Tag Archives: health

My Answer to Uncertainty

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While we are on our doctor trip we paused at a store display of spring bulbs. I asked Hubby Dearest to pick a couple of bags to add to our garden. No surprise he picked daffodils. They are his favourite flower not least because he is a bit colour blind but yellow and orange are among the colours he sees well. They also bring back memories of his youth in Oregon where these daffodils bloom in the wild each spring. On one of our trips we drove slowly north up the coast from California to British Columbia and because of the pace we went at, we had weeks and weeks of enjoying wild daffodils.

His second pick was a bit of surprise. He’s never expressed a liking for crocuses. We did make a special point more than once to go find the wild Manitoba variety, a rare but gorgeous treat and the provincial flower.

“They are first through the snow in spring,” he replied. “I like that.”

It is supposed to rain tomorrow. You are supposed to give bulbs a good soaking after planting. The day was lovely, still, warm enough to work in a T shirt. I took great pleasure in planting the bulbs for us both. It was a great stress reliever. Maybe one of us won’t be around in spring to enjoy them but I am assuming we will be. And if one of us isn’t, it will be a nice reminder of the many wonderful things we did get to enjoy together. Everything else is out of our hands and beyond our control so there is no point worrying about it. The Master of the Universe has our back.

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Stroke Recovery Update

IMG_7886We got so so news. The assessment required we drive two hours and fifteen minutes to Brandon. We left on a Sunday and he had a CT Monday morning and we saw the neurologist on Tuesday morning. We turned it into a camping trip with several lovely walks in the country enjoying the fall colours. Manitoba turns gold in September. We also had one of those strange summer day spells that often happen in September so the daily highs reached 30C (86F). Things are back down to more normal cool now but we enjoyed that brief return of summer. It was altogether a very nice interlude in spite of the stress but even so we were both feeling a lot of stress.

The artery in Dick’s neck is still open, “patent” as they say. However, the tear is not healing properly and has actually gotten a bit worse. The neurologist thinks maybe an accident he had in midsummer when he ended up with whiplash likely caused the increased damage but the blood thinners protected him from having another stroke. We are being referred to an interventionalist radiologist to see if he is a candidate for a stent. Dick and I are inclined to wait since these arteries will take 3 to 6 months to heal anyway and it is only just 3 months since it happened and five weeks since the whip lash. (Our dog was playing with another dog and both dogs smashed in to him nearly knocked him over. He later developed such horrific neck muscle spasms we were off to the ER where he was diagnosed after many tests with whiplash. The ER doctor thought the neck muscle spasms might be due to the atorvastatin (Lipitor) but said we should not stop taking it without the specialist saying so.) Plus the proposed stent is low but not zero risk itself and the standard is only put in a stent if the patient is symptomatic and Dick is not symptomatic.

Given the Canadian health care system, it will be at least several more months until he gets in to have a consult. Our friend across the street has an uncle who is on a waiting list for a consult about a stent. It was nine months ago that he was referred and he’s still waiting. Of course, the uncle is 86 and also has multiple health problems, diabetes and kidney failure and he’s likely to die soon anyway no matter what the doctors do for him so he would rank very low on the list for getting a stent. Dick’s situation might be considered more urgent and likely to save the system health care dollars so he might get higher in the que. Of course, if Dick has a massive stroke and dropped dead he’d really save the system a lot of money and being he is nearing 76 so who knows how long we will wait. The wait lists aren’t supposed to work that way but we all know they often do.

On the stroke symptoms front, Dick is doing remarkably well. The post stroke sudden fatigue is mostly gone which is a real blessing. The other nice thing is the specialist said we can stop the atorvastatin. He was put on atorvastatin not because he has high cholesterol, but because the drug supposedly has some anti-inflammatory properties that apparently help with post stroke brain healing. (I could not find any reference on that so I assume that is an off label use experienced physicians learn.) However, 20% of the population can’t tolerate atorvastatin and it has a lot of nasty side effects even in those who can and many doctors are questioning its usefulness. Dick was having to cope with terrible pain from near constant cramping of his muscles, especially his thighs, calves and back. I had extreme doubts about the atorvastatin given the side effects. We could not get the local doctors to listen to my concerns because they all deferred to the specialist and they would only change the meds if the specialist said it was okay and we had a specialist appointment in September. There is no way to get in sooner if it is a nonemergency. Put up and shut up and wait.

