I Didn’t See it Coming

In 2004, I read “Younger Next Year” by Chris Crowley & Henry S Lodge, M.D. The book’s message was: In your 40’s, you can decide to clean-up the bad habits in your lifestyle: Some 70% of premature death and aging is lifestyle-related, according to Lodge and Crowley. You can watch your health improve and live much longer, without significant decline, until you are in your 80’s or longer and then die quickly. Even at age 60, we can get “functionally younger every year for the next five or ten years,” wrote Crowley and Lodge. I embraced, and still do, the message of the book and recommended it to many people over the years.

Protecting our health became a core value for Melanie and me.

Last fall, I turned 72 years old: I hadn’t had a health problem since kidney stones in my mid-thirties—no surgery required. Throughout my sixties, I wondered when I would get hit with a major health issue. I didn’t think it was probable that I would get out of my 70’s without a significant health problem.

When I thought about dying, I figured that strokes would be involved: My dad had a small stroke at about my age and then another at age 90. He declined a feeding tube and passed away quickly on his own terms—just as Crowley& Lodge wrote. Dad was my model for living and became my model for dying with dignity.

Melanie and I walked five miles almost every day. I worked out with resistance tubes, dumb-bells and stretched my body three times a week. Other than having to manage my sugar consumption, my diet was good. My weight was fine. I didn’t smoke or drink.

On December 21, 2017, I was working in my office. I felt fine. My index and middle fingers on my left hand suddenly went numb. The sensation passed quickly. I Googled “Fingers went numb” and Carpal Tunnel Syndrome came up. I hollered to Melanie, “I think I have Carpal Tunnel Syndrome.” I forgot about it and went back to work.

The next day, three fingers on my left hand went numb along with the left side of my tongue and I couldn’t speak for a moment. These symptoms passed in a minute or so. I called my doctor. He said, “Stop taking a low-dose aspirin and take a full dose aspirin until I tell you not to. If it happens again, go to the ER.” We planned to go to the Fargo area for Melanie’s family Christmas party on Christmas Eve. We considered staying home to be safe but we decided to go and keep our fingers crossed. Other than some anxiety for me, I had no symptoms on the trip.

Back home on December 29th, we sat down for dinner. I said, “Melanie, my fingers on my left hand, my left side, left leg, and left side of my tongue are numb. I could not speak correctly. The symptoms went away in a short time. We talked about going to the ER and I was resistant in case we were wrong. We decided to go and I asked Melanie to call my doctor along the way. He said we were doing the right thing. We went to the Maple Grove Hospital ER. We got right in and the doctor’s and staff went right to work. At first, because the symptoms came and went, they thought my symptoms were TIA’s:

Transient Ischemic Attack (TIA) is a warning sign of a possible stroke and is often called a “miniature stroke.” A TIA is caused by brief stoppage of blood flow to the brain. Symptoms are the same as a stroke but appear for a shorter period of time (from a minute to 24 hours) and then go away. A TIA is basically a stroke with one important difference: blood flow resumes before any serious brain damage occurs. From the North Memorial Hospital Stroke Education Guide.

I had an MRI and an orderly wheeled me back to the emergency room.

I was joking with the nurses and technicians when the ER doctor came in. He sounded kind of gruff: “You did have several strokes (five). You are lucky: you could have had a major stroke. We don’t have a stroke center here so we will send you by ambulance to the stroke center at North Memorial Hospital (Robbinsdale, MN). The ambulance will be here shortly.”

The paramedics rolled me to the ambulance and I felt the minus 15 degrees temperature. The two young men had heard that I was once a Secret Service agent and we joked about that during the drive.

I arrived at the stroke center at about 1:00 am on Saturday, December 30, 2017. I had lots of nursing attention for a while: they took my vitals, drew blood and hooked me up to liquids and blood thinners. About 15-20 staff came in and out of the room each night. I didn’t sleep much—too many interruptions and too much stimulation. I wasn’t scared: the symptoms were gone and I didn’t feel any paralysis or loss of function. I could talk fine. Everyone had treated me with dignity and respect and I enjoyed their care and attention.

Melanie walked in early Saturday followed by grandson Nate and step-daughter Natalie. I was happy to see them.

I passed all the physical and cognitive tests. The neurologist’s assistant came and spend a long time answering our questions. I liked her. Actually, I liked all the diverse staff-members that helped me.

