The lullaby music is playing again. So sweet.

“Are they trying to make the patients fall asleep?” I smiled at the nurse as she entered the room.

“No, that means a baby has just been born,” she replied as she turned off Pete’s call button.

We returned to Sarasota Memorial Hospital exactly 5 days after being discharged from my husband’s neck surgery for a cervical spinal fusion. He had been experiencing numbness from the neck vertebrae pinching his spinal cord so the neurosurgeon had recommend this procedure to release the pinching and hopefully avoid future issues, like paralysis.

It seemed like a good idea at the time.

In fact, after a few days in the hospital, he came home and was regularly getting up to walk around to avoid blood clots after surgery. He was eating well and taking his pain medications so as not to “get behind on the pain”.

When he did wait a few too many hours between pain meds one night, it became obvious.

I would not let that happen again. We set our phones for 4 hour intervals. Before bed: 10 pm. Alarm set. 2 am. In the morning: 6 am. Efficiency would get us through this stage!

After the 6 am pain pill, I took Harry the dog for his morning walk.

When I got back, Pete was in bed telling me he felt nauseous. He sat up and was profusely sweating through his cotton T-shirt. I brought over a bucket and he vomited up that pain pill and more.

Oh boy, I thought. I’ve never seen him this sick.

Next came the unsteadiness. He had a walker from the hospital, but when he stood up he was leaning over to the left. He made it to the bathroom with my assistance holding him upright and then back to bed. He was not doing well.

(This is when I should have called 911)

But I didn’t .

We both thought maybe it was from the pain pill. But I called the surgeon anyway.

He called back and determined that this sounded irregular. The home health nurse would be over soon, but he would like to see us tomorrow. Please schedule an appointment with his office, we were told.

Pete was sleepy but made it to the couch. He wasn’t hungry and wasn’t in pain. He just wanted to sleep.

He soon went back to the bed.

The nurse came by and took his vitals. Temperature was fine, no infection. Blood pressure normal. The nausea had subsided.

“You should always eat a little something with pain medications,” she warned us.

OK, I thought. Now I knew better. Live and learn.

The next morning we went to visit the neurosurgeon.

He seemed perplexed by the symptoms we described: nausea, vomiting, and leaning to the left. “This has never happened before,” he let us know.

As we were about to end the visit, Pete mentioned that when he puts on his glasses, he pokes his eye.

“Oh,” he exclaimed “that sounds like a brain issue!”

So, he sent us across the hall for a CT scan of Pete’s neck AND his brain.

We came back into the room and waited for the doctor to view the CT scans. The first words out of his mouth were:

“You had a stroke”.

He told us to drive to the emergency room at Sarasota Memorial Hospital now, and he would call ahead. That hospital, unlike the one across the street from his office, has a neurology unit. SMH was packed with sick snowbirds (people who spend the winter months in Florida). It was going to be a long night.

At this point I still had no idea that Pete would be admitted to the hospital for 5 days and then sent to a rehabilitation facility for 16 additional days.

Here are a few more things I did not know about strokes, until now.

1 – 15 million people globally have a stroke each year 

5 million of these individuals die, while another 5 million continue to live with stroke-related disabilities that impact their families and communities.

2 – Being a caregiver for a stroke survivor is a hard job

After our two weeks in the rehab unit, I know we are one of the lucky ones. Some stroke survivors are paralyzed on all or one side of their body. If speech was affected, communication is a challenge. Many need assistance eating, showering and using the toilet. Since the stroke caused brain damage, personality changes including anger and frustration only make the caregivers new job that much more challenging.

Not a job for sissies as my friend Claudette at Widowed Travelers advised!

3 – Stroke is the leading cause of DISABILITY and the second leading cause of death worldwide

From 1990 to 2019, there has been a 70% increase in stroke incidence. Especially in lower income countries, stroke is increasing in numbers and expected to continue to climb.

4 – Strokes are on the rise in Younger People

Most risk factors for young people are the same as for people over 50, including high blood pressure, diabetes, high cholesterol and obesity.

However, sedentary lifestyle (sitting at the desk too much), stress, and substance abuse are risk factors contributing to the increase in young adults.

5 – There are 3 types of strokes:

Ischemic stroke, hemorrhagic stroke, and transient ischemic attack (TIA).

A ischemic stroke occurs when a blood clot blocks an artery in the brain. About 87% of all strokes are the ischemic type.

Hemorrhagic stroke occurs when an artery ruptures in the brain.

TIA or transient ischemic attack, also called a mini-stroke, is caused by a blockage in the brain that breaks up before damage is done, in about an hour.

6 – Stroke symptoms vary

• One-sided weakness or paralysis ( especially arms)
• Difficulty speaking (aphasia or garbled)
• Loss of muscle control on one side of your face (face drooping)
• Blurry vision
• Loss of coordination
• Dizziness or vertigo
• Nausea and vomiting
• Severe headache
• Memory loss or amnesia

7 – The FDA approved drug tPA increases stroke recovery by 50%

If a stroke is identified within the first few hours, the tissue plasminogen activator or tPA drug can be taken as a “clot buster”. The tPA drug is only offered to ischemic strokes from a blood clot, not from a hemorrhagic stroke from a brain bleed, so a scan needs to be done early as well.

8 – Only 3-8 percent of stroke victims receive tPA

 Compared with other diseases, stroke has received little publicity. Because few people know about stroke risk factors and symptoms, they do not come into the emergency department quickly and are not offered tPA therapy. 

