In a few weeks, it will be 3 months since my 50-year-old husband had a stroke. While we generally made the choice to deal with anything like this privately, I have been asked by a few, to include a few fellow nurse friends and other survivors of CVA (cerebral vascular accident), to write an article on the symptoms that I noticed prior to the stroke. I am a nurse as well as his wife and caregiver, and so what I am writing is a first-hand perspective of what I witnessed. Please note, that every patient is different in what they present as far as symptoms, so this will be more of a guide.
Maybe it is my internet searches, but I have noticed several people sharing an article on a “new sign of stroke.” This is, without question, an indicator of the lack of public knowledge about strokes that this information is being shared as a “new sign”. There are articles as early as 2002 (14 years ago you guys!!) talking about this new sign, so as a nurse, I feel as though putting an objective, clinical perspective "out there", now that I can think clearly and without panic, will be my best chance at sharing the knowledge to those who may not even know.
While separately, these symptoms may seem minor, but combined, they are a good indicator that a major neurological event could possibly happen. Your best bet would be to make an appointment to see your family doctor for further testing if you notice anything that seems “off”.
When my very hard working husband arrived home from work the night before this event, he asked me if a very simple word was spelled correctly. I looked at it, told him it was spelled correctly, and went on with my house work. I never once thought this to be abnormal at all, because sometimes, even if a word is spelled correctly, it still does not look right.
He never mentioned that he was having to retype text messages and social media posts repeatedly, because he could not tap the keys that he wanted on his phone because none of them looked right to him.
He never mentioned that he had stumbled while walking across the floor of the family room or garage when there was nothing there for him to trip over. The few times I did notice it, he said his foot may have fallen asleep or that there was a foot cramp.
He never told me he was having a hard time putting the key into the lock to unlock the door because he kept dropping the keys from his left hand and ended up knocking on the door for me to let him in.
He never mentioned that he was having a hard time putting his phone into the left cargo pocket of his work uniform.
He never mentioned that he accidentally spilled milk onto the counter while pouring a glass with his left hand.
He never mentioned that he was experiencing sensory overload while playing an XBOX game or listening to music.
He did mention to me, that I was speaking loudly to him, when in fact I was speaking with a normal tone.
He did say that he felt like he “was coming down with something" and was feeling sluggish.
He was experiencing over the top emotions while watching the news or reading an article. From one extreme to another.
He did mention to me, a few days before, that when he coughed or sneezed, he felt like he had sinus pressure in his head, but that it went away immediately.
He never once complained of a headache.
He did not present with symptoms of hypertension nor has he ever been diagnosed with it.
He was physically active. At work, he registers approximately 7-8 miles of walking A DAY, per FitBit technology.
He has never been diagnosed with A-FIB.
He has never had labs that indicated that he had high cholesterol. In fact, he has healthy eating habits, minus the occasional pizza and his mom's meatball recipe.
He was a smoker for 30 years (and has stopped since this stroke, or else I would have turned into demon nurse).
The Day of The CVA Event:
He woke up at his normal time and drove to work at about 5:15AM.
He noticed that his LEFT (again with the left arm and hand) felt heavy, but he blew it off as a spasm, as he had a sore shoulder in the past.
He was driving his forklift and off-loading containers as he normally would.
He suddenly felt like he was sliding off the driver’s seat of the forklift.
A co-worker noticed something “odd” and came over and asked him if he was okay.
The same co-worker took him to the plant medical department because the left side of his face was “drooping”, and when he spoke, the left side of his mouth was not working. (He later stated it felt like he had a shot of Novocain from the dentist and was speaking like the Bill Murray character in "Caddyshack".)
From there he was assessed and it was decided that he should visit the emergency room. He refused the ambulance (You know guys?? DON’T EVER DO THAT!!) and waited for me to get there, even though I pleaded with the nurse to call one anyway.
I had called the hospital ahead of time when I was on my way to the hospital with him, to ensure that the company nurse had called to tell them to expect us and to give them report. I fought every part of my education to just call an ambulance and have them meet me somewhere. But I could hear seconds dramatically and loudly ticking in my mind.
By the time I was half way there, my husband went from being a little sluggish with his speech, to drooling and slumping, not being able to lift his left arm, and not knowing where I was taking him, so yeah, I PUT THE GAS PEDAL TO THE FLOOR.
He was physically looking bad at this point and I remember telling him, I loved him and that he was my whole world repeatedly. He would say it back to me with slurred speech (which melted my heart each time he tried to say it), and I tried to keep him as oriented to the present as possible. I had to hold his hand so if I needed to tug on him to awaken him, I could.
Ask them questions!! Keep them in the present.
"Who is the President?" I asked him.
"TUMP!" He replied (he meant Trump, nice try though, the election was 2 months away.)
“Stay with me sweet heart, we are almost there, don’t go anywhere without me okay?”
And his slurred (repeating me) response was, “Don't go without me okay?" And "Don’t leave me okay?” These were the main two phrases he was repeating, begging me not to leave him alone or in the darkness. I would never since I cannot even imagine my world without him in it. Of course our life together flashed before my eyes, and I was trying to envision our future.
"Never!!" I replied each time.
I fought back the tears, felt my throat tightening up, and bit my lower lip the whole time, but we finally made it to the E.R. safely. I had to stay strong and objective. I had to keep my emotions out of this. Just this one time, MOVE OVER WIFEY, NURSE KASEIGH IS TAKING OVER......
So, at the emergency room, all the critical tests were ordered, labs, head MRI, head CT, EKG, etc. And since it is incredibly hard to think objectively when you are in a panic, CALL YOUR NURSE FRIENDS…..GAHH!!
