On the Day After Christmas
My mother had her first (and hopefully last) stroke of her life recently this past day after Christmas. She is the picture of health - so it was completely unexpected. This covers the actual stroke happening and the ambulance ride/hospital admittance.
On the day after Christmas December 26, 2011 we had our annual family Christmas dinner with the whole family. Typically over twenty relatives are at this classic gathering every year: aunts (2), cousins (7), uncles (2), great uncles (2), grandma (1), sisters (2 out of 3), parents (2), their new grandkid(s) (1 out of 4) and myself. It was a beautiful, simple holiday gathering at the Smith home our home in Alabama. Everyone brought food as normal of course, a feast fit for kings. My favorite: sweet potato soufflé with the lightly toasted marshmallows on top. The best had pecan bits and shredded coconut infused. The uniquely-Smith family dessert: "pink stuff." Technically, it's called "pink fluffy salad," but we affectionately refer to it as "pink stuff." Cool whip, maraschino cherries, chopped pecans sprinkled throughout along with the right amount of pineapple bits. Everyone makes quick work of that "stuff" and there never is any leftover after the end of one of our affairs. Sadly, it only makes appearances at Thanksgiving and Christmas dinners.
This year I was particularly pleased to have spent the time with my Grannie learning how to make pralines. It's been a goal of mine for awhile. My grandmother's 82. She facebooks, e-mails, has dabbled in texting and is probably the most active 82 year old you know. The best part is she definitely doesn't look or act 82. That's just good Smith genes, as I'm sure you're aware. Making pralines with my Grannie was a great experience. I'd copied down the recipe for her years ago. The handwriting on the index card was one I vaguely remember. It was purposefully, incredibly legible. My handwriting these days looks more like beautiful scribble. I was proud of myself for taking the time to insist on making pralines with her. Doing it with her, I knew, would be a far better experience than having to learn by trial and error off of just the recipe card. I picked up some invaluable techniques and tips not written down that I'll need to practice soon if I ever want to pass it on to my kids someday. These pralines were packaged up the day before so that each family could have a hefty handful to share.
After enjoying each other's company around the various tables scattered about the house, we circled the tree for a second round of gift giving. We pull names every year because we're so big. The kids have a hat they pull out of (typically at the Thanksgiving dinner) and the adults have a hat they pull out of. Usually the "tweeners" (recent college grads, young adults, etc.) have a hard time determining if they want to be in the more juvenile, yet cheaper "kids ring" or in the more sophisticated (and slightly more expensive) "adult ring." We all want the adult privileges at the kids prices. Similarly, there's always an underlying decision of whether to sit at the "kids' table" or join the adults at the "adults' table." As of late, I've chosen to sit at the adult table. I love my younger cousins who never disappoint me from an entertainment standpoint, but as I've grown older I've learned the value of conversing with my aunts and uncles more, grandma and great uncles, etc.
There's caroling, undoubtedly egged on by the matron of the family Grandma Ann, followed by a state of "calm chaos": the kids are usually bouncing off the walls in one of the bedrooms and the adults are usually content to sit around sipping freshly brewed coffee, attempting to avoid a near comatose state of satiety. After all, most would have to make a near 2-hour drive back to their destinations afterwards.
This year, after all the food was eaten, gifts opened, copious pictures taken and carols sung, we all were in our individual spaces basking in the glow of family togetherness. That's when reality broke and the surrealism of the next 17 days began. I was being thoroughly entertained in my sister Patience's room as my cousin, Patrick, and niece, Paloma, tried out their new dance moves: Patrick's breakdancing and Paloma's "snake"/bellydancer moves (undoubtedly from one of her mother's Zumba classes or something). I videotaped it knowing it would be great material to text to my sister, Nicole (who had to be in Columbia) and show my mom, dad and others later. It would certainly garner a lot of laughs and let-me-see-that-again's. As I was recording and trying really hard not to laugh (mainly not to shake the camera too much), my cousin Ashleigh and sister Juanita (Paloma's mom) grabbed me by the arm to usher me out of the room. They had an odd look of gravity I'd never seen in them before. Both of them. Very odd. Without blinking, my beautiful cousin Ashleigh looked me dead in the eyes and said "Andrea, your mother might be having a stroke." She said it very matter-of-factly, and at the same time, I felt her search my face to see if the news registered.
