In the right hands: A Sharp doctor’s brain aneurysm journey

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Dr. Kalpana Chalasani and Dr. Ryan Viets at Sharp Grossmont Hospital.

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Dr. Kalpana Chalasani at Sharp Grossmont Hospital with her children.

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Dr. Kalpana Chalasani worked closely with her physical therapist to recover after experiencing an aneurysm.

It was as routine a spring day as ever. Dr. Kalpana Chalasani, an internal medicine and pediatrics doctor with Sharp Rees-Stealy Medical Group, had just dropped her daughter off for another day of 7th grade and was heading to work for a meeting.

While driving, Dr. Chalasani suddenly felt as though someone was repeatedly hitting her in the back of her head with a hammer. As a doctor, she knew the symptoms and implications of what’s known as a thunderclap headache — and how quickly she would need help. She was close to home and quickly pulled over.

“I had no history of headaches,” recalls Dr. Chalasani. “I immediately thought it could be a ruptured aneurysm, because no other headache is that quick or severe.”

Dr. Chalasani knew she needed to call 911, but also that she might have just minutes left with the ability to communicate. Because their 22nd anniversary was approaching, she called her husband first.

“I knew there was a chance I would pass away and not even make it to a hospital,” she says. “I wanted a chance to speak to him.” She left him a message to call her back.

Dr. Chalasani’s husband, Dr. Louis Christiansen, is an endocrinologist at Sharp Rees Stealy, and the timing of a voicemail from his wife, who knows he’s working, signaled something was wrong. He called back just as she was about to dial 911, giving her the chance to tell him how much she loved him and their three children.

Making those calls and communicating were miracles. Within two minutes of pulling over, Dr. Chalasani had lost all sensation and the ability to move on her right side. She was also quickly losing the ability to speak, and her sensitivity to the sunlight was so severe that she had to keep her eyes closed.

Taking the reins

The 911 operator asked the usual questions, such as, “Can you spell your last name?" In response, Dr. Chalasani relayed what was happening, that she had little time to spare, and needed help immediately to survive. The ambulance driver planned to take her to the nearest hospital in La Jolla. However, she asked to be taken to Sharp Memorial Hospital, where she currently serves as vice chief of medicine.

“I was thinking, ‘This is severe, and my survival chances are 50/50 at best,’” she recalls. “If I die, I don’t want to be somewhere with strangers. I want to be with the colleagues I’ve worked with for 20 years.”

At Sharp Memorial’s Emergency Department, a CT scan confirmed a subarachnoid hemorrhage, a type of stroke that is the result of a ruptured aneurysm. Dr. Chalasani had already bled quite a lot. It became very clear that what she needed was an endovascular coiling procedure, which uses a platinum coil to promote clotting and prevent rupture.

The need for the procedure meant that Dr. Chalasani would need to be transferred to Sharp Grossmont Hospital. Dr. Ryan Viets, an interventional radiologist and one of the few physicians at Sharp trained to perform this procedure, which goes through the groin to access the aneurysm site, was awaiting her arrival and determined she had a Grade 3 aneurysmal hemorrhage with a 50% survival rate.

“When she arrived, her aneurysm had already bled once and had a very fragile blood clot holding the top of it together,” says Dr. Viets. “If that clot gave way, she would have had more bleeding in her brain, and this almost certainly would have been fatal.”

The coiling procedure would fill the aneurysm with metal and exclude it from the circulation to prevent it from bleeding again. “It was extremely important that she quickly got to our hospital, which is a comprehensive stroke center, where the staff is used to treating aneurysmal brain hemorrhages,” Dr. Viets says.

Traveling the road to recovery

Dr. Chalasani would spend three weeks in the ICU on a comprehensive treatment regimen that focused on reducing her risk of stroke and physically rehabilitating her. But the fast treatment and technology at the hands of Dr. Viets was a game-changer for her brain.

“It was miraculous to watch her become completely lucid and really herself again within just a few days of the coiling procedure,” says Dr. Viets. “Her body quickly cleared the blood from her brain, and she fairly soon felt back to normal. It’s not something we often see happen so quickly, so it was a fantastic outcome.”

In addition to the lifesaving work and care of Dr. Viets, who is now part of the specialized team at Sharp Grossmont Hospital for Neuroscience, Dr. Chalasani praised the follow-up care and treatment from Dr. Charlotte Zhong, who is board certified in neurology and critical care. Dr. Zhong employed the successful treatment strategy that focused on non-narcotic management for pain control, medications to prevent stroke, and the promotion of mobility and strengthening. This comprehensive approach allowed for faster recovery. And then there was the support from her colleagues — truly the epitome of The Sharp Experience. “There were people from Sharp Rees-Stealy I’d known for years and some I’d never met who were helping on all fronts,” says Dr. Chalasani.

Her kids were fed by meal trains they organized, her shifts were covered, and her husband was able to sleep at the hospital. He would run home in the morning to get their younger kids ready for school and then return to the hospital. “I was cared for and visited by an amazing group of nurses, physicians and colleagues from Sharp,” says Dr. Chalasani. “It was an outpouring of love and support that helped me heal, and extraordinary medical care that allowed me to return home to my family and, more recently, return to work to take care of patients again. I am eternally grateful.”

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