Paul, The Physical Therapist

Paul would come to my room every morning....Monday through Friday....at 10:00.  At first, he would barge into my room, and would say "are you ready to go?"  Probably by Friday....I'd be in the hallway waiting for him....and probably a week and 'change' later....I would 'wheel' myself down to the rehab room.

Side note: I spent the next four months in a wheelchair....and I never....EVER....thought I would have to be in a wheelchair for the rest of my life!

Paul....my Paul....was tough!  When he would 'wheel' me around....he was out of control!  In the rehab room there were all kinds of stuff he did for me....but really....he wanted me to try to do it for myself.

He had to flip me over on my stomach....and then wanted me to flip back!  That's easy right?  I just have to push my left hand/arm....and my left foot/leg....and roll over.  I 'could' do it....except my right arm, and my right leg, wouldn't let me do it!  It hurt....really bad!  For the next couple of weeks that's all I did....that and Paul would stretch my leg out....over his shoulder....and my knee into to my face! 

When the morning ended....he said "I'll see you in the afternoon"....I was thinking....great....just great!

Speech therapy....with a Speech Therapist

After I got by the first couple of days....more crying than trying....it did get better!  On this particular day just made me crumble! 
 I 'thought' that I saw this -    in my mind....a Rorschach test
and there was actually this - just a regular butterfly....no kidding!  And I couldn't even begin to say what it was.

She would show me a picture of a pencil....asking me to identify what it is.  Mmmmm....I know I can scribble it around on some....what do you call it....p....p....pa....per....yeah....paper!

She showed me a bench....outside in a park....and 'I' said....it's made of wood....and you can set on it.  She said "what do you call it?"....well....I don't know!

She wanted me to 'write' down on paper....with my left-hand.  I NEVER EVER even tried to use my left-hand!  Why would I want to?  Like I'm ever going to have to use my left-hand?!?!  Guess again!

The Therapist....Sean Connery joke on SNL

After leaving the N-ICU and the cardiovascular floor ....I met with three different therapist....two times a day....five days a week!  On Saturday and Sunday I met once a day....with the physical and occupational therapist'....and started all over again on Monday!

Paul (Physical Therapist), Julie (Occupational Therapist) and Rebecca (Speech Therapist).  I had an idea why I had to go to a physical and occupational therapist'....but what about speech....why would I have to go there?  Well, I found out, the first time when I met Rebecca!

The first day I 'sat' down with Rebecca....I started to cry.  She ask me to describe what happened that got me there.  I tried....but I couldn't.  And I cried!  It got better....a whole lot better....but as they say "pride goeth before the fall"!

Paul was a typical physical therapist....all business....no pity....and that was all good!  No tears in there....work!  He literally beat my body!  I probably didn't adequately describe what happened 'that night'.  When the left-side of my brain froze-up....the right-side of my body said 'bye-bye'!  And I didn't understand at the beginning....that they said it takes time to recover....well, it goes on to this day!

Julie was NOT the typical occupational therapist.  She was 22 years old back then....a very nice young lady.  She gave me a shower....every morning....after breakfast.  I didn't look forward to the shower....or exposing my nakedness!  And after I was able to convince her that she didn't have to give me a shower....or watch me clean myself....my nakedness was still there!  A side note here....she did see my nakedness every morning....however....I ALWAYS had my wife 'excuse' herself from my room when I had to get dressed.  No 'my' nakedness for my wife!

Where Should I Begin (Tammy)

Without all the prayers of our family and friends the night of November 10th, 2010 and the weeks, months and years that follow, would have been much harder. 

The night of the stroke Steve was air lifted to St Mary's Hospital (Mayo) in Rochester while my dear friend Sherri drove me there. Steve was already in having the procedure to try to remove the blood clot from his brain when we arrived. For the first few days he wasn't really aware of anything that was going on, he was able to see us but he couldn't follow what we were saying. Within a couple days he seemed to know who was there, but doesn't have any memory of it. 

When he was asked who I was he pointed to his ring finger but didn't know my name.  When the kids came in he got teary but couldn't say who they were, however when we would say this is Landon or Shelby he would nod in acknowledgement. 

He could verbally spell his name and other things before he could actually say any words.....the brain is an amazing organ. Steve said some 'very interesting things' that he doesn't believe he said....things I won't write but were very humorous (if you ever want to know just send me a private email message..lol).  Lets just say it made us wonder about him!  

