Friday 3 December 2010

My Stroke

So I told you that I would take a moment to tell you about how I fared in the stroke world. What follows is a short bit from information that they shared with me and then a long summary that had been documented on a form by one of my rehabilitation doctors.

The survival rates cited in my Dec 1 post are not bad but what I have been told is that the survival rates are attributed mostly to the Ischemic strokes (the ones that involve "only" a clot). Sometimes, if treated fast enough, a drug can be given to dissolve the clot - that is a very good thing.

Interestingly, I was not in the 80% who have that kind of stroke... I was in the 20% who have a hemorrhage stroke. The survival rates for that type of stroke are very low. This is part of the reason that I feel SO fortunate. I have been given a second chance at life. ...Sighing and staring at the screen as I take a moment to absorb that again...

I will, in the near future, tell you about the actual beginning of my stroke and paint you a picture to understand what that was like (home alone with my three little boys at that time). For now, I will share with you a copy of the medical description of my illness [my comments are offered in square parentheses throughout the medical summary below]. The doctors' part of the story begins after my husband found me non-responsive, unconscious and then having a seizure. He called 9-1-1 on the early evening of September 7, 2010. Firefighters and Paramedics arrived and the medical system kicked in to save my life..

If you can't cope with the medical text that is coming next, scroll to the bottom where you see the text in bold ;) .

Here we go:

"HISTORY OF PRESENT ILLNESS

"The patient was taken to the Montfort Hospital where she had a CT scan that diagnosed her left temporal intracranial hemorrhage. She was also noted to have a seizure [this was a "grand mal seizure" and was the third I experienced - the one and only "extreme" seizure I had in the presence of the medical professionals] and was treated with Dilantin and Ativan. She was then transferred to the Ottawa Civic Hospital under the care of Neurosurgery. The patient does not recall any descriptions of her seizure. On [the early morning of] September 8, 2010, she had a CT angiogram which showed a left temporal intracranial hemorrhage of 36 x 55 mm associated with vasogenic adema, partial left supraseller cistern and left lateral vetricle effacement, as well as a 2 mm left to right subfalcine shift. Her left posterior cerebral artery was noted to be hypoplastic. The vetebral arteries, right posterior cerebral artery (PCA) and anterior cerebral artery (ACA) were patent. There was also an incident of aneurysm noted involving the opthalmic segment of the right internal carotid artery measuring 1.7 x 1.7 x 3 mm. The left transverse and sigmoid sinuses were hypoplastic. A limited examination of the left internal carotid artery cerebral angiogram was performed and showed no arteriovenous malformation, no arteriovenous (AV) fistula, aneurysm, or vessel irregularities. The patient was then taken for a left craniotomy and hematoma evacuation [I was unconscious by that time and my husband gave consent in early morning and I had surgery starting at 11:36 AM]. Intra-operatively, there was some suspicion of a venous sinus thrombosis. Subsequent MRI and magnectic resonance venography (MRV) on September 9, 2010, documented absent filling of the left transverse and sigmoid sinuses.

My CT scan on October 25, 2010
"Postoperatively, the patient was sent to the Intensive Care Unit, was sedated and ventilated. She was also started on intravenous (IV) heparin for treatment of her venous sinus thrombosis. September 10, 2010, Doppler ultrasounds of the legs showed superficial and deep venous thrombosis of the left leg, which was not occlusive. Thrombosis was involved and advised on anticoagulation which was eventually switched to oral Coumadin for long term management. It was noted in her discharge summary from the Neurosurgical service that the hypercoagulable workup by thrombosis was negative. Howerver, a follow-up has been arranged with them [that was an appointment with my hero, Dr. Sinclair, on October 25 - I will go back to them again sometime between March and June 2011. He teaches at UOttawa and here is his bio and a photo about halfway down this linked page].

"During her hospital stay, Jennifer also experienced visual hallucinations involving seeing insects and dots or spots in her visual fields as well as abnormal colours or shadows, which were considered to be seizures occuring while on Dilantin. For this reason, the patient was switched to Keppra and has a followup arranged with Dr. Sharma in three months' time with MRI of the brain [appointment is December 20 and here is an interesting interview and picture of my doctor from Oct 29, 2010].


The Left Side of a Brain
 "The patient's overall diagnosis was left temporal intracranial hemorrhage secondary to venous sinus thrombosis, for which the patient was considered at higher risk given her age [36] and use of oral contraceptives [yep, the birth control pill; the estrogen one... be cautious ladies].

"The patient denies having had recent dental work prior to her stroke. She also denies any recent illness. However, she did mention that four months preceding her stroke she developed an incessant headache for which she took Motrin as needed and was scheduled to see her Family Physician on September 9, 2010."

CHEAT NOTES: I had a hemorrhage stroke in my brain. I had brain surgery (yes, they opened my head and did incredible things to my brain). They found a clot in my left leg. And I had visual hallucinations which were due to the damage to my brain - the hallucinations have subsided since late September. 

I know that was a pretty long and meaty piece of information but I offer it so that you now know (medically about my case) about as much as I know. Well... except what it is like to actually live through this. But over the course of time, perhaps you will see that part too...

See you Dec 3 when I share some information about when you need to get yourself to a doctor as quickly as possible.

A card to me from my eldest son

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