The neurologist got very angry with me. I asked him how long I should wait to hear about the referral before assuming the paperwork got lost (a fairly common event in Canada in my experience) and he got very angry and told me I had to trust him and if I didn’t trust him I was free to go find another neurologist. I got a lecture about the importance of trusting. That is a threat because there are very few neurologists in Manitoba and he’s the only one in our area. I was taken aback by him reacting to this simple administrative question as a gross personal insult. In order to try move things back to a more professional conversation, I let him finish his little lecture and then I told him I worked at Health Sciences Centre for more than a decade and my comment had nothing to do with him. This stuff happens even with the very best doctors. I am just trying to be proactive. He backed off and seemed mollified. I didn’t say this part but if I had been back at HSC with the authority I used to have, I would also have told him threatening a patient like that is unprofessional and he should consider taking a day off since he’s obviously been working too hard. If neurologists grew on trees out here, I probably would change doctors. Since he was really wonderful during the crisis, and he’s hard to replace, I am just going to assume he was having a bad day instead. Maybe one of his favourite patients died or something. I have no doubts about his skills as a neurologist but his office manner sure left a lot to be desired. Admittedly I can be grating and come on strong and I don’t automatically treat all doctors with the deference and respect some of them think they are due simply by virtue of being doctors so maybe I asked for it.

Anyway it is frustrating and disappointing to hear Dick is still walking around with a fragile artery that could blow and cause him a major stroke or kill him at any moment, or that it might just heal up and be fine given more time and there is no way to know what the truth is. I did not get a chance to ask about the other side effects he is having which I think are related to the three blood pressure meds. We got to discuss only the atorvastatin. We were rushed out of the office in under ten minutes after nearly an hour of waiting because Almighty Doctor was running behind. We did not get to hear the blood test results and the doctor did no physical exam. He just took our word that neurologically Dick is better. I realized that after we got to the parking lot and that bugged me a lot too.

I think the three meds my husband is on for his blood pressure are pulling my husband’s blood pressure down too low. Dick is having bouts of such low blood pressure he gets light headed and nearly faints. The monitor shows him occasionally dropping as low as 100/60. I think all the drugs he is on are having other effects as well such as he is really prone to dehydration with the tiniest amount of heat or exertion. Yet I lack the expertise to say, screw it, we’re changing the meds ourselves. We go back to our family doctor next week and I intend to bring that problem with the blood pressure meds up again. Granted all the bad side effects have been linked to atorvastatin in the literature I read on the drug so maybe getting rid of the atorvastatin is enough. That may be why the doctor simply refused to discuss the other meds. He could have said so if that is what he was thinking. We have one week to assess that for ourselves.

It is SO frustrating to me to think my husband is being over medicated and suffering side effects that are ruining his quality of life which he shouldn’t have to put up with when it might be each day is a precious gift to enjoy before he drops dead. On the other hand, I don’t want to do anything to make it more likely he drops dead. My retired nurse friend says I read too much and I should act stupid and slow around doctors. They treat you better when you act that way. She’s right, but can you see my eyes rolling so far back in my head I can see last May?

So that’s our latest update. Symptomatically Hubby Dearest is better. Artery healing wise he is a little bit worse. Nothing has changed except we are rid of one drug and he’s already had a remarkable improvement in how he feels even just two days off the atorvastatin. So we wait. I probably will have a lot to discuss with our family doctor next week. Hopefully I won’t be give a lecture about trusting doctors again.

 

Recovery continues

I wish I could say everything is wonderful on the recovery front. It isn’t. We are not back where we were. We are in a holding pattern with very slight increments of improvement.

