I have a Chiari I Malformation. Most days and for the most part, I am okay with that. I would be lying to us both if I said that I’ve always been okay with it because God knows that I have had my fair share of temper fits, periods of feeling sorry for myself, and, of course, there have been all of those “Why me???” moments.
No two Chiarians share the same story. No two Chiarians are the same. This is MY story. This is MY Chiari journey. It is my hope that through sharing my story, you will know that you are never alone.
Before Diagnosis…
I lived my life for 40 years without ever knowing that I had been born with a birth defect. To me, that is one of the most incredible parts of my story, which holds true for most Chiarians. The not knowing will forever blow my mind. I had headaches my whole life and I honestly believed that everyone had headaches so that was never a red flag that anything was wrong with me. I can remember as a little girl telling my Daddy that my head hurt. And my Daddy being the silly guy he is would always respond, “If I had a head like yours, it would hurt, too.” I would always laugh at the silliness and that is probably what helped in not making me too concerned with having headaches. After all, if it were truly a bad thing, my Daddy would have been worried about them and if he and my Mom weren’t too worried, then I must be normal. So, I’d take baby aspirin, Tylenol, ibuprofen…over the course of the years, the treatments offered for headaches would change and I would adapt and take whatever was available in the family medicine closet to try and get some relief. Rarely did over the counter medications work, but eventually, the headache did go away, so no harm, no foul…life goes on.
Before adolescence, my pediatrician diagnosed me with scoliosis. I saw a specialist at Emory until I reached the age of moving on my own. I never gave the scoliosis another thought for over 20 years. It was a mild case and the only treatment had been regularly scheduled appointments at Emory to keep an eye on it, so there was no reason for alarm. Even today, I only mention it because it is part of my story. I still don’t know if it is a relative piece to the puzzle. It’s definitely not the most important piece, but it is a piece all the same.
Over the course of my first 40 years, I lived a pretty normal life. I had some issues during my child bearing years which resulted in the loss of five pregnancies; two of these in the first trimester, two in the second trimester, and one ectopic pregnancy which resulted in a ruptured fallopian tube. At one point, I was diagnosed with hormonally induced migraines and endometriosis. I was told that I might want to consider a hysterectomy. I had recently divorced and decided that at the age of 35, knowing that God had blessed me with three of the most amazing daughters, to get the hysterectomy. Honestly, the headaches did get better. I rarely had them any more. Now, of course, when I did have them, they were horrible. But going back to everything I believed growing up, every one has headaches, so this was of absolutely no real concern to me.
They say that hindsight is 20-20 and I believe no truer statement has ever been uttered. Some of the other things I had sought treatment for such as unexplained, violent vomiting which resulted in major weight loss (over 30 pounds) in very short amounts of time (less than three months) had scared me into believing I was REALLY sick and dying on multiple occasions. I went through nearly 20 years of various testing and diagnoses…CAT Scans, depression diagnosis, thyroid testing, diagnosis of depression, diabetes testing, depression diagnosed, spastic colon, depression, irritable bowel syndrome, depression, panic disorder and, of course, depression…the list goes on and on and on. To this day, I’m not sure how much of any of it is real and how much was merely grasping at straws to figure it all out. I do know that I ignored so many telltale signs that my body was screaming for me to look at, but life with three children who were born within three years of each other was so overwhelming that I ignored myself. One of these signs was a hearing loss that worsened over the course of 20+ years, but I will tell you about that in a little bit.
The Defining Moment…
Act I.
PROLOGUE.
Two offices inside a thriving business located across the hall from each other.
The time was August 2007.
An accountant who had no idea she was a walking time bomb
She lived her life to the fullest and knew not her limitations
She rose to every challenge and fought with great courage and tenacity
A co-worker had suffered a terrible stroke
This left the accountant with double the duties and responsibilities
What began as just another end of month closing for the accountant was anything but normal.
She never knew that life as she knew it would change forever in the blink of an eye
Scene 1. Two offices.
Enter the accountant into office one. She had begun busying herself with the typical end of month closing activities that were her responsibility. Once the processes had begun, fade into office two where she began the responsibilities of her absent co-worker. For the next three hours, the accountant was running back and forth between the two offices running various accounting closing functions on the computers located in each office. She began having difficulty maneuvering around office furniture and in an attempt not to cause herself harm from continuously tripping over the chair at the desk, she slung the chair in office number two across the room. Several hours had passed and she was getting close to accomplishing the monumental tasks she had set out to tackle. She had a phone call.
The Receptionist: “You have a phone call. Which office should I send it to?”
