Monday, November 26, 2012

Calling All Born-Again Christians

First let me point out that I respect your view point and worldview, as I respect everyone's view point and worldview, even though I don't agree with it. But hey, I'm a live and let live guy anyway.

But there's something I've been thinking about lately, and perhaps you can tell me your rationale for this particular quirk of behavior that Christians all seem to share: as a rule, born-again Christians do not drink alcohol. For some reason they think that drinking is a sin. Now I don't understand this, because one of the most famous of the ways that Jesus was said to have shown His divinity was that He turned water into wine. Now, this was at a wedding. They were celebrating a joyous event with wine, and at some point they ran out. They HAD water; they weren't in any danger of dying of dehydration. Wine was not something they had to drink; wine was something they wanted to drink. And Jesus was said to have used His unlimited powers as God's only begotten son to give the attendees at the wedding (and presumably Himself) more wine! If nothing else, this shows both the societal attitudes of the day towards wine, and Jesus' own attitude towards it.

Why, then, has the drinking of alcoholic beverages become such a taboo among the Christian community? It seems like the attitudes against alcohol are ours, no one else's. If you don't want to drink, because you don't think that alcohol is something you want to put into your body, fine. I personally don't drink. One might say I don't do it particularly well. So I don't do it at all. But that is my choice. Do Christians not drink alcoholic beverages because they think somehow it's against Bible teaching? If so I'd love your rationale. You'd be educating me.

Please don't get me wrong: I'm not judging anyone or anything. If you've given your life over to your Savior, great. Mazel Tov. Who am I to say you did anything wrong or stupid? I misspent the better part of my life, and I'm glad I did. But to each his own. I just want to know: why do you guys not drink?

Saturday, November 24, 2012

A la Recherche du Temps Perdu

(Looking for Lost Time, the title of a Marcel Proust work)

Most of what I remember from the stroke that I had recently was my single-minded notion that hard work would fix me. I would tell anyone who was interested that I had "laser focus" at the task at hand — that being, rehabbing and getting better. It was really hard work but it was very much worth it, as I could measure my progress every single day. I could always do something that I couldn't do the previous day, which seemed to make the effort worth it. It was satisfying and fulfilling, which I guess is why I remember it most vividly.

But I was listening to Tootsie recounting her remembrances, especially the first couple of days, when things looked so bleak. I was reading Very Josie's blog where she described me as quote "in pain on his right side and can't move his left very much." That's not exaggeration; the first couple of days especially, things were that bad. Seeing me in the ICU, with tubes going in and tubes going out, difficult to understand, my left side in spasm, and loopy on morphine, could not have been easy, especially for my wife, my mother, and my best friend.

More to the point it made me remember just how scared I really was. I mean, for all I knew, this was going to be life from now on. I couldn't dare to imagine a life of normalcy or anything close to it at the time. I was pissing into one tube and being fed through another, hoping that they weren't just switching bottles. And when the morphine allowed me a moment of clarity so that I could assemble my thoughts in a coherent way, all I could think of was how stupid I was to allow myself to be in such poor health that I stroked out at 44. Because it was all my fault. I ignored my skyrocketing blood pressure, I was taking double handfuls of Advil to dull the pain because I refused to go to the dentist, and I thought that giving up sugared soda was all I needed to do to stem the tide of the various garbage that I threw into my body.

I put myself into the situation, and I wouldn't let myself forget. And sometimes that was a little too much to take.

I was really, REALLY scared. And the fact that I had no one to blame but myself meant that I couldn't turn that fright into anger at anyone or anything.

Of course, small signs of progress would eventually come. I remember the day they stopped monitoring my heart. The day that they removed my Foley catheter. When they removed the IV. I never thought I'd be happy to be taken off the morphine drip, but there it is. I still couldn't move worth shit, but I had a guess that was coming. The very worst days were behind me now.

I guess this is what women go through when they have a baby: one hears tales that they "forget" the pain of childbirth so that they can consider a second child with a clear head. I reckon I forgot just how scared I was, how scared my family was, how scared my friends were. But now, in the fullness of time, I remember. Oh dear God do I remember. And now, I wish I could forget.

Wednesday, November 21, 2012

Missed It by That Much

11 mm.

That's just under half an inch. And apparently that was the difference between me making a full recovery and me blinking my way through life.

I went to see my neurologist today, a very capable, humorous, and accessible man named Dr. Silver. I felt very comfortable in his presence. He examined me, by giving me an abbreviated version of the NIH stroke scale, which I told him I knew all about. He asked me how I knew so much about the diagnostic process, and in response I told him, "I know a thing or two about a thing or two," which is one of my favorite lines. He was warm and funny, and quite thorough. I'm glad he's my neurologist.

One of the things he did was show me the CAT scans associated with my stroke. He pointed out where the bleed took place, which was more like in the exact middle of my brain at the very top of the brainstem, instead of towards more of the back of the neck, where I thought it was. The bleed was 11 mm in size. But that's not the 11 mm that I was talking about earlier.

You see, if the bleed was just a little bit bigger, say 22 mm instead of 11 mm, it would've encroached upon an area of my brain that is associated with "locked-in" syndrome. 11 mm — .43 of an inch – separated my more or less full recovery and disaster.

I have to say, that rattled me pretty good. He told me quite matter-of-factly that if the bleed was 11 mm posterior to where it was, I wouldn't be in the office today. I'd be were I would always be, in a hospital bed, there to stay for the rest of my life.

Locked in syndrome, by the way, is when you're completely paralyzed, completely unresponsive in every way, with the only thing you can do of your own free will is blink. There is a famous book and movie about it, both titled "The Diving Bell and the Butterfly," where somebody with locked in syndrome dictated an entire book to his caregiver who, letter by letter, would go through the alphabet and the guy would blink when the right letter was gotten to. That redefines "painstaking."

