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Elizabeth47

Uncharted territory

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My husband had subarachnoid bleed in late September 2014.  They never found a cause.  They kept him in ICU for observation for a week and then let him go home .  The doc told him to stay home for 2 weeks and then do as much as he could handle...  He had no deficits physically or mentally.

 

My husband is a very busy surgeon in the states. (or was)  He was a very type A personality.  I never had to give him a to do list.  Every weekend he was off he would have a list of 50 to 75 things to accomplish around our farm/house/with the kids, etc.  Before this event, I could count on one hand the amount of times my husband actually sat on the couch to watch an entire football game...

 

The couple of years before the incident were VERY stressful with things I don't want to get into. We are sure this caused the bleed, though there isn't any medical literature that says so.

 

After 3 weeks he went back, though very slowly.  November and December he wasn't even quite up to half time and his partners took over his call.  ( He normally has to be on call 7 or 8 days each month, which normally includes a weekend each month.)  Right now he generally either does surgeries until around lunchtime or sees patients in clinic until lunchtime ( though he only sees 8 to 10 rather than the 25 or so he used to see in a morning.)  Surgeries are fine.  Clinic however is horrible.  He feels so slow and it gives him such a headache.  He feels like his short term memory is worse.

 

His partners covered call for 3 months, but now he is having to take it again.  First time was ok, but the second time he was operating from 7am to 8pm and was completely wiped out.  Sleep and stress are of course, a problem.  At home, he doesn't do anymore projects and sits and rests A LOT.  He's read more books in the last couple of months than in our 25  year marriage.

 

His headaches and stamina are still bad.  He had some more tests and went back to the neurologist in December who said it would get better with time and he would feel much better by January.  NOT....

 

On the outside, he looks completely fine. We've looked at the medical literature and they go into what great outcomes those that have his type of bleed ( non aneurysmal ) do and yet it is about mortality not quality of life...  The docs seem to have the attitude that since he is a surgeon, he will be just fine because he has the motivation and drive......  My husband feels like a wimp....

 

He is going back to talk to the neurologist, but I'm not looking for much help...  Can you guys point me to any studies or literature or something or are we really just in uncharted territory....  Will it really continue to get better?  His headaches, if anything, are worse...  His stamina might be getting a little bit better... His partners would like answers.  We are only in our 40's.  I'm a homeschooling mom who has launched one and will launch another one in May.  We will only have an 8th grader next year.  I'm just at a loss.....

 

Thanks for any help,

Elizabeth

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Hi there.

First welcome to BTG and also well done to you and to your husband for the recovery he has made so far. I can understand how he is feeling frustrated that here he is with a event/ condition that is 'fixed' in the medical sense but little attention is paid to the effects that this bleed will have had on the conscious state and ability of the mind.

He's a surgeon, he understands more than most the consequence of 'blood' being where it shouldn't in the brain lining' and that is going to have an effect but also he will be used to seeing people just pushing through and getting on with discomfort as a natural part of their recovery but my personal experience is it just doesn't work like that for the brain recovery, , yes we get on with it but we have to be gentler in approach otherwise the control centre lets you know. He is doing amazingly well if he is managing all that stress and concentration only three months on from a bleed so I do believe you can really hope it will improve for you all longer term but everything I have read and learnt would suggest that the more he can reign in the cognitive demands At The beginning then he will see benefit in his recovery.

I think there is a lot in the press in US about brain injury in sport and concussion and the same principles apply here, rest lots, be gentle with the bruised brain. You wouldn't attempt to run a marathon a few months on from a ripped Achilles , I think it's similar. I would find ways to pace better in recovery and gradually build up the cognitive demands of the job plus lots and lots of water and mini breaks in his day, not easy given he is working in a demanding medical department but worth trying to accommodate.