"What?" I said aloud, thinking at the same time that that has got to be the most horrible "you've-been-punked" moment ever and half-way considered contemplating my move to get them back. Ashleigh proceeded to explain, as my sister stared at me in stone-cold silence, that my mother was not talking like herself and they thought she may be having a stroke. At this point, Juanita pressed her hands to her lips, her eyes welling up in tears as she quickly turned her head from me. This is not a test, it's real. "Somebody put the message 'Pray' on Facebook," Juanita said as she tried to keep her mascara from streaking. What? Facebook? I'm probably the biggest social media consumer in the family, and that was the last thing I was thinking about doing.
Dismissing her comment, I walked away into the kitchen and living room areas and the words Ashleigh spoke were further verified by more smaller cousins looking confused, my Aunt Angie and Uncles Ed and Lewis quickly moving about the room. They were calm on the surface but moved with greater than normal speed, larger than normal strides. An air of heightened awareness spurred by the ancient fight-or-flight mode pervaded the room. In surprisingly calm but purposeful tones, the aunts and uncles communicated with one another. "Where's the aspirin?" someone said. "Look in the kitchen." "Where?" "Try above the refrigerator." "Got it" said Aunt Angie. She hurriedly opened the bottle and with her long, gazelle legs, crossed the room in a blink.
The kids in the backroom hadn't gotten the message yet. Someone ushered themselves into the room to quietly hush them. I have no idea what parents said to their children at this point or how the news was broken to them. I knew, because I was soon informed that my mother Thelma Smith was in her bedroom, being tested by Aunt Deborah the physical therapist in the family. Thank God she was there. She performed the standard STR test Smile, Talk, Raise your arms. She also did an additional test of asking my mom to stick out her tongue. All of this was performed in the chambers of the bedroom out of sight. I had no idea what to expect. What does a person look like having a stroke? How do they feel? I desperately wanted to look in the bedroom to observe what was happening, but at the same time, I didn't want to encourage others to do the same and crowd the room which I knew would only cause my mom, dad and aunt who were in there more frustration and panic.
For a moment, a wave of emotion came over me as I all of a sudden felt very powerless and helpless. This was the mother who spent five years of the beginning of me and my sister Nicole's lives at home with us. "I just don't want them taking on the personality of someone else" she said. True, being away here in Greenville, SC with no family around, the few friends of mine who've been able to meet my mother have said "that's where you get your walk. That's where you get your talk. You look just like your mother." I used to hate people saying that growing up "you look just like your mother." Now, I really don't mind. I'm actually kind of proud of that. And I do talk like her. And I rather do walk like her. It's like a princess-diva walk very delicate with a slight touch of priss mixed in.
There was nothing I could do without getting in the way. I felt the instinctive urge to pray. I fell on my knees in the livingroom with instant tears streaming down my face. Burying my head in my hands on the couch, not wanting the smaller cousins to see me cry and in turn frighten them, I spoke to God as directly as I knew how. Whispering urgent, sincere pleas for the one thing only He could grant: help. "Heal her. Touch her. Protect her, Father. This is in Your hands. You are awesome, you are wonderful and excellent. I know you can do it. Watch over her. Heal her body. Fix it, Father, please. We need you. Protect her, protect her, protect her..." Over and over I said these words.
I felt my Uncle Ed gently touch my shoulder as I prayed. I got up and wiped the tears from my face. Quickly I snapped into level-headed, task-oriented mode. Now on my mission, I needed to see in this house of 20 people how best to make things flow. What needed to be done, how efficiently could it be done, who's watching the kids, who's called the ambulance, what's the expected ETA, what's the status of my mother. I've heard I'm a control freak. Quite possible. I swiftly identified the most important priority on my list the status of my mother. I ventured a peek into the master bedroom to see if it was alright to lay eyes on her and assess the situation for myself. Aunt Deborah and my dad motioned that it was OK for me to enter.
My mother lay on the bed shoes taken off. Aunt Deborah was still performing the STR testing. "Hold your arms up over your head." The left one fell down. "Smile for me." "Stick out your tongue." "Yes, I believe she's having a stroke" Aunt Deborah said. My father, a lifetime forester, Tuskegee University professor and Pastor of Wayman Chapel AME Church in Union Springs, AL, prayed. As always, he was calm. He held my mothers hand and prayed for her as a tear slowly crept down her cheek. Aunt Deborah then began her prayer I left the room for a moment to give them space, leaving the door ajar. Aunt Deborah wailed and cried over and over "Jeeeeeesus! Jeeeeesus! Jeeeeesus!" in the beautiful songstress voice she possesses. Her tone meant only one thing: Help us. Help her. Get her through it. Help her hold on until the ambulance comes.
