(Semi-creepy view of Jen’s cranial arteries.)
Last week, Jen had her first post-baby appointment with another member of the team of doctors looking into what’s going on with her head. Actually, this was billed as a simple consultation with an interventional radiologist. He was supposed to look over Jen’s existing scans and recommend whatever tests were necessary to get to a diagnosis. We were fully expecting him to say that the next step was to have a cerebral angiogram (which Jen wasn’t all that excited about) and send us home.
We were not prepared to hear what the radiologist actually said. He indeed had looked at Jen’s existing scans and said he could tell what happened — there was no need for any further tests.
Jen’s internal carotid arteries completely disappeared just behind her jaw (we knew that already). It was the result, he said, of fibromuscular displasia (FMD), a condition that causes narrowing in certain arteries. At some point — he speculated during Jen’s last two pregnancies — her internal carotids had dissected (i.e., severed).
This wasn’t great news. We knew there was a possibility that Jen had FMD, but we were holding out hope for an alternative diagnosis which would mean that her internal carotids were missing as a result of a congenital defect, and that she had been living with that defect for a long time — perhaps her entire life.
He had some more not-so-great news. Everyone who had seen her scans thus far had remarked about how clear and well formed her vertebral arteries are. That’s important because, having lost her internal carotids, Jen relies on her two vertebral arteries to supply blood to her entire brain. This doctor saw something different: Jen had FMD in her vertebral arteries as well. He could see some narrowing and weakening of the arterial walls in those vessels too.
As a result, a cerebral angiogram was contraindicated because there was a small chance that her vertebral arteries could be severed in the process.
So what was to be done? Not much, actually. He said Jen needed to continue to take aspirin to keep her blood thin (likely for the rest of her life). Other than that, there is no preventative treatment.
The doctor then listed off a few don’ts. No roller coasters. No chiropractors. No sudden neck movements (yes, really). No falling asleep on a long airplane flight without a neck pillow.
Strangely, the doctor made a concerted effort to sound upbeat, almost like he was telling us good news. Just after telling us (1) that two of the major arteries in her head had been severed as a result of FMD; (2) that the two remaining major arteries also were affected by FMD; and (3) that Jen therefore had to avoid things like jerking her neck, he followed by telling us (in a pretty cheery voice) that she should just go home, enjoy her kids and otherwise go on living her life because it’s not that big of a deal.
Turns out that he may be right about that. There’s very little collective knowledge in the medical community about what to expect for someone in Jen’s position. But it’s possible for people to live a very long time with FMD, even those who have experienced an arterial dissection. Except in rare cases, FMD tends to develop slowly, so it bodes well that Jen’s vertebral arteries currently are in good shape.
So where does that leave us? Good question. We’re certainly going to seek out a second (and maybe third) opinion on whether Jen actually has FMD. Assuming this latest doctor is correct, we know that Jen has lost a couple major cranial arteries and has some weakness in her remaining arteries. They may or may not be . . . fragile.
In other words, she’s kinda like anyone else. I hate to break it to you, but you’re fragile too. So am I. The Bible compares us to that great symbol of strength and power — grass. As Peter put it, “”All flesh is like grass and all its glory like the flower of grass. The grass withers, and the flower falls, but the word of the Lord remains forever.” We’ve been directed to call 911 if Jen ever experiences stroke-like symptoms. As Charlie Sheen put it, “Duh.” But if I find out six months from now that I have a brain tumor, who will be the fragile one?
I’m praying that Jen’s vertebral arteries would remain whole and that she will be able to embrace her fragility with strength and grace. In the meantime, we’ve been reminded of the pressing need to redeem each day because our days are short.
Only one life, ’twill soon be past.
Only what’s done for Christ will last.”
In other words, don’t waste your life.