I
wanted to type up some of my stroke experiences before I started having
Brian William's issues in remembering the details. Please bear with any typos, spelling,
grammatical errors, etc as I began writing this account just days after the
stroke hit. Here is what has happened
over the last two weeks.
So
what happened? On Super Bowl Sunday Mae and I had come down with a
horrible stomach bug. During one of the times when I was getting sick, I felt a
searing pain in my head above my left eye. When I was washing my hands I
noticed that my left eye had burst blood vessels in the corner by my nose. I
also had a headache right above my left eye that did not go away over the next
few days. I used extra strength Tylenol to try and deal with the pain, which
worked ok, but never really knocked out the headaches. I even rubbed IcyHot over
my eye, which really helped although the smell wasn’t the best, but the pain
persisted. What I did not know at the
time was that this was the beginning of what would end up sending me to the
hospital with an embolic stroke affecting the right side of my body.
I
still felt crappy on Monday so I stayed home from work. On Tuesday, I left work after
lunch still feeling bad with the headache. At home I went straight to bed and was out for the
night. When I woke up Wednesday morning I felt great. I went to work and every
thing was going well. However, as the afternoon wore on I started to feel the
pain again. When I got home Leigh Ann and I made dinner for the kids, turkey
tacos, a crowd favorite at our house. After dinner the boys and Alden went upstairs
to start getting ready for bed while Leigh Ann and Mae were working on a
homework project in our dining/computer room.
Meanwhile I was cleaning the kitchen.
While
cleaning the kitchen I got a rare call from Tom Gladden on our house phone (he
always calls on the cell). It was a cool call because he had an
opportunity to go up to signing day in Athens with his brother-in-law who is a professor
at Georgia and meet Coach Richt (yes I asked Tom if he asked Coach Richt what
the heck he was thinking pooching against GT). I was speaking to Tom and
cleaning a pan when it happened.
I
hate using the word surreal. It just it is so overused, kind of like how the
word synergy was used in business about 10 years ago. However in this
situation, it really does describe what happened. I mumbled an excuse to
Tom that I had to go, saying something along the lines of I needed to take care
of Hugh. I knew something had happened but was not sure if I was
fainting, having a seizure, or what. Everything seemed to move in slow motion.
In my head I could see and know what I wanted my body to do and/say but
couldn't make it work. It was definitely scary but also really frustrating. I have never experienced a more bizarre
feeling then losing control over my mind's ability to control my body and I
hope I never have to again.
Since
I did not know what had happened and knowing that I needed to sit down and not
freak the kids by collapsing on the kitchen floor, which is what I really
wanted to do, I headed/stumbled to the front hall and sat down on the bottom of
the stairs. At this point, I knew I couldn't stand up and also couldn't
speak. Gardner and Hugh came down the stairs with some PJ's they picked out.
Gardner was happy but Hugh was crying a bit. I think they thought I was
messing with them as I just kept sitting on the stairs and not really saying
anything to them rather than helping them get ready for bed. Leigh Ann
yelled to me to see what was going on with the kids. Our trash pick up is on
Wednesday and when I did not answer she assumed I was outside rolling in the
can. Getting four kids ready for bed can be challenging to say the least and
with me sitting in a daze on the steps, it became pretty obvious to Leigh Ann
that nothing was being done towards getting the kids in bed. So once again Leigh Ann yelled for me to see
what I was doing. At this point Gardner had walked to where Mae and Leigh Ann
were working on the computer and told Leigh Ann I was sitting on the bottom
step in the front hall. At this point Leigh Ann, predictably, freaked out. While Gardner had gone to tell her where I was, I
pulled myself up and stumbled through the kitchen into the dining room meeting her as she came to check on me. As soon as I got in there I slumped on to a
cushioned bench and Leigh Ann grabbed the phone and dialed 911. At this point the only thing I could say was that I was ok. I really was thinking that I was ok and was looking to get out of going to the hospital.