When Aunt Deborah was finished, I reentered the room. By then I heard the ambulance had been called. Later, I learned there was a lot of confusion behind that. Since most of the adults were from out-of-town (Georgia, Florida), they were unsure if they should dial 9-1-1 from their cell phones or find the house phone so the paramedics would more easily find the address.
When I knew it was OK to draw nearer, I came over and touched my mother's leg. She was on her back with her left leg bent up towards the ceiling, her right leg flat on the bed. She was shaking. At this point, her blood pressure had shot up to 190/120 I think they said. She had a low tremble all over. I knew she was scared. She thought she was dying. She'd taken a CPR course for work recently (she's a hygienist), and part of the training was to recognize a sign of stroke. She was recognizing the signs as they were happening to her. Problems with speech. Confusion. Numbness on one side of the body. She had been eating a sinfully delicious seven-layer red velvet cake a church member made, talking to my older sister Juanita when it happened. That would explain Juanita's kick into terror. They said the water she was drinking started falling down her face. Aunt Deborah, who happened to be listening in on her conversation, noticed she wasn't making sense anymore. She got up to look at her and knew something was wrong hence her being taken to the master bedroom for private examination.
"How are you feeling momma?" I asked as I held her hand. "Mmm....mmm...." as she struggled to get the words out. Actually I couldn't ascertain whether she couldn't find the words or she knew the words she wanted to say but couldn't get the words out. "I'm scared" she admitted. She spoke in a very soft, trembling voice unlike the joyful, gregarious Thelma we're used to. "It's okay" I said, rubbing her hand. "It's going to be alright," trying to reassure her. The trembling in her body rattled me. I'd never seen my mother scared of anything before. Except that one time in Florida when she thought someone was breaking in the house and dad was out of town. She crept around the corner armed with a can of mace yelling "Come out! Come out there!" I forgot what actually made that noise, but thank God it wasn't a human intruder at least.
I left the room again to check on the status of the ambulance. The closest hospitals had to be in Montgomery or Auburn as we were smack dab in the middle near Tuskegee. "Grannie," I said, "would it not be faster to drive her directly to the hospital ourselves?" Both cities were a good solid 30 minutes away. With my stealth driving skills, I figured I could have her at an emergency room door in 25 minutes or better with my hazard lights on. "No baby, they can get here faster than you can" she said with a straight face. What?!?! I thought. This, however, was not a time to pick an argument with a woman I've never spoken back to or thought about arguing with in my life. I knew she had to be wrong though. An ambulance coming from Auburn or Tuskegee or God knows where else would cause us at a minimum an extra 30 minutes. That was not time I was willing to sacrifice. If there's anything I remembered about strokes, it was that TIME was precious. Time meant brain cells. Brain cells meant function. It also meant life.
I inquired of another family member about the ambulance. Perhaps I could convince someone else to see my logic. "They're taking her to the Tallassee Hospital." Tallassee, Alabama has a hospital? I thought. I'd never heard of it. Granted, I'm not from the area, although I was born there in Opelika. We moved to Irmo, SC when I was a baby, then to Tallahassee, FL when I was 7. After my first year in high school, we moved back to Irmo where I went on to college at Clemson. During my sophomore year, my family moved back to Alabama to be near my grandparents. A good call since my granddad passed away my junior year. I think my dad knew they would need help. They ended up building a home next to my grandparents house under 50 steps from my Grandma Ann. My short answer now is to tell people I'm from Greenville. I've been here close to 7 years and in the Upstate for nearly 13 if you count undergrad and grad school at Clemson. Plus I'm a fan of the Upstate. May as well claim it.
Well, at least if Tallassee has a hospital, she can get there in 20 minutes. I felt better about the fact that even if it wasn't one of the bigger cities she went to first that at least she'd have more immediate medical care in the first few critical minutes and then she could be transferred later.
Someone called my sister, Nicole, in Columbia. Newly married, she and her 3 kids now swapped holidays with the in-laws. We got them for Thanksgiving. They get them for Christmas. Unfortunately, that meant she was now over 5 hours away when the news hit her. I rapidly tried calling her. No answer. I called Duane, her husband and high school sweetheart. An answer. Nicole heard the news already from my sister Juanita who put the world on alert immediately via text/calling/Facebook or whatever she did. She broke down crying, causing my nephew, Gavin (4 years old), to instantly cry as well. Duane said they were definitely coming. Since it was late afternoon already, I knew it would be close to midnight until they got here. But I knew it wouldn't stop her. It was a lot of driving, but I would've done the same thing in her situation. My nephews, Gavin and Crewsie (age 2), would stay in Columbia with their grandparents there. Charleigh Milan, my newborn niece, would come with Duane and Nicole on the hike down to Alabama. "God grant them traveling mercies. Get them here safe."