That being said, I do have a lot of positives to report. The most important is my husband has learned to pace himself with the stroke fatigue. We have accepted it as a real thing and we have adjusted to account for it. For example, Tuesday evening is my husband’s pool night with some buddies. In preparation for the evening yesterday he rested a lot during the afternoon, deliberately taking a long nap and spending a lot of time lying in bed with his laptop doing things that require little or no mental energy. The result was he was able to enjoy the evening with the fatigue only starting near the end of the last game. Now I realize that we are very lucky that he can even walk over to the senior’s centre by himself and play pool. Many people after a stroke simply could not. So I am grateful for that. However, if my husband has to miss his pool game because of post stroke fatigue or miss pool because he can not walk over there, he is still missing his pool game due to the stroke. So this adjustment is a major and extremely important one though it might seem very small.

It is the same thing with his work. He is retired but he loves continuing to do science to and mentor people.  We recently finished a paper linking code biology and our differentiation waves. He did all the final editing of adding the references and numbering the figures and the process of submitting it. He did it at a much slower pace than he would have before but it did get finished. He did not stay up all night and push hard to get it in on time at the last minute. That would have been the old pattern. This time he deliberately got it done well ahead of the deadline so there would be no last minute crush. Other things were neglected in the meantime but it got done.

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I am happy to report he is taking this recovery and rehab thing very seriously. He has been using his treadmill desk faithfully and dropped two inches from his waistline. That is the only risk factor he has for stroke that he has any control over. He doesn’t drink or smoke. He can’t control genetics or his age. He can control his weight and fitness. Plus he has started a ping pong club with his friend Frank Chen for Thursday evenings at the community centre. Ping pong is very good for working on hand eye coordination and forcing the body to use the slightly weaker left side. He was exhausted after the first session but it was a good kind of exhaustion. We even had a good turnout with seven people showing up.

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Our friends the Chens have a new dog and they have been bringing the dog over for play time with our Misty. Both dogs have great fun and it’s good for us when they wear each other out.

We have both suffered a blow to our sense of invulnerability and immortality. He could have died. The feeling of shock is wearing off but we are still both looking over our shoulders watching for the grim reaper. We went out to view some property with a friend and his family that they are considering purchasing. We were having such a nice time on this rural property that we did not keep track of time and we did not hydrate. We abruptly had to leave because my husband had a dizzy spell. The drive home took forever and I was panicking while pretending I was not. I knew rationally that this was likely a side effect of the meds. We had been warned about that. It was most likely not another stroke. We got him home. The blood pressure monitor confirmed he had dropped too low, and we got fluids into him and he had a chance to rest and recover. I had my heart in my throat until he woke up feeling fine.

Afterward, everyone said how wonderfully calm I am in an emergency. I am faking it. Inside I was coming apart at the seams and I’m sure if I had used his machine to take my own blood pressure, I would have blown the thing up. Once it was all over, I had to go and vent to my good friend who is marvellous about listening and nodding sympathetically and just being supportive. Another lesson learned. No long hikes without hydration before, during and after. Hopefully, at the three months post stroke check up we will be told the artery is healed and we can begin cutting back on some of the more powerful meds or reduce the dosage.

We got a bunch of money back from our insurance plan for the drugs he’s on. To our disappointment we only got about half back. It turns out that in Manitoba pharmacists can charge all kinds of extra things like dispensing and counselling fees and there is no regulation on these. It is a free market. We found out our local pharmacy is among those who double the cost of drugs with those additional fees. Who knew? Next month, Manitoba will finally join the rest of Canada in regulating those extra charges. Meanwhile, we are looking for a different pharmacy. We will now be shopping around for the lowest additional fees instead of going where it is convenient and the pharmacist tells a good joke or two. Another lesson learned.

Now those slight increments I mentioned. Before the stroke my husband would typically join me at bedtime around 11:00 am and then get up about 1:00 am and work until about 5:00 am and then wake up with me about 7:00 am. When we first got home from the hospital, my husband needed a good sleep with no working at night and about eight naps, some of them two to three hours during the day. In other words, he was sleeping pretty much all the time. He is now down to about four naps a day and most are only about forty five minutes though there is usually one that is over an hour. He is working at night for thirty minutes to one hour. Part of the improvement is simply he needs less sleeping which is real recovery and part of it he is getting the knack of pacing himself and resting before he needs to sleep. That is our small incremental improvement.

