Contemplations of a Restless Mind

Adventures and Tales of Jessie T. Ponce

How Cindy Survived a Ruptured Brain Aneurysm

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Deadly

It is fatal, could affect anyone, and yet very few have heard of or understand it.    In the US alone, around 6 million people have a brain aneurysm and as many as 1 in 15 people could develop this dreadful disease.  Half of ruptured aneurysm victims die within minutes of a massive hemorrhage and, of the 50% who survive; half will suffer delayed death while  the remaining survivors, depending on the level of the hemorrhage, usually live with severe long-term deficits (data from the Joe Niekro Foundation).

Cindy is one of those who compose the latter group of survivors.  Her ordeal with a ruptured cerebral aneurysm happened  in the Philippines where conditions for emergency treatment and care are often less favorable compared to the US.  This is her story.

Without Warning

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“It felt like my head was about to explode” (Image Source: http://www.sciencephoto.com)

Day 00, March 2, 2009: It happened in seconds and without warning. It has been a pleasant, normal day at our farm some three hours away from our main residence in Davao City. It was around 10:00 pm and we were having a leisurely time after attending to the needs of a group of guests who were now having some fun on their own in another section of the farm.  We were alone, having a small chat on a bench outside our cabin when our two dogs got restless so she stood up, got some dog food, and then stooped down to place the food inside the cage. It was as she stood up when she became unsteady and complained of a sudden severe headache. Persistently health-conscious and a nurse by profession, Cindy never had health issues or any known history of hypertension or major diseases so I did not expect anything serious.  Back on the bench, I massaged her head and nape but she weakly requested to be brought to the hospital complaining that the pain was unbearable and she felt like her head was about to explode.

When we got to the local doctor a few minutes later, she was already half-conscious, her eyes were half-closed, and she was vomiting.  The doctor, initially suspecting cardiac arrest, sent us to a local hospital where, after initial assessments, a specialist diagnosed a strong possibility of a ruptured cerebral aneurysm.  A computed tomography (CT) scan was needed to confirm the initial diagnosis and the hospital had this facility but the nearest brain surgeon was practicing in General Santos City (GenSan), the next city about an hour away.  So Cindy was transported by ambulance to GenSan to ensure that a surgery can be immediately undertaken by the brain surgeon if a ruptured aneurysm was confirmed.  By this time, Cindy was already under life support, 70% of her breathing was administered by a respirator and she was having seizures and stiff involuntary movements mainly in her right extremities.  While a doctor and two nurses were monitoring her vital signs, I had to apply pressure on her arms and legs to control the spasms as the ambulance sped through the now dark and deserted highway.

Day 01, March 3, 2009:  After a CT scan and several tests at Saint Elizabeth Hospital in GenSan, almost five hours after Cindy felt the severe headache, it was confirmed that she indeed had a ruptured aneurysm. She was admitted to the ICU.  Very carefully and in layman’s terms, the brain surgeon and a neurologist carefully explained Cindy’s medical condition to me and our three kids.

A Balloon in the Brain

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Brain Aneurysm (Image Source: modernhealthwisdom.org)

From the doctors’ explanation  I understood that Cindy’s aneurysm was congenital. Since birth, a major artery that supplied blood to her brain had an abnormally thin wall at a certain section inside her skull.   The thin wall, because of the constant blood pressure, gradually swelled over the years into a balloon-like bulge.  The presence of aneurysm is difficult to detect since its symptoms (fatigue, loss of perception or balance, speech problems, double vision) may not be pronounced and can be suspected to be due to unrelated causes.  This blood-filled “balloon” ruptured and caused a massive cerebral hemorrhage which increased the pressure around the brain tissues, caused the seizures and involuntary movements I witnessed, and affected major bodily functions including breathing. The resulting blood clot around the brain blocked some ventricles thus causing the accumulation of fluids (brain water) and aggravated the increased pressure inside the skull.  Because of these disruptions, the brain may shut down and then Cindy will  succumb to comatose or death in a matter of hours.  At that time, Cindy was doing only 30% of the breathing, the rest was being done by a respirator.  The doctors declared that she only had a 20% chance of surviving this fatal condition.

