Monday, March 21, 2016

Witnessing a Stroke



We sat there around the table at a local Italian restaurant, Gab, Debbie, her mother and myself.  Gab had come home from school on her break, making it a good reason to go out for dinner.  My mother-in-law, the day before heard that she was well enough to graduate from rehab and go home.  Hungrily, we ordered our food and then talked over appetizers; everything was going well and everyone was happy.  Then, like a scene out of the Twilight Zone, time seemed to slow and focus became narrow, as we / I looked across the table and noticed my mother-in-law twisted and leaning to her left, away from Debbie whom she was talking to moments before.  “Barbara,” I yelled.  Her eyes had become unresponsive and, though she tried, could not talk.  “Grandma, are you OK?” Gab asked.  I stood up and called her again, she looked over then went back to the same position.  Gab was immediately up and tending to her.  I asked a passing waiter to call an ambulance – she was having a stroke.

A stroke, this would be her second one.  As with the first stroke that she had, they labeled this a mini-stroke, or a TIA (Transient ischemic attack), that should not have any lingering effects.  My grandfather, 30 years ago, suffered a massive, debilitating stroke, which left him wheel chair bound and needing 24 hour nursing care.  He lived that way until he died of unrelated causes about 9 years later.  My father, almost three years ago, had a stroke while recovering from neck surgery that left him mobile, but needing a cane and sometimes a walker to get around.  The Centers for Disease Control and Prevention (CDC) lists three main types of stroke:

  • Ischemic stroke (caused by blood clots) – This is what my grandfather had
  • Hemorrhagic stroke (caused by ruptured blood vessels that cause brain bleeding) – This is what my father had
  • Transient ischemic attack (TIA) (a “mini-stroke,” caused by a temporary blood clot) – This is what my mother-in-law had

After my father had his stroke, someone recommended that I read the book, “My Stroke of Insight: A Brain Scientist’s Personal Journey,” written by Jill Bolte Taylor.  In the book, Taylor describes, in detail, her experience in being home alone, having a massive stroke and the years of recovery that followed.  While the human mind is great at protecting us from remembering trauma, as a brain scientist (neuroanatomist), she was able to observe and remember her own experience.  In my mother-in-law’s case, once the episode passes, within a day, there was no lasting impact (except fear of re-occurrence).  In reading the book, it helped me with my dad in that I was able to ask questions based on some understanding of what happened to him in the weeks that followed.

Unfortunately, when a stroke happens, it is unexpected, can leave the “victim” confused and potentially unable to communicate.  Time is of the essence to get treatment to the patient.  On the Stroke Foundation’s website, they state that “…Recognising the signs of a stroke and getting to hospital quickly for early treatment after a stroke is important to minimise the effects of a stroke.”  In addition, posted on the American Stroke Association’s site, “If you’re having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long-term effects of a stroke and even prevent death. Thanks to recent medical advances, stroke treatments and survival rates have improved greatly over the last decade.”

A police officer showed up quickly, followed by the ambulance.  They asked us a few short questions to help evaluate the situation while the EMT quickly went to work.  After about 30 seconds, they had brought a gurney into the tight quarters and moved my mother-in-law out and into the ambulance.  Debbie told them the hospital that provides her mother’s care, at which the person in charge said they are taking her to the hospital across the street.  Time was important and to not move further than necessary.  As it ends up, the hospital we went to was one of two New Jersey state-certified Stroke Centers in the area.  A few hours later, her functions were returning to normal.  She had dodged a bullet and the hospital stay would be short.

It is sometimes hard to maintain a level head when trauma of this nature occurs in front of us.  It is important to know how to properly react in a given situation and, in this case, know the signs to look for.  We were lucky this time, in being together to spot the situation, in reacting quickly and in taking action instead of waiting to see what happens.