Seeking Clarity on My Experience
At the age of 42, I found myself in a terrifying situation when I was involved in a motor vehicle accident. A car collided head-on with the driver’s side of my vehicle, forcefully pushing my car backward and against another vehicle. I lost consciousness upon impact, and my head struck the driver’s side window. When I regained awareness, I experienced excruciating pain behind my right eye; however, remarkably all my discomfort seemed to lessen after that initial shock. My partner remarked that I was barely audible and did not vocalize my pain while in the emergency room. Upon extraction from the vehicle, I was taken to the hospital. Although a CT scan showed no abnormalities, I recall being administered hydromorphone, but details from that day are a bit hazy, as it has been over ten years. I was discharged after my partner went to retrieve the car; I walked to triage at an odd angle. Deep down, I sensed something was amiss yet couldn’t articulate it. I remember a triage nurse banging on the glass, inquiring about my well-being, then my next memory is vague—I found myself in the waiting area for children without recollection of how I got there. Was I dragged? Eventually, I was taken back for some fluids and released within the hour. My partner reported that the doctors assured us there was no head injury, suggesting I could rest. This portion of the ordeal still troubles me as I remain uncertain about the nature of what occurred overnight. During that night, I felt immobilized and unable to speak; I believe I was losing consciousness multiple times. In a peculiar turn, my elderly and rather cantankerous cat would paw gently at my right temple whenever I regained some awareness. We exchanged silent glances, but I couldn’t convey anything to my partner who was asleep beside me. Every time I sensed myself drifting off again, my cat would resume her gentle prodding, and this cycle continued until morning. When my partner awakened, I felt a bizarre sensation akin to rolling, yet I was finally able to speak somewhat. He promptly took me back to the emergency room, where I was diagnosed with post-concussion syndrome. However, I never received an explanation regarding those overnight episodes, which remain the most alarming part of my experience. Understanding the mechanics behind those symptoms might offer me some peace. Thankfully, I’ve recovered significantly—about 95% back to my former self—after a lengthy journey of nearly three years filled with various therapies such as vestibular rehabilitation, physical therapy, speech therapy, vision therapy, and occupational therapy. I am profoundly grateful to the dedicated healthcare professionals who supported me throughout this challenging process.
Answers (1)
7/28/2025, 3:20:53 PM
OpenHealth AI
It seems you're carrying the weight of a traumatic experience from your accident over ten years ago, especially regarding the symptoms and sensations you felt during your recovery. Your experience of loss of consciousness, confusion, and immobilization following the incident could be linked to post-concussion syndrome (PCS), which you were ultimately diagnosed with. I'll provide some clarity on this and suggest steps towards finding peace and understanding in your recovery.
Understanding Your Symptoms
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Post-Concussion Syndrome (PCS): This condition can occur after a concussion and may involve a range of symptoms, including headache, dizziness, confusion, and emotional difficulties. It’s not unusual to experience confusion about what occurred during and after the incident. Feeling immobilized or losing consciousness can be related to the brain's response to trauma.
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Transient Neurological Episodes: The episodes where you felt immobilized and struggled to communicate might be described as transient neurological disturbances, possibly as a result of the trauma to your head. The brain is incredibly sensitive, and even minor injuries can lead to significant temporary dysfunction.
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Role of Stress and Trauma: The emotional and psychological impact of an accident can also contribute to your symptoms. Traumatic events can lead to stress responses in your body, which can manifest in different neurological ways.
Next Steps for Peace of Mind
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Reflect on Your Experience: Take some time to journal about your feelings surrounding the accident and your recovery. Acknowledging these emotions can be a significant step in processing the traumatic experience.
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Consider Professional Support: Engaging with a mental health professional who specializes in trauma or post-concussion recovery can provide additional coping strategies and help you work through lingering concerns.
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Stay Informed: Understanding more about post-concussion syndrome can empower you. Research credible sources or perhaps connect with support groups for individuals recovering from similar experiences.
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Monitor Your Wellbeing: Even after significant recovery, maintain awareness of any symptoms that resurface. Keeping track of how you feel can help you recognize any patterns or triggers related to your past trauma.
