Mental health is probably the most challenging field of health care. Four of my immediate family members in the last decade have had strokes and all have had completely different symptoms. My recent stroke, only a few weeks old, is somewhat textbook. Fortunately, it was also not a debilitating stroke and therefore I am still able to write about it. Oliver Sacks wrote a collection of short stories entitled “The Man who Mistook his Wife for a Hat” and it is a primer in the strange effects mental illness has.
During the last two weeks, a steady headache descended on me. At my worst, I was pretty disfunction. I remember the headaches become asymmetrical and not being able to sleep. The forest fires were terrible and sometimes you couldn’t see the surrounding hills but my cat allergies were acting up too. When I would sneeze it would be crippling. I would call up the ER but they had good advise. I discontinued 81 mg ASA. This at least provided incremental improvement to let me sleep.
I also visited the ER two more times. The first time, it was for a prescription for some some Tylenol and a nasal rinse. The second time was only a day later. I was talking with my wife into the evening but she could understand me so I went back. The Invermere ER made a reservation with Cranbook ER.
The doctor told my son I was not to drive myself.
Aphasia is a common symptom for strokes. It is the inability to construct speech from thought. Therefore, from a severe headache ( take an Advil, see you in the morning ) to being aphasic ( front of the line, into the ambulance ) was a natural escalation of the medical system at work. I was in Cranbook an hour and half later and checked in to the hospital. During the remaining two days, I had a CT scan and the decision was made to send me to Kelowna. Beds were not available for a day or two in Kelowna but I was mobile. My room mate was not, however, and was quite happy to have a coffee delivered. He had Italian origins and watched cooking shows in his spare time. I suggested Stanley Tucci “A Taste of Italy”. Over 2 days, my speech was quiet a bit better but there was still long delays. Just before I was to load the transport, a doctor showed me the CT scan. It revealed that a great extent of my cranium had been affect by brain bleeds.
Needless to say I was not relieved.
A decade ago, my brother took a fall on his dock. In Ottawa, after brain surgery, the after affects became apparent. He had memories from before accident but was not able to retain memory after the accident. Every time he woke, it was like he had just woke after the accident. His sense of direction was also lost with a couple of turns. Lastly, one half of his vision on his left hand side was lost. But I took him to visit a cafe within the hospital and we had a normal conversations so long as we were discussing things before the accident.
His retention of memory took about 6 months to recovery. He had “found” his sense of direction a couple months later, but never recovered the vision on the left side. There was a bunch for differences between my brothers situation and mine though. It was not emergency surgery and it was done a decade later.
The flight to Kelowna was in a King Air ( fixed wing ). I was sharing the flight with a patient with lung/ cardiac problems but I was able to sit up. The flight was 35 minutes with ambulance porters at either end. One of ambulance attendants had a sleeve consisting of a fantail, a bird which I recognized at once. Amazed that I had identified it, I also added, “my wife chased one, but never got a good shot”. At the end of the flight I was 600 km from home.
The one bed on left the end of the ward, was underneath a mashed heat vent. No amount of prying could stop it from making an impossible noise. I moved into the hall in the middle of the night and covered my eyes to get to sleep. About an hour or two later, a finger intruded on my field of vision. “My bed”. The Indonesia girls had advised that my switch had interfered in their cleaning cycle. A few negotiation, apologies, and I was back to sleep. In the morning, I was to realize there were no showers, no privacy. Because it was the weekend, there were also a short supply of doctors. The ward was half a century old. About the middle of the day, a doctors which has passed me a few time says my name, greets me, gives me a terse two line description of the procedure then leaves. My wife and the doctor’s schedule do not coincide until the last day. Far more common however are the 4 times a day neurological, blood pressure and heart exams. These are committed to paper.
The only test I routinely fail is the city, Kelowna. Before this I had never had to think of it and the post aphasic brain had not caught up with it. At about 3 days, the last of the headache had disappeared and it was a wonderful relieve. I could take long walks into the down town and have a cappuccino and avoid the pandemonium. The surgical team was stalking me however and would put me on 12 hour fasts and then cancel the surgery. I was almost certain that the brain surgery was going to lead to regression in my new found speech and I was not wrong.
The operating room was almost as flashy as the ward was depressing. The team took a sensor through my groin and into my cranium guided by the CT. They sealed the brain bleeds while discussing pickle ball.
Post operatively, my speech had regressed about 4 day. Eva was alarmed. I was relieved. I had been warned that a wrong move may compromise my vision. In another day when I was released to travel the the 600 km home, my speech had improved quite as lot.
My mother had a severe stroke as well, 5 - 10 year ago, and spent a few months in a stroke rehabilitation clinic. She, being past 90, never regained her speech. When I was there a swimmer had a severe stroke that left him paralyzed on his left side and had to be rescued from the pool. He was 6 - 8 weeks from recovery. The work of recovering speech is arduous. You have to fill in the blanks in you memories, not unlike a set of flash cards. In my case, the percentage of words lost seems to be small but can lead to frustrating pauses over a critical word.
The reason for this article is part communication and part exercise. From the first paragraph on day one the text was brutally slow. Within a week, I was functional, but still low. The goal now is a month.