In the meantime, our world remains much smaller. A trip to town for groceries we can’t get from Frank’s little store in town and a short visit, left him worn out the next day and unable to accomplish much even though he slept during the one hour drive there and back. We have a regular dental check up coming up in a couple of weeks. That is also a one hour drive. We have our son, his wife and three grandsons coming for an overnight visit. I am a bit concerned about managing. Trips into Winnipeg are basically out of the question. Our world is going to be centred as much as possible around Alonsa for a while yet. Given all the support and friendship we have been enjoying, I can think of no better place for us to be stuck.

Lover to Caregiver and back again.

I can’t really claim I have been transitioning between the two states very well. Yesterday we went for lunch to Riding Mountain National Park. The park is only forty kilometres away but once we get to East Gate, we have another thirty five kilometres of extremely challenging roads to get to the town of Wasagaming. In the past, we have loved this road because we always see some wild life and often it’s a bear. The road goes up several switchbacks and then continues through beautiful wild country with small rivers and wildflowers, little lakes and wide marshes. When the rain is heavy, the road can get washed out. It was raining heavily. Plus in the back of my mind was the fear. It was a seatbelt accident that caused the carotid artery dissection so I worried the whole way even with the new seatbelt cushion and head rest. When a deer ran out in front of us crossing the road I didn’t gasp at the beauty and grace as I have in the past. I cursed the need for a sudden stop. He slept through it all.

We had a lovely time visiting friends and eating lunch. I watched to see if he got the fatigued look. He did, but when I asked if we should leave early he assured me he felt fine. We ran into our son, daughter-in-law and youngest of our two grandsons and had a happy reunion at the art gallery where our luncheon host had her work on display. What a bright spot of joy that was! We stopped for gelato. He was the charming host insisting on paying for everyone in our group. It was good to see my lover back. We left and started the drive back. He fell asleep slumping over the seatbelt and I woke him immediately and insisted he put down his head rests and not droop over the seatbelt. He didn’t listen. I had to tell him twice. I don’t like that. He is an adult. His wife should not nag him. His wife should not have to remind him how to behave. Lover to caregiver again.

He perked up on the drive through the park after a short nap. My lover was back. We enjoyed the drive through the park back to east gate together talking like the damned stroke had never happened. We stopped at the overlook to take a selfie like the damned stroke had never happened. This spot has many fond memories of many fine trips with friends and family. It’s sort of a tradition to stop here and look towards home. It was just like the damned stroke never happened. Once we were out of the park, he slept all the way home, not even waking completely when I stopped to fill up on gas. Once home, he was cranky and out of sorts. His computer wouldn’t start properly and he was angry and ready to spend hours on the phone with Apple support even though he was still exhausted. I stopped him. I fixed the problem. It was trivial. He should have known that fix but he was too tired to think straight. Afterward he apologized for being cranky.

Today he complained he is too tired to do much of anything. We go out for a six hour spell for an easy lunch with friends and a short stop at an art gallery and a nice drive and he needs the next day to recover. I tell him it’s okay. I tell him this is normal. I am patient and kind. I remind him this three day camping trip he hopes to make with friends in a couple of weeks is likely not a good idea. He’s not recovered yet. He agrees. Again I am left feeling like his caregiver not his lover.

This is normal after a stroke they say. This is the way it will be until he recovers. This may be the new normal. I may have to live with these odd moments of caregiving in order to have the sweet moments remaining with my lover. It is a price I am willing to pay even if I would prefer not to. How many widows would pay far more for far less? Still it would have been better to not have to pay this price at all. it would be better if the damned stroke had never happened.

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“He Took Aspirin.” Stroke and Aspirin

June 24th, 2019 my husband had a stroke. It started with a funny headache around his left eye. He also had ringing in the ears and pain in his upper molar. He decided it was eye strain and took a nap to try to shake it. When he awoke an hour or so later, he was having trouble with his arm and he felt “funny”. The headache, while not bad, was different from anything he had experienced before.