I would strongly suggest visiting a neuropsychologist as it helps chart deficits. I don't suggest this as a reason to dwell on what has changed but rather understand what is different so he can begin to adapt his style and maybe change his way of working from old. Me for instance I can't concentrate at the computer for longer than 2 hours at a time, that's not a comparison to surgery in any way but even that took me ages to achieve if I didn't want to be wiped out mentally and physically. It also gave me some insights into why things were proving hard. My headaches improved once I understood this.

The general theme on here regardless of severity of bleed is that it is very difficult to just resume life as we knew it, some will of course and in time I am sure you husband will resume his familiar role entirely but it may need to be done differently than how he used to. In the UK Headway have some excellent resources which may help but definitely keep hope that it will improve, it will just be different https://www.headway.org.uk/severe-brain-injury.aspx

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Hi Elizabeth,

 

The following link to a video may be of help to you... http://www.uhs.nhs.uk/OurServices/Brainspineandneuromuscular/Neurovascularservice/Neurovascularconditions/SubArachnoidHaemorrhage/PersonalExperiences/Videopatientexperiencesofsubarachnoidhaemorrhage.aspx

 

I can only say that what you've written about your Husbands problems post SAH, doesn't sound that uncommon to me. From my own experience and with running this site for 9 years, I would say that what he's experiencing are pretty common recovery problems in the early months and even the first year, but every recovery is individual re: time scale.

 

Returning to work at 3 weeks must have been absolutely hellish and I feel for him.  

 

xx

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Hi Elizabeth and warm welcome to the site...

 

Well if it was only Oct 2014 then it is early days and he is definatly NOT A WIMP in no way is he that, it takes a long long time to recover from this sometimes we don't get back to what we used to be but that doesn't me life is over NOPE it just means you have to readjust.

 

Drinking plenty water keep hydrated keeps the headaches at bay a lot.

 

resting a lot and listening when your body says rest then do it don't just keep going it doesn't work.

 

Have to say the doctors have their own time lines but in honesty I've never seen them to be right but on saying that working 7am-8pm well he's not letting the healing happen either.

 

take care

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No He is not working 7am to 8pm every day. It was only that day that he had to take call. Things came into the ER that he had to take care of. Most days, he tries to be through by early afternoon. His partners wonder when he is going to be ramping back up........ And his specialty is very much...it takes 6 weeks for a broken bone to heal. There are concrete times to recover, so his own recovery is very frustrating as no one can seem to give us answers... He is wondering whether or not to take disability....but for headaches and fatigue....as I said that makes him seem wimpy. He also can only answer emails or be on the computer for short amount of times. Watching an action flick makes him dizzy during the fight scenes if they are fast...

If he could do his job without taking call, then it might be ok... But call is brutal. And he is wondering if the added stress and call might make him have another one. I'm off to watch the video link.

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Elizabeth I think they can't give concrete answers as the last voyage of real unknown territory is that of our amazing brains. Medicine know about bones, the heart, even some cancers and can predict some outcomes but when it comes to brain injury it is highly personal so they shie away from predicting.

If his colleagues are supportive then I would strongly suggest a even more gentle return to work than he has right now if the headaches are a sign to go by to give him time to heal the brain which after all is his most important asset when it comes to the job he does.

I couldn't watch any TV at first and then after a while I could only manage gentle programmes like the Waltons!! It was very galling but that too with time has improved. He needs to listen to his brain.

Best of luck

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His collegueges have been patient, but as I said, looking at him you cannot tell that anything is wrong.  They want him to pull his weight again.....  That is why he is considering quitting.  But you cannot do his specialty without taking call and so that would mean not working.....  Then you lose skills.  He cannot take off for a year or two and then just jump into the operating room.  We are at a loss.  They will be having a meeting this week and he doesn't know what to tell them...

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Elizabeth,

 

Firstly, welcome to BTG.  A remarkable recovery by any means but it is still very early days.  Some of us have taken years to get back to any sense of normality - over four in my case.  I can only offer my own experiences.

 

I have taken early retirement (I was within a year of reaching retirement age anyway) since my job was also highly stressful (I wasn't a doctor) and it has often been suspected but never proven that stress could be a factor in terms of causation.

