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April 2009
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June 2009

Through the eyes of a 7 year old

"What would you do if you had a stroke in Africa?" He asked me.
"Try to get to a hospital." I answered, even though I knew so much of it depended on where exactly I was when in Africa.
"What would you do if you had a stroke in Morocco?" He knew I spent almost two weeks in Morocco last summer.
"Well, I would try to get to a hospital." I answered.  And in fact, I almost did have to go to a hospital when I was in Marrakesh since I got serious heat stroke (after decided to work out everyday in the 115F weather).

But his questions started me thinking.  I had my stroke in Cambridge, MA.  In fact, it happened on the Harvard Business School Campus (I suppose if you are going to have a stroke, that is as good of a place as any...) Once we arrived at the hospital, I received immediate medical care and now have minimal, if any, residual affects from the stroke.  But this is not always the case.  What if I did have the stroke while traveling?  Would I be ok?  Would the care have been as stellar?  I honestly cannot say.  Perhaps, is my answer.  However I am only familiar with Boston's medical hospitals and research capacities.  I have had great experiences.  I am lucky.  I can only hope the same is true for others.


Grey Matters

I finally watched the Season Finale of Grey's Anatomy.  Yes, I am a fan, and I love the show.  I remember the fall before my heart surgery I recorded every episode so that I would have something to watch as I recovered.  It so happened that some complicated heart surgeries were being conducted that season, so I was particularly interested in the shows in 2006.  But back to the 2009 Season Finale...

Izzy Stevens was getting wheeled in for surgery - a risky one - and while I am not here to write about the tear jerking ending of the show, the topic of DNR (or Do not Resuscitate) emerged several times throughout the 120 minute episode.  This is a topic I became quite familiar with as I prepared for open heart surgery in 2006.  I would be willing to bet that most healthy 33-year olds are not spending a lot of time thinking about DNRs.  Perhaps I am wrong, but until I was told on August 12, 2006 that I would be having heart surgery 4 months later to the day, I spent little time thinking about the "what ifs".  I had undergone three knee operations and one back surgery (yes, I am like the Bionic Woman...) prior to my heart surgery, but I never took the time to think about what might go wrong.  The knee operations seemed too benin, and the back, while serious, occurred when I was 19 years old.  Although 33 is young, 19 is almost infantile (in a good way of course) in respect to 33.  So at that point in time I worried not about a DNR but instead about when I could get back to the gym etc.

But for my heart it was so different.  It had to do with being put on heart-lung bypass (Cardiopulmonary bypass), which literally takes over the job of the heart and lungs by circulating the blood throughout the body while surgery on the heart is taking place.  In my instance an incision was made in my femoral artery and the machine was attached there.  For the surgery, the doctor had to go into my heart and quite literally sew the hole in my heart closed (blue nylon thread in case you are wondering... I asked).  I could not stop thinking about something going wrong.  The doctor - incredibly well respected not only in Boston, but the field - put me at ease, but that did not stop me from conducting multiple web searches on an hourly basis to find out the pros and cons of heart-lung bypass, open heart surgery, and side affects after the surgery.

So this brings me back to Grey's Anatomy.  Izzy was getting wheeled down the hall, she lay on the gurney, and her husband of several hours stood by her side angry with her for signing a DNR form.  I listened to her reasoning, and it resonated a little too much.  Having the man she loved by her side as she was wheeled into surgery also resonated a little too much, as that was the last thing I remembered before my surgery.  I thought long and hard about the possibilities of not waking up or if I did wake up, not being me, being someone else entirely.  Perhaps someone who would be unable to recognize my friends, family, and even myself.  Prior to my surgery, I had already suffered a stroke, which is what brought me to the point of heart surgery in the first place.  I certainly did not need another major medical episode.

Yes, I thought long and hard about what the DNR would mean - for me and for my family.  It was not an easy decision, but it was the right one for me.  So as Izzy, from Grey's, was wheeled down the hallway and she raised all the reasons for her signing the DNR form, I related.  I felt like I was right there by her side, and that December 2006 was yesterday.  These seemingly far away decisions, the ones you think that you will never have to make, the ones that other people make, you might have to make those decisions one day.  They might be staring you in the face.  The writers at Grey's do a great job - it is entertaining and allows me to shut off after a long day at work.  However this particular episode was real.  It was like "real life" (at least the DNR decision making).  So think about all of those things that you might think do not matter... They do, and so do you.


Back to School at Friends

I walked down the hallways, and they really were not that different then they were a little more than 20 yrs ago.  Kids still ran up and down them, the plaques that we all created our final year covered the walls, and teachers bent over the students patiently explaining a sentence in a book or an addition problem.  The headmaster took me to the eighth graders, and I cautiously walked in...  I used to love outside speakers because that meant I did not have to do my work, but I am not sure I ever really paid any attention to what they said.

