Living To Tell My Story – A Stroke Survivor
By Paul Krueger
The fact that I can write this story is something of a medical miracle.
On July 30, I was rushed to Scripps Mercy Hospital’s Trauma Unit, disoriented, unable to speak coherently, and afraid I might never talk again.
Within12 hours, I could clearly communicate with my wife and the medical professionals who restored my brain functioning — and possibly saved my life — thanks to an amazing drug that can reverse brain injury and prevent permanent disability.
The scariest four hours of my medical emergency were a twilight of mild hallucinations, random emotions, and intense frustration. While I knew exactly what I wanted to say, I was terrified that I might never again be able to share my thoughts in a way anyone — myself included — would understand.
My day had been long but uneventful.
I attended a San Diego City Council meeting in the morning, took a break to swim in Coronado Bay, then returned for the Council’s afternoon session.
I drove home, ate dinner, then fell asleep while doing a crossword puzzle.
About an hour later, my wife woke me because she noticed I was sleeping in a strange, twisted position.
I remember feeling — for want of a better word — “spaced-out,”
Everything seemed dreamy, gauzy, and distant.
I wobbled when I stood up, and I knew something was wrong
when I couldn’t tie the drawstring of my sweatpants into a simple bow. Then my right foot wouldn’t budge when I tried to slide it into a sandal.
Watching me struggle, my wife asked if I was OK. When I opened my mouth to reassure her (I always downplay or deny any medical problems), we both knew something was very wrong.
What I wanted to say was, “Yeah, I’m fine. Just a little groggy from that nap.” What I said was unintelligible, something like, “Gah, jordy gammy shord takey.”
I kept trying to speak the words I clearly saw in my mind, but they poured from me like a goofy word salad.
I raised my hands and forced a weak smile. My wife reassuringly smiled back, but I saw the fear in her face. She dialed 9-1-1.
The paramedics were professional and unintentionally funny. When they asked for my driver’s license, I pointed to the sleeve on my I-phone. “Chee, fur da clip son,” I explained. The very sincere EMT asked my wife, “Does your husband usually talk like that?” She politely explained that no, I usually challenge her assumptions and correct her grammar.
They wheeled me to the waiting ambulance. I remember whizzing past storefronts and traffic lights on El Cajon Boulevard while the paramedic prepped me for an IV and called in my vitals to the nursing station. Once inside the ER, I was surrounded by a sea of somber faces. I tried to answer their questions, but only gibberish came out.
Within minutes, my head was inside a CT scanner, then I was back in the exam room.
I kept trying to tell my wife that the doctors needed to know I hadn’t drank enough water that day, and was probably dehydrated. She reassured me she would mention that. Unconvinced, I tried to write it out on paper, but the pen wouldn’t work for me. Then I clumsily spelled out the letters with my index finger in the air. “D-e-h-y-d-r-a-t-e-d.” Everyone politely looked away.
Suddenly, a doctor — who I realized was a neurologist — appeared on a TV-sized monitor in front of me. I could hear and comprehend the questions he asked, but my mind was drifting, bouncing around from the mundane to the existential.
“Will I ever recover my speech?” I asked myself. “Is this my future? Will I miss tomorrow night’s soccer game? I’ll have to reschedule Thursday’s lunch. Will speech therapy help me?”
Then came the cosmic bargaining that follows catastrophic events: “OK,” I told myself. “This is it. You can’t talk, but you can still think, and you can still contribute. You can read, write letters to the editor, engage with social media. You can enjoy the successes of a wonderful son. You can watch movies with your wife.”
The neurologist brought me back to reality with mixed news. Though the CT scan was “unremarkable” — an excellent result, because it showed no blockage or damage in my brain’s blood vessels – he was confident I had an ischemic (blood clot) stroke.
He explained that the treatment of choice would be a dose of a clot-busting medication called “Tissue Plasminogen Activator” or “tPA.” Approved by the Food and Drug Administration in 1996, tPA is now the gold standard for treating strokes caused by blood clots that block blood flow to the brain.
tPA does have risks, because the same chemicals that help dissolve blood clots can cause serious internal bleeding and hemorrhages. But the medical staff agreed that the rewards outweighed the risks.
What happened next was nothing short of amazing.
Within minutes of the IV injection, my thoughts were more focused. I quickly regained sensation in the index finger of my right hand.
The more I talked, the more my speech improved. Within an hour, everyone could understand what I was saying. I felt close to normal.
It was an unfathomably quick and unexpected recovery.
I was wheeled to the Intensive Care Unit, where I spent the next two days. The nursing staff watched for signs of internal bleeding. I started writing this story in the ICU just 12 hours after my stroke.
While I tapped away on my hospital-issued iPad, my wife studied ischemic strokes. We learned the clot buster injection works a lot like water on a wilted plant.
Droopy as a plant’s leaves may be, as long as they’re not dead, a good watering will bring them back to life and restore their luster. Our brain cells work similarly; they can survive a temporary lack of oxygen and will again “perk up” again when the blockage clears, and blood flow is restored.
But timing is crucial, both for our houseplants and our brains.
For tPA to be effective in halting brain damage, it must be delivered within a narrow window of one-to-four hours from the onset of the stroke.
I was beyond fortunate to get treatment well inside those “Golden Hours.”
If my wife hadn’t realized something was wrong and woke me, it could have been too late. If she wasn’t home to call 9-1-1…. If paramedics hadn’t arrived quickly, and recognized the symptoms… If they hadn’t taken me to Scripps Mercy, which has a top-rated emergency stroke treatment program where every minute counts… If I hadn’t been in excellent overall health, with none of the preventable risk factors (high blood pressure, obesity, diabetes, smoking, too much alcohol)…
A follow-up CT scan before I was discharged showed no blockage, internal bleeding, or visible brain damage.
I now take a powerful anticoagulant. I bruise easily and bleed longer, from even tiny cuts. My new treatment regimen is also aggravatingly (and for many, prohibitively) expensive (with Medicare Part D, I paid $793 out-of-pocket for a 90-day supply).
But it will help prevent another stroke, and as my wife says, it is much cheaper than a permanent disability with months — or a lifetime — of intense physical, speech, and occupational therapy.
I went swimming five days after my stroke. I’ve worked in the garden, resumed my reading, and finished writing this story. I was a bit fatigued for the first week, but that too has passed. I recently traveled with my family to Santa Fe for a week of opera, art, dining, short hikes, and long drives.
More importantly, my wife is once again telling me to stop correcting her grammar and contradicting her opinions.
Category: Health & Fitness, Life Style, Local News
