A stroke isn't pretty

[friend of the friendless]

Sirs, Madames,

Just spent a day taking my best friend of 40+ years, age 51, from one specialist to another, through a battery of tests, x-ray, imaging, echo, CAT scans, after he suffered a stroke the other night. His right arm is hanging like a slab of salami in a deli window, he's slurring like a barfly on a bender, he's struggling to come up with words like Jackie Gleason doing humina-humina-humina--which is to say that he's pretty well unrecognizable to me. His parents are elderly--he takes care of them. His brothers have bailed out--nowhere to be seen during all this though they live about four blocks away. His one sister-in-law is a nurse but she's not been around. Single guy--married before, no kids, couple of girlfriends tho' neither particularly serious. It falls on ye old friend of the friendless to step into the breach. (My handle is actually homage to my buddy because he always described himself as "the friend of the friendless" though I'd suggest that he was "the mark of the penniless.")

Anyway, my buddy was a walking stroke magnet. You name it--diabetes (though mild, late onset), asthma, smoking, booze in prodigious quantities, drugs back in what passed for his prime, overweight down from obese, stressed. (He wanted to have a smoke between appointments today. I told him if he could light it with his right hand, go ahead. Otherwise I'm bailing out.) I tried to tell him that construction work actually wasn't a substitute for exercise. Preached various forms of the gospel of healthy living. To no end.

If you know someone who has had a stroke, I can't tell you anything you don't already know. If you don't, let me tell you it's terrifying. Maybe my friend is in there somewhere but I can't see him and having known him so long I'd know where to look. He's like a child at this point. Going from wanting a smoke and in denial, to sobbing like a child at his helplessness and hopelessness. Through it all I have to Joe Friday the deal--play it straight, not act alarmed, ask and answer the medical questions that he's too far gone to handle. If I freak out he's gonna be a puddle.

Strange thing: The night he had the stroke, we were having a beer. He gave me a run-down. He had problems with a blind spot in his field of vision last week. His sister-in-law the nurse looked at. So did his GP, who said it didn't pass for glaucoma or diabetes-related onset of blindness/vision problems. An opthamologist looked at it and said he had a blood clot in his eye and that it would have to get lasered out though it didn't present any immediate health threat. The eye guy also said that his eye was clear--it didn't show any sort of wear and tear that would go with mismangement of diabetes. He also had an elbow injury from construction -- same week, took to wearing a tensor. I noticed he was having a helluva time with his arm. Tendonitis, whatever, it looked pretty painful. Flopping around a bit, obviously bothering him. So right then, into our local, walks our GP--yup, we have the same GP, a kid (yeah, 40, a kid) I coached when he was in grade school and I paid my bill and left. The doctor didn't see it coming and he's a top-drawer guy (among other celebrity patients, the Toronto mayor lets him stick his finger up his ass so you know he has to be good). He doesn't see my buddy is struggling. It's the bar owner who says, buddy are you alright? Slurring, slightly out of it on three beers. Worried enough, he goes to hospital. Bang-zoom.

I have no advice to offer other than: If you're doing **** that puts you at risk for this, take up skydiving or some other less painful way of dying.

YHS, etc

 

[Chef]

Tell your boy to hang in there.

Oh, and after seeing the thread title, **** Clark would agree with you.

 

[The Big Ragu]

