Tag Archives: Renown

Stroke of Fate: Fighting a Winning Battle

Why don’t strokes ever cause super powers?

Weapons of Rehab

A stroke has no sense of honor, nor fairness. It can destroy every aspect of human dignity and leave behind a pulp of flesh. A stroke can wipe out speech, sight, hearing, touch, smell, mobility, cognitive thinking, and the list goes on. Never have I heard of a case of a stroke doing good, like giving heightened senses, or more strength. Strokes don’t even fix missing functions, like giving a blind person their sight, or a deaf person hearing. Quite frankly strokes suck.

After my stroke I was faced with the possibility that I could be incapable of independent living for months, years, or even the rest of my life. That didn’t happen. While I still can’t drive, nor safely move without some type of aid (wheelchair, walker, cane, etc.) I can get around on my own. I can eat as long as I’m mindful of what I’m doing, and see well enough to write, although I often have to use just one eye. My prognosis is great, with the expectation that almost all of my disabled functions will repair over the next few weeks and months.

It’s not easy, but I am fighting a winning battle. I’m fortunate because my stroke did not do more damage. I am frustrated by the fact that my brain seems to lack the capacity to correct my balance and vision issues. Cognitively I know exactly what needs to be done, but my brain has the ability to overrule logic and tell my body that I’m about to fall to the right, so lean right….I said correctly, my brain thinks I’m leaning right, but then insists on shifting more to the right. This irony must be fun for my Conservative friends, but to me it only shows how screwed up we become when we lack balance.

Vertigo has become a major issue in my recovery. The sense that the room is spinning varies from almost non-existent, to a strong rotational pull every time I move my head slightly. Walking becomes a drunken stagger when my vertigo kicks in, which makes my physical therapy sessions almost useless.

Still, everyday I am a bit closer to a full recovery and there are times when I feel almost normal. I have a great team of therapists who are working with me to get better…possibly to get me out of their hair. I’ll talk about living in Rehab next.

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Stroke of Fate: Time and Tide (Thank You, Basia)

Basia's Time and Tide cover

One of my favorite albums is Basia’s Time and Tide. Basia has taken me through many emotional times and I should not be surprised that after this stroke she returned into my life. My brain and body have decided to have a partial trial separation. I know I know they are meant to be together, but now they’re not talking, so with Basia’s help I’m trying to get them back together. Fortunately, I have many people helping us.

Here and now is all it’s about, let’s use it or lose it.
Promises by Basia

Here And Now
Both my daughters live in Colorado. When they heard that I was hospitalized they began talking about coming out. I was ready to discourage it because I couldn’t see the purpose or value of them flying to Reno, Nevada.

I was wrong. I failed to comprehend  the significance of their presence. I have a good close-in support system here with my spouse (Saralinda,) son (Alexander,) and in-laws, but my daughters (Kelli and Katy) added to that support in ways I never could have imagined.

Love is contagious, it’s a part of a chain
Promises by Basia

My temporary home for restart my life

They arrived a few hours before I was transferred from Renown Medical Center to Renown Rehabilitation Hospital. They became an extra lift in the uncertainty of the transfer. Saralinda, Kelli, and Katy, joined forces in becoming an advocate for my recovery and the hospital staff recognized that I was not alone. I don’t fully understand how that impacted my care, but I do know that the staff seemed to appreciate their involvement.

I’ll be there if you need me, I am your helping hand.
New Day For You by Basia

A New Day
Tuesday was an important day in my recovery. On Monday I had a swallow study performed complete with a camera up my nose. From that test I learned that my NG tube would have to remain for the near future because my throat was not working correctly. My swallowing had improved from Saturday’s, but it looked like I was facing at least a week of looking like Mr. Snuffleupagus and the idea of being able to taste food again seemed farther and farther away.  

