A relatively slow day....

A relatively slow day... got one for ya'
from...
MDI woman is on ‘Oprah’

BAR HARBOR — Less than two years ago, Lori Corbani suffered a stroke that left her unable to use language or even form words. Although the experience was the most challenging she has ever faced, she sees it as a gift.

Lori Corbani of Town Hill, who is recovering from a stroke, recently appeared on the “Oprah Winfrey Show.”—OKA HUTCHINS PHOTO

“It makes you realize how precious life is, how you take a lot of things for granted. You begin to live in the moment because that’s really all you have,” says Ms. Corbani, sitting at her kitchen table on Monday, “Looking back, it’s only really done good things.”

The stroke has led Ms. Corbani, 46, to a lot of unexpected places, including a video-conferenced appearance on the “Oprah Winfrey Show” on Oct. 21.

One of the most important things that has grown out of her experience is the Stroke and Brain Injury Support Group she began with friends Diane Bonsey and Steve Langley last June.

“With any kind of chronic illness, a support group helps a lot with the healing and treatment process,” said Chris Schleif, who works at the Jackson Laboratory.

Following her stroke in February of 2007, Ms. Corbani received invaluable support from her husband, naturalist Michael Good and their children. A computer scientist at The Jackson Laboratory, she is also incredibly thankful to her coworkers there for the support that they have offered her. No matter how supportive family and friends can be, it is important to discuss and share the experience with people who have been through it themselves, says Ms. Corbani. Until she met with others who had experienced similar traumas, a part of her felt alone.

Thanks to the support group, Ms. Corbani learned that there were many people living in her community who had gone through similar experiences.

Strokes come in a variety of shapes and sizes, says Dr. Julius Krevans, Jr., medical director of the Emergency Department at the Mount Desert Island Hospital. Dr. Krevans’ ER sees a stroke nearly every week, some minor and some devastating.

“It really is a life changing experience. It is a gift – but it takes a lot of emotion, grief, anguish as well as love and compassion to get to the gift – it’s not an easy journey,” says Ms. Corbani.

A book she received early in her recovery called “Stroke of Insight,” written by Dr. Jill Bolte Taylor, a Harvard-trained neuroanatomist, was another important piece of her healing process. Dr. Taylor’s book is an autobiographical account of the debilitating stroke the brain scientist had in 1996. Ms. Corbani came to see many similarities between the doctor’s experience and her own.

“She had the kind of stroke that I had and the same doctors that I did,” says Ms. Corbani.

When Ms. Corbani learned that the Oprah Winfrey Show would be featuring Dr. Taylor, she wrote a letter to the show praising the book. The producers of the show, which aired Oct. 21, contacted Ms. Corbani in August and asked her if she would like to be featured on the program through live video conferencing. Ms. Corbani accepted, and began to prepare to speak to the woman who had positively influenced her recovery. The idea made Ms. Corbani a little nervous, as her stroke has made it more challenging for her to find the words she wanted to use to express herself. Ms. Corbani has found that it is especially hard for her to converse naturally in new situations, so she reviewed her words several times beforehand to prepare.

Happily, she was able to communicate what she wanted to, and the show went off without a hitch. Ms. Corbani told Dr. Taylor that her book helped her understand not only the medical, but the spiritual side of her stroke.

“Her book was a great piece in the puzzle of my recovery,” says Ms. Corbani.

Like Dr. Taylor, the stroke Ms. Corbani experienced was caused by arteriovenous malformation (AVM), an abnormal connection between the arteries and veins in the brain. When an AVM ruptures, it can cause blood to flow into the brain, which can result in a hemoragic stroke.

Hemoragic aneurysms account for only 15 percent of strokes. Luckily for Ms. Corbani, this type of stroke allows a high rate of recovery.

Now back to work part time, Ms. Corbani has regained her knowledge of words and her ability to use language. She is still relearning many of her former abilities.