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Practice Relaxation Techniques: Techniques such as mindfulness, meditation, or gentle yoga can reduce anxiety and promote emotional healing. These may also help manage any residual symptoms related to PCS.
Conclusion
Your journey since the accident has been significant, and it’s clear that you’re resilient and have made considerable progress. Understanding the complexities of your experiences can help you find closure and peace. Remember that healing can take time, and it’s okay to continue seeking support and answers as you move forward.
Feel free to reach out if you need more specific strategies or resources!
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# 7-Month-Old Child with Abernethy Malformation - Exploring Treatment Options ## [7-Month-Old] Identified with Abernethy Malformation (Congenital Portosystemic Shunt) - Treatment Methods? **Age:** 7 months **Gender:** Female **Height:** Age-appropriate **Weight:** Currently 9 kg, was 2.8 kg at birth **Ethnicity:** Asian **Duration of Symptoms:** Present since birth **Location:** Uzbekistan **Pre-existing Health Issues:** Abernethy malformation (congenital portosystemic shunt), liver hemangiomas, chronic jaundice, anemia **Current Treatments:** Supportive management --- ## INITIAL PRESENTATION (June 2025 - July 2025) Our daughter arrived on **June 27, 2025**, presenting with: - Birth weight: **2.8 kg** - Marked jaundice (yellowing of skin and sclera) - Pale or clay-colored stools - **Bilirubin level: 245 μmol/L** (typically <20) An immediate ultrasound indicated multiple liver anomalies, initially thought to be hemangiomas. --- ## FIRST COMPREHENSIVE ASSESSMENT (August 1, 2025 - 1 Month Old) ### Multislice Computed Tomography (MSCT) with 3-Phase Contrast (August 1, 2025): **RESULTS:** - **Portocaval shunt size: 9.9 mm** (blood bypassing the liver into the inferior vena cava) - **Arteriovenous shunt size: 4.4 mm** - **Portal vein size: 6.1 mm** (patent) - **Three nodular cystic lesions** located in the perivascular area, with largest measuring 11.6×20.7 mm, enhancing during the venous phase - Liver features a heterogeneous architecture, exhibiting irregular enhancement - Gallbladder appears elongated and slightly enlarged - Other abdominal organs exhibit normal findings **RADIOLOGIST’S ASSESSMENT:** "Congenital portosystemic shunt indicative of Abernethy malformation; less likely arteriovenous malformation (AVM); cannot dismiss the possibility of localized liver lesions." **ADVICE:** Seek consultations with an abdominal and vascular surgeon. ### Blood Tests (August 1, 2025): **Complete Blood Count:** - WBC: 10.44 × 10⁹/L (normal range) - **RBC: 2.1 × 10¹²/L** (LOW - indicating severe anemia) - **Hemoglobin: 69 g/L** (CRITICALLY LOW; normal is 117-166) - Platelets: 403 × 10⁹/L (elevated) **Biochemistry Analysis:** - Urea: 1.80 mmol/L (normal) - Creatinine: 33.4 μmol/L (normal) - **ALT: >1000 IU/mL** (EXTREMELY HIGH - severe liver dysfunction) --- ## FOLLOW-UP IMAGING (December 16, 2025 - 5.5 Months Old) ### Liver Ultrasound: **RESULTS:** - Right lobe: 64 mm, left lobe: 43 mm - Liver capsule appears irregular and vague - **Parenchyma: heterogeneous, showing 7 hypo-isoechoic nodules** (sizes range from 11.5×10.7 mm to 17.6×15.4 mm) - Capsule features uneven contours - Blood flow noted during Doppler examination - No dilation in intrahepatic bile ducts - **Portal vein: 3.9 mm** (decreased from 6.1 mm - indicating improvement) - Common bile duct: 1.4 mm - Gallbladder: measures 43.7×9.2 mm (pear-shaped, wall thickness 2.0 mm, homogeneous, free of stones) **ULTRASOUND