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posted: 12/31/2012 6:00 AM

Casual talk with colleague may have saved nurse's life

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  • Olivia Cox, a registered nurse at Mercy St. Vincent hospital, returns to her job following a procedure for a cerebral aneurysm. She recently had aneurysm coiling, a minimally invasive endovascular procedure performed to treat the aneurysm.

      Olivia Cox, a registered nurse at Mercy St. Vincent hospital, returns to her job following a procedure for a cerebral aneurysm. She recently had aneurysm coiling, a minimally invasive endovascular procedure performed to treat the aneurysm.
    Scripps howard news service

  • Dr. John Whapham, a neuro-endovascular surgeon, describes the aneurysm coiling procedure that was performed on Olivia Cox, rear, at Mercy St. Vincent hospital in Toledo, Ohio.

      Dr. John Whapham, a neuro-endovascular surgeon, describes the aneurysm coiling procedure that was performed on Olivia Cox, rear, at Mercy St. Vincent hospital in Toledo, Ohio.
    Scripps howard news service

 
By Vanessa McCray
Toledo Blade

TOLEDO, Ohio -- It started with a headache and pain in Olivia Cox's shoulder, arm and back.

Cox, a longtime surgical nurse at Mercy St. Vincent Medical Center in Toledo, continued to work despite a painful case of shingles, and she mentioned her symptoms in a casual operating-room conversation with Dr. Paul Clark, a vascular surgeon.

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The discussion took place in late September, and it sparked the discovery of a large cerebral aneurysm behind Cox's left eye. A Nov. 27 procedure took place at St. Vincent, where the minimally invasive technique used is so new to the hospital that Cox didn't know about it until she needed it.

"I was very lucky," said Cox, 58, of Petersburg, Mich.

It started with a headache and some left-side pain.

Cox wasn't too concerned about shingles. She figured: "You get old, and stuff starts hurting, and, you know, you still go to work." When she told Clark about her symptoms, he advised her to look into it.

"I thought it might be something else," he said.

It was a passing conversation, but he said he took it seriously because she didn't look well, and he hadn't heard her talk about headaches before. Cox said Clark's office arranged for an appointment with Dr. Ahmed Arshad, a neurologist, who ordered an MRI.

"If Dr. Clark's office had not gotten me that appointment I probably would have had a rough time getting in to see a neurologist because they are so busy," she said.

Had it not been for that appointment, she acknowledged, she might have thought: "I'm a nurse. I can take care of myself."

The images revealed the sinister-looking spot. Enter the next physicians: Dr. John Whapham, a neuroendovascular surgeon, who along with the center's chief of neurosurgery, Dr. Michael Healy, arranged for the coiling procedure, which is fairly new to St. Vincent. It can be used in some cases instead of a craniotomy, during which the neck of an aneurysm is clipped to stop blood flow to prevent rupturing.

The coiling option offers a minimally invasive procedure using a catheter placed in the leg's femoral artery. The physician uses images to guide the way to the brain, where thin coils made of nickel, titanium and platinum are released to pack the aneurysm and block blood flow. Whapham estimated he used about 50 feet of coil, "framing in the aneurysm" like a ball of yarn. Healy was at the ready throughout the procedure in case surgery was required. The coils remain inside Cox.

The recovery period after coiling is shorter than that for traditional surgery techniques, he said. Cox left the hospital the day after the procedure and returned to work about two weeks later, grateful for the help and expertise.

The shingles could be connected to aneurysm and "may have been the only telltale symptom" leading to the discovery by doctors, Whapham said.

"That may have saved her life," he said.

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