My Stroke Story Chapter 2

1:46PM Lydia calmly called Lynne and told her the only thing she knew, that I was likely experiencing vertigo and leaving for the hospital in an ambulance. Abigail was just heading onto the court to play indoor “field” hockey; Lynne called her back and they headed back home. Once home, Lynne squared things away and was back out the door on her way to the hospital.

At 2:25 I arrived in the emergency room.

At 2:45 Nurse's note: Patient not answering simple questions appropriately, patient will not open eyes

At 2:51 Doctors note: Although I think of myself as cooperative generally, he wrote in BOLD “Review of Symptoms is limited due to difficulty with cooperation.” Sorry Doc. He goes on to say “The patient is awake, and is able to follow commands, and answer simple questions. he requires a lot of encouragement to answer questions, however. His speech pattern is normal, and there is no aphasia (speech problem)."

He goes on, “Upon arrival, the patient’s symptoms were most suggestive of vertigo, and he did not have objective findings that were suggestive of an acute CVA [stroke], and therefore stroke code was not called. Due to the severity of the symptoms however an MRI was ordered…"

You must know how strokes are dealt with in the ER. When a person has an ischemic stroke as I did, they have a significant chance for a complete or nearly complete recovery when the “miracle drug” TPA is administered soon after the stroke occurs. Soon means preferably within 1.5 hours and certainly within 3 hours. The time can be extended to 4.5 hours under extreme circumstances. Beyond this time the patient will suffer whatever brain damage the clot causes. Therefore, when a possible stroke patient shows up at the ER, they are FAST tracked through the CT scan to determine if a stroke has occurred and what kind. If they are a candidate for TPA, it is given as soon as possible.

The problem was that my stroke did not fit the normal profile.  Consistently, doctors and nurses that reviewed my case agreed on that point.

At the same time I had my stroke, an apparent gang shooting occurred in the Newtown area of Annapolis, a historically troubling area. The victim was brought to the same ER, and because of the possible gang connection, the whole hospital was put on lockdown. When this occurred Lynne was with me already. Margie and Don Nicholson were at the hospital, but were ushered to a separate safe area. The pastor was in the ER waiting area, about to go through the door to where I was, when the lockdown occurred. He had to return to the waiting area. Moments later, my mother arrived at the hospital to find it crawling with police, and could not come back to me either. Graciously, the pastor was there with her. About 45 minutes later, the lockdown ceased and everyone was able to join me.

At 3:21 Lynne was with me and they were preparing to do an MRI. I was still not responding to questions when asked. Lynne did her best to convince them I was not a drug addict, or drunk, or anything of the sort. "Really, he is an intelligent man!” It was now 1 hour and 36 min since the stroke.

At 4:16 I was still confused and not answering questions. The MRI was still pending. It was now 2 hours and 30 minutes since the stroke.

At 4:24 I was trying to get out of bed so they drugged me with Ativan.

A little later we were off to the MRI

At 5:15 I was in the MRI and I vomited everywhere. Sorry everyone. Really. I got some phenergan for nausea.Whenever they tried to conduct the MRI I would start moving in rhythm with the clacking of the MRI machine. That did not work. The poor radiation technician kept asking me to stay still. Lynne tried to get me to stay still. Somehow the technician was able to get a partial scan and confirmed there was an acute CVA.  It was now 3 hours 29 minutes since the stroke.

Some time after the doctor told Lynne it was too late for the TPA... 

At 5:55 The doctor changes course and tells Lynne, we have 20 minutes left to administer the TPA. A flurry of activity commenced. They were testing me from all directions while they tried to get the drugs out of the pharmacy.  Because TPA can also be a very dangerous, there is an extensive check list that must be completed and the procedure must be followed exactly... and usually they have more time. It is now 4 hours 9 minutes since the stroke.

At 6:10 with about 5 minutes to spare, I get the drugs that save my life. It is now 4 hours 25 minutes since the stroke.

At 6:30 I was resting, calm and cooperative. At this point I am a prisoner in my bed. TPA essentially removes the bodies complete ability to clot. That means a cut or bruise could be disastrous. For 24 hours at least, I am stuck.

At 6:54 I am still a tired puppy and I can’t remember my wife’s name yet.

Around 10:00 I become aware for the first time. I can see just a circle in front of me, as if I was looking through a small portal. Outside the circle its all blurry and sparkly. Inside the circle I can make out faces, though I can’t perceive anyone’s emotional state. My stomach is a little off, and I have a headache. I seem my mom, the pastor, and my wife. Later my brother is there. Then my sister and brother-in-law. I am not much for company, and I think I fall asleep a lot. 

Now I meet Ann the nurse. She has the distinct pleasure of waking me up every hour to administer neurological tests:

• Hold out your arms
• Stick out your tongue
• Smile
• Who is the president?
• Where are you?
• What year is it?
• And so on, and so on, and so on. Painful.

But Ann is a beautiful person. She is gentle and healing. She teaches me that my best friend is my nurse. She drills this in to me, and I believe her, and she is right.

Finally it is after midnight, and the beautiful people that came to visit head home. My beautiful wife sleeps vigil in a very uncomfortable hospital chair. She won’t leave me. My vision is still not great, but I can barely look over and see her there throughout the night, every hour when I play neurological jeopardy again. Tonight the hospital bed is very comfortable and I sleep like a baby.

With thanks to my family and the many healthcare professionals that persisted to find out what was wrong with me and provided the healing drugs to save my life and prevent disability. With thanks to God for helping them make the diagnosis just in the nick of time.