Sunday, October 6, 2013

What Do You Remember About Your Stroke

The following story was taken from the Nebraska State Stroke Association web site (www.nebraskastroke.org). While at the Lincoln stroke camp August 2013 I met Marcia Matthies, Outreach Coordinator for the Nebraska State Stroke Association. I first met her in 2011 at the same camp location. She gave me permission to reproduce on our blog any article they have on their site. Thank you Marcia. 

Keith Fickenscher Stroke Story

WHAT DO YOU REMEMBER ABOUT YOUR STROKE FROM
BEGINNING UNTIL NOW?


On Thursday, May 31, 2012 I had an appointment with a pulmonologist to determine why I was coughing up dark blood every morning. He ordered a CT scan which revealed what he thought was a pulmonary embolism in my left lung and an “unidentified mass” in my right lung. I was hospitalized and he ordered Coumadin and Lovenox to dissolve the PE. Friday night I had a relatively short episode of coughing up bright, red blood, which didn’t seem to be concerning, so the drugs were continued. Saturday night I experienced massive and sustained bleeding from one of my lungs.

I truly believed I would die. A CT scan revealed the bleeding was from the mass in my right lung. There was now no evidence of a pulmonary embolism in my left lung. The Pulmonologist tried twice to sample the mass which was in the lower right lobe, but the airway was blocked with sticky, clotted blood. So the decision was made to remove the mass surgically by removing the lower lobe. When I woke up in the ICU, the surgeon told me I was “very lucky” because the mass was “accumulated pneumonia” and there
“wasn’t a cancer cell in it.”

I went back to sleep in the Cardiac ICU in Bryan East following my
successful lung surgery (thoracotomy involving a wedge dissection of lower lobe of right lung). It was around 11:00 p.m. when a nurse woke me and asked me to brush my teeth. I could not reach the toothbrush on my overbed table. 
It seemed like the nurse was moving the table away from me. I asked her to put the brush in my left hand. She did and I could not control my left arm. When I extended it, the arm “floated” back and forth in a wide arc. I then became aware that the slurred speech I heard in the room was me. I told the nurse I thought I was having a stroke and she agreed. 

This is the second time I thought I might die. She called in the “BERT” Team and they confirmed our suspicions. They sent me for a CT scan and when I returned to ICU, my Thoracic Surgeon and a Neurologist were there. I asked for the clot buster shot but the neurologist said the CT scan did not show the clot. It was gone. He also said the shot would cause fatal internal bleeding related to my surgery that afternoon and he would not give me the
shot.

I expressed concern that the epidural I had opted for prior to surgery had caused the stroke. Suddenly the anesthesiologist appeared in my room and he informed me he had been administering epidurals for “30 years and an epidural had never caused a stroke.” The Thoracic Surgeon assured me he did nothing that would have caused the stroke. Prior to the surgery, they had doplared my legs and carotid arteries and performed an echo-gram of my heart. They saw no evidence of clots. The origin of the clot that caused my stroke remains unknown.


HOW LONG WERE YOU IN REHAB?

On Friday of the week following admission, I was transferred to Madonna for acute inpatient rehab. My anticipated discharge date was set for August9, which seemed like an eternity away! 

I made steady progress in rehab, going from where it took four people to help me take a single step to where I could walk 250 feet with a cane and 1 assist. I went from requiring a Vander-Lift to get me in and out of bed, to transferring to my wheelchair myself and toileting myself and showering myself.

Then one week before my scheduled discharge, I awoke with a severe pain in my chest. My blood pressure had dropped to 50/60. After a full day with no improvement I returned to the hospital where a CT scan revealed a suture in my chest wall ruptured and dumped 2700cc of blood into my right chest cavity.

This was the third time I thought I would die. Back to the hospital for a week to stop the bleeding, then three more weeks of inpatient rehab. I will never forget when I returned to my room at the rehab facility, an Aide removed the sign from above my bed that said I could transfer myself. She said, “This won’t apply now.” I was crushed.

I was dismissed from inpatient rehab on August 29 and went back to work full time on September 12, which was the 90th day after my stroke and my 65th birthday.

About a month later, on October 16th while sitting at my desk at 8:00 a.m., I had a stroke related seizure. I had no warning whatsoever. I woke up in the CT scanner with no idea how I had gotten there. This was the fourth time I realized how fragile life really is. Another week in the hospital and two weeks of skilled inpatient rehab at Lancaster Manor, after which I again returned to work full-time as Administrator of Lancaster Manor. I have
learned a hard lesson in how fast one’s world can turn upside down. After more than six decades of bullet proof health, my health is now my foremost challenge.


WHAT WERE YOUR BIGGEST SUPRISES WITH YOUR STROKE
EXPERIENCE?


My biggest surprise has been how a stroke affects every single aspect of your life. A stroke is a hurdle between you and anything you want to do. I was surprised by how much I detested pureed food and honey thickened liquid.

WHAT WERE YOUR BIGGEST CONCERNS OR FEARS RELATED
TO YOUR STROKE EXPERIENCE?


My fears include having another seizure while I am driving … or having another stroke that affects my right (“good”) side. I also worry about falling, whether I will regain use of my left arm, and whether I will ever be able to walk without assistance. I also worry about the added burden my stroke has had on my wife. Prior to my stroke, I was left-handed. I have been surprised to learn how hard right-handed people struggle to do all the things that come easily for lefties!

ADDITIONAL COMMENTS:
I learned a lot as a resident of nursing homes and a hospital for five months. I learned there are four essentials to giving patients quality of life.

1. Good food … made from scratch by people who take pride in their work and who strive to “raise the bar.”

2. Engaging activities … especially on weekends.

3. Dedicated Rehab Therapists with excellent therapy equipment at their disposal.

4. A staff of direct caregivers and support people who understand how important they are to the residents in their building.

My new mission in life is to teach those four essentials to my colleagues in Nebraska’s nursing homes. My stroke stripped me of everything but life itself … so I am going to dedicate the rest of my life to advocate for quality in the lives of residents in Nebraska’s nursing homes, assisted living facilities and rehab hospitals.
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3 comments:

Anonymous said...

I thank you for that I myself am a stroke survivor and those are some very important values!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Chuck J. said...

Anonymous, Thank you for the comment. If you have any other topics you like to see addressed or would like to write one about your experiences please let us know. We'd be very glad to hear from you.
-Chuck

Anonymous said...

Each journey is different, but has similarities. I agree that there is work to be done to educate the public in addition to the medical community. Aphasia doesn't mean stupid! Tell me "why" I am doing the task in rehab so I don't feel like a child. Look at me and speak slowly, it goes on and on. Good article.