shricthism

well its been a long time since I updated this thread and I thought it might be appropriate at this time.14 months now since my SAH. During last year I gradually built up my work hours till by December I was doing my full hours - only 18.5 per week, which is what I did before the SAH. I do work 8 hr days though and at one point in the cycle there are 4 consecutive ones. I found during the year I was very tired and this didn't seem to be getting any better. After I did a few days at work it took a few days rest to recover. I was starting to believe I would always be like this, and in danger of getting depressed about it. Then one day about a month ago I felt really aweful when I went to work - so tired I could hardly focus and was sent home from work. However after a few days I started feeling less tired than I had at any time since the SAH a year earlier. That was a month ago and I have carried on feeling like that. I have started doing more things away from work, and coping much better with the 4 day stints - in short I feel like I did before the SAH, I am just over the moon with it. It was as if that few days ilness was something letting go inside my head and letting me return to my old self.

Penny, I think I will need to get a new GP first - he shows an incredibly small amount of interest in any medical condition (eg SAH) that I have been to see him about - I don't think I would even get in the door if I went to see him because I am tired 10 months after a SAH. I can picture him now - "And what did you expect?"

Mary thanks for your contribution, I have had far less pain and suffering than you and at times feel I should be happier with my condition than I am! My headaches all stopped about two months after the haemorhage. Since then ( 8 months) I have only taken a couple of mild painkillers all together. The tiredness was of course intense at first, but was gradually reducing and up till a couple of weeks ago, I was leading a very similar life to that I had before the SAH. ( or what you call a NASAH). Almost the only thing I was not coping with completely was my work. I have been working short days and avoiding more intense brain work. However in the last few weeks the tiredness has really come back and hit me, and I don't really know why. I am back to sitting around in the daytime, which I haven't had to do for the last few months. This is why I have been thinking about what more I can do to recover and started this thread. Interesting that you say you have been given a stimulant drug - can you tell us what it is?

Thanks for your replies - all I think contain a part of the answer. The article Karen linked to was very interesting I thought. For myself I have decided to order some Vinpocetine and give it a try.

There are countless posts on the forum about tiredness after SAH, going on for years in many cases. The medical advice seems to be that you just have to cope with this and it will reduce in time, but not necessarily to where you were before. There seems to be no medical interest in helping people deal with this, although I know many people have suggested ways of coping such as energy drinks, naps etc. The effectiveness of these varies between people. However I have been wondering if there is anything else that can be done? I noticed one post where someone mentioned their doctor prescribed ritilan, with some beneficial effects. I also saw a reference to Vinpocetine - which is not licensed as a medicine but is sold as a food supplement. -- quote from the Amazon website " It is shown to enhance cognitive performance and deals with short-term memory loss. It may also have a significant effect on the circulatory parameters including total cerebral blood flow. " There is a interesting Wikipedia article about it here There is also another interesting article on about.com here. I have not tried it, and AM CERTAINLY NOT recommending or even suggesting anyone should take it - but I would be interested in other people's views on this topic. I had my SAH 10 months ago, and went back to my part time job after 3 months. My tiredness improved steadily for the first 6 months but I feel it has leveled out since then, still a long way short of what I was like a year ago. No aneurism.

Well I thought things were going pretty well. Back at work now and did 4 * 4hr shifts this week and found it fairly straightforward - not as hard as the 3*3hr shifts I did the week before. Feeling pretty pleased with things when I went to bed last night. This morning I got a letter from the consultant saying after consultation with a vascular specialist he has decided I should have another angiogram. Given the problems with the last two attempted angiograms, this is not very welcome news. I have to accept his advice that it is the right thing to do, but that doesn't remove the anxiety about this procedure which I know is straightforward for almost everyone, but has already gone wrong twice for me!

There is an interesting article here from the BMJ which says that analysis of incidence of SAH shows that first degree relatives of someone with an SAH have a 3 to 5 times risk of having an SAH compared with the average person. Remember though that the average is 7/100,000 so at 3 to 5 times that much its still a very small risk.

Hi Rachel, it seems that 1/100 people are walking around with an aneurism in their brain and will never know anything about it. There is no way of telling which ones will rupture and which ones will not. Even if someone knew they had one the risks of treatment would be similar to, or even greater than, the risk of rupture, so there is no point in screening. The genetic link is unknown at present, and a large UK project is underway to try and identify one if it exists - see this link Hope this helps a little Chris PS, if you think of something after you have posted, you can always go back and edit the post ( like I did with this PS!)

Hi Melody, I had my SAH on 30/12/12. I have a daughter who is just a little older than you and she too found it very difficult that one minute I was in excellent health and the next thing I was in hospital with a serious brain condition. The worry, the travel to hospital every day, and the anxiety about what the future has to hold are very draining and take more out of the relatives than they do out of the patient I think. I can't say what might happen with your dad, but I am so much better now, starting to get back to work etc and my daughter has got her life back together. Its not easy, but hang on in there. One of the things that I valued the most when I was feeling very bad was my daughter sitting and holding my hand. I am sure your dad will say the same.