The hardest choice I have ever had to make as his wife and a nurse, was, “Do we or do we not use the TPA?” TPA is tissue-type plasminogen activator, in laymen’s terms, it is a clot buster that is infused thru an IV. The tricky part of this is what time were the actual onset of symptoms? TPA must be infused within 4 hours of the presentation of symptoms. So, was this presenting at 530AM on his way to work, or was it when his co-worker witnessed that he did not look well? Administering TPA after that 4-hour window CAN BE FATAL as it can cause a blow out and then hemorrhage can happen. I could not make this decision without knowing what his labs were, his imaging results back, and consulting with a few of my best friends who are critical care nurses. NOT THAT I WAS DISMISSING what the MD’s were saying, but I wanted more than one opinion of the nurses who had experience that I valued, trusted, and respected. I literally had no one there with me in person, so I called a few. I was mentally preparing myself, as advised, to call his daughter and his family and thinking about what would I tell them. A Priest was on stand by for him to administer his Last Rites. When you see the priest, you know that this is real and it is really happening.
You may have heard that doctors can ‘reverse’ stroke damage if patients get to hospital soon enough to clear the clot within a few hours. This refers to an Ischemic stroke, where a blood clot has blocked an artery and cut off blood flow, but again, every second counts, so get to that ER as fast as you can get yourself or the victim there.
(Another type of stroke is an intracerebral hemorrhage , which occurs when a blood vessel within the brain bursts, allowing blood to flow into the brain. The only thing that could be done in this instance is to do everything possible to reduce the blood pressure, pray, wait, and hope.)
Not knowing the exact time that his symptoms began, we went with not using the TPA. It worked. Because here we are, almost 3 months later, and although his personality and his behaviors have changed, he is still with us, and for that I am grateful. I can deal with the intermittent confusion, asking the same questions repeatedly, but I would not do well without him in MY WORLD.
We do not have family support and do not have close friends here locally (my closest relative is about a 3-hour drive), so dealing with all of this for one person, has been extremely challenging and emotionally draining.
Far away family members who call and demand answers when you do not have all the results just makes an extremely difficult situation worse and there were tears most of the night and the next few days. I ignored this, since this person has not one minute of clinical training. Be supportive people. Scolding and arguing with the caregiver when you are not getting the answers you want WHEN you want them is not the way to handle an already emotionally exhausting day.
My husband is very blessed to still be here with us. I have read that one in five people having a first-ever stroke die within one month and one in three die within a year. So, I may still need to prepare myself spiritually, emotionally and mentally, to not be able to grow old with my best friend. But I will remain positive, and I will case manage him to the very level that I would give my most critical patients.
Due to catching his symptoms in time, and the extensive knowledge and understanding of neuroplasticity by the Emergency and Neurology teams at Williamson County Medical Center in Franklin, Tennessee (surprisingly, something which has only gained significant and broad medical acceptance within the last 10-15 years), my husband, and I, and his union brothers and sisters (U.A.W. #Local1853) in #SpringHill, Tennessee, have been very blessed to still have him around. After being in critical care, and then the neuro floor, my husband has worked very hard with his amazing clinical team, and was able to build new neural pathways to compensate for damaged areas of his brain. He had to re-learn how to do a few things and he learned to speak clearly again and thanks to that, he may be back at work soon.
Many stroke patients will never live any resemblance of the life they led before the stroke. Strokes are and always will be TRAUMATIC BRAIN INJURIES folks!! Do not expect the person who you knew before the stroke to have the same behaviors, moods, or temperament to be that same person. They cannot do this. They cannot find the person that they used to be. Children, teenagers, and people in their twenties and thirties can also be, and have been, changed forever by stroke. STROKES DO NOT DISCRIMINATE!!!
I am so grateful for my work family for being so patient for the last few months so that he could take his time and heal properly. More companies should take on the role of not rushing their employees or their families when a health crisis occurs!! The nurses and therapists who were there for me at any time of the day whenever I called, helped so much! Given that this is our company's area of expertise, the wealth of knowledge that I have gained over the years, made this road we traveled a lot less bumpy!! Jamie and I will be forever grateful!!
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Symptoms of a stroke include:
Drowsiness, lethargy, or loss of consciousness
Loss of balance or coordination
Loss of memory
Mood changes
Numbness, tingling, decreased sensation ANYWHERE
Personality changes
Slurred speech, inability to speak or understand speech, Difficulty reading or writing
Swallowing difficulties or drooling
Uncontrollable eye movements or eyelid drooping
Vertigo
Vision changes
Weakness or paralysis of an arm, leg, side of the face, or any part of the body
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U.S. Statistics – from StrokeCenter.org
Stroke is the third leading cause of death in the United States. More than 140,000 people die each year from stroke in the United States.
Stroke is the leading cause of serious, long-term disability in the United States.
Each year, approximately 795,000 people suffer a stroke. About 600,000 of these are first attacks, and 185,000 are recurrent attacks.
Nearly three-quarters of all strokes occur in people over the age of 65. The risk of having a stroke more than doubles each decade after the age of 55.
Strokes can and do occur at ANY age. Nearly one fourth of strokes occur in people under the age of 65.
Stroke death rates are higher for the black population than for whites, even at younger ages.
On average, someone in the United States has a stroke every 40 seconds.
The risk of ischemic stroke in current smokers is about double that of nonsmokers after adjustment for other risk factors.
Atrial fibrillation (AF) is an independent risk factor for stroke, increasing risk about five-fold.
High blood pressure is the most important risk factor for stroke.
Him And Her - photo credit to Amy Gorman Cloutier