Normally I recommend ibuprofen for a headache. I get periodic headaches with aura that last about three days. Aspirin and Tylenol don’t do a thing for those but 200mg of ibuprofen works like magic. For some reason, a little alarm bell went off in my head and I told him to take two regular aspirin. (325mg each meaning 650mg total.) It was while he was pouring the water to swallow the aspirin that I could clearly see his arm wasn’t working properly. He was overshooting and knocking stuff over. As he swallowed the aspirin I first began thinking maybe we should go to the hospital because it might be a stroke.

The drive to our nearest local hospital is typically one hour and fifteen minutes. I made it in under fifty. I was speeding. At the hospital, they said I should have called 911 and waited for an ambulance. If I had done that, the paramedics could have started the stroke protocol immediately and my husband could have been in a CT machine about an hour and fifteen minutes after paramedics arrived on scene. I felt horrible. I felt crushed. However, talking to the local folks here since we got home, many have told me that paramedics take at minimum forty minutes to arrive at our small rural town. And that forty minutes is on a good day with nice weather and only if the nearest ambulance is not busy with another call. Sometimes in an urgent emergency like a stroke of heart attack, it can take an hour and half to two hours for the nearest ambulance to arrive. They would also have had to then make the same drive I did.

It is possible we would not have had to go through the one hour delay to CT involved in a transfer from the small hospital I went to first. That hospital had no CT machine. They had to arrange the transfer to the large teaching hospital for the CT. There are two local smaller community hospitals that have CTs. They are slightly further than the one I went to in different directions. They usually have staff on hand to do a CT. However neither one are equipped for acute care beyond contacting a neurologist at the major centre, administering clot busting drugs and then transferring to the large teaching hospital we ended up at anyway.

The neurologist told me to stop fretting about it. It does no good to blame myself. I did the right thing and the outcome was excellent. He told us that since my husband’s symptoms were resolving on their own and had largely resolved by the time he had the CT and the symptoms were so very mild, he would not have been eligible for the clot buster drug anyway. The clot busting drug is high risk resulting in 6% of patients dying. Compared to a catastrophic brain injury its well worth the risk but that was not what we were dealing with. His kind words took a huge load off my mind and eased my conscious considerably. Analysis of events to improve future response is one thing. Second guessing and regret is another and it is a waste.

In retrospect, I should have called 911 and then took off and met an ambulance somewhere on the trip in to one of the hospitals. The 911 people would have known where the nearest hospital open to do a CT was. Also when we arrived at the local hospital, my husband’s systolic blood pressure was over 220. They treated that while arranging the CT and transfer. The paramedics could have started that treatment sooner. Given their travel time, however, that meant only ten minutes sooner. I risked him having a major medical crash after a catastrophic stroke affecting his breathing and heart during those extra ten minutes. They would have been better equipped to handle that event.

The symptoms of arm weakness and headache my husband was experiencing dropped to about half by the time we hit the first town near us, a 38km (23miles) drive away. It was twenty minutes after he took the aspirin. While he was in the CT machine, the last of the symptoms went away. His arm was still a bit weak but it was working properly and the head ache was gone. The diagnosis was inner carotid artery dissection clearly visible on CT. At that point they weren’t sure if he’d had a full stroke or a transient ischaemic attack (TIA). They had not yet determined if he had thrown a clot that had traveled and lodged somewhere deeper in the brain or if the relatively small area of carotid artery had partial closed due to the dissection and reopened. Later, the neurologist would tell us it was a mild but full stroke and a clot had traveled and lodged in the area of the brain that controls arm movement and it has done a small amount of damage. (That damage will remain but the slight weakness should disappear as the brain heals and rewires itself around the stroke site.)

We went through four days in hospital of careful monitoring, 24 hour heparin drip, a barrage of drugs and lots of fighting his blood pressure. (It needs to be up to get blood into compromised areas but not high enough to encourage another clot of break off and travel. The doctors fretted and administered drugs every time the systolic number went over 180.) Students came and went along with the many doctors and one thing I kept hearing over and over again was how lucky my husband was and how mild the event was. This was invariably followed by a lowering of the voice, heads coming closer and then in a near awe-struck tone someone would say, “He took aspirin.” This would be followed by knowledgable head nods and as if that explained it all. At the time it made no sense to me. I fretted that maybe I had made things worse by telling him to take two aspirin instead of an ibuprofen. I even asked if the aspirin made it worse. “Oh no, not at all,” everyone assured me. No one mentioned it might have been absolutely best thing to do.

