• Paul Fink

My Angiogram

I had a brain angiogram approximately 10 months after my stroke (11 November 2014). 'I bet lots of people and thinking ‘what is an angiogram??’ And why discussing a very minor procedure now? I am writing about my angiogram for the reason that was very significant to my recovery.

An angiogram is a minor test in which fluid is injected into the bloodstream to make blood vessels visible on a scan. Angiograms help doctors detect abnormal blood vessels, clots and other problems. Common angiograms can look at the heart, head, neck, lungs, brain, kidneys, legs, arms etc. I had a stroke (Brain injury), and hence I had a cerebral angiogram.

Angiograms are used to take pictures of the blood vessels in the brain. The involved a local anesthetic and is usually given to help alleviate most discomfort - and an awake during the procedure and normally physically doesn't hurt. The entire procedure can take from one to two hours to complete.

After my stroke (31 Jan 2014) - and after discharged of hospital - I was feeling determined and positive. I was definitely improving daily, but I was still anxious. I heard that a repeated strokes are very common in stroke victims.

My anxiety definitely impacted the benefits of my exercise. I was trying set the bar​ ​higher​ ​and​ pushing it [my exercise and therapy], ​​so​ ​that​ ​I​ ​can​ ​keep​ ​improving. But I was frustrated because I was not 100% effort - maybe 90% - as a result of my anxiety. I wanted to give 100% effort - not 90% - but I was conserved energy because in case worst possible result (eg. More strokes, operations, setbacks, or death). Yes I know, I am hard taskmaster with myself and I am aware of anxiety is a mental game - not physical - but overcoming this challenge was difficult.

Two weeks prior to my angiogram, I went to the neurosurgeon’s clinic at the Alfred Hospital. I was expecting a routine check-up. I met Dr Peter Hwang [neurosurgeon who treated me] - at the Alfred three months after my stroke (~ March 2014) but I was still in a wheelchair, I was difficult to speak. During this appointment I met the Professor - again. I was excited to show him my progress. I was walking (no AFO but walking stick), living at home, my speech was improving. I discussed with him that while I was really committed to my rehab, but I was still anxious about the risk of having another stroke or other problems.

Peter informed to me, that my stroke was because of AVM (a malformation). When I had my first brain surgery, he explained [paraphrasing] 'I think fixed the problem of your brain’ and therefore 'confidently 98% never repeated strokes on the future.' Because of the emergency surrounding that first surgery, and the terrible state I was in that day, he couldn't be 100% certain that they were able to rewire my brain the way it should be. He explained that in order to be 100% sure that I wouldn't have another stroke, they would need to do an angiogram as this is the gold-standard test to confirm that my brain was fixed.

I had mixed feelings after conversation finished. On the one hand, I was excited to see Peter and find out I could help reduce my anxiety about another stroke, but on the other hand, I was so nervous about the test and what if I failed?

My wife drove me to the hospital. We checked in and we waited. I was nervous. Nervous energy is sometimes good a thing - I think - eg. 100 metre race, public speaking etc, but the angiogram was different because the outcome was unknown and hinges on the results and my life. I remember I was calm before the procedure and I even I had a visitor - the social worker Jo (at the Alfred) - but after fare-welling my wife and going to the operation table was hard because was an uncharted territories eg. I was alone.

Very soon I implemented my technique of calming myself - I used meditation easy breathing techniques. Eg. Counting numbers silently (1, 2, 3, etc all the way with 10…. and reverse 10, 9, 8, etc). This method helping eased my mind. The local anesthetic did the job and the staff were very supportive and I was discharged same day with no complications, but with no results.

The Professor scheduled a follow-up appointment (two weeks) after the angiogram elapsed but I was desperately keen to see the results sooner. So my wife called Peter next day and he said my angiogram - and my brain - was all clear. I was so unbelievably relieved.

Hence I was turned a corner on my recovery after that and I was keen to filling my time with busy, productive, fulfilling things. I was excited to looking forward my future - not back. Because my improvements are correlated with my independence. The angiogram was very significant my recovery because after that the worst possible outcome, if I pushed too hard at rehab sessions was too fatigued. That's all. Not more sickness, anxiousness, operations, more strokes etc.

For example, I was trying be a good father to Oscar - especially because I was not here six months his life - and I was always endeavouring to made up for lost time. Also I was attempting to socialising with friends, going to functions, more therapy etc. I went to the Boxing Day cricket - one month after the angiogram and same month I tried public transport, I attended my friends buck's night, I went to my cricket's club golf day, and I traveled interstate with my wife to attending my friends wedding at Sydney.

I had a lots of more examples with my independence - bit by bit - my independence was returning and, I was very happy this situation. I quote George Costanza [at Seinfeld] “I'm back baby!!!”.

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