After about a week in neurointensive care he was moved to the Cardiovascular  floor where he stayed until he went to the Brain Rehabilitation program (4th floor at St Mary's).  

He was at the hospital until the end of December and then he came home.

First Things First

The first week after my stroke....there was very little that I could remember.  The previous post....I could remember....but nothing else!

For the first 168 hours after my stroke....my wife will have 'her say' and probably....I would disagree....but what would I know?

I may have to 'clean it up' a little....because I really can't believe I said anything that my lovely wife said I said! 

The next post will come from my wife.  She said that our daughter was there (at the hospital in Rochester), a very close friend of hers (and me), her parents, and others!  I couldn't say!  My son and daughter in law come in from Los Angeles....I vaguely remember when they went back to L.A....and the hospital moved me out of the ICU. 

From my point of view....what was happening in my brain?

Rochester Minnesota....that's good I guess!

There are only 'bits and pieces' that I can remember the first week after the stroke.  An Ischemic Stroke....I'll get to that later!

After passing out on our kitchen floor....I woke up at the hospital in LaCrosse Wisconsin.  They were wheeling me down to a radiation room....transferred me from a gurney onto a table....and the radiation therapist ask me if I could lift my right arm up.  I could hear her....and I looked at her, stared at my right arm, looked back at her....and passed out again!

The doctor said that there was only a 50/50 chance if....IF....they put a bullet in my brain.  Well how about that?  They did put the bullet in my brain....and put me on a helicopter....ETD....my life!

Rochester Minnesota....here I come!  Mayo Clinic....the finest group of doctors, nurses and therapist in the world....IN THE WORLD....the very best....but what did I know?

What's up with that?

November 10th, 2010 - Drove home from work....was standing next to the kitchen counter....looked over towards my wife....and she appeared to be yelling at me....but I couldn't hear a word she said....and then I passed out!

They say....family, friends and doctors....that I had a massive stroke....say what?

Definition

The cerebrum is the largest part of the brain. It is made of a left and a right hemisphere. In most people, the left hemisphere is in charge of the functions on the right-side of the body. It is also involved in abilities such as the ability to speak, or use language.
A left-side stroke happens when the blood supply to the left side of the brain is interrupted. Without oxygen and nutrients from blood, the brain tissue quickly dies.

Copyright © Nucleus Medical Media, Inc.

There are two main types of stroke ischemic and hemorrhagic. An ischemic stroke is the most common type of stroke.

Causes    

An ischemic stroke is caused by a blockage of the blood flow, which may be due to:

• A clot from another part of the body like the heart or neck. The clot breaks off and flows through the blood until it becomes trapped in a blood vessel supplying the brain.
• A clot that forms in an artery that supplies blood to the brain.
• A tear in an artery supplying blood to the brain. Called an arterial dissection.

A hemorrhagic stroke is caused by a burst blood vessel. Blood spills out of the broken blood vessel and pools in the brain. This interrupts the flow of blood and causes a build up of pressure on the brain.

Hemorrhagic vs. Ischemic Stroke Copyright © Nucleus Medical Media, Inc.

Risk Factors    

Certain factors increase your risk of stroke but can not be changed, such as:

• Race—People of African American, Hispanic, or Asian/Pacific Islander descent are at increased risk.
• Age: Older than 55 years of age
• Family history of stroke

Other factors that may increase your risk can be changed such as:

• Drug abuse from cocaine, amphetamines, or heroin use
• Smoking
• Physical inactivity

Certain medical condition that can increase your risk of stroke. Management or prevention of these conditions can significantly decrease your risk. Medical conditions include:

• High blood pressure
• High cholesterol levels—specifically high-LDL bad cholesterol
• Low bone mineral density, especially in women
• Obesity and metabolic syndrome
• High blood homocysteine level
• Atherosclerosis
• Diabetes mellitus or impaired glucose tolerance
• Atrial fibrillation
• Blood disorders such as sickle cell disease and polycythemia
• Vascular dementia
• Disease of heart valves, such as mitral stenosis
• Prior stroke or cardiovascular disease, such as heart attack
• Peripheral artery disease
• Transient ischemic attack (TIA) —a warning stroke with stroke-like symptoms that go away shortly after they appear
• Conditions that increase your risk of blood clots such as:
  • Cancer
  • Certain autoimmune diseases
• Migraine with aura
• Having a blood vessel abnormality