Well I saw the GP today, he got up the guidance document ( same as that Daff posted) and said yes he was happy for me to drive immediately, since no aneurism had been found. Had a trip out to do some shopping today and will drive to work tomorrow. Oh and I don't mind a bit if extra regulation this side of the pond, it does mean some people are kept off the road who should be off the road. Works in other areas too I think, we have way less incidents of people being shot, since we have rules about who can have a gun and who can't!

From what I have read Tylenol is only available in the US and Canada and is a name used to market a range of painkillers based on Paracetamol. These range from basic paracetemol, to mixtures including co-codomol. In Canada they often include caffeine which of course is not recomended for people who have had a SAH. The basic Tylenol sounds similar to Panadol which we have in the UK. Its paracetamol with marketing and a higher price tag. I think the original post from Goldfishgirl was asking about what people took in addition to Paracetemol, so Tylenol would be a very bad idea, since excessive doses of paracetamol soon starts causing damage to your body.

When I came out of hospital I was taking paracetamol, Diclofenac, Tramadol and Oramorph ( when required). I quickly stopped the Tramadol and Oramorph. When I went for a repeat prescription the GP decided that Naproxen would be better than Diclofenac. However it caused me to feel bloated, and to have disturbed sleep. I stopped it and substituted Ibuprofen, however the pharmacist was very alarmed by this and said I had no business changing medication without speaking to the GP. He was probably right but when I then went to the GP, he was quite unconcerned and said he had no problem with patients switching over the counter painkillers, and promptly prescribed more Ibuprofen. He didn't take my blood pressure. I had no idea until now that there was an issue if taking Ibuprofen for people with high blood pressure, although now I have looked this is confirmed on lots of medical web sites. Maybe it was just as well I only took it for a few days.

Jimmy, glad to hear of your outcome, you seem to have a much more accessible GP than mine, I have to wait a week for an appointment. I think it is quite wrong people are being mislead into thinking they can't drive till the DVLA says they can. In my case the difficulties of the journey to work without the car, which added 2 hrs to the day, made the return to work seem much more difficult than it need to be. I just have my fingers crossed for next weeks appointment now! Chris

Dafodil, thanks for that - the document you posted is very useful in clarifying the situation. Its seems clear that I can drive at least until the DVLA tells me otherwise. I am seeing my consultant next week, so will check he has no objection first. The document does raise one concern in my mind which I was already aware of. It says that if you have had no aneurism then you go into the no restriction category provided you have full angiography confirmation of this, otherwide you are restricted for 6 months. In my case the first sngiogram was clear but the second one was only 50%complete before the catheter got twisted. They tried again the next day and failed altogether. So whereas ideally I would have two clear checks I only have 1.5! I am not sure if the DVLA will therefore put me in the 6 month category when they eventually make a decision. In the meantime, it seems I am legally clear to drive. PS I phoned the DVLA this morning and they said - Your case is being assessed, we sent the papers to our advisor on 5th March, and he is currently dealing with papers sent on 28th November. However there is no reason why you shouldn't drive in the meantime, provided either your GP or your consultant has given his agreement. I have made an appointment to see my GP next week. I could have sorted this weeks ago if I hadn't accepted the words in the NHS SAH booklet that says you can't srive until the DVLA and your doctor have agreed.

I had my SAH in Dec 2012. When I was coming out of hospital they told me it was a requirement that I notify the DVLA of my condition. I did so straight away. They wrote back and said they had written to my consultant and this would take 6 weeks. After 6 weeks they wrote back and said they had the information and it would now take them up to 8 weeks to assess it. I have assumed that during this time I am not allowed to drive, but when I read carefully the DVLA website they don't actually say this, just that you must notify them and can be fined for not doing so or prosecuted if involved in an accident. Nowhere so far as I can see does it say you cant drive while they are making an assessment, only that you must notify them. Neither of the letters I have had from DVLA says anything on the issue. Reading this thread there are those that agree with this analysis and those that don't. I have called my Insurance company and they said there was no need for me to notify them and they were fine for me to drive unless the doctor or DVLA had told me not to. No one has told me not to, its just an assumption on my part, one I now feel is wrong. I don't feel 100% confident though, will make a few phone calls tomorrow. PS Just checked the SAH booklet given to me at the hospital. It says "You will not be able to drive until you have received DVLA approval and you doctor has confirmed you are recovered" so that's where I got the idea from initially, but that is hardly a legal document is it? I wonder who has an authoritative idea on this.

