Having nearly lost his life 40 years ago and again this summer, Patrick Keally knows what it means to be thankful.
"Every day is pretty much a Thanksgiving for me since 1969," said the Upper St. Clair police corporal, referencing his time as a wounded Vietnam War veteran.
Though he received some staggering injuries in that war, including spending five days in a coma, it was a brain aneurysm -- smaller than a centimeter -- that nearly downed the former Marine corporal and gunnery sergeant.
But, with the help of Allegheny General Hospital neurosurgeon Khaled Aziz and Upper St. Clair ophthalmologist Erik Happ, the Peters resident underwent a radical new aneurysm repair surgery and is on the road to recovery.
Dr. Aziz, who began developing a minimally invasive technique for intracranial surgery during his time as a medical resident at the University of Cincinnati Medical Center, has teamed up to perform the surgery with Dr. Happ on 32 occasions during the past four years.
"We're like a well-oiled machine," Dr. Happ said. "The patients have just been very pleased and happy."
"It has been fantastic teamwork," Dr. Aziz said.
Cpl. Keally was referred to the doctors after he suffered a mysterious mini-stroke this summer. After ruling out a heart or lung problem, doctors discovered the aneurysm, a weak spot on his carotid artery that had ballooned outward and filled with blood, putting pressure on his brain and entangling with the bone of his skull.
Cpl. Keally, who has been with the Upper St. Clair police department for 25 years, suffered shrapnel and other wounds in Vietnam. He was awarded two Purple Hearts and a Bronze Star that included the "Combat V," a special award for valor during direct combat.
He has continued to reinjure bones that were broken during the war and has suffered ongoing side effects from his exposure to Agent Orange, such as skin problems and vein damage.
For those reasons and because of an injury to his brain from a rocket-propelled grenade explosion, Cpl. Keally suspected he had a brain tumor.
"I thought maybe it was an old head injury coming back," said Cpl. Keally, who was shocked to find that he had an aneurysm instead, especially because no one else in his family had ever had one.
Doctors have told him they don't know what caused the aneurysm, but finding it in the nick of time saved his life.
"They found it to be a lot worse when they got in there," he said of the surgery, which revealed a larger aneurysm than doctors previously suspected.
Certain patients with brain tumors and aneurysms may qualify for the surgery based on the location and size of the mass, which is removed through a small incision in the fold of the eyelid.
Dr. Happ, who specializes in oculoplastics at AGH, which includes surgery of the eye socket, eyelids and tear ducts, exposes the brain through the tiny incision and removal of the bone above the eyebrow.
Dr. Aziz then takes over, removing the mass before Dr. Happ restores the bone with the use of plates and cement.
The result? A much shorter recovery time than traditional surgical methods and a nearly perfect cosmetic outcome.
Ordinarily, the surgery would have involved a large incision in the forehead and removal of part of the skull.
"Long term, the recovery is faster and cosmetically, it's much better," said Dr. Aziz, who said he knows of no other neurosurgeon who has adopted the practice.
"We are one of the only centers in the country that's doing this on a regular basis," Dr. Happ said.
For patients like Cpl. Keally, the result has been a new lease on life.
For the first few days after surgery, Cpl. Keally said he had incision-site soreness and some headaches, but they resolved after a few days when he was released from the hospital. He has virtually no scar and felt well just a week after undergoing major brain surgery.
In the seven weeks since, Cpl. Keally and his doctors said he has been recuperating very quickly. This week, he even planned to go with some friends on an annual bear-hunting trip to Fayette County.
Though he won't be handling a gun or walking great distances just yet, doctors have told him it won't be long before he can return to work and enjoy all of his outdoor hobbies.
He and his wife Diane, along with their two adult children and grandson, quietly celebrated his 60th birthday recently, but the family is planning a much larger celebration next year when he is fully recuperated.
Cpl. Keally said he relied on his faith to pull him through.
"I've been very grateful for every day of my life," he said.
Janice Crompton can be reached at 724-223-0156 or firstname.lastname@example.org .