 

Short term memory loss is a bugbear and I still suffer with it to some degree but it is not nearly as bad now as it was when I first became ill, so it can get better over time.

 

Fatigue is also a problem and there is no short term answer to this one - the brain and the body simply have to heal and it takes a long time - different for everyone.

 

The other big problem is that, as you rightly point out, he doesn't look as though there is anything wrong with him - that is so true and is very difficult to get across to other people - the only answer to that is that he - and you - have to communicate that to everyone you come into contact with.  It's like looking at an automobile, not realising there isn't any engine in it until you try and start it!

 

Short term memory goes along with concentration - and his will be in short supply at the moment (hopefully, over time it will get better but there aren't any short cuts, it's a tough road to travel) - but the good news is that long term memory is often unaffected.  

 

So in the short term - write things down and go over them constantly/regularly and hope that they will be committed to memory.  Go over text books and try to re-learn some things you may have forgotten, even if you think you knew them.  Sometimes it will work and sometimes it won't but its worth a go.  Also do it in short bursts, don't do too much at once.

 

Being a surgeon means he has to be firing on all cylinders - and he is only a short time into recovery now, maybe a radical re-think may be the best option for you, in the short term at least.

 

I wish you well with whatever decisions you make.  Good luck.

 

Macca

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Ok, he never lost consciousness.    He just had the worst headache of his life. His neck got stiff.  He couldn't put his head down as it felt like it was about to explode.   It looks like this is for those that lost consciousness.

The general theme on here regardless of severity of bleed is that it is very difficult to just resume life as we knew it, some will of course and in time I am sure you husband will resume his familiar role entirely but it may need to be done differently than how he used to. In the UK Headway have some excellent resources which may help but definitely keep hope that it will improve, it will just be different https://www.headway.org.uk/severe-brain-injury.aspx

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Good to hear he didn't lose consciousness. :) that's positve. Sorry I think I may have put the link to a specific section on the Headway site rather than their home page, but they have some great resources but if you check out the effects of brain injury this can help explain more about the after effects and yes that does depend on the severity of the bleed and trauma.

I guess I was trying to clumsily say that even a milder injury just like concussion the effects can be startling more longer lasting than outward appearances may suggest but that's the hardest thing with a brain injury, we all look pretty fine outwardly.

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Hi Elizabeth,

 

The following link to a video may be of help to you... http://www.uhs.nhs.uk/OurServices/Brainspineandneuromuscular/Neurovascularservice/Neurovascularconditions/SubArachnoidHaemorrhage/PersonalExperiences/Videopatientexperiencesofsubarachnoidhaemorrhage.aspx

 

I can only say that what you've written about your Husbands problems post SAH, doesn't sound that uncommon to me. From my own experience and with running this site for 9 years, I would say that what he's experiencing are pretty common recovery problems in the early months and even the first year, but every recovery is individual re: time scale.

 

Returning to work at 3 weeks must have been absolutely hellish and I feel for him.  

 

xx

Yes, that video was very helpful.  I will have my husband start watching it from about minute 12 on. 

 

I try to be grateful that he is still here.  I am grateful.  It just feels so unsettled.  It sounds like it may take him up to 2 years to fully recover, so it is hard to make a decision now.  I think he should be off call for another 3 months but I don't think the hospital or his partners would go for that...

 

Thanks so much everyone..

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Hi,

Mine was non aneurysmal and I never lost consciousness. I walked into the ER. I had all my motor skills just this awful headache as though I'd been shot or hit in the head.

I am not a Dr but my job is stressful and long hours.

I will hit two years in April and it's been a long hard haul. I look perfectly fine but the healing process continues.

I've read mountains of data from NIH, Neurology sites, and organizations. I finally came to the conclusion the answers we seek are truly not out there. Psychological effects are lingering and will take years to heal. Physically, you simply have to come to terms with what you can and cannot do.