Hi Wade, I am not able to offer you advice since I am at an early stage like you, but I can share some thoughts, based on what I have read and what I have found myself. It seems to me that you have gone back to work much too soon, now I don't know what pressure you are under to do this, but if you can I think you would benefit from longer off. I had my SAH three months ago, and haven't had any headaches for about 6 weeks now, so I feel I am making excellent progress. However I have had a lot of "tiredness", although that is an inadequate word! I have started to learn what brings this on and what doesn't. Initially any activity had this effect, but after a little while I found I could cope better with physical exercise than mental. I therefore focused on building this up to start with, just by walking to start with. Initially with someone else, then on my own with the dog, and gradually building up the distance, speed, and frequency. I have only started cycling in the last week (before the snow came!). I limited the mental stuff to very simple tasks, and kept them as short as possible. I certainly wouldn't have been writing this much in an email, a month ago, or if I did I would write a few sentences at a time over a few days. I found by staying away from overdoing it as much as I could enabled me to avoid those exhausted, wiped out days, I had at the start. Now I feel I am ready to start very gently at work and build it up.

Thanks for the replies all of you, much appreciated - interesting that all 4 of you mentioned drinking lots of water. Return to work date is now set for 2nd April and I have suggested 3-4 hrs. I was only working part time, as a job sharer, before the SAH so that is what I am going back to. We shared a shift pattern rather than the day so that meant working 3 or 4 full days, then having about 7 off, before doing another 3 or 4. So to start with my plan is to work the same pattern of days but making them 3-4 hrs till I am sure I can cope with that. As it works out the day I go back is the last one of a group of 4 days before 7 days off, so that will be a nice easy start. Daffodil, thanks for the encouragement - I wasn't coiled though, no aneurism was found. The problems were just in doing an angiogram to check for an aneurism. They did the whole brain the first time, but the second time had problems as described and in the end only did the right side of my brain.

I had a SAH on 30th Dec 2012. I had severe headaches, extreme sensitivity to light, some vomiting etc. It seems I had not had an aneurism. I was admitted to my local hospital a few hours afterwards and the next morning had a CT scan and was transferred to The Walton Centre -a neurological unit in Liverpool. I had another CT scan, MRI scan and Angiogram within a few hours of arrival. A few days later I went for another angiogram but this was not completed due to the catheter getting twisted. They tried again in my other leg the next day, but this time could not get it in at all and had some trouble stopping my artery bleeding. I continued to be very tired and having headaches, taking four painkillers including morphine. I was discharged after two weeks with all of these painkillers. I spent the next week in bed feeling completely exhausted, but gradually improving. After that I started getting up and then getting around, walking the dog twice every day. Headaches stopped after about 4 weeks and I stopped all medication. My leg ballooned as a result of the problems with the angiogram, and a DVT was suspected but ruled out. Since then its been a matter of slowly getting stronger. I found I had very little mental stamina and got very tired doing anything that needed a lot of concentration. Its now three months on and I feel almost back to normal - just the tiredness. I plan to go back to work on a phased basis in a couple of weeks. The most frustrating thing is not being able to drive. The more I read about other people's struggle the more I realise what an easy time I have had -- so far at any rate. I am surprised to find how little follow up there is after discharge. The GP has given me the painkillers I have asked for and issued notes for work, but has shown little if any interest in my recovery as such. If I hadn't needed the sick notes for work I don't think I would have seen him at all! The prescriptions were issued without a meeting of any sort. PS used my full name when i registered - is it possible to change this now?

Dan, from what I have read it seems that I have been very lucky and you even more so! I had a SAH on 30th Dec 2012. I had severe headaches, extreme sensitivity to light, some vomiting etc. It seems I had not had an aneurism. I was admitted to my local hospital a few hours afterwards and the next morning had a CT scan and was transferred to The Walton Centre -a neurological unit in Liverpool. I had another CT scan, MRI scan and Angiogram within a few hours of arrival. A few days later I went for another angiogram but this was not completed due to the catheter getting twisted. They tried again in my other leg the next day, but this time could not get it in at all and had some trouble stopping my artery bleeding. I continued to be very tired and having headaches, taking four painkillers including morphine. I was discharged after two weeks with all of these painkillers. I spent the next week in bed feeling completely exhausted, but gradually improving. After that I started getting up and then getting around, walking the dog twice every day. Headaches stopped after about 4 weeks and I stopped all medication. My leg ballooned as a result of the problems with the angiogram, and a DVT was suspected but ruled out. Since then its been a matter of slowly getting stronger. I found I had very little mental stamina and got very tired doing anything that needed a lot of concentration. Its now three months on and I feel almost back to normal - just the tiredness. I plan to go back to work on a phased basis in a couple of weeks. The most frustrating thing is not being able to drive. The more I read about other people's struggle the more I realise what an easy time I have had. You seem to be the first I have come across who has had it even easier! Good luck and let us know how you get on.