“My math skills are horrible right now. I can’t even remember multiplication tables,” she says.

The support group she and her friends founded continues to be a source of comfort. She hopes that it will continue to evolve and be a source of solace to people who have experienced trauma. “Just because you look okay doesn’t mean you are okay inside,” says Ms. Corbani. Through their family, friends and each other, however, each member of the group has come to view their experience as a gift, she says.

Ms. Corbani hopes that the support group can help educate people as well. She didn’t know until after her stroke that stroke and brain aneurysm injuries are the third largest killer in the United States today.

“If you have significant chest pain, get it checked out right away,” advises Dr. Krevans. “Getting treatment in the first minutes to hours statistically improves the outcome of a stroke.”

The Stroke and Brain Injury Support Group meets at 6 p.m. on the last Sunday of every month at the Bar Harbor Congregational Church at 29 Mount Desert Street. Call the church at 288-3280 for more information.

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And that's it... yah I know .... but what can I say.... It was a really slow day....
And nothing on the home front either.

go here ya' go...

Got a few...AVM news!

A Patient's Guide To Brain AVMs

If you or a loved one has recently been diagnosed with an arteriovenous malformation (AVM) of the brain, it can be a stressful and confusing time. You, as well as other family and friends, may have concerns about what the diagnosis means for the patient's long-term health and whether treatment is possible. To help alleviate these anxieties, this article provides answers to common questions about brain AVM.

What is an AVM of the brain?

An AVM of the brain (also known as a cerebral AVM) is a disorder of the body's circulatory system. AVMs occur when an intricate tangle of blood vessels directly diverts blood from the arteries to the veins. Though localized in the brain, cerebral AVMs can lead to severe neurological problems. Left untreated, a cerebral AVM can cause severe hemorrhaging, which may lead to serious complications or death.

How common are cerebral AVMs?

It is estimated that an AVM of the brain occurs in approximately 1 in every 200 to 500 people (less than one percent of the general population). Cerebral AVMs are commonly misdiagnosed, with most cases found only incidentally through the performance of CT (computed tomography) and/or MRI scans on the brain. Patients often complain of regular headaches and seizures before diagnosis.

Other neurological complications can develop including speech and visual difficulty, dizziness, memory deficits, confusion, hallucinations, dementia and difficulty with event planning. Physical side effects range from loss of coordination, numbness, tingling and spontaneous pain to permanent paralysis. Patients' symptoms may be directly associated with the location of the cerebral AVM with certain sites causing hydrocephalus. Hydrocephalus is caused by a cerebral AVM preventing the circulation of cerebrospinal fluid thereby causing fluid build-up in the skull.

How is an AVM of the brain diagnosed?

Brain AVMs can be diagnosed using a few methods, with the most non-invasive techniques being CT and MRI scans. Both scans reveal lesions while CT scans are particularly helpful in showing hemorrhaging. Three dimensional representations of cerebral AVMs can be detected by CT and MRI imaging.

A more intricate process in identifying an AVM of the brain involves angiography. A contrast agent, or water-soluble dye, is injected into the brain allowing an x-ray to deliver more precise images that highlight blood vessel structure.

How can brain AVMs be treated?

Brain AVMs can be difficult to treat and often require a multidisciplinary approach to therapy. The method of treatment performed should be thoroughly evaluated with the surgeon identifying the best option on a case-by-case basis.

Endovascular embolization is a minimally-invasive treatment option for cerebral AVM that involves the intentional closing of blood vessels. It may be done as the sole form of treatment or in preparation for microsurgical resection or radiation therapy. For patients with cerebral AVMs that cannot be cured due to the size or location of their lesion, embolization can be palliative. This means that the procedure is not a cure, but rather offers an improvement to the patient's quality of life by diminishing symptoms such as headaches, seizures or other problems.

If you'd like to learn more about treatment options for cerebral AVM and other vascular disorders of the brain, please visit: http://www.vascularcarenyc.com/.