I was alerted that the ambulance would arrive in 15 minutes. I grabbed my mom's new overnight bag she loved (one of her many gifts to herself "from Ronnie") and quickly moved about the bathroom grabbing her toiletries, makeup, contact case holder, hairbrushes, blowdryer, underwear, socks everything I could think of that would fit that the hospital wouldn't have. I was thinking: what would I want someone to grab for me if I had to be rushed to the hospital?
By the time the ambulance arrived I was finalizing the last bit of items I could think of to include in the bag and the smallest kids were actually sitting still in one place on the living room ottoman. Patrick and Paloma, the oldest of the "younger kids" sat next to each other, weeping together. That was the last image I wanted my mom to see coming out of her bedroom. "Can someone take the kids to another room?" I directed as the stretcher was being wheeled into the living room. Someone took care of that. At that time, there had not been a soul in the household that hadn't wept at some point.
"Does someone get to ride with her in the ambulance?" I asked. "Not in the back, but someone can ride in the front." My dad, standing near, said "Do you want to ride?" I nodded yes. I wondered why he would let me do that. Didn't he want to be closest to her? I had already somehow grabbed my purse, had my coat on, mom's overnight bag in hand. I motioned to Ashleigh to come here. "Can you grab my phone charger in the guest bedroom by the bed?" I knew I would want to communicate with family later my sister coming down the road to check when she was coming in, others who wouldn't be coming to the hospital to keep them informed in case my dad hadn't thought to bring his charger and his phone died. A minute later as the stretcher was being rolled into the ambulance with my mother strapped on top, Ashleigh appeared with my iPhone charger. "Thanks Ash." My dad would trail behind in their newly purchased Hyundai Santa Fe. Black. Fresh interior. My mother loved that car. I know she hated for anyone else to drive it.
I have no idea why I was so polite to the EMT's. For some reason, it was important to me to maintain a very calm and pleasant exterior while on the inside, I was contemplating pushing them out of the way and putting the pedal to the metal myself. We made small talk, Steve and I. I desperately wanted to ride in the back with the other EMT who had the benefit of being able to see my mother's face. "Are you from here?" I asked. "Yep, born and raised. We've lived here..." blah, blah, blah... I tried very hard to appear to listen intently, but my eyes were stretching as far as they could around the corner of the seat to catch a glimpse of all that I could see of my mother: a tuft of her hair on the top of her head. Every five minutes I would ask "how are you momma, are you okay?" The EMT would nod back to me yes. She was nowhere near in a position to speak loudly enough for me to hear. I thought the ride was unusually rough. That can't be good won't that jostle around her brain fluids, etc., unnecessarily? For the first time in ten years I regretted not going to med school.
That was the most painstaking twenty minutes of my life. You simply had to wait. There was nothing extra I could do. In between making small talk and checking with the EMT on mom, I would say a silent prayer. Please hurry this man up. Please get us there in time. Please do Your work, God. Show up for us, we need you. Protect her, protect her, protect her...get us there...help these men do their job...please make them go faster (but safely)...
I could see the headlights of the new Santa Fe trailing behind us. My dad. What was he thinking? Could he see her face? Probably. Lucky him maybe I should've volunteered to trail behind. Finally, we arrived at the Community Hospital in Tallassee, AL. Again, I promise you: I have never known in all my times coming home for the holidays that such a hospital existed in this extremely small town. This town, which for years, had only one red light. Where "Wal-Mart" was like the mall since it was the biggest store in town (though it's branding was five generations old). There was a fairly big river (the Tallapoosa River) you had to cross over to get to that side of town, typically. A huge dam loomed underneath the bridge. Kids from the local high school used to be allowed to spray paint graduation messages on it once a year. I wondered if they still let them do that. I thought it was quite dangerous given how incredibly steep and high that slope is.
