Because I can never talk to my doctor (only his assistants) I was hoping you could tell me what this means.

DEAR READER:
The Circle of Willis is an area at the base of the brain where several arteries join together. While all brain aneurysms are potentially dangerous, one situated in the Circle of Willis is especially so because the interior carotid arteries branch off from this area and supply about 80% of the brain’s blood.

Encephalomalacia is an abnormal softening of part of the brain, usually because of a restricted blood supply (ischemia) or death of the tissue (infarction, often due to loss of the blood supply).

The right temporal lobe is responsible for the memory of shapes and sounds. Damage to this area can cause loss of that type of memory and occasionally can cause personality changes such as loss of libido, humorlessness, extreme religiosity and others.

From your brief letter I cannot determine if you had the aneurysm surgically repaired or if it has remained untouched. In either case, the aneurysm may be directly related to your brain softening because the right temporal lobe is in close proximity to the right side of the Circle of Willis.

You need to have a follow-up examination so I urge you to see a neurologist for further testing. He or she can explain in better detail what symptoms may be caused by the abnormality and if there are any possible treatment options. The specialist can also give an accurate outlook about how this may affect you in the future and if it will require any special considerations as you age.

I would like to add that I am disappointed at the hospital doctors and your personal physician for not providing you the diagnosis, prognosis and other vital information. If your doctor cannot be bothered to speak with you about your situation, it is time to find a new physician who will be more caring and attentive. Because of your age, you may find that a gerontologist (practitioner who deals with senior citizens only) is an appropriate choice. These specialists are specially trained to recognize and care for maladies of the elderly. They also serve as general practitioners for normal routine check-ups and more.

To give you related information, I am sending you copies of my Health Reports “Alzheimer’s Disease” and “Parkinson’s Disease”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

My 45-year-old son is prescribed Oxycontin monthly. He suffered a brain aneurysm eight years ago that left him partially disabled. He has no use of his left arm and has a bad gait on the left leg. He also had surgery for Crohn’s disease when he was 14 years old. He’s used numerous drugs since the age of 12, most of which I don’t even know the names or types. As of this date, he only uses the Oxycontin, but he doesn’t use it according to physician direction.

I know this addiction has to be extremely dangerous. Please print your response as soon as possible so I can prove to him that he is killing himself.

DEAR READER:
Oxycontin is a habit-forming narcotic similar to morphine that can be prescribed in liquid or pill form for the treatment of severe pain. The pills should not be crushed, chewed, mixed with water, or broken. Breaking a pill will cause too much of the narcotic to be released at one time, giving a faster “high” that doesn‘t last long. This often results in a patient taking the next dose sooner than recommended, ultimately consuming more than is prescribed. Mixing pills with water for injection can literally result in death. Oxycontin overdose in any form can be fatal.

I can only hope your son’s physician is careful in his prescribing methods, as you are correct that taking the drug differently than recommended is dangerous. Your son might be appropriately prescribed this medication because of the constant pain he is in, but I doubt his physician is aware he is misusing it.

While you can show my response to your son, I can — in all likelihood — assure you he will not stop until he is ready. He’s had a 32 year history of drug consumption and there isn’t much you can say or do that will make him see the light. He will have to be the one to reach the conclusion that enough is enough.

There are support groups, pain clinics and other facilities available, no matter where you live. While he might not have an interest, I recommend you take care of yourself by connecting with a support group. Regular meetings are held across the country and will be an excellent means to teach you to cope with the problem. I’m sorry for what you are going through and wish you luck with this scary dilemma.

To give you related information, I am sending you a copy of my Health Report “Mental/Substance Abuse”. Other readers who would like a copy should send a long, self-addressed, stamped, number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

His stomach protrudes slightly but also has a smaller “bump” beyond that. It’s noticeable through t-shirts or when he lies flat and is located exactly where the internet information says an aortic aneurysm would be. I cannot find anything that says if one can be visually detected, though. This spot looks like a grapefruit is hidden in his stomach.

He is “medically dense” and doesn’t even know that it’s there. Looking straight at it in a mirror, it can’t be seen. I don’t want to raise a red flag if there is nothing to worry about.

DEAR READER:
To the best of my knowledge, an abdominal aortic aneurysm (AAA) is not visible through the skin because the vessel is located deep within the abdominal cavity.

Your male partner most likely has a hernia. This can be easily diagnosed by his personal physician and an ultrasound examination. Depending on the location and severity of the hernia, he may need surgery to repair it to ensure the loop of bowel that has become displaced doesn’t become necrotic (dead) and cause serious problems. Testing is especially important if he is having bowel problems or abdominal pain.

The technician should be able to do an AAA screening at the same time as the hernia screening if that is something that is still a concern. As I have said before, men over the age of 50 should be checked for abdominal aneurysms. At age 71, your partner is, in my opinion, overdue for the test.

If you are truly concerned about him, I urge you to speak to him. I am sure he would be more than willing to see his doctor to put you at ease. Don’t push and nag. Simply voice your concerns and wishes. Show him my answer to your question.

About three months ago, I was outside at night watching the stars, lost my balance and fell. I hit my head on the concrete driveway but did not have a headache, blurred vision or dizziness — just a large bump. The next day, I went to my doctor who ordered an MRI and an MRA. He found the original aneurysm AND another one on the right side of my head.

I was then sent to the University of Texas to see a specialist who deals with brain aneurysms. I had another angiogram to confirm the results of the MRI and MRA. The specialist recommended a surgical clip be placed on the right sided aneurysm due to its location. He also said the original one could be “repaired” with a non-invasive procedure to place a stent.

I have been advised of the low risk involved in both of these procedures and of the recovery times for each. My concern is related to the surgery that would “open up” my head. It carries the very real risk of brain trauma and other side effects.

I have lived 44 years with the first aneurysm with no problems at all. I have no idea how long I have had the other one but it is not showing any symptoms either. I do have some tension headaches but feel these are due to my uncertainty about surgery.

I know the above is not a full analysis but hope you can give me your opinion based on what I have told you and your experience. I would greatly appreciate knowing what you would do were you in my shoes.

DEAR READER:
If your original aneurysm has not enlarged in 44 years, you can safely adopt a wait-and-see approach. In this manner, you can have both aneurysms monitored every 6 or 12 months and if both or either enlarges, go ahead with the repair procedures.

Although there is always a possibility of operative complications, brain surgery is much safer now than it was in 1963. I suggest that you once again review the situation with the specialist to discuss what he will do and what the risks are. You may also wish to find out if there are any other options. You also can choose to have a second opinion from another neurosurgeon. This should eliminate some of your stress and help you come to an informed decision.

To give you related information, I am sending you a copy of my Health Report “An Informed Approach to Surgery”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.