My 62-year-old husband had a stroke Saturday afternoon. We were about to go to the movies, but he wanted to take a nap first, feeling a little off from battling a cold all week – he thought. He took a 500 mg aspirin for a headache, then laid down. I was in my office across the hall, working on a construction proposal he had given to me, when he called out my name.
He was leaning over the end of the bed and I thought his back had gone out on him again, but he said he did not know what was going on and thought he should go to the hospital. I got him back onto the bed and called 9-1-1, when he whispered that he thought it might be a stroke. He mentioned driving to the hospital and I instantly vetoed that stupid idea. Whatever it was, I wanted EMT there to check his vitals ASAP. It was 2:20 p.m. I put an 81 mg aspirin under his tongue, not knowing he had taken a bigger dose earlier, and called my daughter. She and the ambulance arrived at the same time ten minutes later. Danny had deteriorated: he could not see out of his left eye, could not speak properly, and could not move his left arm or leg. He was also white as a sheet. There were four EMTs in the bedroom assessing him, calling the hospital, strapping on an oxygen mask, and strapping him to the gurney. His blood pressure was 188/113. He could hear their questions, but all he was able to do was smile evenly and stick out his tongue and move it from side to side.
Christus Santa Rosa Hospital in New Braunfels does not have a neurologist, so he was taken to the nearest hospital with one, Northeast Methodist Hospital on Toepperwein Rd. in San Antonio. My daughter drove and we left ahead of the ambulance. Halfway there, the ambulance passed us and made it through the usual southbound congestion between Schertz and 1604. We were at Northeast Methodist by 3:00 p.m., only a few minutes after the ambulance. Since the EMT had called ahead, the ER was ready for him, transferred him off the gurney onto an ER bed and began his workup. They would not let me go back yet and only asked for his SSN, insurance, and if he had a “Do Not Resuscitate” wish. I shakily answered but did not fill out any paperwork. By 3:40, I could not wait any longer to see him, and they let me go back to the ER trauma room. He had had both a CT scan and an MRI by this time.
He was less pale, but that was the only improvement. His glasses were off and his eyes were closed against the bright overhead light. Both forearms had been IV-readied and he was hooked up all over the place to monitors. He was wearing a gown, but was lying on his shirt. He still had on his warmups and socks. I touched his right hand and his eyes fluttered open. He mumbled and closed his eyes again. I leaned in to hear what he was trying to say and could only recognize “‘fraid.” His breath smelled of vomit, which had occurred in the ambulance. I squeezed his right hand, let him rest, and asked the busy-as-a-squirrel, male nurse what was going on.
The MRI, but not the CT, showed that Danny had indeed had an ischemic stroke (caused by blood clot or plaque blocking blood vessel) in the right, posterior cerebellum, which controls the left side of the body. Oddly, when the EMT and the neurologist, Dr. Grote, asked Danny to smile, he could evenly raise both sides of his mouth and move his tongue from side to side, but that was the only part of the stroke test he passed/failed(?). His left lower eyelid drooped; his left arm and leg were paralyzed.
After explaining the blood-thinning treatment they were going to give him, its 45% risk of causing hemorrhaging, and a small chance of full recovery if he did not have it, Danny illegibly signed a release form before I got in there. When it was explained to me. I signed another release and quickly went out to the waiting room to tell my daughter and grandchildren what was going on, before returning to Danny. At 4:00 p.m., an 8 mg bolus of blood thinners (Activase and Alteplase) was injected quickly, followed by a one-hour IV drip of 100 mg of the same blood thinners. By 4:20 Danny was speaking more clearly, though still slowly, telling me he hated what was happening because he needed to get to work. By 4:30 he could move his left fingers and toes. By 4:45 he could raise his left arm and leg. He began telling me what it had been like: there was no pain; his brain was telling his body what to do and say, but his body was not able to respond. At 5:00 p.m. the drip was finished, and he could squeeze Dr. Grote’s and the nurse’s fingers and push his feet, legs, hands, and arms against their hands with renewed strength. The nurse and the neurologist were amazed by Danny’s quick recovery.
With a big smile and lighter step, I returned to the waiting room, where two of my sisters and my nephew had joined Merideth and the grandkids. After telling everyone the news, my daughter went back to see Danny, while I called Danny’s brother in southern California to tell him how well Danny was doing. He would pass the word along among their other siblings. When Merideth came out, I went back to Danny. He had thrown up while she was in there, but she didn’t mention it. The shirt he had worn had been tossed onto the floor away from the bed while I was gone. I picked it up and found that it had been cut or ripped off of him and was adorned with vomit. I dropped it in the trash can. Danny and I talked a bit around the nurse’s and neurologist’s ministrations. We were told that he would be transferred to the main Methodist Hospital in San Antonio’s Medical Center, because Northeast was without a neurologist and stroke monitoring at night.
At 5:30, he wanted to rest, rolled over onto his side, which he had been incapable of doing an hour earlier, and went to sleep. I went back out to the waiting room for a half hour and gave my family more details of all that had occurred up to that point. At 6:00 p.m., they began to scatter for dinner. My two grandsons had been picked up to spend the night at a friend’s, so Merideth said she and 11-year-old Lizzie would see me at the other hospital later. I hugged everyone goodbye and returned to Danny.