I have since put things together in my mind. In ScienceDaily, 18 May 2016, there was commentary on how taking aspirin as soon as you have symptoms of a stroke, especially if you are far from medical help, reduced the chances of a major stroke by 70-80%.

The authors concluded ‘Our findings confirm the effectiveness of urgent treatment after TIA and minor stroke — and show that aspirin is the most important component. Immediate treatment with aspirin can substantially reduce the risk and severity of early recurrent stroke. This finding has implications for doctors, who should give aspirin immediately if a TIA or minor stroke is suspected, rather than waiting for specialist assessment and investigations.’

Furthermore: ‘The findings suggest that anyone who has stroke symptoms, which are improving while they are awaiting urgent medical attention can, if they are able, take one dose of 300 mg aspirin.’ [Note I gave him 625mg which may have been too much but then again….]

I am an avid follower and reader of science news consolidators such as Science Daily. I often then go back and read the entire article they reference. In retrospect, I think I must have read that article about stroke and aspirin and it sat in my subconscious. I now also think the dramatic improvement we saw in twenty minutes was due to the aspirin starting to dissolve the clot. The fact that the symptoms pretty much vanished even as he had the CT was when the clot was fully dissolved. All the other stuff the doctors did, like keeping his blood pressure in a range that allowed more blood to get to the brain but not so much as to cause the delicate healing process of the carotid artery dissection to break open, those anti-inflammatory drugs to stop the brain from overreacting to the damage, and the blood thinners, all prevented something much worse from coming afterward.

Am I recommending taking an aspirin if you have symptoms of stroke? I can’t do that. I am not a doctor. (Okay, I am a doctor but the PhD kind not the medical kind.) There are two kinds of stroke. One kind (about 30%) is caused by blood vessels rupturing and bleeding into the brain causing damage. The other kind, the 70% kind like the one my husband had, is due to a blockage, usually but not always by a clot. Aspirin could make the bleeding kind worse. That’s why doctors don’t just give you clot busters if they think you are having a stroke. They do the CT first to make sure they don’t make a bleeder worse. I also don’t know if it will help all kinds of blockage. There are also people who should not take aspirin because of other reasons. So no, I can’t recommend you take aspirin if you are having stroke symptoms.

I recommend instead that everyone read up on the symptoms of stroke so you know if it happens to you or someone you love. Understand your best options for getting to medical care quickly before you need it. Talk to your own doctor about it and read up on taking aspirin. Weigh the risks. Make your own decision once you are fully informed and do it before you need to deal with an emergency. If you live next door to a major teaching hospital you can afford to wait to treat. If you live 250km from the nearest hospital, like we do, you have to play different odds. Aspirin might be your answer. Maybe.

We got lucky. As Louis Pasteur said, “Luck favours the prepared mind.” We were also prepared with knowledge even though I did not recall from where during the emergency. We had aspirin on hand. I distinctly remember buying that aspirin even though we never use it, in order to have it in the house, just in case. [My husband has been on the low dose aspirin for decades which he takes with a multivitamin which is why we don’t use it randomly for other things.] I don’t recall just in case of what. The aspirin bottle has an expiration date of this year. That means I likely bought it around the time I read that article in 2016. It doesn’t have the vinegar smell of spoiled aspirin and aspirin lasts a lot longer than the three years or so written on the bottle. Even so, I will be buying a new bottle next trip to town. I might even buy a half dozen or so and keep aspirin in my truck, my RV and a couple in my purse.

We got lucky. Luck favours the prepared mind. Be prepared.