I am a worker and do not keep still but there are those days when my body says ENOUGH.

My neuro said to me, "Make no mistake, you have had a life changing event and will never be the same person so do not compare yourself to who you were". No truer words...

I

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Even working 7-8pm for one day, then that's a long time when only in early recovery I mean.

 

Seems the one profession you think would be more understanding too, he's not had much time out to repair and adjust to what's happened to himself, then go back on phase return.

 

I've noticed on here a lot of people say I'm fine and I can do it, so people assume they are & they can - then they wonder why no one understands because you haven't explained how it effects you how you find some things more difficult to do or handle now..

 

Don't know if this makes sense to you.

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He has tried to explain.  He was talking about the headaches and one of his colleagues said, "oh yeah I had the worst headache  the other day....  " :roll:   They don't get it...  Plus, I wonder if by acknowledging that the difficulties are real, then it means that they are just as vulnerable...  If you had picked a person for this to happen to, it would not have been my husband.  His blood pressure has always been low ( 100/60), his cholesterol is around 90.  He is 6 foot and 155 pounds..  ( 150 when he left the hospital...) 

 

But yes, there is a part of pride involved as well...  My husband just doesn't know what to do.  He is staying at half time permanently.  He will only work until lunch except the days he has to take call.  We are going to see if he is making his overhead and then some at the end of March.  If he isn't, then I guess he will have no choice but to quit.  Or if the call weekend goes badly at he end of the month and he feels like he just cannot do weekend call, then I guess he will have to quit as well....  But what in the heck does a type A surgeon do with himself if he isn't operating?????  You have taken away a giant part of who he is.

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Elizabeth, all my best wishes to you and your husband. The advice here is so helpful, with the same so consistent message. Poor Stamina, tiredness, poor short term memory and inability to concentrate/work on computers for too long..... It all sounds very familiar, and mine was in June. He is doing well and is not a wimp, not in the slightest.
Timescales seem different for everyone, but whatever, they are long.

Difficult for a type A (as you describe him) to accept, but we are simply not in control, not anymore. You cannot 'man up' and beat it in submission, (as everyone says). Loss of control can be of course very difficult to deal with. Control is a basic human emotional need, especially for type As.

I had a similar bleed to your husband and could not agree more that the focus is not on the recovery. Yes, yes, the outcomes of this particular type are good when you look at survival, but not quality of life. I would agree that the video and the headway info is very very helpful. I also found the book 'A dented image' very good. http://www.amazon.co.uk/Dented-Image-Journeys-Subarachnoid-Haemorrhage/dp/0415386721
It is discussed on this forum too. Several survivors are interviewed across various themes and subjects. This, more than anything, set my expectations for a long road, not necessarily to recovery - can you even get your old self back completely? - but nevertheless to somewhere good. The title itself is apt, as the psychological image is impacted. And these are definitely journeys.....there is no magic bullet.

I have to say, reading your account I did feel a little angry, on both your accounts. What do his colleagues mean by 'they want him to pull his weight again?'
.... I am sure he would love to do that too!
It's just not possible right now as he has an injured brain.

 

It is not easy having been so highly trained, so competent, to deal with the changes he will be noticing right now. It's difficult too, to still have the cognitive abilities to see, to know, exactly what you cannot do.
Are these really 'medical people' that are implying that it is time now for him to pull his weight ? They should be ashamed at the shallowness of their medical expertise. That said, your husband is gaining depth as a practitioner. I can only imagine how tough it is navigating his workplace at the moment with such colleagues, and his own expectations and hopes. But this experience could also strengthen his patient-facing skills and broader medical knowledge. This is a recurrent theme here, and in a dented image - the hidden gifts that in time we can make use of.

