Cerebral Volume Loss.

Not something you want to read about, re: the state of your brain.

But let me start at the beginning.

Last Wednesday, March 24th, I was messing around the house, doing the stuff I usually do. I’d played a game on my iPad while drinking my lapsang souchong tea, I worked out for a while in the bedroom, and then I was standing at the kitchen counter sending Amy a text.

But as I hit send I suddenly felt odd. I was pretty sure I was going to faint. There was no black tunnel or anything, just a strange feeling and I staggered over to the couch to sit down. So weird. I felt a little better sitting but wasn’t sure how to proceed. I wanted to tell Kevin, who was down in the basement, but I didn’t think I had the energy to call down to him. I settled back on the couch and figured he’d come up the stairs shortly. He did just that, and I told him I felt weird.

He quizzed me about my symptoms and I explained that I’d thought I was going to faint and felt light-headed and weird. He went to the bathroom to search for a thermometer while I decided to eat an apple and peanut butter because maybe I was just hungry.

I felt no better, and Kevin finally told me he couldn’t find a thermometer so I got up and found one, and then another one. Men just can’t find things, can they? I took my temp and it was normal. But still the weird feeling. Kevin took my blood pressure and it was much higher than it usually is, maybe 150/90. Kevin suggested that I call my doctor. I can’t just call my Dr. Yu’s office anymore because the medical system is now interconnected. But because my symptoms had some red flags, the main call center connected me with Dr. Yu’s nurse right away, and after I explained my situation she immediately asked the doctor what he thought.

He said I should go to the emergency room. The nurse said they would check up on me and when I went, I should say I had a “sudden onset” of feeling faint.

Now, I’ve taken people to the emergency room quite a few times and I knew I would probably be there a while no matter what, so I started hustling around, changing my clothes and gathering my phone and my iPad and my phone charger and another phone charger and my big blue water bottle which I’m never without. I also called my insurance company because our friends had just taken their 88 year-old dad to the ER at St. John’s Hospital and their experience reminded me that I didn’t want to go there, but I knew that in the past we didn’t have a choice, insurance-wise.

I told the person on the phone that my ER choices were St. Johns and Memorial, and could I go to either one? The woman put me on hold to check, as I wandered around the house looking for stuff to bring with me and feeling very out of breath and maybe I should try to hurry up since when you go to the ER you’re supposed to get out the door in a reasonable amount of time not wander around for a half hour or more. The woman came back on the phone and asked, “so you could go to Northwestern?’ which was funny because Northwestern is in four hours away in Chicago, and no, that wasn’t a good option, but then she assured me that I could go to whichever hospital I wanted to.

Finally we made it out the door and to the ER. When I checked in they took my temperature and gave me one of those flimsy light blue masks which had to swap with my superior dark blue mask. They told me that Kevin couldn’t wait with me until I got into a room.

So he sat in the truck while I waited, glad to find a separate waiting room that was partitioned off from the main one, and only one other person was in there. As far as I could tell, everybody was appropriately masked. It was kind of interesting to be out amongst people since I haven’t done that much in the past year except for going to the grocery store. Two cops were talking to a woman in the other waiting room. She was sitting next to a woman who looked like she was in bad shape, and they wheeled her away as the the other woman kept talking to the cops. Hmm, had that woman been in an accident? I worried that she’d been abused by somebody, because why else would cops be there? I try not to think about all the bad things happening to people all the time.

I only had to wait 25 minutes which seemed good to me because there were quite a few people in that main waiting room.

When they checked me in they weighed me and I didn’t even care that I didn’t take off my shoes, which is something I always normally insist on . They asked me lots of questions as they took my blood pressure which was still high. Then then put me into a very wide wheel chair and wheeled me back. It was funny to be wheeled around, something I also don’t recall ever doing.

The nurses’ station in the middle of the ER was surrounded by beds full of people. They wheeled me past a guy in a prion uniform and parked me on the far side of the nurses’ station. My nurse, a very nice guy named Michael, apologized that I’d have to stay in the hall for a while because all the beds upstairs were full, so people in the ER rooms couldn’t be moved out. This was fine with me. I was only a little bit worried about potential Covid germs in the air as all kinds of medical people hurried back and forth and all around. Michael hooked me up to an IV, explaining that I might be dehydrated which could have made me feel like fainting. I don’t know why I didn’t mention that I’m almost always overly-hydrated, but I wasn’t at my sharpest while lying there. I do recall that there were quite a few guys walking around with electric drills and stuff, were they remodeling?

