The irony of fate – happy anniversary to Ralph!

A year ago today, my life changed.

A bit dramatic I know, but what happened exactly a year ago was dramatic. I approached today’s date with trepidation;  at some point I was told the risk of having a first rupture is 1% per year. Once you’ve had your first rupture, the risk increases to 5% within the first year after. The closer it got to today, the more I worried with any headache, or slight funny feeling. Which I was not without, but I think it’s in part my own anxiety psyching myself out and manifesting in a physical way. The past year has been incredibly hard; the headaches, the fatigue, the brain fog, the long nights of crying hysterically, the mood swings that lead to hysterical laughter, the side effects of steroids, the seizures, the cognitive impairments I’m now left with, the life changes, the sensitivity to stimuli, the impairment to my processing speed, the reduction of my brain to an “average” version of what it used to be, the disappointment at interrupting my studies, the battle with different funding companies. Approaching a year off for recovery seemed like a monumental task – it’s funny how at the beginning of a year, it seems like forever. But at the end of it, it always seems like nothing.

But no matter. I made it. It’s officially been one year! A whole year since Ralph came into my life! Well I suppose technically it’s been 22 years and a few months. But a year since he made himself known. Usually you celebrate anniversaries with a significant other with some form of meal, or a gift or something. Does Ralph count as a significant other? I suppose he is a significant other part of me. Regardless, this year is coming to a close the same way it started; with cheer. However on THIS 22nd of March I will not be training, just watching!

Taking a year out forces you to rest. It forces you to relax. But most of all, it forces you to reflect. Perhaps “R&R” should be renamed to “RRR” – rest, relax and reflect. Growing up, lots of strange things happened that never really had an explanation. Sometimes I would watch a programme and, in the advert break, completely forget what it was I was watching. I do remember joking with friends that I had short term memory loss. I now realise, many years later, why. Whenever I climbed stairs too quickly, I used to get incredibly light headed and dizzy to the point where I would almost pass out – but I always put that down to my low blood pressure. However, the AVM would definitely be another factor. The headaches I used to get, I guess they have an explanation too now. So did the weird tingling I used to get on one side of my body (that, when I was on my neurology rotation, made me think I had multiple sclerosis for a brief period of time – but again I laughed that off as med student syndrome). The weird “woosh”ing noise I used to hear in my right ear whenever I put my stethoscope in my ears (for the medics reading this, it’s called “pulsatile tinnitus”. It’s like hearing a bruit or an ejection-systolic murmur, but very specifically in your ear). I now realise that was actually me hearing blood flowing through my AVM. The entire left side of my body is about 1cm longer than my right – so much so that I get hip pain if I don’t wear my special insoles in my right shoes. Is it possible that, as I have had an AVM since birth, my AVM has either stunted the growth of one side of my body, or accelerated the other side? This last point is highly unlikely, but forming conspiracy theories is fun.

Never did I realise waking up on that sunny Saturday morning how small decisions would change the course of the year. It’s like butterflies and hurricanes.

I feel the lyrics to this are very relatable right now.

First and foremost; if I hadn’t have filled in for that missing team member last year, and fallen, would I still have had a rupture? My surgeon assures me it was going to rupture that day anyway, but it’s still easy to think “what if”. If I had chosen to go back to my student house, instead of back to my boyfriend’s with him, would I have gone to hospital, or just collapsed in an empty house and been found by my housemates when they returned late that day? If I had been in my student house and gone to hospital, I would have ended up at King’s College Hospital – where many of my peers were at the time doing their neurology rotation and would have been the ones to clerk me and assess me. When I myself was on my neurology rotation, I shadowed a neurosurgeon every week, observed his surgeries every Thursday. The first neurosurgery I ever saw was a subarachnoid haemorrhage – the same thing I had. And every surgery I saw was related to…. guess. Yes, AVMs. For the neurosurgeon I shadowed was the AVM specialist at King’s. Meaning if I had indeed ended up in KCH, he would have become my consultant. I spent a lot of time thinking about things like this, how small decisions made big impacts. And it made me realise the irony of fate.

Most people will adhere by the old adage, “Everything happens for a reason,” whether that belief be of a religious or secular basis. The more time I think about my situation, the more I can’t help but think I am definitely being signposted along some path. From the age of 6, I knew I wanted to be a neurosurgeon; my mom swears by it that I was a precocious little girl that had decided the she would cut brains for a living (and in her spare time be a ballerina, a farmer, a policewoman, a vet and an artist). But specifically, a neurosurgeon. I apparently even knew the word for it, as opposed to saying “brain surgeon”. And now I have a neurosurgical condition myself, which I am fascinated in! The weirdest part I still feel is shadowing the AVM consultant. Out of all the neurosurgeons at KCH, I just so happened to have asked the one that specialised in the condition I would later find out to have. Even within neurosurgery, before discovering Ralph, I was beginning to want to sub-specialise in neurovascular. I have a poster of the blood supply to the brain in my bedroom, the same one that adorned the theatre I had my angiogram in. The more I think about it, the more I want to specialise in neurovascular conditions – especially AVMs – even more. After all, how many neurosurgeons can say they have personal experience with the condition they are treating? This was cemented by a conversation I had with my surgeon back in May 2014, during my second hospital admission:

Me: “I get headaches all the time now. How do I know if the headache is just a headache, and not another bleed?
Surgeon: “To be honest, I don’t know. I can tell you what the textbooks say, but you already know that. I’ve never experienced what you’re going through, so it’s very hard to say.”

That precisely sums up my motivation to get through the past year, and whatever the future years are going to throw at me. One of these days, I want to become the AVM consultant who can reassure their patient that they had managed to get through having an AVM and carry on to lead an awesome life.

So happy anniversary Ralph. Here’s to a year together in my new life, and to hopefully not many more!


2 thoughts on “The irony of fate – happy anniversary to Ralph!

  1. Having previously read your blog and forgot everything since (cheers AVM!) I have given it another re-read today, it’s great stuff and interesting that you have both the medical and personal perspectives of an AVM. I do hope you manage to become a AVM specialist! Keep on keeping on Gwen 🙂

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