The Accountant: “Send it to Dianne’s office!”
(phone rings)
The Accountant: “Hello? Oh, it’s YOU. Thank goodness.”
(Realizing she could take a break from her frenzied routine for the day, she decided to take a load off. She could have sat down slowly. Maybe even gracefully. But she sat as though she was a woman with a purpose. A purpose to finally rest a minute. As she began the decent downward, she realized, the chair was across the room. She didn’t stop until she met the concrete floor. She never missed a beat with her phone conversation, but inside her mind, she knew something was terribly wrong. Tears flooded her cheeks. The person on the other end of the line never knew anything had happened. Her ears were ringing loudly. Her body was screaming from the trauma. Her pride refused to allow her to stay there on the floor and she quickly crawled to the desk and pulled herself back to her feet. She finished her phone conversation and pulled the chair back to the desk and sat there. All the while knowing something was wrong. Terribly wrong. She chalked it up to embarrassment. After all, who wouldn’t laugh at someone who missed their chair? She finished her work day as though nothing had happened.)
Scene 2. Home.
By the time the accountant made it home, she was hurting terribly. She crawled up the stairs to her bedroom, took 800 milligrams of ibuprofen and went to bed. The next morning, she couldn’t move.
The Accountant (screaming loudly): “Can somebody PLEASE come help me!!”
Her daughters: “What’s wrong, Mom?”
The Accountant: “I don’t know, but I cannot move.”
(Her daughters helped her out of bed. Once standing, she realized that she couldn’t lift her right leg off the ground. Her daughters helped her get undressed and into the shower. She showered quickly and the daughters helped her get dried off and redressed. She then drove herself to the Emergency Room.)
Scene 3. The Emergency Room.
The Accountant explained to the ER staff what had happened. X-rays were ordered.
The ER Doctor: “That must’ve been some fall you took!! It’s no wonder you are in so much pain. You have a broken coccyx (tailbone) and a fractured pelvis! I’ve written you a prescription for pain medication and here is an inflatable doughnut for you to sit on. It will help disperse the pain and keep the pressure off your coccyx until it has time to adequately heal. This process can sometimes take as much as a year to completely heal. You should take it easy and get plenty of rest the next few days.”
Fade Out.
What Happened Next…
I did take it easy for a while after that painful adventure and the doctor was absolutely correct, it took months for me to heal. I got SO sick of hearing jokes about my booty and being asked how my booty felt, I could have screamed!! That’s probably the main reason that I ignored things that were happening inside. I didn’t want to draw any more attention to my booty than had already been drawn.
A year and a half goes by and my booty has fully healed; however, I began having some other issues. Severe pain in my neck that I had at first attributed to sleeping wrong, which couldn’t have been the case after it happened for more than six months straight. I mean, who can sleep wrong EVERY single night for more than six months??? There was also a nagging pain in my lower spine that hurt all the way into my butt and hips. My pelvic region began going numb as if it were asleep. Sometimes, it even had that tingling feeling like when your foot goes to sleep. There were other things happening as well. I began having severe balance issues. Staying on my feet became a challenge. Headaches increased in severity and in frequency. I began having vision issues…things such as depth perception, floaters, jagged, bright lights jumping around. I was nauseous most of the time and eventually began vomiting almost daily. My feet had become numb, yet they ached and hurt, too. This made no sense to me. I couldn’t understand how something that was numb could hurt. There were many other things; however, they were not nearly as alarming to me as these that I’ve mentioned.
That’s when I began doing my own “research” on the Internet and had convinced myself that I had Multiple Sclerosis. It was the week before my 40th birthday and I scheduled my yearly physical examination. It was also a year and four months since my fall. I never even put the two together in my mind. I know that sounds like it would have been a given, but I figured I had completely healed from that, so whatever was happening was new. So, I made an appointment with my family doctor.
At the time of my appointment, I explained to the doctor my concerns. She dismissed it all. She was standing behind me pressing that cold stethoscope on my back and telling me when to take breaths and I wasn’t cooperating. I couldn’t hear her commands. She walked around to the side of me and got my attention and asked me what was wrong. I was a little confused and just looked at her. She explained that she was telling me to take deep breaths and wanted to know why I wasn’t. I told her that I hadn’t heard her and that I was sorry. She became immediately alarmed at this statement. She began asking questions about how long I hadn’t been able to hear. I told her that my hearing had gradually gone over the course of 20 years. I didn’t know why and no doctor had ever seemed to think it was a big deal, so nothing had been done about it. She referred me to an ENT immediately.
