Surviving a stroke

What does it feel like to have a stroke?

I actually had the stroke while I was sleeping. I woke up with a terrible headache and thought, “You really need to get more sleep.” That was about 2:30 a.m. When I woke up in the morning at about 6:30 a.m., I was very confused. I still had the headache. I had trouble understanding my husband and I couldn’t talk or write.

What symptoms made you think something was wrong?

When I joined my husband in the kitchen for breakfast, I soon realized I couldn’t talk and had trouble understanding what Bill was saying. He asked me to write the names of our three children on paper with their ages and I was unable to do so. All I could do was cry.

My brain waves were so scrambled that I was unaware where I was.

What type of health care did you require? Describe your time in hospital and any tests or treatments you had.

We first visited our family doctor and he insisted that I go to emergency right away. Bill took me to the hospital. The nurses took my blood pressure and pulse.

I didn’t see a doctor until 2:30 that afternoon. I never looked like a stroke victim. I was dressed for work and I think they wondered what I was doing in emergency.

The doctor ordered a CT scan, which showed a cerebral infarct in the territory of the anterior division of the left middle cerebral artery. In layman’s language, there was an obstruction in one of the arteries to the brain. I was hospitalized for 12 days.

In simple terms, a stroke like this is either due to a problem in the pump (the heart), the pipes (blood vessels) or the blood.

These were the tests I had in the hospital:

• A cerebral angiogram, in which dye is injected into the bloodstream and an X-ray taken, to examine blood vessels in my head and neck. It came back normal.
• I wore a holter monitor with electrodes attached to my chest for about 24 hours in order to look for atrial fibrillation, an irregular heartbeat that can lead to blood clot formation. It came back normal.
• An ultrasound examination of the internal structure of the heart, which came back normal.
• Special blood tests to look for evidence of: a congenital or acquired thrombophilia, which is a predisposition to excessive blood clotting, and vasculitis (also called arteritis, meaning inflammation of the blood vessels, particularly the arteries). These tests were normal or negative.
• A blood test for cholesterol. The values were reasonable because the angiograms showed no evidence of clogged and hardened arteries.

(Special thanks to my doctor for this information. I had no idea what they were doing to me while I was in hospital.)

Was there any family history of stroke?

My father died of a stroke at age 70. His mother died of a stroke as well. The neurologists attribute the stroke to family history. If stroke runs in your family, take extra care.

Did the surgeries or treatments have any side-effects?

Following my second stroke, an MRI angiogram was conducted to look again at the blood vessels in my head and neck. This was also normal. The transesophageal echocardiogram, in which a small ultrasound probe was sent down my throat, showed a small hole in the wall between the left and right chambers of my heart (called a patent foramen ovale). This is a congenital heart defect that is present in about 20 per cent of the general population, and in a higher proportion of young patients with otherwise unexplained strokes. This defect is thought to predispose to blood clots getting to the brain to cause stroke.

I had to go overnight to the hospital and have the hole repaired with a catheter. The catheter was fed up through my groin via a major artery. They repaired the hole in my heart with a little metal button device, which deployed when it was inserted in the proper position.

Twenty years ago, this would have entailed major open-heart surgery, but all I had to do was be anesthetized and undergo a very minor repair. I was overnight in the hospital and after that, I was able to go back to the office. The cardiologist warned me of the risk, and I’m not sure it was so simple for the doctor who conducted the procedure.

There were no side-effects.

After I was released from the hospital, I was prescribed two medications to help prevent further strokes: a blood thinner and a drug to lower cholesterol.

I saw a speech-language pathologist for almost a year after my stroke. We worked on my speech. I owe so much to her: It’s because of her that I can speak again. She took me to the banking machine, did math problems with me, worked through all the forms I fill out as a realtor, helped me search the phone book for names and businesses, taught me synonyms and antonyms for words that I couldn’t recall.

I had lost all my math and computer skills, and forgot how to play the piano which I had studied for years.

I also saw a neuropsychologist. She was very helpful in working through problems that I faced when I went back to work. I still see her from time to time. She is very supportive. She taught me how to keep a notebook with me at all times lest I forget important information, taught me how to do deep breathing exercises in times of stress, how not to panic when I make a call and get an answering machine. These normal things cause stress in the lives of stroke survivors.

How has your life changed since?

I think my family would tell you that I am fragile emotionally. I cry very easily. I am still very intimidated by my speech, even though people tell me they would never have known that I had had a stroke. When you were very articulate but now seem to be fumbling for words, it causes a lot of stress. Strokes destroy your self-esteem. Things that seemed easy before the stroke are now hard, and physically tire you out. After a day at the office or out on appointments, I am ready for bed at 9:30 p.m. I tend to do my business during the day, because I feel like I don’t even make sense after supper.

This presents a challenge to my family. I am married to a minister and lots of meetings are called in the evening. I have learned to send my regrets if I can’t attend. We limit the number of guests we have in our home because I don’t handle crowds very well. Entertaining seemed so easy before, but is a real chore now.

I have learned to be quiet rather than say something and be misunderstood. One of my stroke-surviving friends says she “talks around” the subject. That’s because the right words aren’t there. So rather than say anything, I say nothing. My husband says he misses just “yakking” with me.

How can family or friends help others who have had a stroke?

Be very patient! Perhaps your loved one can’t move as quickly or be as articulate as they could before the stroke. Give them your undivided attention.

I will never forget the medical team and students who came to visit in my hospital room on Monday following my stroke. I couldn’t speak and I was overwhelmed by the 20 or so people in my room. They were talking about the seriousness of the stroke – “Can she hear?”, etc. I heard every word they said and all I could think was, “Oh, my goodness, they think I’m brain dead.” Recently, I spoke to a group of speech-language pathologists at Halifax's Dalhousie University and I reminded them of this incident. Stroke victims are only too aware of people’s words and actions. Be very kind.

My family became my caregiver in the months following the stroke. A word to caregivers: take care of yourself. Take some time away from the patient. Don’t stop doing the things you do in your normal life, like jogging, playing an instrument or going out with friends. It will alleviate the resentment that can build toward your loved one.

I think it’s like a grieving process. You grieve the loss of your loved one just as the stroke survivor does. Things will likely have to change forever and that is a tough thing to wrap your head around both as a caregiver and as a stroke survivor.

What is your advice to others who may be at risk?

• If you are still a smoker, stop for your health’s sake.
• If you’re drinking too much, stop for your health’s sake.
• If you have high blood pressure, get exercising for your health’s sake.
• If you are overweight, lose as much weight as you need to for your health’s sake.
• Get active and forget your sedentary lifestyle.
• Take a workshop on how to deal with stress! We all need help with this.
• Be sure that all your relationships are in order. It would be so sad to have a stroke and then try and repair a relationship.
• Be sure you keep forgiveness in your heart for all who do you wrong. Make your peace with God.

A stroke can change your life forever. Do whatever it takes to avoid one. If you have a family history of stroke, be very careful. See your doctor for ways to prevent a stroke.