Written By: R.L. Fielding
R.L. Fieldeing is a freelance writer who has written on a wide variety of topics, with special expertise in the education, pharmaceutical and healthcare, financial service and manufacturing industries.

Disclaimer: This article is for informational purposes and should not be considered a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any question you may have regarding a medical condition.

About the Center for Endovascular Surgery

The Center for Endovascular Surgery is a division of Beth Israel's Hyman-Newman Institute for Neurology and Neurosurgery (INN). The Center for Endovascular Surgery is a world leader in using minimally invasive techniques to treat vascular disorders throughout the body, including AVM , hemangiomas and cerebral hemorrhages.

Center for Endovascular Surgery
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A Note from Jay

Dear friends,

Last week, we had the privilege of meeting with Katherine’s attending neurosurgeon, Dr. Nestor Gonzalez. We spent the night at Katherine’s mom’s apartment in Westwood on Wednesday night, then walked over to Dr. Gonzalez’s office at UCLA at 8am on Thursday morning. Katherine’s grandmother, Amanda, also happened to be in town, so she and Kim joined us at the visit. This appointment served as a 6-month follow-up to Katherine’s surgery on April 21, as well as a time to discuss some specifics about what happened that day.

Dr. Gonzalez has naturally become a very special person in our lives, not just because of the huge role he played in saving Katherine’s life (though he gives God the credit for it) but also because of how Katherine’s surgery and recovery have deeply affected him. As our visit began, we all embraced then sat around the exam room as Dr. Gonzalez began to lovingly explain to Katherine the details of her surgery.

Katherine’s path first crossed with Dr. Gonzalez at the UCLA Westwood Emergency Room. Katherine was originally taken from our Pepperdine apartment to UCLA Santa Monica. There they performed a CT scan which showed a huge bleed in her brain. After stabilizing her there, she was immediately sent to the much more specialized unit of Neurosurgery at UCLA Westwood. At the time, we did not even realize that UCLA is considered one of the top hosptials in the country (#3 according to US News & World Reports) and is a world leader in the treatment of vascular brain injuries and stroke. Though we didn’t know it when we first moved to LA, one of the major reasons God brought us out here was to be close to UCLA and to Dr. Gonzalez. Isn’t it beautiful to look back at life and see the Lord’s hand working in ways that we never expected.

When Katherine arrived at UCLA Westwood’s Emergency Room, a procedure was done to release the incredible pressure that was building up in her brain. Then, an angiogram (the first of around 10) was performed by Dr. Gonzalez which revealed the cause of the bleed–a massive AVM in her cerebellum. One of the most disconcerting findings of the angiogram was that the very high intracranial pressure had created a major herniation in the tonsils of Katherine’s cerebellum. In other words, the pressure from the bleeding was causing several inches of Katherine’s cerebellum to be pushed down through her spine. Almost always, this type of herniation very soon after leads to the person’s death.

Dr. Gonzalez recounted that months after Katherine’s surgery he presented her case to a group of UCLA doctors as a teaching, case study. He showed the CT scans and presented her stats from that day in the emergency room. He then asked his neurosurgery colleagues if they would proceed with the surgery, based on the given facts. The majority of the UCLA neurosurgeons said that they would NOT have chosen to do Katherine’s surgery because of the herniation, massive bleeding, location/size/complexity of the AVM, and extreme likelihood of death or persistent vegetative state. The mood was somber because of the bleak prognosis for this anonymous patient, but spontaneous applause broke out when Dr. Gonzalez finished the presentation by explaining that not only did Katherine survive the surgery, but she had recovered so well that she was on her way to rehab. He said that in all of his years at UCLA, Katherine’s case study was the first to receive applause.

