A Stroke of Luck

I should be dead: pushing up daisies, taking a dirt nap, shuffling off this mortal coil. I should be looking at the grass from underneath and the worms should be going in and going out, and playing pinochle on my snout. Why I’m not is a mystery, or at least a rare stroke (pardon the pun) of dumb luck, because I had a stroke of the brainstem and aside from a few lingering effects, pretty much walked away from it. Because the brainstem controls vital bodily functions such as heart rate and breathing, victims of a brainstem infarct often die. As relieved as I am to still be alive, I’m even more pleased to not be a vegetable. The idea of having no future prospect in life other than lying in a bed being kept alive by machines scares the living hell out of me.
It started as a bad cramp at the base of my skull on the left side of my neck in the middle of the night. At the time, however, I didn’t realize what that cramp had in store for me. It woke me up out of a beer-induced sleep, but after the initial cramp sensation passed, I went back to sleep until the morning. I got up and was having the obligatory morning coffee when the cramping sensation hit me again, this time with tingling in my left arm and the left side of my face, and my throat felt like it was being squeezed shut. It was hard to draw a breath and for a few minutes it was difficult to speak normally. I was getting a little scared when the symptoms kind of turned off almost as quickly as they had begun, the whole episode lasting perhaps ten minutes or so. I should have gone straight to the Emergency Room, but didn’t. I looked up information on strokes on Google, and gathered that I had had a TIA—a Transient Ischemic Attack or a mini-stroke as it is sometimes called. I knew I should have gone to the hospital, but I think it was a combination of male ego, fear, and lack of insurance that made me hold off. I wish I had gone then; it might have saved me a lot of aggravation later. The old saying about hindsight holds true once again! As it happened, I ended up sleeping most of the rest of the day and that night without any further incidents until the next morning.
I woke up Sunday morning feeling okay. I figured that resting the day before had done me some good. Wrong! I was going about my usual morning routine, and I was in the middle of scooping out the litter box (digging for buried treasure, mateys), when it hit me again. It was pretty much the same as the previous day, except stronger, and although it slacked off, it didn’t stop. I knew then that I had better get to the ER., so I got in my truck and drove to the hospital. The trip was uneventful. Thankfully, it was 6:30 on Easter Sunday morning, so traffic was light to non-existent, most people either still in bed or at sunrise church services. I made it to the hospital and drove to where the Emergency Room used to be and now wasn’t, much to my chagrin. Oh, yeah, they moved it! I drove around to the other side of the building, found the E.R. and staggered inside. Being the cynic I am, I was prepared to wait for hours to be admitted, but whether it was due to an empty E.R. or the fact that I was having a stroke, I got right in which was a relief, because my condition was deteriorating pretty rapidly. I walked into the E.R., but by the time they took all my info, I could barely stand up, let alone walk to the examination rooms. My left side was becoming numb and my left eye quickly went out of alignment with the right, and I experienced extreme double vision and vertigo. They took my vital signs and some blood, and then took chest x-rays and a CAT scan of my head. During the wait in between tests, I watched Spiderman on the swingarm TV and tried not think about what was happening to me. I have always been very independent and used to being able to do what I wanted when I wanted, and I couldn’t accept the fact that those days might be over for good. The vertigo finally got the better of me and I vomited into a medical waste container that was luckily nearby. The strain caused the world to grey out for a minute and black spots danced in my vision. I did feel better after that, though, and I didn’t experience any more nausea after that. They then rolled me up to the second floor for an MRI scan, and I couldn’t even get out of the chair without help. The MRI tech practically had to lift me onto the machine because when I tried to stand, I would just fall over to the left. The MRI takes about a half-hour to complete its cycle, and I was so fatigued that even through the noise of the machine, I almost fell asleep during the procedure. I was then taken back to the examination room and was given a cardiac ultrasound. I really wish I could have seen the screen, because that kind of stuff is fascinating to me. At any rate, I could hear my heart pumping steadily which was strangely comforting, although the tech had no sense of humor. I made a comment to the effect that my wife would question whether or not I even had a heart, and the tech assured me in a serious manner that I did indeed have one. Sheesh! Lighten up, Sparky! Man, those ER techs have no sense of humor. The doctor finally came in and informed me that I had not had a TIA, I had had a full blown stroke, and they were admitting me. Shit. That wasn’t what I wanted to hear. I was wheeled up to the SICU (the Surgical Intensive Care Unit- there are a lot of acronyms in the hospital, kind of like the military) and that was the beginning of my week-long hospital stay.
I was put into a room that contained a bed, a TV on the wall, equipment that monitors vital signs, and little else. I was fitted with a cannula to deliver oxygen, had an IV drip inserted to deliver a cocktail of glucose solution and an anti-coagulant called Heparin into my system, and was fitted with an array of cardiac sensors stuck all over my chest, one on my left index finger, and a blood pressure cuff on my right arm that were all connected to a telemetry machine to measure all of my vital signs. The first day was the worst. I didn’t know what to expect and I couldn’t really see anything clearly even when I shut one eye, because at first, both eyes were suffering from nystagmus, or involuntary lateral eye movements, which is just a fancy way to say that my eyes couldn’t focus in one spot, but kept moving away from where I was trying to focus. The ICU is a pretty busy place in the hospital, and there was constant activity, even in the wee hours of the morning; sometimes especially in the wee hours. Patients were being brought in at all hours and the nurses were always busy, so getting more than an hour of sleep at a time was damn near impossible, not only because of the constant activity, but also because I was periodically subjected to the ministrations of “the vampire”: the loving term of the nurse’s aide that takes blood samples. Samples of my blood were taken every couple of hours to monitor the level of coagulation, called PT/INR tests. The Heparin was being administered not only to start dissolving the blood clot in my left vertebral artery, but also to prevent new ones from forming. They also gave me aspirin and a blood pressure medicine called Lopressor because my blood pressure was so high that it’s a wonder that my head didn’t blow off of my shoulders. When I was admitted, my blood pressure was around 195/90. After a day in ICU and a few doses of Lopressor, though, it was down to almost normal.