 

Two weeks post stroke and counting

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Hubby dearest had his two week post hospital release check up. We saw our new family doctor. This is a point of loss for us because I really liked our previous doctor but her practice is not geared to his needs right now. Fortunately, the new guy turned out to be a nice young man, personable, and knowledgeable and he works closely with the neurologist on other issues with other people. We left feeling confident about him.

I knew on a rational level that we were in for a long recovery but emotionally I was not ready for what this new doctor said. One thing that added to my hope was the slight weakness of the left leg and the occasional tremble of the left hand seemed to have pretty much gone away within the first two days home. I was hoping to get a “Yes, your life can go back to normal now”. I did not get it. Instead I got a reality check. The neurological exam showed the weakness on one side is still there. Life is not going to return to normal anytime soon. In three months we go for the update CT and a neurology consult. Then we see the new doctor again one week later. Meantime, we do nothing unless something changes. If something changes we are to come in right away no matter the time of day or the day of the week. Otherwise we carry on as is.

Because of how mild the stroke was we have no instructions for rehab. Basically he is to simply go back to life and ignore the tiny tremor and slight weakness on one side. They will go away or they will not. For the strange fatigue that hits like running into a wall, same thing. Rest when tired. Stop when you don’t feel like working and then work and live when you do. It too might go away in time (but not anytime soon) or it might not. This might be the new normal.

We brought up all the meds and some side effects, and got kind of a shock. Maybe in three months we can talk about changing or lowering meds but most likely not.  All he is allowed to do is change the time of day to a better time. On this new doctor’s advice we ordered our own blood pressure monitor. We got home and filled out forms for all those new meds and filed it with our insurance company and promptly got audited. Their computer noticed something new and now we have to prove this change is real. All the money we spent on drugs must now wait for fourteen extra days for the audit to be processed and then up to ten more working days for the refund. For the first time in years, we have blown through our deductible. And to think I was ready to cancel that supplementary insurance because of the cost of it. Thank goodness I did not!

We are in for a long winter in our little house because we won’t be able to travel south for at least one year. No travel insurance will cover him. Among our recent investments was a desk treadmill combination. In the past, cold weather meant we just didn’t venture out and we got fat and grumpy. That was the main reason we went south, to be healthier. This will simply not do in our new normal. The combination of desk treadmill should mean we can keep up with our walks in winter. Of course another friend told us he purchased a treadmill post heart attack and it is now a very expensive clothes hanger. His good intentions went nowhere. You get used to limitations, he says. Can I live with that? Right now today we are determined we won’t. I alternate between wanting to start blowing some of our savings to purchase everything we need to make the house perfect for winter right now, and trying to remain within a budget just in case we both live another thirty years. There must be a happy medium in there somewhere.

And then there is the fear. Every cough, every yawn, every bout of fatigue and I am watching him. If he naps for too long I go and check he’s still breathing. If he complains of being tired and goes to rest I calculate in my mind how long since the last nap. Is this worse? Is this a change? He grumbled about something ordinary and I found myself wondering, is this a personality change? He got impatient and overreacted to some normal family drama. I worried about what the stress was doing. Could this bit of drama, which forced his systolic blood pressure up 40 points for a few minutes on the damned machine, cause another stroke? Please calm down. Don’t respond. Leave it. I didn’t want to nag him so instead I told the dog to leave it and she looked me all puzzled and hurt. Leave what? I was sleeping. Fortunately dogs are forgiving. A bit of cheese and all was forgotten.

It has affected our children. I got so angry at the grown son involved in the drama for that rise in blood pressure and then I was shocked to discover he has his own anger. Mortality and aging has come up and smacked him in the face from both his father’s near miss with death and his now adult son who is going his own way and doing something contrary to what Dad wants for him. The son is entitled to his anger too. The strong adult reaction and support we have received from the grown grandson during this drama simply illustrates what a very fine job of parenting the son has done but he isn’t in a place to realize that just yet. Children grow up and do not fulfill your dreams for them. Instead they pursue their own dreams. It is easier to understand when you have already been through that life phase yourself. For some reason it is also easier for grandchildren to accept aging of grandparents. I suspect it is because the young are still young enough to think they are immortal.