At 6:40 the Metro EMTs arrived for the transfer. They were surprised when Danny quickly sat up and helped set himself onto the narrow gurney. At 7:00, I rode in the ambulance to the huge Methodist Hospital on Floyd Curl Drive. Danny’s gurney was removed from the Metro Ambulance and taken directly up to his 7th floor ICU room. His assigned ICU nurse turned me away so they could settle him in and I did not get a chance to thank the two EMTs.
A few minutes later, I was brought back to Danny. He had been regowned, re-IVed, and sponge-bathed. He was sockless and naked under the gown, because he had to remain in the bed until 5:00 p.m. Sunday. With the side effect of the ER treatment being a chance of internal bleeding in his brain or hemorrhaging from a bump or scrape, they did not want him walking around and accidently falling or hitting anything. Also, they would not take any blood for testing until after the 24-hour period as well. My darlin’ was restored safe and sound, so I did not spend the night at the hospital. However, I didn’t sleep much anyway. I kept looking over at his side of the bed and thinking, “He’s not visiting his daughter in California. He’s in the hospital.”
The next morning, I brought his coffee, cell phone, toothbrush, electric razor, change of clothes, and two books. The new neurologist, Dr. Neeley, came in and told us that the stroke had been caused by a blood clot, but its origin could not be determined. Also, his basilar artery had some atherosclerosis, but his carotids were clear. After asking Danny some questions and putting him through another round of stroke tests, he informed us that to prevent another stroke Danny would have to change his diet drastically and walk everyday for at least 35-40 minutes. Plus, he would be put on high blood pressure and high cholesterold medications and have to take an 81 mg coated aspirin everyday for the rest of his life. Should another stroke occur he was to immediately chew a non-coated aspirin. No problemo, we assured him. We were also told that with Danny’s lack of symptoms he would probably be discharged the next day.
At 2:00 p.m. he had another CT scan, which did not show any brain damage. At 5:00 p.m., the oxygen tube was removed and the standard potassium-chloride drip was unhooked. Danny got out of bed and walked up and down the hall without weakness or dizziness of any kind. At some point that night, he would be moved out of ICU to a neurology room on the 9th floor. With a kiss and a hug I left at 7:00. He would be fasting until they drew his blood the next morning. At 10:30, he called to tell me what room he would be moving to and to say goodnight. I slept a little better.
By the time I arrived yesterday morning with his coffee, his blood had already been drawn. He was about to eat his breakfast. None of his meals seem to have any restrictions other than low-fat milk for the cereal. Danny said that last night his blood sugar was 205, so he was given an insulin shot before being moved. He said the pin prick hurt worse than the shot.
A physical therapist came by to assess Danny and any need he would have for rehabilitation. When he took off walking down the hall faster than her, rehab became a non-issue.
At 2:00 p.m., one of the two in-hospital doctors, Dr. Obinna Ozigbo, came by to give us the low-down on the blood tests, new diet, and discharge instructions. The blood tests showed LDL of 140 (should be under 100), HDL of 29 (should be more than 40), and A1c of 7.5 (should be 6.5 or less). His triglycerides were over 200 and should be under 150. His fasting blood sugar was 139 (should be under 126). The potential diabetes can be controlled through diet and exercise for the time being, but Danny will have to test his blood sugar before meals and at bedtime everyday for four weeks, at which time he would be reevaluated by the neurologist, Dr. Neeley.
Danny’s new dietary regimen: no butter, low sodium, no sugars, no concentrated fruit juices or jellies, no fat, no sodas; only fresh or frozen vegetables/fruits, fish, chicken, turkey, lean beef, lean pork, wheat bread, thin-crust pizza; and fat-free everything from coffee creamer to cheeses. To Danny, the worst will be cutting out popcorn and candy at the movies, sweetened jalapenos on Triskets with cream cheese, ice cream with chocolate syrup, Domino’s hand-tossed extravaganza, cakes, cookies, pies, pastries, McDonald’s egg/sausage/cheese McMuffin, and candy at bedtime.
We left the hospital at 6:00 p.m. yesterday, armed with dietary information, stroke information, and prescriptions for lisinopril (high blood pressure), pravastatin (high cholesterol), and diabetes testing materials. We already had the 81 mg coated-aspirin, as well as omeprazole for acid reflux.
Sooooo…Time is of the essence with stroke! There is no pain. Your brain cannot make your body do things. At the first sign of not seeing clearly (Danny only saw half of me), dizziness, weakness in limbs, and/or slurred speech, call 9-1-1 and chew uncoated aspirin. Get to the hospital within 1 hour of onset. Treatment must be administered within three hours of first stroke symptoms. Danny is living proof! Don’t lollygag around!
If EMT is far away, call your nearest neighbor and have them drive to nearest neurology hospital with 9-1-1 on phone all the way. Advice: After reading this, check out the nearest hosopital with neurologist available and put the info in your wallet and glove compartment, in case this happens while you’re not at home.
BTW: 80% of strokes are ischemic; the others are caused by hemorrhaging in the brain.