FoTF, My dad had a stroke a few years ago. Scariest thing ever. He was 71 or 72 at the time, and as a second career in retirement he was teaching college courses. He had a warning sign (a TIA) a few weeks before, when he blacked out and passed out in a classroom. He may have had others that he didn't recognize as warning signs. He did all the right things. Saw his doctor, saw a neurologist. They didn't do anything to prevent the big 'un--gave him no warning. He was overweight and a diabetic, had high blood pressure, etc., so he had some of the risk factors. As others who have had to deal with this know, not all strokes are the same. They effect different parts of the brain and knock out different functions. In my dad's case, the right side of his face droops and it affected his mouth and right eye. It is still the thing he is most uncomfortable with. His eye muscles on that side don't work so he can't focus his vision--apparently your eyes work together to give you a single line of vision without seeing double or triple images. His stroke effected a part of the brain at the stem and at first it looked really bad. I have a sibling who is an M.D. and based on what she was hearing it sounded like there was a decent chance he was going to die. They wanted to rush him to surgery, but it was the type of surgery more people die from than survive. I was frantic. Luckily we were able to get him out of the crappy hospital he had gone to and got him to a better hospital that specialized a bit better in what he was dealing with, and they were able to treat it without the treatment killing him. It was a long road. He couldn't walk and was an absolute mess. After a few weeks in the hospital stabilizing him (he was bed-ridden, couldn't move or feed himself, etc), he went to a rehab hospital for a few months. He had to learn how to walk all over again. He was really depressed. It changed his life markedly. He then went to live with one of my siblings who is a good-hearted version of a marine drill sergeant. She put him on a strict diet. It was great. Because he couldn't move or take care of himself, he was stuck eating what she gave him, and she got his weight way down. He was actually healthier for about a year, than he had been before the stroke -- except for some decreased physical functions that had gotten hit. He continued with physical therapy and it helped a lot. The diabetes got under control and his blood pressure was as low as it had ever been. He eventually moved back home and has a friend who lives with him and helps him take care of himself. But he is remarkably independent for a guy who has been through so much. He walks pretty well (without a cane or walker now), although occasionally he gets unsteady on his feet. He can't drive anymore. He has had two surgeries (which were dumb, because someone in his shape shouldn't be putting themselves under general anesthesia) and seen every doctor you can imagine about his bad eye. He can't accept that it is not going to change. He had one other health issue in the interum that I won't detail, and he is back to not taking care of himself. That has been the nost disappointing thing to me. He was so scared right after the stroke -- thought he was going to die -- and lost so much weight and got so much healthier. And when he got back on his own, he couldn't stay disciplined. He and his friends go out to eat every day and they eat bad food. He doesn't push himself to get physical activity. He has put on a ton of weight again. I visit him and he always wants me to go out to eat with him, and I now just refuse. I can't watch him do it to himself--shovel in bad food. But I am not like my siblings -- I don't lecture him. He's an adult and he has to make decisions for himself. At least he'll be going out on his terms.

My dad was a really sharp guy. This may or may not have anything to do with the stroke, but he has definitely slowed down some mentally. Part of it may be related to the fact that he has gotten very hard of hearing. He is still cognitively there, but he can't concentrate for long periods, forgets things and isn't on top of things the way he was. He's almost childlike in some ways. I talk to him every day, and we talk about baseball (the only thing we have ever had in common; unfortunately he doesn't care a lick about football or any other of a thousand non-sports things I care about). Our conversations sometimes have the feel of an adult talking to a child, with our roles reversed. He also used to be a lot like me: restless, a bad sleeper. He woke up every day at about 5 or 5:30 a.m. He now stays up later and can sleep until 10, 11 a.m. or even noon. That is unbelievable to me, given the person he used to be.

Anyhow, I know that doesn't offer you much, but the months after a stroke seem really bleak. It almost always gets MUCH better. The physical limitations improve -- especially with good rehab. When my dad was going through it, I was amazed by how many friends told me they had parents or friends who had had strokes and were doing well a year later. And in just about every case, things looked hopeless at first, but in time the victim got a lot of function back. Just keep your head up and be as supportive as you can, while maintaining your own life (sorry if that sounded trite; it wasn't meant to).

 

[DocTalk]

Strokes are devastating to both patient and family. Those who provide the nursing and moral support and care are truly angels on earth.

Many CVAs are preceded by warning TIAs and give opportunity to potentially intervene.
http://www.emedicinehealth.com/transient_ischemic_attack_mini-stroke/article_em.htm

 

[jgmacg]

No advice, but I send the warmest regards of our tiny household to all here.

 

[patchs]

My dad had a minor one a few years back and they are scary.
Thank goodness he has mostly recovered.
FOTF, good luck to your friend and hang in there yourself.

 

[Flash]

Stay strong, FOTF. You're a great friend to that guy.