Despite its efficacy and cost-effectiveness, tPA treatment for stroke patients remains underused. Patients’ lack of information about the drug’s benefits, physicians’ fears of legal liability for administering tPA, and cost are 3 possible reasons for its underuse.

9 – Strokes can occur at any age

Anybody can have a stroke, from children to adults, but there are some people who have a greater risk than others. Strokes are more common later in life (about two-thirds of strokes happen in people over age 65).

There are also certain medical conditions that increase the risk of stroke, including high blood pressure, high cholesterol, type 2 diabetes, and people who have a history of stroke, heart attack or irregular heart rhythms like atrial fibrillation.

10 – Everyone’s stroke is different

Types of stroke differ according to which part of the brain is affected. The terms right-brain stroke and left-brain stroke refer to the side of the brain in which the stroke-causing blockage occurs. 

Right hemisphere controls movement on the body’s left side. The right hemisphere also handles an individual’s sense of their position in space, awareness and consideration of music and art, imagination, and intuition.

The left hemisphere controls the right side of the body. This part of the brain also handles more logical and critical thinking and reasoning — like math, science and other number skills — as well as writing and language comprehension.

11 – Men are at greater risk for a stroke but women are more likely to die from a stroke.

Research states that 33% of women do not report typical or expected stroke symptoms like jaw or arm pain or drooping of the face. For this reason, stroke is more fatal in women. Women report less apparent symptoms like headaches that may not warrant emergency treatment.

12 – 25% of stroke survivors don’t know what caused the stroke

Most strokes are ischemic, so a blood clot blocks the flow of blood to the brain. Despite testing, sometimes the cause of the stroke cannot be determined. It’s estimated that 1 in 3 ischemic strokes are “cryptogenic” or from an unknown cause.

13 – Ischemic strokes (blood clots) are caused by:

• Atherosclerosis is when plaque causes arteries to narrow, blocking blood flow. The plaque can also burst, leading to a blood clot.
• Clotting disorders
• Atrial fibrillation or Afib meaning irregular heartbeats, especially due to sleep apnea.
• Heart defects

14 – Hemorrhagic strokes (brain bleeds) are caused by

• High Blood Pressure, especially when you have it for a long time, when it’s very high, or both.
• Brain aneurysm or a bulge in a weak area of a blood vessel in or around your brain
• Brain tumors
• Diseases that weaken or cause unusual changes in blood vessels in your brain, such as moyamoya disease.

15 – Having a stroke increases the risk of getting a second one.

One in four survivors experiences a second stroke after their first episode. So, effective preventive measures are critical for patients who have had one stroke in the past.

16 – 80 % of strokes are preventable

There are lifestyle changes that you can make to your every day life that can help prevent a stroke:

• Physical activity can help you stay at a healthy weight and lower your cholesterol and blood pressure levels. The surgeon general recommends 2 hours and 30 minutes of moderate-intensity aerobic physical activity, such as a brisk walk, each week.
• Eat a healthy diet  and choose fruits, vegetables, nuts, fish with Omega-3 oils.
• Avoid smoking at all costs.
• Stay happy and avoid stress – try a meditation app on your phone
• Take your medications to manage blood pressure, cholesterol and diabetes.
• Get plenty of good sleep.

17 – Recovery doesn’t just happen in the hospital

Due to the large number of people coming into the emergency room in Sarasota the night we arrived, it took some time before all Pete’s test were completed. The MRI especially had a long wait – almost 3 full days!

Once the tests were done, the hospital’s neurologist met with us to go over the results.

We were also visited by the physical therapist who assessed Pete. She told us that he would be going to a rehabilitation facility next so which one did we want.

What?

Whenever I had heard the phrase “so and so went to rehab” it seemed to indicate they had a drug or alcohol issue and were detoxing or something.

Well, I learned that in the United States we do have different types of rehabilitation facilities and some specifically geared toward stroke rehabilitation. Once a stroke survivor leaves the hospital, insurance will often cover the cost of 7-10 days in a rehab facility until it is safe to send the person home.

Pete spent 16 days and nights at a stroke rehabilitation facility which offered him 3 hours of therapy each day and 24 hour nursing care.

 Stroke rehabilitation is a major part of recovery for most people who have a stroke. That rehabilitation can take many forms, including:

• Speech Therapy: Helps regain language and speaking abilities and improves ability to control muscles that help you breathe, eat, drink and swallow.
• Physical therapy: Helps improve balance issues and the muscle weakness in hands, arms, feet, legs.
• Occupational therapy: Helps retrain your brain so you can go about your activities of daily life and improves fine motor control and dexterity.
• Cognitive therapy: Helps with memory problems and with activities that require focus or concentration.

18 – Neuroplasticity is our superpower!

Until recently, it was believed that once our brain cells died, there was no coming back. When someone has a stroke, brain cells die.

However, in recent years scientists have identified neuroplasticity as a process that involves structural and functional changes to the brain.

Our amazing brain has the ability to change, reorganize, or grow neural networks.  A stroke damages some of the connections inside the brain, and between the brain and the body. When you do rehabilitation activities, the brain starts making new connections in the healthy parts of the brain.

 Not everyone can make a complete recovery, but many people make progress with their individual goals like getting stronger, more mobile or more independent.

I’ve learned a lot in the past month about strokes. Joining several support groups on Facebook has been helpful and enlightening as well. To find more information about symptoms of a stroke and stories from stroke survivors, visit the website for American Stroke Association.

Let me know if you learned something new about stroke awareness today!

My book No Simple Highway: A widow’s journey to seek justice for her husband’s death is available on Amazon