I still couldn’t walk without falling over, I’d lost temperature and pain sensation over half my body, my right and left eye were each giving me their independent version of the world, my head and body were in a constant state of spin, and I survived by fluid going in my arm or goo going to my stomach via my nose. There was not a lot of good news.

However, all that was blunted by the news that my daughters and one of my granddaughters would be arriving on Tuesday. In the moment it didn’t seem to be that important, but in hindsight, it made my world seem much brighter. It was Tuesday when my life seemed to come back to firm ground. On that day my stroke found out who it was dealing with, and it didn’t expect to be met head on by women of mass reconstruction. It whimpered.

It would be on Wednesday that I…and my stroke, would meet the rest of the team…the medical staff at Renown Rehabilitation Hospital. It was an another good day for me…not so much for my stroke.

We got time, oh baby, there’s no rush
Gonna be a better day for us
Time and Tide by Basia

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Stroke of Fate: Day Two

I spent Saturday night fighting muscle spasms all over my body, possibly from a reaction to the nausea medication given to me in ER at Renown Medical Center. I was also feeling weak and disoriented. The right side of my face felt like I been punched by a massive fist, but with no pain, just numbness. I had no idea why my body was malfunctioning so badly with no obvious trauma. A stroke was the most  plausible cause, but no one really knew.

Me and my NG tube

Sunday morning brought new symptoms. I now had double vision. My right eye took the same image of my left eye, but put it above and at a 20° angle, which was higher on the right, lower on the left. In addition, both images seemed to spin and skip. I have not been falling down drunk many times in my life, but that is the only way I could describe this sensation.

I was incapable of functioning as a normal adult. I couldn’t stand, walk, eat, drink, see, read, or write.  I now relied on an IV to supply my fluids, and by late Sunday, would need a tube inserted for nourishment.

90° Flip: This is what my brain did to my vision for about four seconds if I closed my eyes, relaxed, then opened them

The answers did not come after initial MRI scan. The Radiologist found no visible sign of any type of hemorrhage in my brain. More tests were scheduled, but the diagnosis would eventually come after a second look at the MRI scans. I had a tiny stroke on my brain stem. The doctor told me that this type of stroke caused Wallenberg’s Syndrome or Lateral Medullary Syndrome As it turns out I am almost a textbook case.

While I was in the neurological unit I learned that I had lost heat and prick sensation on my right side of my face and the left side of my body. I could sense touch, but not pain, nor temperature. I also discovered that if I closed my eyes and relaxed, once I opened my eyes, the visual image would be turned at a 90° angle for about four seconds and then would spin and become horizontal. By the end of Sunday I had a good understanding of how much damage my stroke had done. It would be Monday before I would see any signs of hope of recovery.

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Stroke of Fate: Day One

All days come from one day, That much you must know
You cannot change what’s over,  But only where you go

Pilgrim by Enya

Last Saturday, February 4, was our 17th wedding anniversary. It was also the day of two six-year-old birthday parties that our son was to attend. The first birthday party was at Fun Quest in the Grand Sierra Resort in Reno, NV, USA. At about 3:15 PM I was eating the remnants of the piece of birthday cake that my son barely touched when I felt woozy (a technical medical term.) It felt almost like the way I feel before I become sick, but I wasn’t nauseated. It passed, but I told my spouse that I may need to leave. She became concerned, but the feeling was slowly fading.

Paul Kiser

About five minutes later it happened again, but this time was stronger. My spouse left me, and I assumed that she was getting Alexander and saying our goodbyes. Shortly, Virginia,  the Grandmother of the birthday boy was sitting next to me. She was a nurse and she began asking some questions. Although I wasn’t presenting the classic symptoms of a stroke, I’m guessing that my behavior indicated that something neurological was amiss. Again, the feeling subsided.