The
next 30 minutes were blurry and chaotic. I somehow got myself up again
and made it to the living room and sat down. I was still in the mindset that
this was just some weird sort of neurological episode. CMFD and Medic
arrived soon after Leigh Ann called. I must have been acting fairly normal
because the paramedics could not figure out who was hurt and we're giving Leigh
Ann a hard time. The kids were running around but we got them all on the
couch and quiet so the medics could start to question me after Leigh Ann
confirmed that something was wrong with me. They asked what I had for
breakfast, lunch, and dinner. Here is where the frustration kicked in. In my head I could clearly remember making
and eating eggs with the boys in the morning but all I could get out was
"I don't know." Heck, I had just helped prepare, eat, and
clean up dinner and I knew we had had turkey tacos but still said that I didn't
know, because I could not get the words out.
At
this point I saw the fear in Leigh Ann's eyes. I started to realize that this
was something more then just a spell. The medics began to ask more basic
questions and I was reminded of one of my favorite movies "My Cousin
Vinny." During one scene, Vinny, played by Joe Pesci, is proving
that an elderly lady could not have witnessed the robbery because she needs new
glasses. As he stood at the back of the courtroom he held up two fingers
and asked is she could read them. Before she could answer the Judge, played by
Fred Gwynne (aka Herman Munster), told the reporter to let the record show he was
holding up two fingers and thus gave the answer to the witness. I am sure you
remember the rest of that scene. When the medic asked me what day it was Alden
promptly spit out… “Wednesday,” then had the exact same awkward expression the
Judge had when she realized her mistake. Good thing for Alden because I
had no clue what day it was. For that matter, I had no idea what my age
was, birthdate, current month, year, nothing. The medics didn’t waste anymore
time and put me on the stretcher and into the ambulance.
I
would be remiss at this point not to mention our amazing family,
neighbors, and friends. That first night when Leigh Ann and I left in the
ambulance our neighbors jumped to get our kids ready for bed and make sure that
we were all set at home. From that point to where we are today, they have all
taken turns on watching the kids, washing clothes, cooking meals, visiting, and
being a huge support network for us. Without the dedication all of
this fantastic group of people I really don't know how we would have
managed.
Growing
up, I think any kid is excited to see an ambulance or fire truck go by.
Although it sounds kind of silly, I did enjoy riding in the ambulance with the
sirens going and, according to our neighbors, our kids ran upstairs to
play with Gardner's new toy ambulance he got for his birthday right after we
departed so whether or not brain damaged, I still was thinking like a kid which
is something I never want to grow out of! Anyway, the medics kept a close eye
on me and continued testing me to see what was going in my brain as we went to
the hospital. They put oxygen on me and
started an IV and got me to the hospital (Presbyterian Main) as quickly as they
could. As soon as we got there I was rushed into the emergency room. I did
not realize that Leigh Ann rode in the ambulance with me and was there with me
as the doctors began to try and to figure out what was going on with me.
During
the late 80’s and early 90's, Emory University was conducting clinical trials
using a drug called tissue plasminogen activator or TPA. TPA had been used
for years to break up blood clots found in the heart. The goal of the clinical
trials was to show that TPA could be used to also break up blood clots in the arteries
in the brain caused by stroke. Interestingly, working on these clinical trials
was my mother and a team of Emory neurologists. Oh what a small world we live
in as these trials proved to be a huge benefit in stroke patients. TPA, if administered
within the first 3 to 4 hours of the initial onset of stroke symptoms, is now
the gold standard in treating patients suffering from stroke. Therefore, when I was admitted to the
emergency room the doctors immediately made the determination to give me TPA.
As it had a been about an hour since the stroke symptoms hit me until the
TPA was administered, it worked just as it was supposed to and broke up the
clot in my brain. The next issue is how did a clot end up in my brain in
the first place.
