How To Have A Stroke
On April 22, 2010 I suffered from an acute right occipital lacunar infarction as well as an acute/subacute right cerebellar cerebrovascular accident.
Diff'rent strokes, as it were.
The artery that feeds the right side of my cerebellum was inhibited by a dissection. This is a separation of the layers within the artery, causing a blockage. Picture the inside of an old frayed garden hose. As the blood was forced and squeezed through this tighter area, a blood clot formed. When released the clot caused the occipital lacunar infarction.
I am 29 years old.
This is what I know now.
What I knew at the time was that I felt sick. That something was wrong and I didn't know what exactly was going on.
Here's how it went down:
April 22 was a Thursday, overcast. I was at work finishing up some projects as I had taken the next day off to have a long weekend with my wife to celebrate our first wedding anniversary.
Friday we were going to spend the day hanging out in Boston Common, seeing some art at the ICA and grabbing a cocktail.
Saturday we would lounge, nap and read.
Sunday we would have dinner at Menton, Barbara Lynch's new restaurant in Fort Point Channel.
I felt fine all day Thursday. No dizziness, no sick feeling, nothing. At some point between 6:30 and 7:00PM, I swooned and nearly passed out. Not a blackout or a fainting, but my vision dropped to television static for a few seconds.
Sweat poured out of my body and I was nauseous. I was going to be sick. Standing up from my desk I made my way to the bathroom and leaned against the inside of a stall, staring into the toilet.
I'd been here before, years before, after rounds of drinks and shots and late-night food that seemed a good idea at the time. This wasn't the same, though. There was a difference to it that bothered me. When you're sick from too much booze, or bad shrimp, you already have a good idea of the diagnosis. Most times it's your own damned fault.
I felt nauseous but nothing was coming up. Must be food poisoning. The sweat came on again so heavy it was as if the fire sprinklers had gone off. Beads ran down my face, soaking into the collar of my shirt.
My equilibrium was off, standing was a chore, and I remember staring at myself in the bathroom mirror, hands clamped on the sink for balance and wondering when this was going to pass.
As quickly as it came on, this thing that was attacking me seemed to drift away. I wet my face with water and went back into the office, entered a side room and lay down on the floor. Within about ten minutes I felt better.
I got up and packed up my computer. All color must have drained from my face and several of my co-workers asked if I was alright and offered me a ride home. I declined, made assurances that I was fine, and made my way to the parking lot to get in my car.
The cool air outside felt good. My nausea seemed to have waned and my balance returned. As far as I was concerned at this point, I had eaten something during the day that didn't agree with me and my system had just hit the peak of trying to fight it off. I would go home, have some soup, and get to bed early. The next day everything would be fine.
I work in Danvers, MA and live in South Boston. The trip home down 128 to 95 to 93 should have taken me half an hour with no traffic. I've made this trip hundreds of times.
Where I ended up was Route 2 in Lincoln, 25 miles West of my intended destination.
I don't remember passing the 95/93 exchange. I don't remember passing through Burlington, past the mall.
Eventually I realized that I was unfamiliar with my surroundings so I took an exit to turn around. I either turned around on the road or got on a different road, I'm not sure.
At some point I pulled over on a side street and pulled out maps I keep in the car. The pictures inside looked familiar but for the life of me I could not read or understand how to navigate them at all.
I pass road signs, one after another, without understanding what they meant.
It was then that my wife started to call. My voice was scared and quivering. I couldn't tell her where I was or what was going on. I tried to talk, but nothing came out right. I cried. I tried to pull up Google Maps on my phone, but couldn't understand how to operate it.
She asked if I'd been drinking. My speech was slurred a bit and I wasn't making any sense. I told her I'd call her back.
My wife called me back and begged me to call 911. They would find me, she said. I told her I would and spent the next ten minutes trying to figure out how.
She called back to ask if I had called for help. I had to tell her I couldn't. Didn't know how. Her voice was scared and concerned and I began to worry more about how I sounded and what might be happening.
"What road are you on?" she asked. "I need you to concentrate and tell me what road you're on."
I recall clearly staring at a sign that said Route 2. Green background, silver/white center. Big #$*&@)# 2.
Out of my mouth came an answer, "93, 5, 8000."
What I didn't know at the time, though may have been told, was that my sister-in-law had contacted the State Police and they were out looking for me.
I was being hunted and I wanted to be found. I pulled over again on a narrow shoulder and was able to successfully call 911. When I did this I noticed two missed calls from an unfamiliar number. This was the police trying to contact me.
"I need help."
"Where are you now?"
"I don't know."
The operator kept me on the phone long enough to use the GPS locator signal in my phone to track me down. While on the phone with them, blue lights came up behind me, and while I'm sure it was a regular cruiser, it appeared to be a tall boxy truck, like a paddy wagon.
Three officers were at my door quickly and I unrolled my window.
"Hello sir," one of them said.
"Hey, officers." I smiled and waved.
I was unable to answer most of their direct questions, though I got my name, right. I was able to express my frustration with not being able to tell them how I'd ended up where I was. "Why the %&#& can't I tell you that?"