In another five minutes it came back stronger. At this point I knew this may be more that just a sudden onset of a flu. Virginia asked me to lay down and I was in no position to disagree;; however, the moment I laid down I felt the I was gong to lose the cake I had eaten, so I stood back up. I don’t know exactly what I said, but I indicated I needed to leave and headed out of the room. My spouse had gathered up Alexander and Virginia came up to me and said to lean on her. I did and the farther we went the more I became reliant on her support as my balance forced me to fall to the right.

We finally got to our car and left for the Emergency Room at Renown Medical Center, which was a few blocks away. There was no wait. My situation seemed obvious to everyone that I needed medical assessment immediately. In ER my symptoms were a loss of balance, a feeling of weakness, extremely high blood pressure, a tingling on the right side of the face, tingly right fingers, and possibly some dropping around my right eye. My spouse summoned our son’s grandparents who came and eventually took Alexander to the next party in hopes of keeping him from becoming drawn into the drama that he couldn’t fully grasp.

Meanwhile the ER staff set about to learn what was going on in order to establish a treatment. As a precaution they were going to give me an aspirin. That’s when we discovered I couldn’t swallow even a sip of water, let alone a pill. A CAT scan was done with no overt indication of a stroke.

The feeling was that it was either a small stroke, or an infection, with a stroke being more likely. I was admitted into the neurological unit and scheduled for a MRI scan on Sunday morning. At this time my vision was still normal, and my strength was good on both sides of my body, but I couldn’t stand, nor swallow. It would be Sunday before the damage was complete and I would know why.

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Positive Harm Part II: Downs and Ups

Play Surgery before the big day.

Yesterday our 4 1/2 year-old son, Alexander had his tonsils and adenoids removed.  In Part I of this story

(See Positive Harm to Our Son Doesn’t Feel Okay)

I talked about the concerns of harming our child in order to make him healthier and our efforts to prepare him for the experience.  It is impossible to know whether that preparation was good or bad, but we certainly have seen the downs and ups of the experience and the problems of too much knowledge.

The Downs of Surgery Eve

On Sunday night we did another session of play surgery before bed and then just before he went to sleep I reminded him that there would be some pain after the surgery and that we would be with him until he went into the OR. That was probably a mistake. Alexander woke up just before 1:00 AM crying.  He said his throat hurt, then his ears, then his head.  His Mom took it at face value, but he didn’t have a fever and at times the pain was only the throat, so I was more suspicious.  He was clearly scared and violently battled to stay with Mom and wanted me to stay away.

We were able to get him to sleep in 10 minute chunks, but he always woke up crying.  To me it was clear he was terrorized by the thought of going to the hospital in a few hours.  Needless to say, none of us slept the rest of the night.

Mood Recovery Before Surgery

Alexander at home a few hours post op

At the hospital he fell asleep in Mom’s arms in the waiting area and got about an hour in before we were moved into a pre-op room.  When he woke up he was still in a foul mood, but he wasn’t crying.  In the pre-op room I decided to see if I could get his mind off of the surgery.  He had been given a stuffed duck during his tour of the surgery area the week before so I began flying ‘Quackers’ around the room.  That got him to laugh and lifted his spirits some.

A Boy Rests

The staff at the Renown was aware of his fears (I got the sense they had experienced one or two patients with a similar concern) and they all worked to help him get his mind off of the surgery.  Nurse Toni, (the nurse that gave us a  tour of OR the week before,) checked in on him, and his pre-op nurse (I can’t remember her name) did a great job of asking him questions and involving him in the conversation.  By the time the anesthesiologist came in Alexander was no longer focused on the surgery and he continued to talk directly to Alexander…and listening to him.  By the time the star of the show, Dr. Jenny Van Duyne, entered the room Alexander was ready to hold court.  When it came time for Alexander to go to the OR, he had no problem taking a wagon ride away from Mom and Dad.

The next 45 minutes were blessfully short and when Dr. Van Duyne came out we knew everything went as planned.  She explained that he had one very large tonsil and she put in one stitch to keep the back of the mouth symmetrical, but everything else looked good.