Possible Treatment

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Coil Embolization and Surgical Clipping (Image Source: brainaneurysm-symptoms.com)

I frantically tried to understand the possible treatments for Cindy’s condition.  Simply put from the surgeon’s explanation; there are only two ways to treat a ruptured aneurysm.  The older but allegedly more reliable method is called surgical clipping which involves opening a portion of the skull (craniotomy) and closing the ruptured aneurysm by clipping its base. On the other hand, the more recent and minimally invasive technique is called “endovascular coiling” or “coil embolization” where a catheter is passed into a major artery in the groin, through the aorta, into the brain arteries, and finally into the aneurysm itself then platinum coils are fed into the aneurysm through the catheter. The platinum coil fills up the ruptured “balloon”, initiates clotting and thus plugging the leak in the artery. The risk level is said to be the same in both methods but only surgical clipping procedures can be done at the hospital where Cindy was confined.

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High Level of Uncertainty

Day 02, March 4, 2009: It appears that Cindy was also subjected to another medical practice called “watchful waiting”.  None of the above methods were administered to her from the time she was admitted into the ICU.  The surgeon felt that, despite all the tests, there is still a very high level of uncertainty about the conditions inside Cindy’s head. Her already dismal situation can quickly drop to worst at any time and risks of undertaking a surgery outweighs the desired benefits. Of course, it was very difficult for me and the kids to understand this approach. To us, Cindy’s life was like a lighted candle that was rapidly getting shorter with every minute that passed.

Day 03, March 5, 2009:  Unconvinced that watchful waiting was the best way to manage Cindy’s case; I went to Davao City (our home city) to get a second opinion from another brain surgeon at Davao Doctor’s Hospital. This hospital has competent medical specialists, more modern and complete facilities, and a good track record in handling cases similar to Cindy’s.  But another issue comes into the picture if Cindy was to have treatment at Davao Doctors – travel.  The inside of Cindy’s head was so fragile at this time that even a small disturbance from the travel can trigger seizures, comatose or another bleeding.  The blood clot presently controlling further bleeding can be dislodged and a second, usually fatal haemorrhage can occur. The second expert opinion I got was to allow the morbid “watchful waiting game” to continue for another three days before transporting Cindy to Davao. We had no choice but to trust the judgement of these surgeons and pray that they recommended the right action. Only time will tell.

Extremely Fragile

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The CT Scan film showing the huge aneurysm inside Cindy’s brain

Day 06, March 8, 2009: Cindy’s condition actually showed some signs of improvement. She has been unconscious at the ICU since day 1 but there were brief moments on the sixth day when she showed signs of being awake and her dependence on the respirator for breathing was now down to 50%. It was a good sign and we thought that she might have felt that she was about to go home. But the extremely high risk associated with the two-hour trip to Davao was still a very grave concern.

Day 07, March 9, 2009: It was only on our faith in God and that small sign of improvement where we clung to when we moved out of Saint Elizabeth Hospital towards Davao City just a few minutes after midnight (I chose this timing so that the weather will not be hot and traffic along the route will be minimal).  I joined the medical team in the ambulance and positioned myself above Cindy’s head to help cushion it in case of bumps on the road while the kids, who I tried to prepare for any eventuality during the trip, did their prayers in a van following behind us.  The atmosphere inside the ambulance was tense during the first half of the trip but, thankfully, Cindy’s vital signs remained stable and, with great relief, we arrived at Davao Doctor’s Hospital without any incident.

Fatal Options

Day 08, March 10, 2009: My primary concern, now that Cindy will be subjected to a surgical procedure soon, was to make sure that the operation addressed as many of the problems as possible. In my mind, coil embolization was appealing because of its minimally invasive procedure but it only closes the ruptured aneurysm and does not address the problems with the blood clots and hydrocephalus or accumulation of fluids around the brain; whereas a craniotomy and surgical clipping can potentially address all these three issues. My fear was that if we subject Cindy to coiling embolization, another surgical procedure might be needed to remove the blood clots and fluids around the brain and that might be too much for her to handle. The brain surgeon agreed to schedule a surgical clipping operation as soon as the condition was right.

Day 15, March 17, 2009:  Though Cindy remained unconscious at the ICU, she has been receiving continuous medications to improve her condition and prepare her for a surgical clipping procedure which was scheduled on this day.  However, upon assessment by a number of specialists, the operation was not given clearance because she still had fever and some pulmonary infections.

