What It's Like To Have a Stroke
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What It's Like To Have a Stroke

I was way too busy, and too young, to have a stroke. Then I blacked out in a parking lot and nearly died. The fact that I'm writing this story is pretty much a miracle.

Meetings drive me crazy. I manage a busy national cooking school based in Milwaukee, and there are never enough hours to do my job -- you know, the one where I actually run a cooking school instead of sitting in a conference room. I can't count the number of times I've said, "If someone schedules another premeeting to have a meeting to plan for another meeting, I'm going to freaking cry." I didn't mean it literally, though, until May 23, 2012.

There was nothing unusual about it: just some minor administrative matters I needed to go over with a colleague. I walked in at 11:30, sat down, and we turned to the business at hand. In the middle of it I started crying. And then I was sobbing and couldn't stop. I know the woman I was with well, both professionally and personally. And she was like, "Whoa, what's going on? Where's this coming from?"

"I don't know," I told her. And I didn't. It was just so totally out of character for me. I'm normally cooler than the cucumbers in our kitchen's commercial refrigerators and I rely on my sense of humor when things get too serious. Crying? What was that all about?

And that was how, at the age of 41, I started to have a stroke. There were none of the typical warning signs, no numbness or weakness on one side, no difficulty speaking, no sudden headache, no pain at all for that matter -- just tears out of nowhere. I didn't know it then, but a blood vessel had burst in the left frontal lobe of my brain and blood was pouring into the space between my brain and the thin tissues that cover it. The crying jag, I later learned, was triggered by pressure building up in the areas of my brain that control emotion. We somehow wrapped up the meeting and, at 12:15, I hurried back up to my office to get my purse and keys to make an appointment. I was rushing because it was across town and if there was traffic I was going to be late.

I hurried across the lot, talking on my cell phone to one of my staff members as I headed for my car. It's a long walk. I work with many Midwestern early birds, and if I arrive at work after 8 A.M., all the best parking spots are taken. About 20 feet from my car, I stopped the conversation. "Something's not right," I said. "I have to go."

People talk about an instant as if it's a fleeting thing. This instant was not. It felt like the longest period of time ever created. It's really, really hard to come up with the words to describe what happened, but I'll try. Everything, the entirety of my life, all I knew, or would ever know, simply started going away. I understood there was nothing I could do to stop the overwhelming force that was descending on me. I knew everything was about to go black and I knew not to bother asking, "Why me?" And because I realized I could do nothing about any of it, I drifted into a feeling of calm and peace.

I was dying. And everything did go black. Then there were a few flashes of things, just impressions -- I don't know whether you can call them memories or whether they're simply what happens when a life turns off. I'm sure I felt my late Grandma Dot's hand -- the distinct it-could-only-be-hers sensation of her soft fingers. I know that sounds like a scene from every Hallmark Channel movie ever made, but what if it really happened?

I could see myself being loaded into the ambulance. I could see its colors: red, blue, white, metallic silver. I could see someone talking on a phone. Then I don't remember much of anything. For a little over a week I was in and out of a coma. During my moments of consciousness in the hospital, I began to find out what happened: that someone -- I don't know who to this day -- found me collapsed near my car and called an ambulance. That I had suffered two strokes, a hemorrhagic followed by an ischemic (see "A Few Words From Erin's Doctor" on page three for more info). That neurologists had been able to do lifesaving procedures on my brain internally, without cutting my head open or even shaving off my hair. God help 'em if they had shaved my hair -- I'd rather have been left in the parking lot. That one doctor especially, the blessed and heroic John Lynch, M.D., did amazing things to save me, given how much blood I'd lost and how much brain area had been affected. That I had forever been split into two different people: pre-stroke Erin and post-stroke Erin.

Post-Stroke Erin

My mom, Susie, was at my bedside when I fully regained consciousness in the ICU. In fact, she had never left it. Post-stroke Erin came to rely on her and her superhuman efforts to help me heal. I had lost the use of my left side and, with it, the ability to walk. My vision was so blurry it was almost useless. I had real difficulty speaking. I couldn't think straight; everything was disjointed, jumbled, a mess.

I was transferred to a step-down unit from the ICU, then released three days later. I wasn't anywhere close to being able to care for myself, so I went to my parents' house. I left the hospital only 11 days after my stroke -- barely able to move under my own steam but walking nonetheless. Then I began months of intensive rehab. Let me tell you, it was hard.

I worked with a physical therapist and an occupational therapist three to four hours at a time, most days of the week, to regain full use of my left side, relearn how to balance while walking, rebuild strength, and renew my memory. My mom was there through it all, shuttling me back and forth to rehab and medical appointments and caring for me around the clock. I honestly can't imagine what people would do, how they could recover from a stroke, if they didn't have support like that. Mom, I can't thank you adequately or ever repay you for all you've done. I love you so much.

