Back in early February, Rachel had been working with her orthodontist to plan jaw surgery that would hopefully fix her headaches. As part of the pre-operative workup, she went in for a routine MRI just to rule out any other causes for her headaches. Much to everyone's surprise, the MRI showed a large cerebral arteriovenous malformation (AVM) on the right side of her cerebellum. In simple terms, an AVM is a tangle of arteries and veins that is extremely fragile and prone to bleeding. Rachel quickly made an appointment with a neurologist in Quincy who then referred her to a neurosurgeon at Barnes Jewish that specializes in AVMs like hers.

Once down at Barnes, the first step was more imaging. Rach had an angiogram done to better map out the AVM and help the neurosurgery team develop a treatment plan. Because her AVM was very close to her brainstem, it was decided that they should essentially try and shrink the size of it with an embolization procedure before attempting surgery.

April 17th was Rachel's first embolization procedure. They were able to go in through an artery in her wrist and inject "glue" that plugged off blood flow to part of the AVM. This first procedure shrunk the AVM by 30%, not quite enough to proceed with surgery so a second embolization procedure was scheduled for May 28th.

With how flawless the first one went, we were all feeling pretty good about the second one on Tuesday. The plan was to try and shrink the size of the AVM by a total of 70% so that they could go ahead with surgery to remove the whole thing. A few hours into the procedure the neurosurgeon came out and updated our family that there had been a complication. The AVM had ruptured. They were able to balloon the vessel and stop the bleed within 1-2 mins (thanking God for that one), but were going to have to take her to surgery emergently to relieve the pressure on her brain.

Rach got out of surgery around 8:30 Tuesday night and was brought up to the neurosurgical ICU with a lot more tubes and wires than any of us had prepared for. In surgery they placed a ventriculostomy drain which allows the staff to not only drain fluid from her brain and keep the pressure down, but also lets us know exactly what her intracranial pressure is. She's currently on a ventilator, but she is breathing over the vent (which is a good thing). She is being rather stubborn about waking up for us, but rest right now is key. We've all been joking about how hard Rach sleeps on a normal day, let alone after a big brain surgery, so I like to think she's just being stubborn. They do have her on a low dose of propofol for sedation to try and keep her calm and let her brain rest while the swelling tries to go down. The first few days are critical so we greatly appreciate all of the prayers and support. I promise the next posts won't be quite as long, I'll try to keep everyone updated as much as possible throughout this journey. We're all hoping that Rachel will be back to her fiesty self here soon.