Like many young dads, Josh Glazer, a 35-year-old Arlington Heights, Illinois husband and father of two, is happy to be celebrating Father's Day with his family. But he is even more grateful since surviving a near-fatal brain hemorrhage in 2010.
“The date was January 10,” Josh recalls. “My daughter was two at the time and my wife was pregnant with our son. Until that day, I hadn't felt any sort of symptoms. I had just put my daughter down for a nap when all of a sudden, I felt this headache like I'd never felt before.
“It was painful,” Josh recalls, “but even more so, I could feel a blood-rushing sensation in the back of my head. Then all of a sudden, the vision in my left eye became very blurry. I knew right then that something wasn't right, though I had no idea of the seriousness.”
“I tried to call my wife—she was at a family function,” says Josh. “Her phone was turned off, so I called my father-in-law's cell phone. He answered and I started to describe everything I was feeling. To this day, I can still hear him say, ‘Call 911!’
“Then he handed the phone to my wife, Jodie, and I told her everything,” says Josh. “She said, ‘Call 911!’ and that's what I did.
“The 911 operator sent an ambulance right away and the paramedics got to my house in three to four minutes” he recalls. “I kept the door open just in case I passed out. I knew I had a family to worry about.
“I saw the paramedics coming in my house and I summoned them inside. I was on the floor by this point,” says Josh. “I vaguely remember saying, ‘Do what you've got to do with me. I've got a daughter who's taking a nap upstairs. Can one of you stay behind and watch her until someone comes home?’ They said, ‘No problem.’ The last thing I remember is when they put me into the ambulance.”
Dr. Foroohar was on neurosurgery ER call at Northwest Community Hospital that week. “I remember getting called by the ER physician, who briefed me on Josh's history and the results of his neurological examination and imaging tests,” she says. “He told me the patient became lethargic, he was intubated and underwent a CT scan of the brain.
“The CT showed hemorrhage in two locations in Josh's brain: one subdural and one intracerebral,” Dr. Foroohar recalls. “I said, ‘I'll look at the CT brain scan and call you back.’
“My first impression was, here is a young person with no history of trauma—this doesn't sound good,” she says. “Where is the hemorrhage coming from? Automatically, Josh's case was more complicated than the usual hemorrhage from trauma, which is how subdural hemorrhages normally occur.
“I called the ER physician back and said, ‘We need to do a couple of other emergency tests,’” Dr. Foroohar recalls. “I wanted him to immediately have an MRI brain to better understand both hemorrhage and a CT brain angiogram to better assess the brain's blood vessels and determine the source of the hemorrhages.”
On her way to the hospital, Dr. Foroohar began orchestrating Josh's emergency care and neurosurgical intervention. “After I hung up with the ER physician, I called the MR technician and the CT technician to make sure both the MRI brain and CT brain angiogram would be done immediately,” she recalls.
“I also contacted the radiologist on call to see what he thought of the CT brain results,” Dr. Foroohar explains. “I made at least 15 phone calls before I ever stepped foot in the door at Northwest Community Hospital.
“I called the operating room and arranged for emergency brain surgery,” she recalls. “I wanted to make sure there was no delay in getting the patient to the operating room.”
“When I got to the hospital, I remember seeing Josh's wife—a petite woman, very young-looking and pregnant, and the patient's father,” says Dr. Foroohar. “I introduced myself and said, ‘I'm going to look at the MRI brain and CT brain angiogram, and then let you know what needs to be done.’
“As I looked at the images, I quickly understood what was going on—that there was a dural arteriovenous (AV) fistula—a site of abnormal connectivity between arteries and veins in the covering of the brain called the dura,” she explains. “The fistula wasn't actively bleeding, because if it had been, the patient would have been dead. The bleeding had stopped for the moment.
“Josh was intubated and not responsive, so I was not able to really examine him,” says Dr. Foroohar. “I went to the family and said, ‘We're going to go ahead and perform emergency brain surgery to remove the subdural hemorrhages and relieve the pressure on the brain. Once that is completed, we will address what caused the hemorrhage, the dural AV fistula. The subdural hemorrhage is the first priority.’”
Directly from MRI and CT, Josh was wheeled to the operating room. “I removed the subdural hemorrhages that was putting pressure on the brain, and had caused Josh to deteriorate and become unconscious,” Dr. Foroohar explains.
“Josh needed to remain intubated after the brain surgery to proceed with treatment for the dural AV fistula by the interventional neuroradiologist.
“I spoke to the interventional neuroradiologist before and after surgery,” says Dr. Foroohar. “After the surgery, it was about 10:00 p.m. and the patient was stable.” Josh was taken to the intensive care unit and Dr. Foroohar spoke to his family.
“The patient's family was very stressed, as any family would be,” she recalls. “By then, there were 20 people there—Josh's wife, father and all these other family members.
“I told them, ‘The surgery went as well as it could. I removed the subdural hemorrhages and now we'll just have to wait and see whether he wakes up and find out what neurological deficits he might have,’” says Dr. Foroohar. “I also discussed the need to proceed with treatment for the dural AV fistula.
“During that night, Josh did wake up. He began following commands, even though he was still intubated and was on some sedation,” Dr. Foroohar explains. “I knew that night that he was going to make it. The next morning, the interventional neuroradiologist treated the dural AV fistula.”
Josh was in the operating room within three hours after Dr. Foroohar got the call from the ER. “It could not have been faster,” she says. “The essence of neurosurgery with somebody who has an expanding hemorrhage pushing on the brain is to take that pressure off as soon as possible to minimize any brain damage.
“In Josh's case, it was done so efficiently that he didn't really suffer any brain damage, although he was unresponsive for those few hours,” Dr. Foroohar explains. “The fact that he didn't suffer any consequences from that is a miracle. He might have not woken up, and even with waking up, he could have had weakness on the right side of his body, or visual problems or speech problems. Or he could have had other neurological deficits.”
Josh doesn't remember anything from the time he was put in the ambulance until a day and a half later. “All I can remember is that I woke up in a hospital bed,” he says. “I had no idea what day it was or why I was there. I could vaguely remember having had some head pain, but I had no idea the severity of the situation. I saw a nurse in the room and I asked her what happened.
“She said, in a very direct way, ‘Sir, you just had two major brain surgeries.’ I had absolutely no idea how severe this was, and it was very shocking to hear.”
“It gives me the chills knowing that had I not called 911, I probably wouldn't be here right now,” says Josh. “I think of Dr. Foroohar every day because if it weren't for her, I'd either be dead or I'd be a vegetable—I'd be worthless. She saved my life.
“There could have been a chance that I'd never have met my son, and my wife would have been raising two kids by herself,” he tearfully acknowledges. “I'm happy my kids weren't in a situation where they didn't have a dad. There could have been so many dire consequences. I literally owe Dr. Foroohar my life.
“My birthday was January 19, a week after my surgery,” says Josh. “I can say without a doubt my survival was the best gift I've ever received.”
Josh has made a full recovery; by March, he was back at work full-time. “I count my blessings every day that everything fell into place,” he says. “It's probably a good thing that I'm young—if this had happened when I was in my 50s or 70s, who knows what the consequences could have been?
“I'm happy I survived,” says Josh. “Despite the everyday frustrations we all feel, I know that I am very lucky. It really puts everything in perspective. I'm very thankful that Dr. Foroohar was there and that she did the phenomenal work she did.”