When she was 40-years-old, Michelle Gustilo-Smithson began a rigorous workout routine that included cardio, strength training and weight lifting. During her post-workout cool down, Michelle noticed a slight ringing in her ear. She did her best to ignore the ringing, which at first seemed more like a nuisance than a concern.
But as the weeks progressed, the ringing became frequent and intense. The ringing sounded like a “heartbeat” or persistent “whooshing” sound in her ear. The sound began interfering with meetings and work discussions. Michelle knew something was wrong.
“The ringing became maddening because it was something only I could hear,” says Michelle. “I think people around me knew I was uncomfortable because I would constantly tug at my ear in hopes of stopping the ringing.”
Michelle visited several different ear, nose and throat specialists and underwent numerous tests only to be assured that nothing was wrong. Michelle was even told that she would have to learn to live with the relentless ringing. Frustrated with this prognosis, Michelle knew she had to exhaust all options.
Finally, Michelle met a specialist who was willing to order an additional MRI test. Within two days of the MRI, Michelle received a phone call that would change everything.
The results showed Michelle had a brain arteriovenous fistula — a tangle of abnormal blood vessels connecting arteries and veins in the brain. These arteries transfer oxygen-rich blood from the heart to the brain. Veins then carry the oxygen-depleted blood back to the lungs and heart. The brain fistula was disrupting this vital process.
The doctor explained that Michelle could continue living with the fistula as it might not affect her overall health, besides the bothersome ringing. However, the fistula could rupture at any moment, causing bleeding in Michelle’s brain.
Michelle was in shock — she felt like her brain was a ticking time bomb. Within 30 minutes of receiving this life-altering update, Michelle received a call from the Division of Interventional Neuroradiology care team at Long Beach Medical Center.
The next day Michelle met with Viktor Szeder, M.D., from the Division of Interventional Neuroradiology, MemorialCare Neuroscience Institute, Long Beach Medical Center, who gave her the facts on her condition. The abnormal connection of arteries and veins - located directly behind her ear – was causing the “whooshing” sound and could potentially cause Michelle to have a stroke.
The Division of Interventional Neuroradiology care team treats cases such as Michelle’s and recommended she undergo an embolization — a recent minimally invasive treatment that eliminates the abnormal connection that was creating a “short circuit” between the arteries and veins in her brain. During an embolization, a catheter is passed through the groin up into the arteries in the brain that lead to the arteriovenous malformations (AVM) - in this case, Michelle’s fistula.
“Embolization is less invasive than conventional open surgery,” says Dr. Szeder. “As a result, the recovery is easier, the hospital stay is shorter and there is no surgical incision.”
Undergoing the embolization eliminated Michelle’s risk for stroke and cured the ringing in her ear. The minimally invasive technique of embolization allowed Michelle to leave the hospital in two days and return to work only eight days later.
After treatment, Michelle was able to continue her rigorous workout routine, volunteering to feed the homeless and spending time with her family and friends.
The MemorialCare Neuroscience Institute at Long Beach Medical Center strives to perform novel techniques and use advanced technology to make sure that patients, like Michelle, have the highest level of patient care available. The team is comprised of neurologists, neurosurgeons, stroke nurse and interventional neuroradiologists that make up a highly-trained stroke rapid response team who is available 24/7 – enhancing rapid response times and positive outcomes.
“As difficult and frustrating as a health problem might be, listen to your body and be persistent,” says Michelle. “I think we all are our own best advocates - do research, but most importantly, seek help from practitioners who are just as persistent as you are, who care, are proven and are confident about their abilities to help you.”