD. Looking through it myself I knew exactly what to look for. Stenosis, of the right and left jugulars was quite evident to me and I was excited to go back to my PCP.

He called me few days later and told me that results came back normal. I objected that the results are far from normal and I would be happy to show him. He was interested how I, a regular citizen, knew what stenosis looked like. I told him I would show him.

I came to his office with my laptop and showed him the otherwise misdiagnosed MRV images. Wow, he said and told me that he would speak to the IR he recommended. This IR could have done the exams her self but she did not want to have anything to do with me. Anyway, I asked him for another IR to see and he gave me a name.

This IR saw me and questioned me on my MS, already eager to hand this off to an MSS. Hearing who I saw previously, he became excited that the doctor was one of the best MSS. No, I said, look at the images. He left the room and came back 10 minutes later and told me that the jugulars are fine. Unbelievable. He said that the right one is blocked but left one has flow, 1 is enough. Ok.

My mothers doctor recommended a Vascular Surgeon and my mother went to him with printed images of my MRV. Specific images that were most striking were chosen by me for this adventure and indeed the surgeon also said that it does not look normal but could be breathing but in either case a venogram, the gold standard, would be much more reliable. He sent the case over to his IR since for him this was to minor of a procedure.

The morning consult with IR consisted of him, stating that he heard of the Italian theory however he could not guarantee results. "We will go slow, lets look first," were his other comments. Surely fearful that this is not expected to produce anything serious.

I was prepped and wheeled over to the surgical room where I was further prepped. The doctor came soon and began. The needle did not hurt at all and the only sensation of pain was when the catheter reached my head. The crunch accompanying the minimal pain was evident as problematic. "Stenosis," he finally spoke out, "mark the time and get a balloon." A wonderful sound for someone reading the materials on a daily basis.

"Don't breathe, don't move," he said and the pain in my head increased, as my stenosis was high and in my head. "That's better flow," he said. I smiled while laying with the radioactive xray over me. He moved the catheter to my left and spoke out for another balloon, bilateral problems. He struggled with the left and even noted how beautiful the right one dilated.

A few more of "don't breathe, don't move," and it was all over. My and my mother's demand to check the azygos vein was probablu annoying but he took a picture of it and said its fine.

Neither the doctor nor the staff had ever seen this and thus were fascinated that the correlation was consistent with Zamboni elegant theory.

Turns out that one of the assistants trained with Dr. Dake in Virginia and knew more about this by studying Dake, still I was the first for him.

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