Monday, July 15, 2013

Stroke happens

I’m positive there’s no convenient time for a stroke, no perfect moment for this thing that will so completely alter every aspect of life as you know it. My sister-in-law says we’ve gone down the rabbit hole. I barely remember Disney’s Alice in Wonderland that I saw as a kid 50+ years ago, but I’m sure it’s an apt description of this journey into the unknown. It’s been almost two months since the stroke, two months of nothing else but the stroke, and today it occurred to me that I could write about the experience on my blog. I’m thinking that may indicate that I’ve turned a corner of some kind.

Pardon me, but ‘stroke happens’ sounds like ‘shit happens’, doesn’t it? Bad stuff, unforeseeable stuff, monkey wrench kind of stuff. Stroke is a whole genre of sub-categories of life’s monkey wrenches. And the hits just keep on coming - the unexpected blows of life. And since I believe that all things have a purpose, I think I can help make the unforeseeable aspect of stroke a little less so for someone out there who is now grasping desperately for answers by sharing what has happened and some of our responses along the way – from a safe distance, safe for you and safe for me. 

Tom’s stroke happened at 5:30 on Saturday evening, May 18, 2013, as we were waiting for son and daughter-in-law to arrive to go out to dinner at Carrabbas. He fell forward out of the chair in our bedroom, hitting his head against the night stand. I was in the living room, heard a loud bang and saw him on the floor. I asked him what happened. He said he fell asleep which sounded reasonable since he could fall asleep at the drop of a hat. What was unusual was that he wasn’t getting up, and then I noticed his left arm tucked under him in an odd way. He was slumped over on the the floor, kind of in a lump. When I urged him to push himself up with his left hand, he didn’t do it and said he had. I was unable to lift him at all, being that he’s 6 feet tall and weighed 225 pounds at the time. So I got behind him and let him lean back against my legs. That’s when I saw that his left leg was stiffly straight and wasn’t moving, and that’s when I knew what it was. Dear son and DIL arrived just then and got him onto the bed. His speech was garbled. I said, “It’s a stroke” and called 911. The EMTs were there in less than five minutes.

The ER doctor and nurse were very good and considerate. The CT scan revealed that his stroke was the bleeding kind not the clotting kind (I remember my head reeled sideways like rolling eyes), so he wasn’t a candidate for the drug that lessens the stroke’s effects by thinning the blood and breaking up clots. In Tom’s bleeding situation that drug would have killed him. The other danger, added to this bleed in the basal ganglia part of the brain, was his very high blood pressure -- 199 over 140-something – which they needed to bring down quickly. They gave him two drugs one after the other to lower the BP. When they didn’t work, they gave him Nipride titration. Suddenly, Tom started fidgeting kind of wildly and looked like he was in distress. That’s when I noticed the low BP – 74/40. The titration had dropped it like a rock in seconds, his heart rate dropped into the 30’s, and he went very pale. They gave him another drug to counter the Nipride to raise his heart rate and BP, and it worked – too well. The BP shot up again, this time to 221 over something. It was a nerve-wracking time, watching the doctor and nurse deal with this volatile situation. The ER doc thought possibly his brain was herniating which isn’t a good thing and has dire consequences, but Tom was talking and the doc said that doesn’t usually happen while the brain is herniating. They rushed him to another CT scan at about 9:15. It showed that the brain was not herniating and the bleed was a little bit bigger than at first. The doc explained that the basal ganglia controls vital functions, and probably the things that are supposed to be automatic (breathing, heart beat, blood pressure, etc.) were all confused by the stroke.
 
In a short time a bed opened up in the Neurology ICU where they put him on a very low Nipride drip. About 30 minutes later he was settled in his room, and his BP was 131/75. Heart rate was good. The ER doc said the blood would reabsorb and the nerves in that area would heal. The crucial thing was getting the BP down. He would have another CT at 6AM to check for changes.

20130522_093159
I was so exhilarated by Tom's bright face five days after the stroke and thought the worst was behind us, but many days would go by without seeing his smile.
That was two months ago, and the rabbit hole goes on and on. In the vague notion that started this blog I figured I’d chronologically tell it from the beginning, but today’s news (some of it, anyway) is demanding to be told. And of course, ‘today’ began nine days ago when Tom presented with a fever and very low blood pressure and the rehab center’s nurse called an ambulance for transport back to the hospital. It turned out to be a urinary tract infection where the bacteria is an antibiotic-resistant one. Oh, that rabbit hole! He went into the ICU where blue gowns and gloves were required. To give you a sneak peak, two atrial fibrillation episodes have occurred (oh, joy!), and my darling is as weak as a kitten from the infection which has stolen the one thing left in tact, his strength. He is plagued with diarrhea and tethered by a feeding tube to a dangling bottle of goo, er, nutrition. His mind is fine. He can speak. His left side was the effected one, including the left side of his throat which prevents him from knowing when food or liquid is going down his airway. The list of the stroke’s consequences goes on and on

It truly will take a whole blog to tell everything that has slammed him and me as well as our responses, which I plan to do, but today followed a night of two hours sleep on the most uncomfortable fold-out bed I have ever tried in his room on the cardiology floor, and I must share my feelings. They are desperately fearful and sad. Emotions and possibilities that I don’t want to confront are standing over me like a robber with a gun. My prayers are hollow, empty murmurings devoid of the comfort of the earlier days. Telling them all would be a good catharsis, I think. Perhaps my wishful thinking imagines that bringing them to light will make them go away or even that God will notice and will rescue us from this nightmare. That sounds like something a non-believer would say, not someone who believes strongly and loves the Lord Jesus Christ as her Lord, Savior and Friend. Through all this, pat answers have flown out the window. Even “this too shall pass” holds no consolation, and reading the Psalms has at least for the moment lost its comfort and joy for me. I feel alone and frail, doing battle against a mighty, gruesome foe – no, about to be consumed by that horrible foe. Hmmm, I didn’t really intend to go into that much negative detail, because Tom has asked me to read this to him. So I won’t include the specifics of my blackest thoughts. Hopefully, if I keep them locked in my head, they won’t escape and terrorize anyone else, especially Tom. And why should I give my enemy a foothold, anyway.

Tom collage
The face that makes my knees go weak, my heart do flip flops, and my lips pucker.
So now you have the beginning of our story and the currently happening part of it, too. I will try to use that format… a little beginning with a little current news. So much has transpired in between, and I will do my best to say it accurately in a way that will be most digestible. Please know that it may be more than some want to deal with, and I totally understand that. Been there, done that. However, if even one person can find affirmation and feel comforted and encouraged by my words, then I will be happy with a readership of one. As comforting and loving as friends and family are, I think that reading the words of someone who is in the same fire as I am would be like holding onto a strong hand in the storm, maybe even like being embraced and held tight by strong arms in the storm. So even as the storm still rages and the days radically alternate between bad and good – even from hour to hour, I will be here telling the story of one stroke. Try not to judge me too harshly for my weak moments or praise me too highly for my brave ones. It’s not as though I ever had an alternative to standing by my best friend and love of my life. (And Tom just added..."even when I gave up.")

No choice at all.

T&S.1990
Back in the day...circa 1990.