Main Problem Solved

Day 17, March 19, 2009:  While waiting for Cindy’s condition to improve, her managing physician decided to conduct another set of tests to determine the status of the hydrocephalus and blood clots.  The tests showed that medications have successfully dissolved the clots and flushed out the unnecessary fluids around the brain. It was great news. Now we can agree to a coil embolization!

Day 21, March 23, 2009: Twenty one days after the rupture, time has finally come to fix the aneurysm once and for all.  The team of specialists has confirmed that a coil embolization procedure can now be undertaken with the least possible risk to Cindy’s condition. She was brought to the operating room at 2:00 pm and, for 3 hours, family members and friends waited and prayed at the waiting area until the surgeon called me into the operating room; directed me to the screen which showed Cindy’s arteries and the path that the catheter followed; pointed to the various frames which recorded the process as the aneurysm got filled by platinum coils; then declared that Cindy was safe and the operation was a success.   She was later returned to the ICU for further intensive care.

The Road to Recovery

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Home at Last: Cindy on the road to recovery

Day 32, April 3, 2009: Cindy’s condition continued to improve after the operation and she was moved out of the ICU into a private room.  She was having more frequent “waking moments” and her dependence on the respirator has totally ceased although feeding her solid food was still not advised.

Day 38, April 9, 2009:  A physical therapist has started working with Cindy to revive her motor skills particularly in her right extremities which seem to be the most affected by the massive disruption inside her brain.  Although she still cannot communicate, she can now take a few solid foods and even  showed excitement when I and the kids joined her during meals.

Day 47, April 18, 2009:  Forty-seven days after she had a ruptured aneurysm, Cindy was finally discharged from the hospital and we went home to the welcoming arms of family members and friends who were overjoyed and thankful that she had survived the ordeal. She was still in a wheelchair and we still needed to work with speech and physical therapists to help her recover her normal functions and minimize the deficits but we were confident that she will be able to overcome this part.

A Second Life

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Almost Fully Recovered: Cindy two years later

Day 1095, March 03 2012:   It is the birthday of our eldest daughter, Nikki, today and on that tragic day three years ago when it was confirmed that Cindy had a ruptured aneurysm.  But the day is bright and glorious and the atmosphere is a lot more festive on this day, far from the cloud of gloom and distress that enveloped the whole family three years ago.  Cindy is now fully functional at home, in social functions and even in the farm where her long ordeal started.  She still has a slight limp on the right leg and occasional lapses in speech and memory but she continues to amaze us with instinctive reactions to situations and sudden spontaneous recollection of things.  Even her doctors and therapists comment that, compared to other patients who have gone through the same ordeal, she appears normal – “as if nothing had happened” was the common comment.  Indeed, the meager 20% chance of survival she had in March 2009 has been fully reversed.   She is now 100% alive and, as a bonus, she came out from the experience with such cheerful, child-like innocence that made her more endearing to people around her with each passing day.

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Author: Jessie T. Ponce

A traveller and avid, almost obsessive, photographer; I prefer the off-the-beaten-track over tourist-laden hubs, a rural paradise over a five-star urban haven, the simple and uncomplicated over the glitzy and glamorous --- if only life allows one to choose!

32 thoughts on “How Cindy Survived a Ruptured Brain Aneurysm

  1. Amazing, indeed. Thanks for the post. Very informative.

  2. Pingback: Contemplations of a Restless Mind | A Traveller's Tale

  3. What a nice ending to an unsettling story, Jessie….

  4. I held my breath as I read this, exhaling only at the last, when I was relieved to read that she is alive and apparently doing well. You write well. Captivating.

  5. Pingback: An Episode of Mental Anguish | Contemplations of a Restless Mind

  6. I suspected from the depth of insight and compassion of your photography and the writing that you do on your other site that you had some incredible personal stories.

    • A fellow author’s intuition? 🙂 I do have a number of stories that I’m itching to write about. For now I’m just republishing what I have pulled out from sites I closed. Thanks for visiting and letting me know that you were here.

  7. Well, Jesse. I just stumbled over here from Traveller’s Tale, somehow. And what a treat I found here. Cindy is lovely. She looks like a girl. Such a sweetheart face too. Thank God she came back to you. I started reading about the spiny fruit and the coconut. Fascinating and I wondered if you ever ate the durian fruit? Your accounts are in-depth and the photographs illuminating. But, my opinion of you as a writer was reinforced by your account of Cindy’s experience and by your response to it. You are one of the most articulate, balanced and dispassionate writers around. That’s unusual. I enjoyed the essays.