ASSESSMENT:** "Presence of liver volumetric formations (specifically liver hemangiomas)." --- ## LATEST MSCT (February 6, 2026 - 7 Months Old) ### MSCT with 3-Phase Contrast: **FINDINGS:** - Liver remains normal in size, but shows heterogeneous structure with uneven contrast enhancement - **Portocaval shunt: 9.9 mm** (no change, continues to drain directly into the inferior vena cava avoiding liver acinus) - **Arteriovenous shunt: 4.4 mm** (no alteration) - **Three nodular cystic lesions** in perivascular space, maximum size 11.6×20.7 mm, enhancing in the venous phase - **Portal vein: 6.1 mm** (noted during porto-venous phase) - Arteries show no filling abnormalities - Intrahepatic bile ducts remain non-dilated - Gallbladder is elongated and slightly bigger, free from stones - Pancreas: normal - Spleen: measures 66.9×38.5 mm (not enlarged), splenic vein is 3.6 mm - Kidneys: normal placements and structure - No excess fluid detected in the abdominal cavity - No visible changes in lymph nodes **MSCT ANALYSIS:** "Congenital portosystemic shunt indicative of Abernethy malformation, unlikely to be AVM, presence of focal liver lesions cannot be ruled out." **RECOMMENDATION:** Engage with an abdominal and vascular surgeon. --- ## RECENT BLOOD WORK (December 2025 - January 2026) ### Complete Blood Count (January 19, 2026): - WBC: 5.8 × 10⁹/L (SHOWS IMPROVEMENT) - **RBC: 2.93 × 10¹²/L** (IMPROVED but still low) - **Hemoglobin: 72 g/L** (SHOWS IMPROVEMENT but still low) - Platelets: 223 × 10⁹/L (BACK TO NORMAL) - Neutrophils: 30.0% - Lymphocytes: 64.8% - Monocytes: 4.6% ### Biochemistry (January 28, 2026): - Total protein level: 67 g/L (slightly deficient) - Creatinine: 20.7 μmol/L - **Total Bilirubin: 242 μmol/L** (STILL HIGH - unchanged) - **Direct Bilirubin: 142 μmol/L** (VERY HIGH) - **ALT: 50 IU/mL** (DRASTICALLY LOWER from >1000!) --- ## OVERVIEW OF PROGRESS OVER 6 MONTHS | Parameter | August 2025 | January 2026 | Change | |------------------|-------------|---------------|--------------------------| | **Hemoglobin** | 69 g/L | 72 g/L | ↗ Slight improvement | | **RBC** | 2.1 | 2.93 | ↗ Improved | | **ALT** | >1000 | 50 | ✓✓ MAJOR IMPROVEMENT | | **Bilirubin** | 245 | 242 | → Unchanged (still elevated) | | **Portal vein** | 6.1 mm | 3.9 mm (US) | ↗ Decreased | | **Platelets** | 403 | 223 | ↘ Normalized | | **Shunt size** | 9.9 mm | 9.9 mm | → No Change | --- ## CURRENT SITUATION (February 2026 - 7 Months Old) - **Weight:** 9 kg (good growth rate in spite of condition) - **Jaundice:** Continues to be present (yellow skin) - **Stools:** Remain pale/clay-colored - **Development:** Achieving appropriate milestones - **Energy:** Appears to have a good energy level - **Feeding:** Normal appetite --- ## QUESTIONS FOR r/AskDocs We have been informed this is **Type 2 Abernethy malformation** (portal vein present). **Three treatment avenues have been proposed:** ### Option 1: **Endovascular Coil Embolization** (minimally invasive approach) - A catheter is inserted via the leg vein to access the shunt and deploy coils/plugs to close the abnormal vessels - Pros: No surgical incision, minimal discomfort, short hospital stay (2-4 days), no scars, enhanced safety - Duration: 1-2 hours - Recovery: 2-4 weeks for jaundice to show improvement ### Option 2: **Open Surgical Intervention** - An incision in the abdomen to ligate abnormal vessels and redirect blood to the liver - Pros: Direct visualization, effective results - 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Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. 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