Recovery Room Down and Up and Down

Post surgery was no cake walk, but the important note is that it was after the surgery…meaning the scary part for us was over.  Alexander was groggy and hurting post op but he did what he need to do.  He drank liquids and rested.  Again the Renown staff did great.  Nurse Kim was his post-op nurse and she kept close tabs on us and did not hesitate to give pain meds if she thought they were needed.

If either of us had felt that Alexander wasn’t getting the best care we could have been difficult parents for the staff.  We were both exhausted and feeling very protective; however, I don’t remember any time where I felt that Alexander was being neglected.  Alexander did his part by drinking water, eating two Otter Pops, and he even went potty.

All was going as planned until we were ready to leave.  Just as I picked Alexander up he lost his cookies, or in this case his Otter Pop.  It could have been a lot worse but Nurse Kim had made sure we had the emesis (sick) bag at the ready.

Roller Coaster at Home

Alexander - 26 hours post op...vacuuming

Since being home we have dealt with the challenge of getting Alexander to take his medicine (which tastes horrible), vomiting right after taking medicine, sleep in four-hour stints at night, and a really sad and hurting boy.  We have also experienced a boy who wants to vacuum and clean the furnace air filter.  He feels good for about two hours at a time today and then he doesn’t.  Hopefully, each day he will feel stronger.

Our journey is long from over, but we are able to see that doing positive harm to our child was for the best.  We know that he will sleep better and feel better.  In hindsight I would have not discussed the scary parts of the surgery as much.  The pain is best dealt with at the time it hurts, not feared before it happens.

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Positive Harm to Our Son Doesn’t Feel Okay

Alexander prepares for 'play' surgery

On Monday we will get up early and take our four and a half  year-old boy, Alexander, to Renown Hospital in Reno.  He is basically healthy…that is when he doesn’t stick a plastic bead up his nose,

See Blog Post

but he snores and is awaken at night because his tonsils have grown too large and block his airway when he sleeps.  He also has a persistent cough at night that comes and goes.   We are confident this is absolutely necessary as his Dentist (Dr. Stoker), his Family Practitioner (Dr. McCarthy), and two Ear, Nose and Throat (ENT) Specialist have all agreed:  Tonsils Must Go.

Play Surgery to Prep for the Real Surgery

Still, it is getting harder to shrug off that this surgery is going to hurt him and there are always risks and complications that can’t be anticipated.  Parents may not be required to take the Hippocratic Oath (First, Do No Harm), but even so, it’s instinct for most of us, and when we turn Alexander over to Dr. Jenny Van Duyne on Monday morning we will be asking her to hurt our son.  Yes, in the long run he will be better off, but that doesn’t change the fact that when he comes back from surgery he will be injured.

Our Play Operating Room

Ironically, I was pushing for us to have him checked out and to have this surgery done.  I had my tonsils out when I was around six and I was eating crackers the next day.  My older brother Mike had his done around the same time and as a teenager he had a much harder time recovering from the surgery.  Of course, that was back in the days of rusty, old surgery instruments when doctors sharpened knives with a leather strap…okay, it wasn’t that bad, but it  was almost 50 years ago.

Post Play Surgery Recovery Room

It doesn’t seem that the surgery has changed that much and the recovery time is one to two weeks, so this is not an overnight hurt that will be better the next day.  We also know he gets worried and scared in unfamiliar situations, so we took him for a tour of the Operating Room last week and Nurse Toni did a great job of reassuring him.  He’s also watched a DVD over and over that was produced to help children overcome their fears of this surgery.  Finally, we’ve been practicing the before, during, and after surgery with me as the doctor (complete with poofy shower cap) and him as the really good patient.  So far, so good, but Monday morning will be the final exam for all of us.

I was thinking that this was going to be harder on Mom than Dad, and in the end I will likely push my fears aside for Alexander and Mom, but it still feels odd….I don’t know, maybe it’s just the poofy shower cap.

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