 

There has been a lot of great advice on this thread, which I take too. With these colleagues in mind, and in the medical environment he is in, I would also suggest that his colleagues be asked to watch the video, read 'a dented image' and look up headway. Maybe not now, but in time, would your husband be up to actually taking on educating parts of the medical profession - including surgeons - about the hidden disabilities behind the apparent good outcomes? He is in an ideal place to do this, or to coordinate/support someone else to do this if its not for him.
Best wishes to you both

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Still think he went back WAY to early - & on a personal not I wouldn't be too keen to know that the person operating was doing so because he had no choice in the matter really.

 

Its just my opinion we've all had to come to terms with it, you'll find a lot on here were sporty BP fine and stuff like that me apart from the SAH I was ok it happened I have no family history of anyone else having one...  & the difficulties will be REAL believe me...

Oh I so go with Sara saying:

I have to say, reading your account I did feel a little angry, on both your accounts. What do his colleagues mean by 'they want him to pull his weight again?' .... I am sure he would love to do that too! It's just not possible right now as he has an injured brain.

 

 

Ok think I've said enough on this one....

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Hi Elizabeth,

 

Your husband is obviously a highly skilled, conscientious and talented man.  A professional man.  He has taken a knock (metaphorically speaking) to his brain and so has his self esteem and his confidence.

 

Time to take a 'time out' now, I believe, and apply a professional approach to his recovery.

 

Would he be telling his own patients to go back to work almost straight away?  Probably not, so why does he expect to do this himself?

 

I sense a yearning to be back to normal as though this event never happened.  I've been there too, it's a natural reaction to what has happened to him, and there is no doubting that it is difficult to accept that things might not be the same again, or at least not for a considerable time. It is also a difficult time for you and I recognise that, we all have families too and they go through the mire with us but from a different angle.

 

In my experience, the best way to deal with this situation is to meet it head on and build from the base you now start from.  You may have to re-adjust things, how much work, shorter hours, lifestyle, do things differently and so on.  It's not easy but it can be done. Sometimes you have to go a couple of steps back before you can move forwards again.

 

I used to consider that my job was part of who I was.  I re-appraised my situation after my SAH and my return to work and I turned my life on its head. Although I returned to work and was able to do it I found that not only was I being asked to do what I did before but more as well.

 

I know your husband joined his profession to help others and that is very laudable indeed.  However, in my opinion, you can only help the weak from your own position of strength.  You can't do it if you have been weakened yourself, no matter how much to think you can.  So take stock, allow a good period for recovery and reflection and work out what you both can do and want to do from here.

 

I decided what I was being asked to do was not acceptable to me any more.  I now wanted to 'work to live' not 'live to work.'

 

Then I became much calmer, because I realised I was in charge of my own destiny and was in control of my own life.  I was no longer at the beck and call of others.

 

Of course there was resistance and pressure from others, in particular those over me, but I stood firm and took the decision to leave last April.  They have still not replaced me and now have to try and buy in my skills from outside, but those I am still in touch with say it is not the same without me there on a day to day basis.  So in me, those managers have lost a very experienced and skilled man, though I say it myself, because they wouldn't work with me to find a solution that was acceptable.  But I am in control, I am the one making decisions about my life and I could not be any happier than I am now.

 

So you will come out the other side of this and hopefully feel all the better for it.  Whether your husband went unconscious or not isn't the issue for me, it's the effect the event has had on his life and it is the decisions you take now to move forwards that are important.

 

As I said before, I can only offer my own experiences and I hope they are of help to you.  With hindsight I might have done some things differently or in a different order, who knows, but no-one ever said life was easy!

 

I wish you well and I am sure you will make the right decisions in the end.  Good luck. I wish you the very best and I hope your husband makes a full a recovery as possible.

 

Macca

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Elizabeth, I think that it's going to be up to your Husband as in finding "his new normal" post SAH ... my advice has always been, especially in the early months, not to compare yourself (in recovery terms) as to what you were like before the SAH, but judge your recovery against the day that you left hospital and see the improvements. I think that it takes time to find acceptance and get into that mindset.