    • Hello, George. I was not even aware that you have stumbled into this site. As you can see, I’m still working on it but my intention for this site is to sort of showcase my writing over my photography. However, I recently got caught in a hectic schedule and would have to wait for another lull in my travels before I could work on my writing again. Thanks so much for your kind words about Cindy and for the generous commentary about my writing. You have inspired me to do more! All the best to you!

  8. Thank you for sharing this. My son is now at the ICU in Manila with a similar diagnosis and this has given me hope for a happy ending… Your story is inspirational and serves as a reminder that even at your darkest hour, you can find hope, redemption and healing…

    • Hello, Victoria. Sorry for the delayed reply. This disease can really come as a shock. I hope you found the courage and strength to face whatever the Creator has in store for your soon. God bless.

  9. I pay a visit each day a few web pages and blogs to read articles, however this blog provides
    quality based posts.

  10. Hi there! My sister is currently in a coma and reading this is probably God’s way of showing us what to do. Can you pls provide the name of the surgeon? Thr only thing is we are here in Laguna. Please help!

  11. Great article and helpful information. Thank you for sharing this to us.

  12. I Loved to read this story. I also have lived throught the same thing with my husband about 15 yrs ago. My husband had the Surgical Clipping’ and suffered for many year with seizures, usually in a cluster of three at a time. It took many years to get the medication level right to stop the seizures. He is functioning quite well cognitively and does work approximately three days a week, however he struggles physically with fatigue, always feeling tired. We are blessed that he is alive, and thank God every day.

    • Dear Victoria. Thank you for sharing your story and I’m glad to hear that your husband survived. While we, loved ones of survivors, indeed go through a lot of difficulties, we can still consider ourselves fortunate in spite of deficits in recovery because the greater majority don’t even get to see their loved one rise up from this terrible disease. God bless you and your husband.

  13. This is a great story and brings much needed hope to victims and loved ones of those who suffer this disease! I myself survived a ruptured aneurysm 4 short years ago and thanks to God and my angel on earth, my fiancé (now my wife since June 2012), my life is back on track and without major after effects. It does great good to read of other survival stories and how you have come through the worst possible storm (if I may call it that). Thank God for Cindy and for you Jesse, keep up the fight and best of luck to the both of you.

    • Hi Charles. What a great surprise to meet another survivor! Yes, thank God you have joined the ranks of the very few who survived this horrible disease, along with my wife, Cindy. Really happy too to know that you are not suffering from major after effects. You keep up the fight too and thanks for your well wishes for Cindy and myself. Cheers!

  14. My name is Debbie and I must share my experience of having a ruptured brain aneurysm. About 2 years and 3 months ago I suffered from a ruptured brain aneurysm. Years before my aneurysm ruptured I had extremely bad, horrific migraines that progressively became worse. Then my aneurysm, which I did not even know I had, ruptured. The multiple CAT scans and MRI’s I had due to my migraines never picked up my aneurysm. I was in the middle of a horrible, wretched divorce (not exaggerating) by two years when my aneurysm ruptured. I was so close to death that I unconsciously let my bowels go as my dad and boyfriend were taking me to the hospital. The doctor at the first hospital was almost in tears said I was being prepared for life flight, but I probably would not make it. When the helicopter reached the hospital in downtown Cleveland the doctors there told my dad that I am alive and they are going to operate on me, but I probably would not make it. I do not remember any of this, nothing at all for at least three weeks after my aneurysm ruptured. I was in a dreamlike state during this time. I was seeing things all around me…yet I could not move. This did not bother me, though. After 3 weeks of this “dream like state” I was in, I slowly started to wake up. I remember my eyes slowly opened and I heard my mom say with such excitement “Oh, my god…she’s opening her eyes!” I was so sleepy. It was shortly after that I found out I was in the hospital from a ruptured brain aneurysm. Apparently, I had coils and a stent put into my brain before I woke up. I had learned that for about 2 weeks into my hospital stay the doctors all thought I was not going to make it. About the third week the doctors thought I may make it, but I would have serious issues and my parents should start looking at help from nursing homes, and possibly hospice. I could not see when I woke up due to the muscles that my eyes use going every which way, but straight. I was an avid runner before my aneurysm ruptured, but now I could not even stand up, let alone take a step when the nurses tried to get me to walk. But, I then started to recover at an extremely fast rate. I was home within one week after waking up. I had a speech, vision and physical therapist at home. When I first met them they were so nice and I was just talking and talking to them. They did look at me funny, but more as if in disbelief…like I was a ghost. But they too were gone within a month after I came home. I went through a great deal, but I did learn a lot from my ruptured brain aneurysm. I learned that so many people in my life care about me. I learned that miracles really do happen to good people. But, more importantly I learned that there is so much more love in the world then I could ever of imagined. That feeling is so powerful that I feel I must tell people that. I feel I must tell people if they are ever feeling down, depressed or sad in anyway that there are people thinking about them and loving them. That is worth everything that I went through…and back again.