I am
in fairly good shape for a 43-year-old guy. I try and run and/or work out
regularly. With four young children and worrying about all of the steak I had
eaten throughout my life, I had a cardiovascular exam two years ago which
included a stress test and a carotid artery ultrasound. The carotid ultrasound
gives a good idea if a person has a build up of plaque in the arteries
throughout the body as the carotid arteries show plaque buildup really well.
Both of these tests came back with great results which raised some questions as
a stroke of this kind is usually due to issues with bad arteries due to the
similar types of things that could lead to a heart attack.
After
multiple CT, CT-A, and MRI scans the source of the clot was found to be a
dissection of the left internal carotid artery.
This issue is usually related to some sort of trauma to the neck, in my
case I literally threw up so hard that I tore the inside of my artery wall. Artery walls are made up of three layers of
tissue. A dissection is essentially a tear in the artery wall that
allows blood to leak into these layers causing a bulge. Picture plywood getting
wet to have a better understanding. This bulge caused two issues. First,
it threw the clot that caused the stroke. Second, it restricted the blood flow
to my brain. After the TPA broke up the clot, the major issue was to address
the dissection.
I
was moved from the ER to the Neurological Intensive Care Unit on Wednesday
evening. What began was a very trying next few days. In order to keep
blood flowing to my brain I was given levophed, a blood pressure medicine,
which raised my pressure up to around 180/100. In addition, I was given plavix
and aspirin to stop any further clotting at the point of the dissection. The
biggest problem for me was the increased blood pressure plus the damage to my
brain was causing massive headaches. The headaches were addressed with various
different intravenous and oral pain medications. The problem with the pain meds
is that they counteracted the levophed so a push and pull situation developed.
Eventually the headaches got better and the focus became about my brain working
correctly as the levophed was reduced.
In order to
test whether or not I was making any progress I was put through various
physical and mental exams. The tests
used to evaluate me were the NIH’s stroke scales. The physical tests did not bother me too much
as I felt I would get back my feeling and movement on my right side (left brain
damage equals right side issues). That
stated, there were some pretty wild situations where I could not feel the
nurses pinching my leg or arm. I also had
tests where I put my arms or legs in the air with my eyes closed that were
pretty hilarious. I thought they were up
in the air when they were lying on the bed.
The physical tests really were ok as I had control of my body within a
day or two after being admitted.
The mental
tests were an entirely different experience.
These exams were trying as they really evidenced to me that a part of my
brain had actually died. For example, I would
be shown a picture of a strange kitchen scene (see attached) and be asked to
describe what was happening. I could get
some of the items correct but other things I could not verbalize. For example, I could not say the word stool if
my life depended on it. I could say
chair, but no matter how hard I tried I could not get the word stool out. I have attached all of the other test
pictures, phrases, and words on the next few pages. Among them I could not say feather,
huckleberry, baseball player, cactus, and the phrase “Near the table in the
dining room.” I even tried to cheat and
look up desert plants as I could remember that a cactus is found in a desert
and if I could just read the word cactus next to a picture I would have
it. Even going to that extent I still
could not get the words out. Eventually
these tests became easier as my brain adapted the changes in blood pressure
flow and worked around the portions that were damage by the stroke.
The
patience eventually paid off. I was
discharged from the hospital with strict instructions to take things easy (once
again, like patience, not something that will come naturally to me). The dissection will take from three to six
months to completely heal, think of a bad bruise taking forever to finally fade
away. I am currently on Plavix and a
baby aspirin to keep any clotting from occurring. I still have times where I
lose feeling in my right arm but I am confident this too will pass. I am very happy to be home with my family and
of course to finally be able to take a shower!
Keep in mind that this incident was a freak accident. Really, how many of you have heard of a
stroke due to a throwing up from a really harsh stomach bug? With that stated, it is great to have the
medical professionals that knew exactly how to address this situation and work
towards a positive outcome. Thanks to
all for support, prayers, thoughts, etc, over the last week and a half. I have always cherished time with my family
and friends; I will do so even more now.
There is still a long way to go but the scariest part is over.




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