Our daughter and another son came to visit and I was surprised to see how long they held on and hugged their father. They too have had their world rearranged. Yes, their father got lucky this time but what if next time it doesn’t go so well? What has felt best for me from the family support? What has comforted me the most? The long generous warm hug from one of my daughters-in-laws whose eyes say she understands mortality with her soul of great compassion. Being one step removed, she can stay detached. I have no need to comfort and reassure her. She comforts and reassures me instead.

We are so much more tender and caring of each other as husband and wife. There are many more “I love you”s and little pats and moments of pausing for a hug and more loving looks. Today, he actually put up that hook I had been waiting for since we moved into the house four years ago. It doesn’t make up for the fear. It serves to emphasize how much we have to lose. I keep feeling like I need to have a good cry but there are no tears.

I did get a bit of good advice from another friend who had a far worse stroke though she has made a really remarkable recovery. I mentioned again how the doctor had said how fortunate we were. She said, yes, she knew that feeling too. While she was in rehab she saw lots of examples of how much worse it could have been for her. However, she advises that it is important to let yourself get angry. Yes, you are lucky it wasn’t worse but it would have been even luckier to not have a stroke at all. You have to go through all the steps of mourning to get to finally accepting loss. It was strange to be told I had a right to be angry and feel loss but it certainly made me feel better. Our world has shrunk. So what if others have had it worse? We have still had a loss and we are entitled to mourn.

The Scare

My husband had a headache. He took a nap and woke up an hour and a half later and couldn’t move his arm properly. Next thing he’s being transferred from our small rural hospital to a major teaching hospital with lights, sirens and a full stroke protocol organized.

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We got lucky. Hubby dearest had a dissection of the inner carotid artery causing a mild stroke. He had four days in hospital and was released with residual damage only the neurologist can detect. It was the mildest stroke one could have. The neurologist also said all the signs the stroke occurred should vanish completely because it was so very mild. If one has to have a stroke, this is the type to have.

The dissection is considered traumatic in origin because of a seatbelt accident. That means it will likely not happen again. All the other blood vessels are clear with no more plaque or issues than that of a twenty year old on a bad diet. My husband is in very good shape for 75. During his hospital stay, my husband had crazy wonky high blood pressure the doctors left alone up to a point. If it went up to what they considered too high, they gave him drugs to pull it down. He spent one night hooked up to monitors with the ICU crew. Fortunately, his 72 hours CT scan showed no change from the one he had on arrival. And so he was released with an arsenal of drugs and strict instructions on followup. He has been fine at home except for tiring easily. Post stroke fatigue is well described in the literature. His blood pressure was still pretty high on release but once he got home it soon dropped to normal. The drugs they sent him home on and the relief of being back in his own bed both did wonders for him. The dog was so happy she kept giving little yips of joy and shivering and then nudging him for a head pat during the two hour and fifteen minute drive home.

We got another wonderful demonstration of how the Canadian health care system works. It has two speeds, glacial and lightning and nothing in between. Folks around here wait literally months to get a CT if it is “elective”. My husband got his CT in the stroke protocol within twenty minutes after arrival at Emergency Room. He had a second one exactly 72 hours later. I have no complaints about the quality of the care. We had the usual issues with different doctors telling us different things. We had to repeat multiple times no pork for food. Breakfast was ghastly so I picked up take out and then got scolded for all the salt in the Subway sandwich. We had friendly wonderful nurses and grumpy ones. Normal hospital stuff. The quality of care was excellent.

We had demonstrations of wonderful kindness and much appreciated support from family, friends, neighbours and perfect strangers. Most people are good. We forget that fact sometimes in a world of 24 hours news services, but most people are indeed good.

He’s home. We dodged a bullet. He has used up one of his lives.

We went walking today because exercise between bouts of post stroke fatigue helps you get over the fatigue in less time according to the literature. The air was sweet smelling. His hand in mine as we walked felt so very warm and so very alive. Colours are brighter and more vibrant. His laugh, his smile, his scent, and the twinkle in his eye and everything about him is handsomer then it has has been in a long time even though I didn’t think I ever took him for granted.

Thank you, Master of the Universe for giving us a little more time together.

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