 

If you pit yourself up against your pre-SAH normal and start failing to achieve, then you feel like a failure and this starts to lead to feeling very frustrated and in some cases depression. Life does and will get better and good improvement is seen by most people on here. This does not just happen over the early weeks or months, but we experience it over many years. It really isn't all doom and gloom and the brain will take time to heal .... it also learns new pathways and we also learn ways to cope and to try manage and get the balance right with our life.

 

Whether your Husband will achieve all of the activities that you've listed ... I can't tell you.  He may or may not .... but if he doesn't, he needs to cut himself some slack, as it is possible that next year, he will achieve it and if he doesn't, may be the year after ... recovery from brain injury is an unknown quantity and individual to us all.

 

Your support and understanding is the most important aspect .... make sure that he does rest up/take a break .... if you see him struggling with fatigue or isn't coping with any aspect of life .... talk to him and keep the lines of communication open. What you see now, is not necessarily how it's going to be, this time next year ... or the year after ... it will get better but he needs time to recover and his brain to heal.

 

I was told that it takes 3 months for the blood from a bleed to fully dissipate down the spinal chord. A minimum of 3 - 6 months in return to work and that obviously depends on how severe the bleed was and damage etc. I've never managed to return to work, but I'm going to be 10 years post this SAH this year and I can promise you, that I can do stuff now, that I couldn't do 5 years ago ... it does get better and knowing when to rest up and knowing your limitations is key ... however, you do have to find those limitations yourself and discover what does and doesn't work for you.

 

Did you show him the video?  Three of those guys were early members of Behind the Gray and we were treated in the same Neuro Hospital .... When I was sent one of the first copies from them in my early years, it was very emotional.... It was the first time that I'd really had a decent cry and could say that I wasn't abnormal as to how I was feeling .... I suppose that it was acknowledgement as to what had happened to me and probably to be a lot kinder to myself. I did watch it in private though, before showing my Husband and children.  ;)

 

You've described yourself as feeling "helpless" .... it sounds to me as though you're being thoroughly pro-active .... it's as much a learning curve for you, as it will be for your Husband.  You're doing great and you're on here looking for help and recovery information .... don't see yourself as being helpless ... we're all here if you need anything. :)  xx

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Elizabeth, sending positve thought to you and him indoors across the Atlantic. No you can't fix him nor him you but you can be kind to each other and most importantly yourselves. There is no reason on earth why he should know what to do here, no one does when it happens and we each have to find a way to reach a new balance and level of recovery that we are comfortable with .

You have a lot of plans this year, I know that I also had a lot of plans in place in my first year of things we had in the diary. I was 39 when I had my SAH with very young kids and let's just say that cancellation and reorganisation became a common landscape in our family as realisation hit that I couldn't partake at the pace and capacity I had prior no matter how much I wanted to and didn't want to let people down. It was a big adjustment for all of us and even now my kids and hubby find it hard to realise I am not the same model as old. In computer terms it is like some of battery power has gone, most processes I can still do , maybe a bit differently, usually just as well but I can't sustain it For as long and don't ask me to multi task !!

Karen is so right that you have to measure from the point of the bleed but that takes whole while to come to terms with. If you can avoid making any big decisions right now that might help to take the pressure off but I don't know how realistic that is but taking things one day at a time is a lot easier but again that is a big adjustment when you have been used to time managing life in a high pressure environment. Changing to ' how is today working out for me' is a really strange habit but nice all the same in my experience. Maybe it's a perfect time to take a career sabbatical !

PS just adding to this that I was very fortunate with my work/ career that my company understood the importance of phased recovery and the fact that I just couldn't do what I used to do, it was out of the question but also the severity of my bleed and physical effects enforced a prolonged period off work -14 months. It meant a cut in income and big changes at home but we knew we could just about cope as in a previous year hubby had been made redundant and we managed and tbh I just couldn't work, hey I could hardly walk! even now nearly three years in I am still managing a phased return but I have been valued and supported throughout which means I am now purposefully working at a similar level to previous but doing far less hours and with arrangements and terms that have allowed my brain to gradually rebuild stamina and learn new ways of doing things but I appreciate that is not possible in many working environments.