The appointment with the ENT was the week of Christmas… Christmas Eve to be exact. After about two hours of testing, it was determined that I had a total hearing loss in my right ear and approximately a 40-50% loss in my left ear. She stated that I was “legally deaf” which made me laugh. I was grateful that if I had to be deaf, at least I was legal instead of being illegally deaf. Wouldn’t that suck to go to jail for being illegally deaf?? Okay. Bad joke maybe, but bad jokes are what get me through. Believe me. The bad jokes only worsened from there. The ENT explained to me that she believed one of two things were happening…I either had a brain tumor or else the main blood vessel in my brain was kinked like a water hose and that was causing my hearing loss. Merry freakin’ Christmas!! I somehow managed to make it through Christmas that year with my sense of humor left in tact; however, I only shared the news with my daughters. I figured they needed to know why I was in a haze during the holidays, but I didn’t want to ruin anyone’s Christmas, so we kept it to ourselves. Humor got us through. For the next week, I blamed every stupid thing I did on my “brain tumor”…bad parking jobs, forgetfulness, and anything else that suited me.
The ENT did send me for an MR of my brain. Within that week after Christmas, I had this MR done and I returned to her office where she greeted me with the best news I’d ever heard. She told me that I did NOT have a brain tumor and the main blood vessel in my brain was fine. Instead, I had a Chiari I Malformation. She explained that I was probably born this way. She didn’t know a lot about it, so she referred me to a neurosurgeon at Duke University. She said he was “the best” in her opinion and that I would be in very capable hands. I can remember almost skipping to my car after that appointment. One year later, I reflected on this moment and realized that the old adage “Ignorant is bliss” probably came from a moment exactly like this one that I was experiencing.
I went to my appointment with the neurosurgeon who I will affectionately call “Dr. Clueless.” He ran a battery of tests on me during that appointment and he explained to me the best he could what a Chiari I Malformation was and what it meant for me. He told me that I had “a great story” and that he would “love to do my surgery” and he explained exactly what this surgery would entail. Brain surgery???? Seriously??? A week before I had been skipping to my car and now I was hearing brain surgery??? I was stuck in a REALLY bad dream. I told him “Thank you, but no thanks.” I thought the entire thing was absolutely ridiculous. After all, the ENT had told me that I was probably born this way. And I had only heard the words “Chiari I Malformation” the week before for the very first time. There was NO way I was letting anyone crack my head open like a coconut. I had gone 40 years like this…why brain surgery NOW??? Then, to make matters worse…he had told me that there was “less than a 20% chance of fixing me”??? Umm. NO!!! That was my final answer.
He told me that I needed to stay under a doctor’s care and said he would refer me to a neurologist in his practice. I called every week for several months and I never got that referral. So, I began going through my provider directory and quickly discovered that as soon as I mentioned “Chiari,” no one had any openings. I was down to the last neurologist in network and finally, she agreed to see me. I have affectionately named her “Dr. DumbAss.” I only saw her twice. These two visits cost me literally thousands of dollars. She was trying to diagnose me with Lupus and malnutrition. She wouldn’t even talk about Chiari. She said that I had something going on, but there was no way that it was Chiari. I truly believe that had I continued to see her, she would have spent however long I allowed racking up tons of bills and coming up empty handed. Luckily (and I use that term somewhat loosely), I had lost my insurance at work and it was replaced with a Catastrophic Comprehensive Coverage only policy. That was my last doctor appointment for over a year.
What to do, what to do…
I spent the next year or so educating myself as much as I could. I made some GREAT friends along this journey who have helped me to understand this condition. I soaked up information like a sponge. All the while, I had problems that were progressing rapidly. I made several trips to the ER for headaches, rapid heartbeat, blood pressure issues, blue-ish purple legs, back pain and came up empty handed. In one ER visit, the doctor kept calling it my “Chianti” and it was then and there that I realized, I was screwed. I was on my own in trying to get treatment, but luckily God had placed a whole bunch of people just like me on my path to cheer me on, offer encouragement, share in my fear of the unknown, and to simply love me. I learned quickly, in this life, that’s all you need. A good support system. And I have the BEST. No doubt.
The only thing that was keeping me down was lack of insurance. I struggled with this for over a year. Even if I did come up with answers or even a game plan, how in the world was I going to do anything about it?? I figured I would cross that bridge when I came to it. What else could I do?? I continued on my journey and then, the most miraculous thing happened. I heard of a doctor who was close enough for me to get to, I only had to come up with the money for the initial examination. $900. Wow. It may as well have been a billion dollars, but I was determined. I knew this was my only hope. I had to get in to see this miracle man that one of my Chiari friends had dubbed “The Brain Whisperer.” So, when I filed my taxes this year, I knew where that money was going. No doubt.