Michael took some of my blood and a very nice doctor came over and talked to me, and then they wheeled me to a CT scan room and then an X-ray room, and a nurse put sticky things on me to do an EKG. The time passed and I was content to just lie there; I didn’t even feel like opening up my iPad, much less playing anything on it. I kept Kevin updated and after a couple of hours I started feeling bad that he was just sitting there in his truck, but I was also glad that he wasn’t out amongst all these people. I texted him that he should go get some coffee, or he could just go home and that I was fine.

Meanwhile, I suddenly remembered that this had happened to me before. Why hadn’t I thought of this? In 2010, Kevin, Mollie and I were out east, camping and traveling around, and we stopped to spend the night with his sweet aunt somewhere in Virginia. We went to dinner at his cousin’s restaurant, had a lovely meal, and then they gave us a tour of the place. While we walked around I suddenly felt like I was going to faint and his elderly aunt ended up driving us to an urgent care place in some tiny nearby town. I remember that the exam room at the hospital or whatever it was was also a closet, filled with mops and cleaning products and a ladder. I can’t recall what kinds of tests they did, but I know that the only thing they could find was that I was a low on potassium. We picked up some potassium at a Wal-Mart the next day and drove on to the Shenandoah National Park. I felt OK after that, a little weak the next day, but nothing came of it. We even hiked a little on the Appalachian Trail, so clearly there was nothing too wrong with me.

I flagged down Michael and told him about the incident, and I told the doctor. MIcheal said the low potassium could have caused the near-fainting, but my potassium today was OK.

I called Kevin and reminded him of the story and we both marveled that we’d forgotten all about that incident. He finally drove home at about 5:00 and the doctor came back and said the EKG showed that I have a “right branch bundle block,” and explained what that meant at least three times and I finally got the gist of it – at or near my heart, there are two branches of electrical impulses and the right one does a weird little thing, making the impulse ricochet over to the left branch, which is abnormal. She said that she didn’t think this had anything to do with me almost fainting, and that it was something that I might always have had.

She talked to Dr. Yu on the phone which I thought was good, and she came back to talk to me one more time. Basically, they didn’t know what happened to me. She said that I should make an appointment with Dr. Yu soon, and handed me a stack of the findings of all those tests and told me to give them to Dr. Yu. Nobody seemed concerned that my blood pressure was still pretty high, but they put some different sticky pads on me which hooked up to a Holter Monitor, which would read my heart rate for 24 hours. It was about the size of a small cell phone and attached to a lanyard, but the heart guy who hooked it up told me that I could detach it from the lanyard and stick it in my waistband.

I called Kevin, who had only been home long enough to feed the starving kitties, and he came back to get me. As we drove home I started leafing through the papers and stopped at the results of my CT scan. Mostly it was a bunch of “blah blah blah is not abnormal, No hydrocephalus, basilar cisterns are preserved, blah blah blah.”

But then something leapt out at me. “mild generalized age related cerebral volume loss.”

MY BRAIN IS SHRINKING.

Yeah, fine, it;s age-related and it’s mild, but still, SHRINKING. I haven’t been able to get that out of my mind. my shrinking mind. Can I do something to build it back up a little? Brain food, is there brain food? I must look into it.

When we got home Mom came over and I showed her how I was hooked up with the electrodes and she said that a long time ago a co-worker had to wear a Holter Monitor but it was huge, as big as a tape recorder, and in a big bag. At least things have gotten more compact.

I didn’t care for that Holter Monitor though; I somehow managed to unplug a couple of the sensors a few times. I turned it in the next evening and nobody called to say that my heart is completely out of whack, so that’s good.

I’m going to see Dr. Yu on Thursday and I bet he’ll tell me that this is something that randomly happens to me every eleven years.

I wonder, will I remember this incident when it happens in 2032? Almost certainly not. Think of how much my brain will have shrunk by then…

As I started writing this this morning I had to stop and I thought about one more thing I wanted to add. I’ve been trying to recall it ever since then, to no avail. shrinking shrinking shrinking…

Meanwhile…here’s a short little video of Lovey being brave and venturing out into the fenced yard with Kevin. She’s been inside our house during the entire pandemic, having come in late last March.

ok then,

mrs. cerebral volume loss hughes.