Edited by Daffodil
To add a PS about my work experience to add context
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Elizabeth, I can't advise you what to do ... but from your post it seems like your Husband is looking for you to give him an answer or to tell him that it's okay? It's not just his decision, but yours too to some degree.

 

A SAH is not an excuse ... it's a medical condition and a brain injury. It took me six months to get my Husband to have some sort of understanding as to why I was going to have to quit my job. I wanted to get back to "normal", but I couldn't ... I was too ill and it wasn't for the lack of trying to work. I put myself through hell and at that point I still didn't understand it all myself. I was waiting for him to tell me that it was "okay" to quit and he was waiting for me to tell him that I wasn't "okay" ... lack of communication and non acceptance... trying to make it all okay for the other person... It was me that had to tell him in the end and I felt like a complete failure, but I couldn't continue feeling like I did and the pressure had become huge ... trying to cope with feeling so unwell and trying to look and continue as if all was normal, when it was far from it.

 

Financially, it was difficult and a worry... I was self employed, earning pretty good money pre-SAH and my Husband had just taken another job that was salaried rather than hourly paid and we needed two wages in at that point to pay the bills or so we thought.  However, we had no choice and I had to stop working .... we looked at all of the bills, the two cars and where we could reduce our finances. Our lifestyle altered, it had to ... but you know what? .... we did it.  I'm not saying that it's easy .... it wasn't....but life has worked out pretty okay.  :)

 

I have gone back to work on occasions ... but only on a temporary basis.

 

May be have a look at the alternatives and see what you can do financially..... neither of you are happy at the moment and it sounds as though you're not talking because you don't want to upset each other.  It's not about fixing each other, but communicating and being realistic as to what adjustments can or need to be made.

 

I wish you both well .... life does and will work out..... sending hugs and love. xx

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Elizabeth

This is my first post but I am a surgeon also who recently had a bleed, the big difference is my practice was winding down and was already much lighter, I am late 50s. Your husband has to realize is that guy who he was pre bleed died that day he will never come back which is not to say healing won't occur, as a previous poster noted he had a life changing event. OK specific advice.

You and hubby have to decide if he is going to take disability and this depends I suspect on whether he has specialty specific coverage, heroic efforts on his part to get back to work can be used in the future by insurers to deny coverage. Need to be careful here.

Naps are a wonderful thing, I went back a little over a week after getting out of the hospital and it was way too soon. I have a couch I can lay down on and take a ten minute timeout and it really helps.

You say your husband's specialty is one in which he HAS to take call, I question the validity of that. This might be true in your city but the US has a significant physician shortage so older physicians are finding and creating low intensity niches in all sorts of specialties. Maybe one of these low intensity niches is what your husband needs. Financially perhaps it is better to consider a lower income maybe plus disability and your income in jobs that can be sustained until you are 70 vs him going back to work full time and burning out in a few years.

Stress, I am with you on this one but one thing you have to realize stress is a very, very difficult thing to study in medicine, it is very subjective and hard to measure. Then even if you know it is a problem what is the intervention?

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All I can say is that when I do too much, I get headaches.

 

So, what is too much?  It is different for each person and changes as you heal.  People vary on when or if they can return to working their pre-SAH schedule.  Disability is certainly one way to go.  You can use it temporarily as a stop gap measure, but as you said a medical specialty requires continuous work.  I was a neurophysiologist and did surgeries daily and now I don't.  My life is way different than it was, but I am glad I had the SAH to teach me who I am to become.  It took several years to see this.  

 

There are many decisions to make during the first year.  Good luck with navigating them all.  It is funny to think that we have to make all these decisions at a time when our brain isn't always cooperative at making good ones.  Therefore, sometimes we have to make the decisions in those days...good later, instead of making good decisions at the time.

 

Take care,

~Kris

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