Wednesday, November 4, 2015

Vagal Nerve Stimulator (VNS)

Sorry I fell off the face of the Earth....AGAIN! BUT, I am back.

I'd like to talk about a topic that most people are not familiar with. It is called the Vagal Nerve Stimulator or the VNS. The Vagal Nerve Stimulator is a device that is implanted into a person's chest. It looks much like a pacemaker and in a way, serves a similar function. The VNS is an option for some patients with Epilepsy who have not responded well to medications and have Simple Partial seizures. (Also used with treating Bi-Polar depression) The device is implanted on the left side of your chest, and a lead (wire) is connected to it, bringing it up and wrapping around the Vagus Nerve. To the right is a diagram of what it looks like inside the body.

What the Vagal Nerve Stimulator does is, it sends pulses of electricity up the Vagus Nerve into the brain. When you get the generator first turned on a week or so after surgery, it is programmed to go off every five minutes for thirty seconds. By that I mean, every five minutes, the VNS sends out pulses of electricity up the Vagus Nerve, and this lasts for thirty seconds.

Along with the VNS comes the VNS Magnet. The magnet is extremely strong. It is designed to (when the user swipes it) send an extra boost of stimulation to the Vagal Nerve Stimulator. Though the VNS goes off on its own every five minutes, if you were to feel a seizure coming on and were able to grab the magnet, or the person you were with noticed it, you/they could swipe it and get that extra boost of stimulation. When the magnet is swiped, the stimulation goes off for a full minute instead of thirty seconds.
The Vagal Nerve Stimulator is originally set for .25 volts of stimulation. That means it is not very strong. The VNS magnet is always set for .25 higher than the VNS itself. As time goes on, your body adjusts to it, and your neurologist can turn it up or down, depending on how you feel and what is best for you. When adjusting the voltage, the neurologist uses this contraption (on the right) to do so. They connect it to an iPad or some sort of screen, and you hold this up to where the VNS is inside your body. A few seconds later, all of your information is pulled up onto the screen! The neurologist then talks about what voltage or frequency it should be on, and whether you are comfortable with the settings.
I never wanted to get the VNS. The thought of something being implanted inside me was terrifying. I did not want to be changed at all. My neurologist had brought it up as an option one time, but I refused. One day, my mom and I were taking a walk, and the topic came up. "Don't you want to be seizure free? Don't you want to see if this works?" My mom asked, as she tried to comfort me. I brushed it off, still set on my decision. One day, unlike any other, I had a few seizures, and something popped into my head. "I'm tired of having seizures! It is so exhausting to worry about them and be so embarrassed!" I told my mom what I was thinking, and I told her that I wanted to get the VNS. At my next neurologist appointment, I told my neurologist about my decision. It was simple after that. She gave me a pamplet and a DVD about the VNS, (I never watched it) and we just had to decide when I wanted to have the surgery. We thought that it might be best to wait until after my parents would get back from Cambodia that February of 2015. "No. I am not going to wait that long. I want to go to college with it!" Those were my thoughts. We met with the neurosurgeon that would be performing the operation, and scheduled it to be a month later, right after my 19th birthday.

The surgery date came quicker than I thought. I researched the VNS everyday, watching what little YouTube videos they had on the VNS. I was so excited and wanted it so badly, but I was also terrified. The night before the surgery, I slept over at my sister's house. I wasn't allowed to have any food or water after a certain time, and was only allowed to take one of my medications. I was so grateful that the only one I was allowed to take was the one I normally took at that time. The hospital was only 30 minutes away, but it felt like much longer. My sister and I thought the surgery would be in the Outpatient Center, so we checked in. We were wrong, and had to walk a ways to get to the right building. As we sat down after checking in, all sorts of thoughts were racing through my head. "WILL IT HURT? WILL I WAKE UP DURING THE SURGERY?" So many thoughts and horrors went through my mind. My sister tried distracting me by playing this game, "Mr. Crab". That didn't work very well. (It's a really fun game, as I now know) After getting into my room, they took my vitals and all that. I was scared to get the I.V., because I hate needles. I wasn't too scared, because I don't mind as much when things are being put into my body, as much as when they are taking fluids out. But this needle hurt! It was big because it was needed in case they needed to give me blood or other important things during the surgery. The nurse tried to distract me, but that never works. I spent about three hours in that room waiting to be taken to the operating room. The nurse went to lunch and when she came back said that it would be another 45 minute wait. Ten seconds later, a man came in telling me he would be taking me to the OR. My sister was able to go with me to that floor, but couldn't follow me any more. I lay on that bed in the hall for what seemed like forever. It was probably about 45 minutes. Nurses and doctors came in and out of the OR, sometimes waving at me and saying hi. I was shaking from being so scared. A woman came out with a bunch of bags full of what looked like bloody towels. That made me sick to look at. At last, the anesthesiologist came out to get my paperwork, and talk to me. He joked around with me, and I asked him, "Will it hurt?" He said, "Well yes, it is surgery." That makes sense. Getting cut open hurts. A few minutes later, I was wheeled into the operating room. It looked like a party in there. Everyone was talking and laughing, having a good time, and there I was, scared out of my wits. They lifted me up and put me on the table. They got these white gauze pads, (I don't know the name) and put them all around me. I expected them to tell me when they were going to be putting the anesthesia in the I.V., but right then I started closing my eyes. For some reason, I tried to keep them open, but that did not work.

I woke up what seemed like a second later in the recovery room. The nurses noticed I was awake, and asked me how I was. It was a bit blurry, but from what I can remember, they asked me on a scale of 1-10, what my pain level was. I was in pain, but I was so disoriented that I was not sure what number to pick. I sat up right then and threw up. As I lay back down, I heard the nurses talking about my sister, and how she wasn't answering her phone. When I heard that, my stomach got even more queezy, and I got nervous. Even though my sister wasn't answering her phone, (according to them) I was wheeled back to my room. My sister met us there.

Before my surgery, I was so excited that it was a same-day surgery, and that I would be able to go home shortly after. Let me tell you, when I was back in that room after the surgery, I did not want to leave that hospital. I was in so much pain, and I could barely move. Unfortunately, I had to leave.

Those first few days of recovery were awful. I could physically not lie back in bed. I had to have three or four pillows propped up, but when I would lie back just a teeny bit, I couldn't breathe. I had huge bandages on my incisions, which I thought was the cause of my not being able to breathe. Although, when I took those off, and I was left with the small tape on the incisions, it felt the same.

This is the longest post I have written, and for that I am sorry. I hope you all enjoyed!