July 27, 2020
Some milestones flash by. You get married, acquire in-laws, have kids, make new friends, change jobs, attend weddings, move to a new town. You’re reminded (someone always knows) of birthdays, anniversaries, graduations, soccer games, swim meets, then deaths and funerals, sometimes after they’ve occurred. If you don’t pay attention, life can be a blur of missed special occasions.
Not this one. One year ago tomorrow Sandy was released from the ICU at Bryn Mawr Hospital in Bryn Mawr, Penn. She spent a week there, starting the day before her birthday. Her birthday present was an MRI, followed the next day by an angiogram—a catheter inserted in her thigh and pushed into an artery in her brain. The diagnosis: an ischemic stroke, in which blood flow to the brain is blocked.
The Centers for Disease Control and Prevention reports that strokes kill about 140,000 Americans each year. Nearly 800,000 have strokes each year.
She experienced symptoms: numbness in her arm and an optical migraine, on Saturday, July 20. It was the hottest day of 2019 in eastern Pennsylvania. Our daughter-in-law Caroline rushed her to the Bryn Mawr ER. Luckily, the hospital is a stroke specialty center.
The docs said Sandy’s stroke was “minor”; it didn’t seem minor at the time. It affected the left side of her brain, but she didn’t suffer any loss of physical or brain function. Through her ICU week, cardiologists and neurologists debated the right level for her blood pressure. Too high could cause damage to limbs or vital organs, possibly blindness and death (true for anyone with chronically high blood pressure, if untreated). Too low risked inadequate pressure to push blood through her brain’s constricted arteries and veins. I don’t think they flipped a coin, exactly, but the range they agreed on, between 140 and 160 (systolic, or top number) is too high for most people, but strong enough to keep blood flowing to her brain, with moderate risk.
It was a rough week: following the angiogram, two or more blood draws, days and nights, a continuous IV and real-time blood-pressure monitor, an emergency CT scan, summits with a rotating crew of specialists who shared their uncertainty. The problem: how much blood pressure medication would she need to stay in that 140-160 spectrum? They came up with a mix of pills.
Through it all—or most of it–she smiled, or tried to smile. She gritted her teeth during the blood draws, but came up with a grin. She toughed it out.
We picked up her first prescriptions from the closest CVS after discharge. It still was hot as blazes. We stayed with our son and daughter-in-law for a couple of days, extending our total stay from a weekend to twelve days. Then, at home, weekly visits to the family doc for blood-pressure checks and appointments with a cardiologist and a neurologist.
A few quiet weeks passed. We started walking, first up the street, then around the block, then a mile, then two. I covered this in some of my posts of last summer. Sandy’s BP was way up, then down. She went through two or three of those at-home blood-pressure devices, including one with an audio feature. It spoke to her: “Your systolic pressure is … your diastolic pressure is …”
Time crawled by, weeks, then months. She saw the cardiologist and took the stress test and passed. A “B+,” I called it. The neurologist visit was a little creepy, he grilled her about depression and gave her a prescription for anxiety. More pills. But she started feeling better.
She went back to the gym and walked on the treadmill, rode the exercise bike, lifted light weights. She went to weekday Mass. We kept up the walks. She talked to other women who had lived through strokes.
We got back on the road, to a family wedding in Georgia, then, for symmetry, Thanksgiving with our son and daughter-in-law in Pennsylvania. I suggested driving by the hospital, she wasn’t interested. For Christmas we trekked to South Carolina and watched the grandsons open their stuff Christmas morning.
She talked to people at Sentara hospital and a nearby assisted living facility about visiting with recovering stroke patients. The need is real, and urgent. Recovery, even for minor strokes, is slow, difficult, painful.
We managed to get our last “on the road” junket in, to Florida, in March. Then covid-19 hit. The workshops and visitation programs all shut down. We shut ourselves down. Like the rest of the country, we watched the reports: seniors were the first victims, then first responders, then everyone else.
Meanwhile, healing continues. Sandy still is on her meds, 6:00 AM then again at 6:00 PM. That will be every day, forever. She won’t be getting off the stuff, with one exception, the anxiety prescription. One day she simply stopped taking it. The doc was OK with it. I haven’t noticed a difference, probably because anxiety is contagious. She may have passed it to me.
She came with me to my oncologist’s appointment last month. We sat in the waiting room, everyone wearing masks, looking nervous. The doc came in, we talked through our masks. He looked over my scan and said it looked good. Back in four months.
So this week, her anniversary week, we looked back to the stroke birthday, 66—here we were at 67. It was uneventful. The kids called and sent gifts, we went to Mass. Prayers were for the covid victims, for all those suffering.
Later we went to dinner, socially distancing. We looked back two years, when she turned 65, a big deal. I recruited all the kids to show up for a surprise party. I called friends local and long distant, most made it. We ordered food, drinks, the works. The weather cooperated, it was clear and cool out in the yard. It all came together.
This anniversary moves us forward. We’re thinking of all the stroke victims, still in need. You push on, knowing what they’re experiencing, while their doctors and nurses now are in their own danger. Then we remind ourselves: another year is ahead. Prayer and courage gets you through it, to healing, peace, and the next anniversary.