    • WOW! Just wow. I’m at a loss for words, Debbie. Your story is an amazing, almost unbelievable first person account of your ordeal with a ruptured brain aneurysm. Thanks for sharing it! I hope you don’t mind if I share it to inspire others with your experience too.

  15. Thank you for your post. It’s been 14 days since my brother in law suffered from ruptured aneurysm. A very difficult situation for my sister. Your story gave us hope. Tomorrow will be his schedule for surgery, hoping and praying that the outcome would be as miraculous as Cindy’s. God bless…

  16. Hi Jessie, my mom just had ruptured aneurysm this morning, our location, Davao City was a big advantage that we were able to bring her to the hospital within an hour from the rupture. She’s stable, responsive and awake at some time. CT scan and angiogram was performed, we’re just waiting for angiogram results as our final basis. I’m somewhere on the other side of the world (Maldives), I can’t do much but wait. I’m the only child and the only source of income in the family, I want to be prepared for the worst and what it would cost. How much is coil embolization? Thanks

    • Hi Sheela. Really sad to hear about your mom. Will be good if we can communicate through messenger so I can quickly answer any questions you may have. Can you look for me (Jessie Ponce from Davao City)on FB or Skype?

  17. I was really in tears while reading this because 3 days ago (March 26, 2016), while we were having an activity/game in our monthly Church youth gathering, a sudden pain and head ache has been felt by my friend Zy. At first we thought that it was just a normal head ache as an aftermath of the game because it includes running (which is really tiring) but after a while, he said that he can’t feel anything on his left side of his body (from his arms down to his legs). He was immediately brought to the hospital.
    Sunday morning (Easter), March 27, 2016, I just heard from my dad that he has aneurysm. Upon hearing that, I thought that it was just a form of anemia (I have no idea of what aneurysm is) but when I reached home, I searched for it and yes, I was really terrified. I watched videos and read articles and went to various medical sites wherein I can find treatments and to find out more about this “silent killer”
    He underwent angiogram in Perpetual Las Piñas and was transferred to PGH after. He’s now in the emergency room in PGH and a good friend told us that he is having a hard time speaking.
    I honestly couldn’t think of anything but to pray for Zy’s condition. I know that God is in full control of everything and he knows how ever cells, veins, and muscles, work in our body. I humbly ask for prayers for my friend Zyron, he’s just 16 years old, for complete healing from the top of his head down to the soles of his feet. I pray for comfort and abundance of financial blessings towards his family. Lord God, you hold his life and everything of Him, may you protect our dear Zyron and embrace Him with your healing, mercy, and grace. Amen!

    I’m truly inspired from Ate Cindy’s story. I pray that Zy will also have a total 101% recovery. I’m also grateful and inspired upon reading the comments below of the different stories about brain aneurysm. I learned a lot from the experiences of others 🙂 May God bless our families and dear friends. Let’s continue praying for them especially with their health and safety everyday. God bless everyone!

    Thank you for all the prayers and to God be the Glory forever! Amen.

  18. This post is very inspirational, Sir! I, now have the idea to comfort my Mother and Father-in-law. My sister-in-law is also in this condition right now, and travelling (as of this moment) to Cebu City for surgery/medication. Anyway, we are from Lanao del Norte. Do you have any idea sir on how much will surgical clipping cost? Or the endovascular coiling? Which is more safety? What about the chances? I am totally amazed in Cindy’s story.. And I am also praying (very hard) to have the same success with Cindy.

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