Tuning in to the signals

The Interview Having come close to death, Evelyn Byrne knows the value of heeding the body’s warning signs.

The Interview

Neill O’Neill

AS the anaesthetic wore off, Evelyn Byrne could see the smile of the consultant who carried out her surgery. The mother-of-five knew by his face it had gone well – but she wasn’t prepared for what he said next.

“We found a massive aneurysm,” he said. “It wasn’t showing up in any of the scans or tests because there was a false membrane wall growing over it that was flattening it down and concealing its true size. The pressure had become so great that the surrounding artery walls were beginning to break down.”

Had that happened Evelyn would have died inside 20 minutes.

Three hours earlier she had gone under the knife to remove a small splenic artery aneurysm, but now Mr Sultan, a Consultant Endovascular and Vascular Surgeon at University College Hospital Galway (UCHG), had a look of relief on his face.

That was Tuesday, October 24 2006. The previous Friday she had been given the choice to wait two months for key-hole surgery, which was a less serious procedure and carried an 80 per cent success rate, or of having open surgery, a riskier operation that carried a 99 per cent success rate. With hospital beds at a premium, and wishing to be rid of the growth on the artery going into her spleen that had plagued her for almost a year, Evelyn opted for open surgery.

“There was no urgency in terms of the aneurysm. I was told it was small and, while it was somewhat rare, it wasn’t as serious as aneurysms at other organs. As I understand it now, I wouldn’t have survived the eight weeks if I had opted to have key-hole surgery. I would not be alive today.”

Evelyn’s story began, rather innocuously, ten months previously.

“It started off with a dull ache under my rib cage which would give me severe pain for a second or two during the night. At first it seemed like nothing so it was easy to dismiss as something small. As it continued to go on I began thinking ‘something isn’t right here’. I went to my usual GP but she was on time out and there was a locum doctor there, who I didn’t know. I was told I was fine and to take some painkillers, which I did, but when the pain continued I went back to her and this time I was told it was stress and to rest and take a few more tablets. I would not have expected any GP to diagnose my problem, but I did expect to be referred on.”

Frustrated, Evelyn decided to go to another town and get a second opinion from a different GP. Again she was told she was fine and everything was okay. That was in May 2006 and when the pain didn’t go away Evelyn began thinking she was a hypochondriac.

“In September I went back again but the same GP said there was absolutely nothing wrong inside. I was shocked at how definite she was. I began to wonder if it was my imagination and if I was wrong to trust my gut instinct.”

Not long after this fourth surgery visit, a new GP came to Evelyn’s area. As it happened a simple sports injury sustained by her daughter set in motion the events that saved her life.

“I brought her to see the doctor and while there I decided to explain that I had this ongoing pain I wasn’t happy about. The doctor said ‘if you’re not happy you need to be referred. I can’t tell you what the problem is but we can start ticking off the boxes and eliminating what it isn’t’.”

Evelyn was sent to Galway for a CT scan, which examined her kidneys for the presence of kidney stones. When the radiologist said there was nothing amiss as far as his area of expertise was concerned and he would send the summary to her GP, Evelyn again began doubting that there was anything wrong with her. She had a business trip to Dubai the following week and rang her GP to get the all-clear for the journey. As it happened there was a locum in the surgery, the same one that she had seen originally, who said it was fine to travel. Whilst in Dubai, Evelyn experienced none of the pain that had caused her so many sleepless nights in the previous months.

“I had five GP visits and a scan which showed up nothing and when the pains stopped while I was away I began to think I had imagined it all. I felt as if I was paranoid and should have listened to the doctors.”

Upon her return Evelyn was summoned to meet her usual GP, who informed her that her test results showed she had an aneurysm. The way she was sleeping in Dubai was different to the way she lay in bed at home, where she dragged on the aneurysm, which was the reason she was relieved of the pain there.

Evelyn knew decisive and immediate intervention was required.

“By the time I rang Mr Sultan’s office I was in tears, but Fiona, his PA, was fantastic. She said ‘come and see me straight away’. She didn’t need a letter stating I was a needy case, she never asked had I VHI, she went on my word and knew I needed to be seen. I was sitting at home and she got my test and scan results faxed over. I went immediately to the Galway Clinic.”

Mr Sultan, who operates out of the Galway Clinic and UCHG, saw Evelyn that same day. He wanted his own diagnosis on her aneurysm but had a long waiting list.

“Fiona jumped through hoops to get me in. That was Monday and I was admitted to UCHG on Wednesday. By Friday I had to decide about surgery. Mr Sultan’s team were so professional and efficient.”

Mr Sultan encouraged her to have open surgery, as he wanted to see the condition of her spleen, but explained that key-hole surgery would be more than adequate on the small aneurysm the scans had shown up.

Evelyn opted for the more imminent open surgery, a decision which saved her life.

Thinking back Evelyn knew something wasn’t right. When technology and medical opinion failed her, her own mind did not, and though she doubted herself at times she feels it is very important that no other person does so.

“You can’t think ‘I have a problem that needs attention but it’s not as serious as it could be’. If you think this a blasé effect creeps in and your files are going to the wrong hospitals and you are waiting longer than you should be for every test and procedure.

“You have to be decisive and take firm action. I don’t like to think about the outcome for my family had I not rang Mr Sultan’s office directly.

“Even if your doctor says you are fine you must trust yourself and interpret what your body is telling you. Women especially, whose bodies, by their nature, go through a lot of trauma, need to know that it is okay to see a doctor as frequently as is needed. You should never feel bad or like a hypochondriac. The worst that can happen is that you end up healthy or cured, whereas if you leave the problem, the outcome can be much worse. Shop around and do whatever you can to give yourself a better chance, and don’t be afraid to ask to be referred, even if your doctor feels it’s not necessary. All the technology and doctors in the world couldn’t figure out the extent of my problem. The truth was only uncovered after I was opened up.

“A GP once told me that 90 per cent of patients know what is wrong with them when they walk into the surgery. Nobody knows your body like you, you must read and believe the signals it sends out.”

Apart from spending time with her husband and five children, who range in age from 18 to six, Evelyn is now back at work in Castle Travel, the business she founded in Castlebar 18 years ago.