Risk factors specific to women include:

• Previous pre-eclampsia
• Use of birth control pills, especially if you are over 35 years old and smoke
• Long-term use of hormone replacement therapy
• Menopause
• Pregnancy—due to increased risk of blood clots

Symptoms    

Symptoms occur suddenly. Exact symptoms will depend on the part of the brain affected. Rapid treatment is important to decrease the amount of brain damage. Brain tissue without blood flow dies quickly.
Call for emergency medical help right away if you notice any of the following:

• Sudden weakness or numbness of face, arm, or leg, especially on the right side of the body
• Sudden confusion
• Sudden trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden dizziness, trouble walking, loss of balance, or coordination
• Sudden severe headache with no known cause

If you or someone you know has any of these symptoms, call for emergency medical services right away. Brain tissue without blood flow dies quickly. Early care can decrease damage.
Longer-lasting effects of the stroke may include problems with:

• Left-sided weakness and/or sensory problems
• Speaking and swallowing
• Vision (eg, inability for the brain to take in information from the left visual field)
• Perception and spatial relations
• Attention span, comprehension, problem solving, judgment
• Emotions
• Interactions with other people
• Activities of daily living (eg, going to the bathroom)
• Mental health (eg, depression, frustration, impulsivity)

Diagnosis   

The doctor will do a physical exam and look for muscle weakness, visual and speech problems, and movement difficulty. If possible, you will be asked about your symptoms and medical history. Your doctor may use a CT scan or MRI scan of the brain to confirm a stroke or rule out other conditions.
Your doctor may also order tests that create detailed images of blood vessels. These test will help see which blood vessels may be creating the problem:

• Magnetic resonance angiography (MRA) —maps blood flow
• CT angiogram (CTA)—creates detailed images of the blood vessels and their blood flow
• Doppler ultrasound —evaluates flow of blood in the head and neck

Blood tests can also help determine if there is a bleeding problem.

Treatment    

Immediate treatment is needed to:

• Dissolve or remove a clot causing an ischemic stroke
• Stop the bleeding during a hemorrhagic stroke

Oxygen therapy may be needed.

Medications

For an ischemic stroke, medication may be given to:

• Dissolve clots and prevent new ones from forming
• Thin blood
• Control blood pressure
• Treat an irregular heart rate
• Treat high cholesterol

For a hemorrhagic stroke, the doctor may give medication to:

• Work against any blood-thinning drugs you may regularly take
• Prevent seizures
• Reduce how your brain reacts to bleeding
• Control blood pressure

Surgery

For an ischemic stroke, procedures may be done to:

• Reroute blood supply around a blocked artery.
• Remove the clot or deliver clot-dissolving medicine.
• Remove fatty deposits from a arteries in the neck.
• Widen carotid artery and add a mesh tube to keep it open.

For a hemorrhagic stroke, the doctor may:

• Place a clip or tiny coil in the aneurysm to stop it from bleeding.
• Remove a piece of the skull to relieve pressure on the brain.

Rehabilitation    

A rehabilitation program focuses on:

• Physical therapy—to regain as much movement as possible
• Occupational therapy—to assist in everyday tasks and self-care
• Speech therapy—to improve swallowing and speech challenges
• Psychological therapy—to help adjust to life after the stroke

Prevention    

Many of the risk factors for stroke can be changed. Lifestyle changes that can help reduce your chance of getting a stroke include:

• Exercise regularly.
• Eat more fruits, vegetables, and whole grains. Limit dietary salt and fat.
• Stop smoking.
• Increase your consumption of fish.
• Drink alcohol only in moderation (1-2 drinks per day).
• Maintain a healthy weight.
• Check blood pressure frequently. Follow your doctor's recommendations for keeping it in a safe range.
• Take aspirin if your doctor says it is safe.
• Keep chronic medical conditions under control. This includes high cholesterol and diabetes.
• Talk to your doctor about the use of a statins. These types of drugs may help prevent certain kinds of strokes in some people.
• Seek medical care if you have symptoms of a stroke, even if symptoms stop.
• Stop the use of recreational drugs such as cocaine.