We have always been so grateful to have been at a teaching hospital like UCLA that would take on more difficult surgeries like Katherine’s. It seems that Katherine’s case was even too much for UCLA, but thankfully Dr. Gonzalez was on-call and said that in his gut, he knew that he had to attempt her surgery. A resident in the ER even told him that the patient’s husband was an attorney, which was a big negative in his decision to operate. In his words, he was also tormented by the fact that Katherine might not just die but could also very likely be subjected to the living hell of a persistent vegitative state or locked-in syndrome (”The Diving Bell and the Butterfly”). Despite the horrible odds and exposing himself to major liability, Dr. Gonzalez felt that both Katherine (though non-responsive at the time) and I seemed to be calmly and confidently delivering her life into his hands. He proceeded with the surgery.

Katherine was very close to death by the time she entered the Operating Room. A craniectomy was performed, removing the back right portion of her skull, as well as a laminectomy, removing several of her top vertebral bones to give her swelling brain a little more room to expand. The AVM took up over half of her cerebellum and was interwoven with many aneurysms. The bleeding had formed a large hematoma in the middle of that part of her brain, near her brain stem. The first half of the surgery went to the removal of the AVM and with it, over half of her cerebellum. Also, the collection of blood (hematoma) that had formed near her brainstem had to be removed, which required cutting through part of her brain to get to it. This portion of the surgery involved a lot of bleeding, so much so that Katherine’s full blood volume was replaced 5 times (that day, Katherine used 10% of all the blood used at UCLA). The second half was dedicated to microscopically removing any possible remnant of the AVM from her brain stem and intracranial nerves. In order to save her life and prevent any future bleeds, Dr. Gonzalez had to inflict some damage on her intracranial nerves, though he said that only the 7th intracranial nerve (to the face) was cut because the AVM was literally wrapped around it. The 8th intracranial nerve (auditory) runs right next to the 7th, which explains the deafness in Katherine’s right ear. The intracranial nerves are hair-like and have the consistency of butter, so any disruption or heat near them can cause damage, which is why the full extent of that damage is sort of unknown. Most of the end of the surgery invovled the brain stem, where any amount of damage could have surely killed her as the brainstem controls the heart beat and breathing. At the end of this incredibly complex surgery, Dr. Gonzalez was shocked to see that 16 hours had passed. He knew that Katherine was alive, but he was not certain of any other outcomes.

BUT something very special happened less than 24 hours after Katherine’s surgery. Dr. Gonzalez was awakened by an excited ICU nurse. Katherine had responded to commands and slightly moved the fingers on both hands and wiggled her toes. He rushed over to Katherine’s bedside where he asked Katherine to squeeze his hands, which she did. This was beyond miraculous to the neurosurgery team and to Dr. Gonzalez who thought that not only would Katherine likely be in a coma, brain dead, or paralyzed, but that she would definitely be under for several days after her surgery. It was a moment that we would never forget, and neither would he. This was just the first miracle in Katherine’s long road to recovery at UCLA and a gracious glimmer of hope from the Lord.

In the coming weeks in ICU and beyond, Katherine embodied innumberable miracles but also faced many, many obstacles, such as vasospasms, pneumonia, infection of the ventriculostomy tube coming out of her brain, weaning from the ventilator, high fever, etc. Dr. Gonzalez was quick to point out that despite all of these issues, Katherine was blessed enough to not have any new bleeding or any further brain damage beyond what occurred in the initial surgery. An angiogram soon after her surgery revealed that the AVM was entirely gone.

Dr. Gonzalez says that he cannot give Katherine a prognosis on her recovery because thus far, she has disproved every prognosis he has given her. He feels that in time, Katherine will be able to make a wonderful recovery. Katherine’s AVM was the largest AVM Dr. Gonzalez had ever seen, in the worst possible location, with the worst type of blood drainage. To see her sitting in his office 6 months after the surgery, talking about her baby’s 1 year old birthday, has to give Dr. Gonzalez such a huge boost. He put himself on the line when he took on her surgery, and this time, it paid off immensely.