Another major discomfort of my ICU stay was the fact that I couldn’t have any food or drink for the first day and a half due to the dysphagia (difficulty in swallowing). They wouldn’t even let me have any ice chips due to the chance I could choke on them. I have to say, those little lemon swabs they give you are a poor substitute for a cold drink of water. By Tuesday morning, though, I was able to have some ice and finally a little ice water. I don’t think water ever tasted so good as that first sip after my almost two-day fast. Finally, on Tuesday afternoon, I was moved to a regular room because I was stabilized and they needed the bed space in ICU for people sicker than I was. Speaking of people who were worse off than me, there was one code emergency in the ICU unit while I was there. I never got the details of the incident, but apparently an old woman who was there had some sort of episode and the staff had to perform resuscitation to keep her alive. There was quite a ruckus for a little while, but I couldn’t see what was happening because they had pulled the curtain across the doorway when it all started. I suppose they got the lady stabilized and averted a tragedy, but I never found out what happened to her.
I was transferred to a regular room and taken off all the telemetry equipment, the only thing connected to me being an IV with the Heparin drip and the cardiac electrodes that were connected to a portable reader that fit into a pocket on the front of my hospital gown. I was visited by nurses with meds, nurses who took vital signs, nurses who took blood samples (I felt I was being drained 1.7 ml at a time), and several therapists: a speech therapist, physical therapist and occupational therapist, and although it wasn’t real pleasant to be poked and prodded constantly, I can’t say enough about the ladies and gentlemen that work the seventh floor- they were all great. I hope when I get finished with the respiratory care program at school, I can be a part of a team of people like them.
I was feeling better and looking forward to getting out of the hospital when I had a setback. On Wednesday morning, I had another minor stroke: pretty much the same symptoms as before, but not nearly as intense. Nonetheless, I was taken for another CAT scan, and then for another MRI series, one normal run and another with dye injected into my bloodstream. As it turned out, it was another blood clot, but the symptoms passed fairly quickly and I was back to feeling only mildly crappy. I didn’t feel too bad physically, other than the lack of balance and the double vision. I could deal with the minor weakness in my left side and the topical numbness of my right. The numbness actually came in handy: they took so many blood samples that not feeling pain was an asset. It was strange not to feel temperature, though. I can still grab a handful of ice and not feel a bit of coldness. It is a strange sensation.
The worst part of the hospital stay for me was the boredom. Aside from the nurses’ visits, the days were broken up only by mealtimes—breakfast at 8:00, lunch at noon, and dinner at 5:00. Even with my wife sitting with me, the days were long and drawn out periods of watching TV and waiting for the next bland installment of hospital food, and the nights were even longer drawn out periods of watching TV and trying to snatch an hour’s worth of sleep between bloodlettings. I couldn’t read due to the vision problems I was having, and I couldn’t get up and walk around without an aide because I was hooked up to the IV and I couldn’t walk without hanging onto a walker and I couldn’t walk without someone to pull the IV stand and hold onto me. I couldn’t even get to the bathroom on my own. I can tell you, you get used to peeing into a bottle fairly quickly, but it was good to get back to doing it the old fashioned way. I don’t know which I looked forward to more at the time, eating real food or having an upright pee. It was definitely a toss-up.
After a week of all this fun, I was finally allowed to check out and go home. They performed a final PT/INR test and determined that my numbers were close enough to ideal to be released. By now I was not only on the Heparin drip, but also taking Coumadin to keep my blood from forming clots. Before I was released, I was disconnected from the Heparin and given a booster shot of another anticoagulant injected into my belly, which wasn’t very pleasant. I joked to the nurse about stabbing me like Jack the Ripper…she got a good laugh out of that. Like I said before, the nurses were all great and most of them appreciate and reciprocate a good sense of humor, but they all seemed to like me anyway.
It was a great feeling to finally breathe the outside air after sucking the canned air of the hospital for a week. The humid air with its odors of salty breeze, cut grass, and car exhaust were like a sweet perfume after the generic, antiseptic air of the hospital. It was good to be free! It was even better to be free and still be more than semi-functional! I had survived a moderate to severe brainstem stroke with basically little more than some double vision, some misbalance, minor weakness, and topical numbness of the right side. The doctor at the clinic where I go for my follow-ups was amazed and I’ve heard the word “miracle” a couple of times, but I really don’t feel that much different, and I certainly don’t feel miraculous. After seeing the work that the nurses and techs do, however, I do feel an urge to be a part of that profession and to do something that has some substance. Maybe this whole thing is pushing me to that end. Hopefully I’ll soon be spending more time in the hospital as an employee instead of a patient and providing the same care to other patients that was provided to me.