Before and After

I’ve been thinking about my mom and her brain a lot lately.  Pull up the aneurysm tag and you’ll stumble across most of the story if you don’t know it.  We’re working on getting her in with some neuropsych people to prod her recovery just a bit.  She’s doing so well and I’m so proud of her.  I love her so much and have been missing her lately.  I stumbled across this tonight.  I wrote it a few months ago.  It’s the beginning of something, I just don’t know what…..

 

There are defining moments in life which serve as clear markers, delineating one part of one’s life from another.  Some of these are apparent and expected:  Before graduation, after graduation.  Before marriage, after marriage.  Before kids, after kids.  Some are unplanned, but normal and preparation is possible:  Before divorce, after divorce.  Before one career.  After another.  Sometimes they might come along without your knowledge, and only in retrospect do you realize their significance.  Before meeting someone.  After that person is in your life.  But some are so completely and wholly unexpected, that you cannot possibly plan for them, nor can you hope to regain any sense of before in the after. 

 

I have a before kids, after kids.  I have a before divorce, after divorce. Now, the most defining mile marker in my life is before aneurysm, after aneurysm.  And it wasn’t even in my brain.  One sunny day in March, the world was spinning as it always did and my dramas were small and petty on the grand scale.  The next, sunnier morning, a 15mm portion along the internal carotid artery in my mom’s brain decided it was really worn out from keeping all that blood in one place.  It put it’s feet on it’s desk, clocked out, and quit doing it’s job unleashing a torrent of trauma into Mom’s subarachnoid space, and into all of our lives.

 

She didn’t believe us at first.  When we said aneurysm, she rewarded us with a furrowed brow and a confused tilt of her head.  When she finally regained cognizance about a month after the rupture, she found herself weak, drugged, and unable to speak.  All she knew was she couldn’t talk, couldn’t remember, couldn’t comprehend what had happened.  Surely we were exaggerating.  Surely she had just had a migraine yesterday and now we were trying to scare her.  Surely she was just a little wiped out from the meds they’d given her and everything would be back to normal by next week. 

 

I don’t know what she thought because she couldn’t tell us.  That lazy artery wall had leaked blood all over the part of her brain that controls speech.  I could see the questions in there, the words bouncing around in her brain.  Everything multiplying exponentially and crowding up in that space.  The pressure of their isolation showed in her eyes.  She’d spent nearly 50 years being the most outspoken and eloquent person and now….now…. Her tools, her weapons, her thoughts, her loves, her words wouldn’t come.  They stayed in her head.  Reluctant to leave her mouth and be seen in the light.  Stubbornly denying her her voice.  The brain which had served her so well, which she prized, by which she defined herself and attained every goal to which she aspired… it was now her enemy.  After aneurysm.

 

It could have been worse.  We tried to explain how lucky she was.  How those initial phone calls from the doctors in Louisiana held no hope, only grim statistics and admonishment to drive the 300 miles as fast as safely possible.  How we were preparing to say good-bye at worst, and preparing to care for her in a vegetative state at best.  I did what I do best and googled.  I found stories with worse outcomes; it wasn’t hard.  Mention an aneurysm to someone and the stories told back to you are those of a relative who died.  Always unexpected and always tragic.  Maybe 1 in 10 will be a shared story of survival.  I printed medical texts that detail in black and white those same grim statistics hammered into my brain by the doctors.  50% die before reaching the hospital.  Of those who make it to the hospital 30% die within 48 hours.  Of those who survive that long, the next 30% die within a month.  Those lucky percentages left either die within the next year, or survive with significant deficit. 

 

She beat all the odds.  She survived the surgery.  She ruptured fully while on the operating table.  Had they waited even 10 minutes to operate, she would likely have died.  She survived post-operative complications, never having a stroke from vasospasms.  She didn’t get pneumonia.  She wasn’t paralyzed.  She walked within 2 weeks.  She could see and hear and taste and swallow.  Mom!  You can swallow!  Isn’t that awesome news!  Her confused and frustrated expression was answer enough for that ridiculous question. 

 

Before aneurysm: Project Controls Analyst working on a multi-million dollar project for a major energy company.  Avid reader.  Accomplished scholar, gifted musician, loyal friend, and doting grandmother.  Active, articulate, intelligent, beautiful and amazing woman, who taught, guided, supported, and inspired.  After aneurysm:  You can walk!  And eat!  And breathe!  All by yourself!  Aren’t you proud?  Aren’t you fulfilled?  We know your before aneurysm self is still in there.  We see it waking up, flitting about, screaming to get out and straining against its new bonds.  We hear it in our own minds and know it will be strong one day.  But for now it tires easily.  Go rest and gather strength.  It will come back.

 

The words began to find their way out.  Furry and vaguely malformed, but coming to the party finally.  The cloud of confusion gradually lifted.  The puzzled look was permanently affixed for a few weeks.  We had to retell the story a few times and learned to limit the length and detail.  After awhile, we didn’t have to tell her.  She knew she had crossed a line and was in the after of something. 

 

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