Our appointment ended with a silently, tearful embrace between Katherine and Dr. Gonzalez. This man has saved Katherine’s life, but in some ways, Katherine has also saved his. He has told us several times that experiencing a case like Katherine’s has pointed him to the Lord because what has happened with her can only be attributed to the Lord’s intervention. It’s a rare occasion in life when you get to thank another person who has literally saved your life. It’s even more rare when that person gives the Lord all the credit. I ask for your prayers over this amazing man. He is truly an instrument in the hand of God being used to change so many people’s lives.

Many times the slow pace of Katherine’s recovery is so disenheartening, but as we are able to revisit the beginning hours and days of this new life, we are given such encouragement. The simple truth is that Katherine should not be here today. As we are reminded how far Katherine has come, we know that no matter what hard days are ahead, undoubtably that hardest one is already over, the victory has already been won. The God that has conquered death is the same God that remains now and continues to restore us back to life.

“Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen.” (Ephesians 3:20-21)

God Bless,
Jay

from...

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Wow! That's news for ya'.
So tell me... what do you like in my blog?
What do you hate, in my little blog?
Go on leave a comment....

da da da dum.....my avm

My first AVM...I have a pic of no. 2. but I can't figure out how to get it loaded.

There is nothing going on today.... not even on my other blog.
here if you are interested.
So what to do.... well how about me?
(or at least my story)#2
I was on a working vacation.
I went to lunch with a friend... I think....
I woke up in a hospital... my second.... weird.
I could not talk... I was paralyzed on my right side.

My wife had showed up.... with a couple of her sons... they were not well behaved... they are 30 and 27 in age.

My friend showed up too... he is webmaster here.

He spent quite a lot of time with me.

My friend that I went to lunch with stayed with me too... she was an angel!
I quit smoking... it just was not a concern.

Then came the transport came... Another friend drove his camper down.
(I live in GR Mi.)

I really can't tell you much about the trip, I was out of it.

Next came rehab... it feels like it was yesterday.... It was closer to 2 years ago.
I can remember wheeling around the hospital at night and early in the morning... I don't know what I was looking for... but I don't think I found it....

Rehab is a blur... I just don't remember it much... truth is I don't remember much these days.

I got to go home I think it was 2 months... Then came more rehab.
The only thing I was missing was a bed where I took rehab... This lasted 3 months.
Then I was told go home... you are cured... well as much as your going to get. I could not talk... I was terribly frustrated. I knew what I wanted to say... but something in between the thought and my mouth there was a block of some kind.

Fast forward to now...
I still can't talk as well as I would like... but it is getting better. (slowly)
I can manage stairs! I am a little slow... but I manage them none the less.
I got rehired (part time) by my old job. I am not in the same position... but they have me working a little.

I stared smoking again..... dumb I know.
but I did quit drinking... that is one check it the good coulomb.
I take an antidepressant... but that is it.
Not bad if you ask me.... not to bad at all.

I still can not spell... but I never could.
And that's about it...
so let me give youtube a plug...


ha ha ha!


Iron Maiden - 2 Minutes To Midnight (Music Video 1984)

I can cut-and-paste as well as the next guy.

here buy something....

Got two today....

Told he’d never speak again, singer releases new CD

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Singer, songwriter and Somerville resident, Jason Crigler, suffered a brain hemorrhage four years ago and nearly died while performing on stage. Doctors didn’t give him much hope to survive. He did. The doctors told his family he wouldn’t walk again. He learned to walk again. The doctors said he would never speak again. It took him 18 months of intense rehabilitation but he learned how to speak again.

Jason Crigler is a fighter and a survivor and he’s back to what he loves doing the most, playing the guitar, singing and performing.

He’s out with a new CD called “The Music of Jason Crigler,” and there is also a documentary out about Jason’s life and traumatic prognosis and recovery from the hemorrhage. The award-winning film is entitled, “Life. Support. Music.