The Brain Whisperer…
I made an appointment to see Dr. Rosner on Valentines Day this year. I was SO excited and anxious and nervous, but for the first time since this had begun nearly four years ago, I had hope. Hope for answers. Hope for a game plan. It came to be and for the first time since my original diagnosis, I received ALL of this and more.
Dr. Rosner was everything I had hoped for and so much more. He only sees new patients on Monday mornings at 8:30 a.m. What I didn’t know was that he only makes one appointment for that morning. Monday, February 14th, I was that appointment. He spent two hours with me. He was incredibly thorough and validated my thoughts, my feelings, and my symptoms. That was worth more to me than I can even find the words to describe. I was validated. I wasn’t crazy. I wasn’t depressed. I wasn’t a hypochondriac. I have a Chiari I Malformation and for the first time, I finally knew what that meant.
I have a 7.5 mm herniation. Most people’s skulls and brains are symmetrical. This means that if you were to draw an imaginary line down the middle and fold it in half, they would be identical. People with Chiari do not have symmetrical brains. Not only is my brain not symmetrical, neither is my skull. One side is much larger than the other…even though, in reality, my skull is not large enough to hold my brain. When I fell, my brain shifted into the larger side. My brain stem is now tilted. My brain tonsils are also falling out the opening at the base of my skull (the foramen magnum). My tonsils are deeply impacted within the foramen magnum and laterally across my brainstem. My right tonsil is much lower and larger than the left.
I have intermittent weakness in both my upper and lower extremities that have increased over time. I also have difficulty with memory and cognition. Dizziness and balance issues are always present. If I stand up too quickly, I black out. If I bend over, I black out. Please keep in mind that by “black out,” I do not mean pass out. I mean that literally everything goes black. I, personally, have never lost consciousness. Doing simple mundane tasks such as laundry can cause black outs and severe nausea. The act of simply bending over to empty the dryer and standing up to hang up piece by piece can ruin my entire day.
In addition to the issues I mentioned earlier in my story, I also have bladder and bowel incontinence issues. Embarrassing? Yes. Most definitely. Especially since I am only 42 years old. I had no idea these were related to my brain issues. I have intermittent abdominal pain and cramping accompanied by either constipation or diarrhea. Females need to be aware of any changes during your cycle. I thought because I had a hysterectomy that I would be immune; however, I still have my ovaries. And although I am single, I’m quite certain that if I were sexually active, I wouldn’t be able to reach orgasm due to the paresthesia in my genital area. Dr. Rosner agrees with me. One of the questions he asked me was about my sex drive. I explained that it was non-existent which is a stark difference from where I was even two years ago.
The official diagnosis:
- Adult Chiari malformation with multiple neurologic findings and symptoms.
- Neurogenic bladder secondary to #1.
- Sympathetic dysautonomia/NMH/orthostatic intolerance secondary to #1.
The game plan:
- Craniovertebral MR scan with quantitative views of the cervical spine
- Thoracic MR scan to rule out syringomyelia
- Flexion extension cervical spine films to establish craniovertebral and cervical stability
- Refer to urology for urodynamic evaluation
- Refer to cardiology for tilt table evaluation of orthostatic intolerance
Once I’ve accomplished these given tasks in my official game plan, I will meet with Dr. Rosner again to discuss brain surgery. It is my understanding that if I do not get surgery; I will only get progressively worse over time. This time, I feel confident in my neurosurgeon. This time, I feel better educated and equipped to make this sort of decision. This time, I will be getting brain surgery. There is hope for Chiarians. There are good doctors out there. If you read nothing else in this enormously long story of my Chiari journey, PLEASE read this…don’t let the doctors choose your treatment if it doesn’t feel right to you…don’t let them decide what’s best for you if you don’t agree. Educate yourself, find a support system (even if you have to create it yourself), look for me on Face Book (Danica Grider Martinson) or comment here and I will put you in touch with the BEST people on the planet. This is YOUR life. YOU be the one in charge. No one knows you like you know yourself. Remember that. And most of all, listen to your body. I ignored my body for entirely too long. This made Dr. Rosner’s job much more difficult than it had to be. I’ve had to promise him that I will pay attention and listen. And remember that no two Chiarians are the same. We are each unique and different. We each have a story. This is simply mine.
Until We Meet Again…
As my Chiari journey continues, I will update my story. But I would like to leave you with links to my greatest sources of information thus far…
www.conquerchiari.org
www.ASAP.org
www.wacma.com