The Dread Of A Shred

Ann Kathryn Kelly

Word Count 1,534

I’ve had a headache for thirty days. OK, I’m lying. It’s closer to sixty, but sixty days sounds terribly long. Terribly scary. I know it’s been closer to sixty days because my niece was visiting, and the day she left to go back home was a Sunday, and it was four days before her twenty-seventh birthday, which is not important to this story, but those facts are how I remember that it’s been close to sixty days now with this constant headache that is sometimes dull and mildly annoying, but sometimes severe. Always, all day long. I wake with it. I go to sleep with it. It never leaves me alone, neither the pain of it nor the psychological impact.

I’ve been putting off scheduling an appointment with my primary care physician. Partly because I have a standing appointment with him every October for a physical and a flu shot; it’s now mid-September. I keep thinking, what’s another thirty days? But then, ninety days will have passed, and ninety days with a daily headache is much … too … long. By anyone’s standards.

It’s not that I don’t want to see my physician. He’s more than just a doctor in a white coat to me. I’ve never felt rushed, never just a cursory appointment in his day of rounds. We’ve pondered life-after-death while he taps my knees and elbows with a small silver reflex hammer and asks me to breathe deeply as he slides a stethoscope along my back. We’ve discussed the merits of believing in a Higher Being, how it can help us grieve and move forward after a death of a loved one. He sometimes imparts to me a lesson from his medical schooling and, in the next breath, shares his take on Buddhist teachings and the importance of marrying the two schools to provide more compassionate care. I walk out of my appointments feeling like I’ve caught up with a friend.

Yet, I don’t want to call his office and move up my appointment to get in to see him earlier. You see, he was the one who urged me twelve years earlier to get a head CT scan and, soon after, an MRI. He was the one who didn’t like the look of the shadow on the screen. He told me not to squander time going to my local hospital in New Hampshire and referred me to Boston, home to some of the top specialists in the United States and some of the angriest drivers in the world. I spent a summer collecting second and third opinions, with my brother Sean behind the wheel carting me there and back because I’m a chicken when it comes to Boston drivers who think yield signs mean hit the gas.

Speaking of Sean, when he heard from our mother I’d had a headache for nearly two-thirds of the summer, he erupted. Demanded to know why I’d put up with something like that for more than six days, never mind sixty. Sean has a right to be angry. He was with me at all of my appointments with three neurosurgeons at three Boston hospitals. He spent a week in a hotel room with our mother as I recuperated from twelve hours of open-head brain surgery in the autumn of 2009. He drove Mom, who like me doesn’t like city traffic, back and forth nearly every day for a month to the brain injury rehab center where I learned how to swallow again and progressed from a wheelchair to a walker to a cane before coming home. My brother put his time in, pulling me through the lows and lows before and after surgery. He gets a pass when he lectures me, this time in a thundering tone.

“With your history, what the hell are you waiting for?” he demands.

It’s precisely because of my history that I’m waiting. Hoping is more accurate. Hoping it will resolve on its own. I’ve blamed my daily headaches on everything from the ungodly humidity this summer, to menopause, to a sudden intolerance to white wine, to allergies, to a possible COVID breakthrough. The Delta variant stalks all of us in our days and in our dreams. I feel my temples thump as I consider how it would be my luck to be a breakthrough statistic. Very me.

“Don’t give me that about allergies or humidity,” Sean snaps. “You think Angie’s returned, and you don’t want your doctor to validate this possibility.”

Yep, I named my tumor twelve years ago. I hated the sound of my diagnosis: cavernous angioma. A neurovascular disease. A brain tumor that bled. “Angie” was easier to talk about. It didn’t sound as scary. In a twist that left me speechless, I learned from those neurosurgeons that I’d had Angie my entire life. I was forty when diagnosed, and it took time to come to terms with the fact that I’d lived with a bleeding brain tumor for forty years. I should have known. My lifetime of headaches, sometimes severe enough to make me vomit, muscle weakness on my left side, a chronic limp from grade school, and a mysterious crossed eye when I was four told the story. Later, during the summer before my surgery, I’d add nonstop hiccupping to my list of symptoms.

I’d learned to work around my limp and headaches in a childhood when MRIs were not common in my rural hometown. I’d learned, over a lifetime, to accept my headaches as an integral part of me until a summer day in 2009 when three brain surgeons agreed I could no longer ignore it. Given Angie’s location on the brain stem, which controls involuntary functions—breathing topping the list—my surgery was scheduled after MRIs showed a series of frequent bleeds.

They removed nearly all of my tumor in that daylong surgery, except for a small shred tangled in the vascular recesses of my brain. I resumed my life after rehab, returned to my job, picked up where I’d left off on the home front. I had headaches for a few months post-surgery, something they’d told me to expect as the swelling subsided and the tissue and nerve endings healed. My headaches eased in time, then stopped. I found new joy in a life free of daily episodes. For a long time, I could count on one hand the number I had in a year. It was glorious.

So, it’s true. I am, as Sean says, kicking the can down the road. I like my life as a person without a brain tumor. I got used to it, and I don’t want to start a new circuit of doctor’s visits. I don’t want to think that Angie—that shred of her—decided to return. It makes me feel better, more in control, to blame the humidity. This summer has been a bitch, on the heat index front. And I’m 52 now. Mom said she suffered from crushing hormonal headaches for six months while she endured menopause. She said she was about my age when they started.

The worry finally gets to me, and I call my physician’s office to request that we move my appointment up by a month. I’ve got my headache journal, with dates, symptoms, a list of food triggers. I slam back another thirty-two-ounce bottle of water from my Iron Flask tumbler. Only God knows what’s causing my headaches, and She’s not talking at the moment, but at least dehydration can be checked off the list.

I think about the shred left in my head more often than I should. I dread said shred as I coach myself not to let my imagination spin up what may or may not be happening. My fears have eased since moving up my appointment, where a full panel blood test ruled out potential culprits like a hormone imbalance. We agreed I should schedule another MRI for peace of mind. I’d had one last year as part of ongoing follow-up every three years with the neurosurgery team who managed my care twelve years ago. Last year’s MRI was clean, and my neurosurgeon believes that because I’m not showing signs of neurological deficits aside from my headaches—no dizziness, muscle weakness, constant hiccupping, or dry heaving like I had previously—that it’s unlikely my angioma has returned. She suggested eye strain.

While I wait for insurance preauthorization for my next MRI, I’ve minimized the countless hours I usually spend on my laptop and mobile phone. I periodically stretch my neck and shoulders throughout the day, hooked up an external monitor to alleviate my hunched posture over my laptop, and am now scheduling monthly massages.

I celebrated the twelfth anniversary of my brain surgery on October 6. I think about the very sick person I was then, the very scared person, and how my family, friends, and doctors helped me survive. Though I’ve not felt well for several months, my body seems to know it’s different this time. My headaches have eased with autumn’s cooler temperatures and less time spent staring at screens.

“Angie has not returned,” I remind myself, and I repeat this as if to make it so.

Ann writes from New Hampshire’s Seacoast region. She’s an editor with Barren Magazine, a columnist with WOW! Women on Writing, and she works in the technology sector. Ann leads writing workshops for a nonprofit that offers therapeutic arts programming to people living with brain injury. Her essays have appeared in a number of literary journals. https://annkkelly.com/