We were told that half of the strokes emanate from the heart. Fifteen percent of them are due to the patient having untreated Atrial Fibrillation: an irregular and often fast heart rate that can increase the risk of strokes and heart disease. Blood clots in the atria (top chamber of the heart), get pumped out of the heart to the brain, blocks a blood vessel and causes a stroke. I wore a heart monitor in the hospital and would wear one on my first week at home to see if AFib was present. If they detected AFib, they would give me different medication but they wouldn’t change my medication (Plavix plus a full-sized aspirin) without the diagnosis of AFib.

I had an echocardiogram W/Bubble Study of the front of my heart to look for defects in my heart where blood could form into clots that could go to the brain and cause strokes. No defects were found.

On Sunday, the doctor told me I would fast and he would get a Transesophageal Echo W/bubble procedure scheduled for later in the day. It didn’t happen: this was the New Year’s Day weekend and staffing was minimal. I would fast again on Monday, Jan.1, 2018. I fasted and again no procedure. Now the procedure would be first thing Tuesday morning so I would fast for the third day in a row. Overnight, my nurse told me the procedure would be early Tuesday morning. As morning approached, something changed: my nurse said I would have the test on Tuesday but maybe not first thing. Shifts changed and I got a new nurse who I had not had before.

She told me the test would not happen on Tuesday. I got mad. I said, “Hold on, you don’t have the history. I have fasted for three days and each time the procedure in Cardiology got canceled. This is not acceptable. This procedure is the only thing holding up my discharge. I’ve been here one or two extra days because the hospital couldn’t get this done over the weekend. Go talk to the doctor and tell him this.”

Melanie and I waited for the nurse to come back and plotted what I would do if the test couldn’t be done that morning.

Twenty minutes later, the nurse came back and said, “The gurney is on the way to take you to Cardiology for the procedure.” The orderly came, I hopped onto the gurney and he wheeled me to Cardiology and into the procedure room. A nurse was waiting and prepped me. I sat in something like a dentist’s chair. I had to gargle Lidocaine for two minutes and then swallow it. Then they would put me to sleep and they would go through my nose and go down my throat into the food pipe to get pictures of the backside of my heart. The examination would show clear pictures of the heart chambers and valves. The doctor came in and asked me a few questions. The next thing I knew I was awake. The procedure had gone fine and no issues were found.

My internist later said to me: “You had the Cadillac of heart examinations.”

Melanie and my daughter Becky and the nurse and two doctors were waiting in my room when I got back. An hour later, Melanie picked me up at the front door and we went home.

I thought the story was over. But it had just begun. More to come in future blog posts.

Stroke Warning Signs from the Mayo Clinic:

  1. Trouble speaking or understanding,
  2. Paralysis or numbness of the face, arm or leg,
  3. Trouble with seeing in one or both eyes,
  4. A headache,
  5. Trouble with walking

 

10 thoughts on “I Didn’t See it Coming

  1. Thanks, Tom, for this well-crafted piece that uses your own adversity as an instructional guide for the rest of us. May all your future adventures in medical science turn out as well!

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  2. Hi Tom, I was thinking just a few days ago that I had not seen anything from you online for quite some time. I’m sorry to know the reason and wish you good health. Judie Ramsey

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  3. Thanks, Tom, for the update. I’ve wondered why you hadn’t posted in a while. Your last sentence, before the Mayo list, is concerning me. Am I reading correctly that you’ve had more problems in the New Year? I hope not, but please don’t keep me in suspense. I hope you are doing well in any event.

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  4. Hello Tom

    Been there, done that (stroke – due to presence for some time of A fib) and so was fascinated by your account, brought to my attention by your dear bro. An excellent read but have the feeling that I missing something. What follows the last line? (“It was best on that happy day that I didn’t know what the near future would bring.)

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  5. Somehow it’s even more chilling to read your account than it was to hear it from you in person, Tom — maybe because here I was able to read between the lines and imagine the what-ifs? It’s a comical understatement to say I’m glad and relieved you didn’t have to face any of those more dire scenarios … I believe your healthy living really did pay off! Just as I believe that through your dogged determination and self-care you will continue to enjoy good health for a good, long time. My very best to you, as always …

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  6. Thank you so much for sharing your update. It was written so well. I as you know can relate to the wheels of health falling of this car!
    Prayers my friend.

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  7. I am extremely thankful to Melanie and all who provided your medical care for sparing me the loss of such a precious friend. I was at Gary’s side when he experienced his TIA in 2007. He also put off going to the E.R. He does have the same level of recall about the experience as you do. I am so pleased to know that your body and most obviously that clear and concise mind of yours suffered minimal damage. Regardless, I am concerned for you and the state of your health going forward. I eagerly await your next post.

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