 

[Dyno]

What a timely thread for me. My dad had a minor stroke last week and thankfully, thankfully, thankfully, has no lingering effects. His happened while he was having a medical test and when he came out of it, he was speaking gibberish and not responding correctly to commands (he raised his right hand when they asked him to raise his left). He had a couple of CAT scans and after the second one, he was fine - able to speak normally, good memory, etc. By the time, I got to the hospital about 5 hours later, he was completely back to normal. I cannot express how thankful I am that he came out of this one OK.

My best friend's sister had a stroke last year - at the age of 41. She was in perfect health - not overweight, never smoked, ate well, not that much stress in her life. She was running a 10K and collapsed afterwards. She had some speech issues afterward, which were fixed with therapy, but unfortunately, she lost the vision in one of her eyes. Other than the lost vision (no small matter), she's fine.

FOTF - best of luck to your friend, and Ragu, hang in there.

 

[fishwrapper]

Truth is, you don't have to be a big drinker, smoker or eater to be a stroke victim.
Unchecked, elevated blood pressure is the catalyst to tens-of-thousands of strokes and heart attacks yearly. Not to mention the leading cause of kidney malfunctions.
If high blood pressure can't be remedied by the patient, an 18-cent-per-day pill can literally be a life safer.
In our deadline-oriented profession, do yourself and your loved ones a favor and have your blood pressure checked regularly.

My regards, Ragu and Friend. Good luck.

 

[Moderator1]

A stroke is what killed my mother.
They are indeed not pretty.

 

[DocTalk]

Truth is, you don't have to be a big drinker, smoker or eater to be a stroke victim.
Unchecked, elevated blood pressure is the catalyst to tens-of-thousands of strokes and heart attacks yearly. Not to mention the leading cause of kidney malfunctions.
If high blood pressure can't be remedied by the patient, an 18-cent-per-day pill can literally be a life safer.
In our deadline-oriented profession, do yourself and your loved ones a favor and have your blood pressure checked regularly.

My regards, Ragu and Friend. Good luck.

Blood pressure control is one of the important cornerstones in prevention of heart disease and stroke. The American Heart Association has persented new guidelines for what is considered normal. Anything over 120/80 is considered pre-hypertension and requires attention. Inital interventions remain exercise, diet and weight loss.

Whilte you can't control family history and genetics as a risk factor for stroke and heart attack, the other risks of diabetes, high cholesterol and smoking can be minimized. Lifetime attention to the small things we can do pays long term dividends for quality and quantity of life.

 

[fishwrapper]

Doc,
For those of us not in the medical profession, or -- at the most- - the peripheral, this is a very troubling line for for us: "any part of the body is accessible with a long needle and a strong arm."

 

[DocTalk]

Doc,
For those of us not in the medical profession, or -- at the most- - the peripheral, this is a very troubling line for for us: "any part of the body is accessible with a long needle and a strong arm."

And your concern is...?

 

[wickedwritah]

Wow, FotF, you are going above and beyond to stand by a friend. Stay true to that, for his sake. (I'm sure you will, to the degree that you can.)

 

[Dan Rydell]

Echo that: Way to stand in there, Friend.

 

[Angola!]

A stroke is what killed my mother.
They are indeed not pretty.

Agreed.
A stroke killed my grandfather.

 

[Mystery_Meat]

Every time I read a thread like this, I pray for the people involved. Then I pray that when my time comes, I go quickly. I don't think I could handle a slow, lingering death, and I certainly couldn't handle putting the people around me through that.

 

[crusoes]

My mom had a stroke last December, a mild one. It happened at 5 a.m.; by 2 p.m. she felt well enough to order us out of her room and back to our homes. But it was scary, and my best to FOF and his friend.

 

[pallister]

The effects of even a "mild" stroke can be pretty devastating. My dad suffered a stroke during a heart procedure about a decade ago; he woke up and could only speak gibberish. That went away pretty quickly, but to this day he still can't say many words and phrases; he means to say one thing and says another. It makes him feel pretty bad. But the biggest thing is that he can no longer read books. He used to read voraciously, especially his Civil War books, but he hasn't read anything more extensive than a credit card bill since his stroke.

 

[Herbert Anchovy]

http://www.nytimes.com/2007/07/10/health/10robo.html?_r=2&pagewanted=1&ref=science&oref=slogin