Finally. The Haynes Ambulance pulled us up to the Community Hospital. I must admit, I was highly unimpressed with the service we received. The nurses were nice enough but my mother was forced to wait in a small holding room where they first assess a patient's situation when they enter the ER. I caught myself holding my breath especially as a guy in the curtained room next to us was apparently hocking up a lung. What does he have?? I just didn't feel a sense of urgency on the medical staff's part. We ended up simply waiting in that room a long time as CNA's and an assigned nurse checked on a few vitals here and there. Thank God my dad had the foresight to grab my mom a robe. She ended up being quite cold in there and the one blanket they offered after request was rather thin. She indicated she needed to use the restroom. The nurse took the opportunity to make sure she took a urine test while she was at it. This is when I learned my mother needed complete help walking.
Between my Aunt Deborah and I, we served as human crutches for her for the first three steps. "Maybe you should use this wheelchair." Agreed. I'd never seen my mother in a wheelchair before. Really odd. We rolled her the next twenty steps over to the restroom. This would be the first time I could ever say I watched my mother use the bathroom. Can't say that's ever happened before either. It was very clear that her left leg was betraying her. Upon trying to smile, it looked more like a mean grimace than anything. I fought back tears as I saw her look at her own attempt to smile in the mirror, only to see that smile break halfway up. God, have some mercy.
She was talking that was good!! I was so thankful she had that. Vital signs showed her blood pressure was still extremely high. We were notified that she would have a CT scan (i.e. "cat scan") done. My dad, Aunt Deborah and I had been standing by her while all of the initial assessments were performed. We would have to go back to the waiting room while the CT scan was being conducted. Sitting there was my Grandma Ann and Uncle Ed, along with an unknown family of about 8 and growing. Someone else had a trauma accident with a four-wheeler. Apparently it flipped and sent him straight through a barbed-wire fence, the family said. It's possible he could die. I'd seen him across the hallway from us back in the assessment area. Bloody, he had several lacerations on his body from the few parts of him I could see. Some already had bandages on them. His eye was already blackened and puffy, possibly oozing. God, help him make it too.
After she came back from her CT scan (no results ready for us yet), they stated she would need an MRI done but would have to wait until morning. OK...is that normal, why can't we do it now? Being in that setting, I felt extremely frustrated. We had no way of telling what should or should not be happening. All I knew is that I wanted to get her to a bigger hospital, asap. Tonight, however, we would need to wait. I unhesitatingly agreed to stay the night with my mother. Both my dad and I. I'm sure they only wanted one relative staying in the room with her, but I'm thankful no one turned me away.
At 9:39pm, she was transferred to her room. Number 325. It was small, a little dated with a mega-chunky TV hovering from the ceiling's crevice. Outside it had been raining. Thunder-storming rather hard in fact. Lord, watch over my sister and brother-in-law as they drive here tonight. I instructed my sisters and cousin, Mindy (who'd heard the news and wanted in on the updates asap), not to call the room so she could rest. I told them they could call us directly on our cells.
Ten minutes after being in the room we learned that the CT scan came back normal. Why didn't someone show us the actual images from the scan to explain them to us? Does that come later? Hmm. EKG was normal also. Come on people, she's obviously having or had a stroke. What's next? What else do you need to verify it? They did note that the scan identified a choroidal fissure cyst somewhere near her eye, but that's "nothing and a lot of people have them." Google verified this. "She was admitted tonight to rule out the possibility of stroke." I suppose that's medical-speak for saying that they haven't been able to verify she's had a stroke yet. The blood tests hadn't come back either. They checked her blood pressure again it was coming down: 124/57. Much better.
More texts went out to the family after midnight to update them on mom's status. We'd noticed that she had severe numbness on the left side of her face and hands. Being a hygienist, she's extremely familiar with the feeling of numbness in one's cheek/jaw/lips. She said her hand felt "fat" like those areas of your mouth do after being numbed by the dentist. She kept touching her hands when we were in the ER and her face, trying to be able to feel that they were there.
Twenty minutes after entering the room, she fell asleep. Good. She needed to rest. Her body and mind needed that precious deep slumber to recuperate, to recompose itself. There was a great sense of knowing that everything was out of our hands. I had never seen my mother so very weak before. Though thankfully she could think relatively clear still, it took immense effort to speak. When asked a question, it took nearly a solid ten seconds for her to finally get the words to come out. God, please don't let this effect her speech or mind long term. My dad and I found an extra chair so the both of us would have a place to sit/try to sleep for the night. I sat as close to her as I reasonably could. I wanted to be able to hear her breathe. See her face at all times. One of the CNA's came in about every two hours to check her vitals. The main medicine she received while there: Tylenol. Is that the best we've got?