Crigler suffered from AVM, which stands for Arterio-Venous Malformation on Aug. 4, 2004. AVM is a collection of abnormal blood vessels in the brain, which then burst, like an aneurysm.

“I was playing a gig and after the first couple of songs all of a sudden things got really weird – everything sounded and felt very distant. It got so freaky I had to leave the stage. Thank God my wife Monica was there. I couldn’t hear anything. I finally lay down on the ground and that’s the last thing I remember for a year and a half. It was like a Twilight Zone episode.”

Though Crigler has no recollection of any memory between August 2004 and Christmas 2005, it was a very stressful fifteen months on his family, including his pregnant wife. Wife Monica is from Massachusetts and decided to return home because she needed the help during her pregnancy while taking care of her husband. The medical bills reached more than a million dollars.

Friends, such as singer, Norah Jones helped the Criglers to raise money in paying medical costs.

“I was an in-patient for a year just lying in bed and then spent 10 months of rigorous rehab at Spaulding Rehabilitation Hospital in Boston,” said Crigler. “After suffering from my brain injury, I had to endure other surgeries as complications arose with my mouth, eyes and teeth.”

The rehabilitation is never-ending and though he doesn’t go quite as much as he did before, he still needs rehab every once in a while for his fingers in gripping a guitar. He also finds he gets fatigued a little easier than when he did before. However, he’s very happy to be back and knows how lucky he is.

“I’m blessed to have a great wife, a great daughter in Ellie, who is now 3½-years-old, a great family, great friends, and I love living in Somerville.”

Crigler really does enjoy being back on stage.

“My connection to music feels so much stronger than what it did before. I used to be so self-critical of myself but I get so much more self-satisfaction in performing my music ever since my injury.”

Crigler is performing Atwood’s Tavern in Cambridge at 6 pm on Saturday, Nov. 1, and he plays in New York City on Nov. 19.

The CD “The Music of Jason Crigler” is available at Amazon and at CDBaby.com.

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AVM

What is an Arterio-Venous Malformation (AVM)?
Under normal circumstances blood flows from the heart, under high pressure, through arteries which become progressively smaller until it reaches the cells where oxygen is absorbed. The deoxygenated blood then flows back to the heart via progressively larger veins. The pressure in the veins is lower than that in arteries. An AVM is a malformed area of blood vessels where the artery feeds blood directly to the vein without passing through the cells first. This means the pressure in those veins is higher than normal. This leads to wear and tear on the vessels over time until they rupture. Most patients do not know they have an AVM until it ruptures. AVM's can be found throughout the body but are most common in the brain.
AVM's are a congenital defect i.e. people are born with them. They are not generally considered to be hereditary but there are cases where they run in families and there are some rare conditions e.g. Cowden's Syndrome which include AVM's.

Diagnosis
Some AVM's may cause symptoms such as severe headaches, blurred vision, partial paralysis or speech problems, due to pressure affecting the brain around the AVM, but many people have no warning before the AVM ruptures. Upon rupture there is commonly extreme headache, some loss of function, collapse and possibly rapid death. If any symptoms are present URGENT medical attention is required. Diagnosis may be confirmed by CT (Computer-assisted Tomography) scan in the case of a bleed, angiogram in which dye is injected into the blood vessels so they show up on xray (considered to give best results), MRI (Magnetic Resonance Imaging) or by analysis of a sample of cerebrospinal fluid to detect blood (Lumbar Puncture). The method used will often depend upon the availability of suitable equipment.

Treatments
Options include surgical removal, radiation therapy to shrink the AVM, embolization (filling the AVM with a glue like substance) to cut off the blood flow and prevent rupture or a combination of these. The best option depends on many factors such as size and location, if it has ruptured, severity of symptoms, etc. Choice of treatment must be made in consultation with your specialist.

This is a very basic introduction to AVMs. For further information go to the medical sites in our links page.

Newcastle Aneurysm and Arterio-Venous Malformation Support Group
Australia
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