By all outward appearances, I was tanked. Though I did not smell like alcohol, and my car had no substances in it, I was confused and stating I was unable to walk on my own.
While the cops were questioning me, I took a minute to ignore them and sent a text to my wife to let her know I was found.
"Gope are here" it read.
As the boys in blue stood back to talk to each other, I saw a familiar Ford Taurus slide in front of my car and my wife jumped out and ran back to me. I let her know I was all right.
Then the ambulance arrived, and EMTs were at my window.
Eye tests. I blew in everyone's face. I have no idea if I passed anything.
I was asked if I wanted to get into the ambulance. I said yes. They asked if I could walk. I said no, but they could carry me. "We've got a stretcher for that."
The car door was opened and my Jell-O legs came out. The EMTs helped me up onto the stretcher and laid me down. I was put into the back of the ambulance, strapped in and testing began immediately.
Blood pressure tests. Finger prick to see if I was diabetic. What's the date? What's your name? Who's the president? What year is it? Was that your wife? What's her phone number?
This time I got them all right. The date and the year were slow, but only a few seconds.
I was driven 1.5 miles to the Emerson Hospital Emergency room.
What else I didn't know at the time was my mother-in-law, sister-in-law and father-in-law were on the scene, and instead of my car being inventoried and towed, my family intervened and told the cops to back off, and that they would drive it away and their services were no longer needed.
I was coming back. I could now answer questions. Some still took a bit longer than others, but the answers came.
At Emerson they put me in ED 6, a room in Emergency with a wall painted with a river scene. Birds and trees and it was very busy lots going on. At first it was difficult to look at, then not so much.
I was in the Emergency Room, but had no answer as to why I was there. I was now carrying on conversations with people. Doctors and nurses. My wife. I felt much better. I wanted to go home. The hospital wanted to keep me. I signed the form allowing them to admit me.
What I really wanted was just an explanation.
I had a chest x-ray and a CT scan.
They moved me around the corner to a bland room called 13, and there I spent the night. It took some convincing, but around 12:30AM or so I finally got my wife to go home. If not to get sleep, then at least to regroup change clothes, shower.
Still no answer as to what happened.
That night I slept fitfully. I had an IV in my right forearm, but I wasn't hooked up to anything. Blood pressure cuff on my left bicep. Heart monitor cups on my chest, hooked up to the wall behind me.
I took a Tylenol before sleep and tried to eat half a dry turkey sandwich. Drank water.
I was up again at 6:00AM for blood. I ordered breakfast, cheese omelet coffee with toast and coffee.
I was scheduled to see the neurologist, Dr. Gonzalez, in the morning. I was scheduled to take an MRI.
My parents arrived from Maine, worried enough about me to drive 4+ hours to see me.
I was taken up to radiology for my MRI around 10:30. I lay in the machine for 40 minutes while it clicked and banged. I slept inside. Afterward I was taken back down to emergency. In the halls, I joked with people, felt good enough to shuttle myself around.
I was back in room 13 for approximately five minutes when they came for me again and said I needed to have another MRI. Things weren't clear on one of the images they got, they said and they needed another round.
I went back up. They slid me back in the machine. Again, I slept while they concentrated on my neck.
I came back downstairs. I waited. A nurse came with a lunch menu. Before the nurse came back to take it in, a doctor and the neurologist appeared.
With my family in attendance, the doctor said, "I've had a chance to review your MRI. It appears as though you've had a stroke. Two of them, actually."
To be sure, this is not what I wanted to hear. This is not what my wife and family wanted to hear. A few mouths dropped open.
While the doctor explained what had happened, administered some cognitive and strength tests and described what further testing would be done, I was finally satisfied that I had an answer. More than that, it was an answer that made sense. Though I had not lost feeling or mobility in any of my limbs the area where my stroke occurred controls attention, language, and accurate timing.
This is why I didn't know how long I was missing and why I couldn't explain things on the phone.
Once the diagnosis was in place, treatment came quickly. I was placed on a Heparin drip (blood thinner) and given cholesterol medication. I was moved to the cardiac ward and hooked up to a wireless monitor.
Within five days I was released, prescribed Coumadin, Lovenox shots and Zocor.
To date, I have no symptoms relating to this event. Were you to see me on the street there would be no thought that something had happened so recently.
My reason for writing my story is because while I was doing research on strokes, especially strokes in young people, the information available was scarce. Strokes occur all the time, and are less uncommon than you may think in people under 40.
What I found was that most of these stories involved athletes having trauma to the head or neck. Other stories pointed toward heart problems, high cholesterol, advanced age and hypertension.
One thing I was looking for was a step-by-step analysis of how this happens, what it feels like, and why.
I have supplied as much information as I can recall on what it was like to have a stroke or two.
Had I made it home, I would have determined it was a bad day, gone to sleep and never known what actually happened.
The official scientific explanation is that my strokes were "cryptogenic".
That's doctor-talk for "$%&# happens."