Just over four months later I went back to work. Do you know how lucky that makes me? So many people have devastating lifelong deficits after a stroke like mine; the fact that I don't is Ripley's Believe It Or Not-level amazing and has changed me to my core. I'm constantly finding new things now to be grateful for -- life itself most of all. And that gratitude has uncovered reserves of tolerance and patience and kindness I didn't know I had.

I am so much better, but I still continue to discover things I can't do as well as before. I close my eyes to rest them a lot and my right eye is still a bit blurry. I struggle with waves of exhaustion. My short-term memory needs lengthening. I sometimes stop in the middle of a sentence, just when . . . Sorry, couldn't resist that little joke. My train of thought still goes off the rails every once in a while.

My proudest moment was when, two months into recovery, my ability to make puns came back. Because, you see, there was this man who lived in a mushroom-shaped house and I said, "Boy, I bet he's a really fun guy." (Fungi? Get it?) My family didn't laugh either. C'mon, that was funny. It may seem trivial, but that's the kind of thing that reassures you that your brain still works.

I've also worked hard on changing the things that led to my stroke. I take a beta-blocker to control the unmanaged hypertension that I now know caused the blood vessel in my brain to burst. I didn't know I had high blood pressure before; I certainly didn't feel any symptoms. I've quit smoking, something made easier by being unconscious for weeks and in rehab for months. You don't tend to want a cig so much after your brain just blew up. Yet it astonishes me to find myself still craving one sometimes, even though I was just a social smoker. Nicotine is such a crazy addictive drug. I've lost most of the extra weight I was carrying (although I don't recommend this kind of weight-loss program -- it's a bitch of a way to lose 26 pounds).

My biggest challenge is changing the way I eat. I'm not, nor have I ever been, a big fan of the vegetable. I am, though, a big fan of cheesecake, bacon, and pork chops. I run a cooking school, remember? I'm trying hard to work healthier foods into my diet, but it's an ongoing process. It helps that I've had the biggest kick in my fat pants -- I nearly lost my life.

Every day I still park in the same lot at work, even if I get there early enough for a primo space. Every day I walk by the spot where someone found me crumpled on the pavement and called 911. And every day I say to that spot, "There's no way you're going to beat me. Not today."

 

A Few Words From Erin's Doctor

John R. Lynch, M.D., director of the Neurointensive Care Unit at Froedtert & The Medical College of Wisconsin in Milwaukee, had a tough case on his hands. The unconscious woman in front of him, Erin Puariea, was having two kinds of stroke at the same time. The first was a subarachnoid hemorrhage, or SAH. That's where an aneurysm, which is a blood vessel that has burst, floods the brain fluid with blood and disrupts the chemical balance that neurons need to function. And if the bleed is large enough, as it was in Erin's case, tremendous pressure builds up in the skull, damaging wide areas of delicate brain tissue. Worse, it often kills the person immediately.

The second was an ischemic stroke, the most common kind, where a blood clot lodges in a blood vessel, reducing or stopping critical blood and oxygen flow. The clot had been dislodged during the SAH and thrown into her brain by blood vessel spasms, which often accompany a hemorrhagic stroke. Basically, her first stroke caused her second stroke.

"She was in critical condition when she arrived," says Dr. Lynch. "She was in a coma, near death." But she also had enormous luck. She had arrived at Froedtert, which is a certified primary stroke center, the gold standard in stroke care. And she had arrived quickly, which allowed Dr. Lynch and his team to begin treatment within an hour of her stroke.

They worked with the speed of people who know that time is the most deadly enemy during a stroke. They inserted a shunt to drain the blood pressing on her brain. Next they did what's called a coil embolization, where they threaded a catheter up to the site of her bleeding and sealed off the balloon-like aneurysm with a tangle of tiny platinum wires. Then, using imaging, they hunted down the clot, broke it down with a tiny state-of-the-art clot retrieval device in the catheter, and vacuumed out its pieces. They had just saved Erin Puariea's life.

"Not very long ago the vast majority of people who came in like Erin either ended up in nursing homes or dead," says Dr. Lynch. "In the past five to 10 years, that has changed dramatically as we've developed new tools and techniques to treat stroke far more quickly and effectively. What she represents is quite a miracle."

But as miraculous as Erin's recovery is, it also shows an alarming trend. The number of people, especially women, who are having a stroke at a younger age is going up at record levels. "When I was training, seeing a stroke in someone under 60 was rare," he says. "Now we routinely see people in their 30s and 40s who are having strokes. It's truly a national tragedy."

Of the controllable risk factors for stroke, Erin had two: unmanaged high blood pressure and smoking (yes, social smoking counts). Erin has made changes in her life to address them both. Too many other people, though, have not. Obesity, a sedentary lifestyle, dangerous cholesterol levels, and type 2 diabetes also increase the chances of having a stroke.

"There's a certain unpleasant irony in that stroke victims are getting younger and younger while we've been getting better and better at treating them," Dr. Lynch says. "But you don't want me fixing your stroke in an emergency. The far better thing is to make the lifestyle changes to avoid having the stroke in the first place."

-- Christian Millman

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