After introductions, I started the story telling...a story about a young woman who lost her words.  She then eventually found out her heart was broken, she truly had a broken heart that needed to be fixed.  The students' eyes all looked at me as I tried to make an impression on the young adults.  I told them the importance of time (the first three hours are so critical when someone is having a stroke), I asked them if they knew the symptoms or signs of stroke (many of them did), I asked if any of them knew someone who had suffered a stroke (unfortunately the answer for several of them was yes...)  The questions they asked were more perceptive and better than I could have hoped... Did I have any lasting affects? How long did the effects of the stroke last? How did I feel about open heart surgery?  What was the recovery like?  And on and on...

It was exactly what I wanted.  I wanted to get to know them and I wanted them to know me so that when I spoke to them at their Class Day it was a bit more personal and it would make some kind of impression. However, I also told them that I did not remember who gave me my Class Day speech, and it was just fine if after the days, weeks, and years, they came to forget me.  However, what they should never forget is the importance of the signs and symptoms of stroke.  So:

Josephine, Anya, Tim, Molly, Katie, Kim, Sophie, Rachel, Connor, Tristan, Blake, Trevor, Reilly,Michelle, TJ, Oliver, Thomas, Tim, Celeste, Stephanie, Kelsi, JC, Jenna, Kristen, Mia, Anne... 

please do not forgot. Know what to do in case you are every faced with a situation like I was faced.

OK, now I have to work on that Class Day speech for all of you!

Stroke Awareness...What would you do?

Stroke

It happens suddenly, out of the blue, from nowhere.  You know that you want to talk, the words are there, somewhere, but they just cannot come out.  He starts to ask you questions: what is your name, what is his name, what day is it.  Really, you  know that these answers are somewhere, but you are unable to find them, and even worse, you know that you are unable to get them.  One or two letters might float around in your head, and somehow they relate to the questions being posed to you, but you can't reach them and pull them to your mouth in order for actual sense to be made.  It is as if someone shut off your ability to speak.  A switched went from "on" to "off".

Suddenly, you are brought to the hospital, and there is a flurry of activity around you.  You are rushed into the nurse's triage room, and as your right arm is being prepared for a line to go in, the nurse is asking you questions.  Basic questions,  However, you cannot answer as the words are gone.  Your blood pressure starts to raise as you being increasingly upset, and begin to understand that something is seriously wrong.  The IV is in and you see the dark ruby color fill up have of the line.  The nurse asks your name. You cannot answer.  Your age, nope, and hopefully you look good enough that she will guess lower than it actually is... Your address... Luckily H knows these answers, and he fills in the blank when needed.

Again, more activity, and you are placed on a gurney and brought into the CT-Scan room.  The test occurs, but no one gives you any information.  In your head you try over and over again to talk, and try to make sense of words, it all begins with the alphabet.  Maybe you can do the A-B-Cs?  And just as you try and get the first 6 letters out, you are asked to stop, and rest. They insist that you try to relax as you need to decrease your blood pressure.

As you lie on the gurney, with H by your side after the first test, the ER doctor walks in - tall, blond thinning hair, angular face, creases around his eyes.  And his eyes are kind, probably due to his job.  He pulls up a stool and sits down one your right side.  His face is merely inches from yours.  He starts to ask you questions: your age, what activity you did that day, have you taken any medication, specifically, have you taken cocaine?  You desperately shake your head no, and can hardly believe the question.

He tells you that he sees something that he does not like something on the CT-Scan, and he would like to do another one, this time with contrast.  You look into his eyes and nod.  What else can you do?  Your options are not very plentiful.

A nurse comes in and takes you back down the hallway and in to the CT-Scan room.  She explains that the contrast is going to warm you, even make you feel hot. No one really lets you move, and you are limited to that gurney.  She leaves the room, and there you are alone.  With your thoughts and nothing else.  Still no voice to explain your fear, frustration, or the beginning of a massive headache that would be more painful than you could possibly explain.  Following the nurse's cue, you feel the warm rush of the contrast liquid pour into your vein and spread out into your chest, pelvic area, arms and legs.  It does not last more than a few seconds, but for some reason feel like a lot longer.

She takes you back to your room, and after a few minutes the doctor reemerges.  His face is grim, and there is a shadow sadness over his eyes.  He pulls the stool up again to your right side, and he sits down.

"Lily, you've had a stroke. You have a 1.5 cm blood clot in your head." And after hearing those words, your life is forever changed.

May is National Stroke Awareness Month.  Be Aware. Know the Signs, the Symptoms.