I knew I was lucky, even though I put a lot of hard work in to facilitate my recovery, that I had a chance to do so, instead of sustaining permanent damage. But I had no idea how close I came to a nightmare existence of complete musculoskeletal unresponsiveness. I can't even imagine a more or less intact brain inside a body that offered no ability to express itself. I really don't know how long my will to live would have sustained me, and most of my effort would have been taken up with me painstakingly blinking a request to end my life. Instead of glibly trading bon mots with the doctor, I could have been, to use a cynical expression, a potato.

That gave new meaning to the term "perspective."

I also learned some things about the nature of hemorrhagic stroke. Before, I had counted myself lucky that my stroke was the result of the bleed as opposed to that of a blood clot. As it turns out, though, you're better off getting an ischemic stroke than a hemorrhagic one, because doctors can give you medicine that dissolves a blood clot almost instantaneously — but they can't do squat for a bleed. Best they can do is hope that the pressure caused by the bleed closes the blood vessel before any significant damage is done, and then try and work with what is left. Funny little sideline – if they think you have a blood clot when you really have a bleeder and they give you the anti-clot drug, it will just keep the open blood vessel bleeding and you will end up with a good case of death. That's why, even though time is such a factor, they got to give you a CAT scan before they give you the drug.

But the visit wasn't all jarring news. For example, in response to my request, and after he examined me ("you're giving me the NIH stroke scale! How quaint."), He pronounced me fit to drive, and authorized same. Yay! A quick call to AAA to have them inflate a tire that has gone flat, and I'll be back to being a menace on the road. I can't wait.

I had to walk from the front entrance of the hospital to the doctor's office, a distance of approximately 275 miles, after which funny enough I found my gait to be markedly improved. It seemed a lot more natural, without me having to think about it. And navigating my way to the parking lot where the car was involved a lot of curbs, rough surfaces, inclines and declines, and just to round things out, a set of stairs – all of which I navigated completely naturally without any troubles. Hosanna in the highest. Don't get me wrong: my career as an international ballet star is over. But I can get from point A to point B without having to worry about taking a digger into a mud puddle.

I got some encouraging news about my overall recovery. My doctor indicated that the window for me to recover coordination that I have lost is far from closed, and that I had the better part of a year to improve my condition. It's time I have no intention of wasting.

This NIH stroke scale that I keep talking about, by the way, is a standardized series of tests to determine consciousness, cognition, limb control, speech clarity, and sensation. Each individual test is scored with your aggregate score representing roughly how severe your stroke is. The lower the score, the better. Someone who had a major stroke, for example, who was severely aphasic (aphasia is roughly defined as the inability speak properly or to comprehend speech), paralyzed on both sides of the body, and unable to feel stimuli such as a pin prick might score as high as 25 on the stroke scale. Me, I scored an eight, which was pretty damn low.

I bring this up because one of the questions I asked the doctor was, was he surprised at the degree to which I made a more or less full recovery. He told me no; my low stroke scale score was a decent predictor of my ability to get back what I had lost, though he was glad that I put in the work and got the job done.

Well, you now probably know more about strokes than you ever cared to, but I hope it's at least interesting. If you've nodded off by now it might be an indicator that YOU need a stroke scale test. Can you tell me what month it is? Do you know where you are right now? Hello? Hello?

Thanks for paying attention. Go see a doctor if you haven't done so recently.

Monday, November 19, 2012

The Dust Settles

Well, it's seven weeks, more or less, since Oct 2, when I suffered a hemorrhagic stroke.

I made a few videos to tell my strokey story, in four parts. Feel free to watch them.  Links at the bottom of the post.

I should update you on what life is like for me now. I can do anything I used to do, with the partial exception of the fact that I play the guitar like I was 12.  The one remaining vestige of the stroke is a certain lack of coordination in my left hand.  But it's getting better. The more I type, for example, the better I get at it; I suppose I'm not done rehabbing.  Up until recently I created a huge amount of typos, but that's slowly resolving itself.

Below the belt, I can walk just fine without benefit of a cane, even outside; it's time to put the old girl into storage instead of hanging by the hall table.  Sometimes though, when I'm really tired, like when I wake up in the middle of the night to take a squirt, I catch myself doing what I call "the stroke walk," that old-man shuffle that is characteristic of stroke victims. I won't swing my arms like I'm supposed to also, and will find myself holding my arms in a weird position in front of me. But when I pay attention, my gait is more or less perfectly normal. I'm sure that at some point it'll become unconscious behavior again.

Stairs are just fine; I can walk up and down stairs without a rail.  I need to pay attention to the first step to sort of get me started. Down requires more attention than up.

If there's any downside to the stroke, it is this: I  can do anything you can do, but I always need to pay attention.  I guess that's as close to a one-line answer as to how I'm doing as it gets.  That was the true cost of the stroke: a certain mental vigilance with fucking EVERYTHING. It can get exhausting. Good thing I sleep well.

On that subject, I've been forbidden from taking NSAIDs like Advil. I told my doctor that I wanted something for the aches and pains of being me, but that the stuff (oxycodone 5mg, the primary ingredient in Percocet) I had was a bit strong. He perscribed me something a little more gentle, hydrocodone/APAP 5/325, which is Vicodin more or less. So I have something in the house at least for pain.

I have numbness and nerve pain in my thighs, from the stroke, that the Neurontin and the Lyrica can only affect so much. I've pulled the offending teeth out of my mouth, so I have no mouth pain, but my knee hurts almost all the time (that's new) and I seem to be prone to muscle pulls lately. Just the other day I fell asleep while sitting on the couch, slumped over and pulled every muscle in my ribcage. These are just the kind of aches and pains that I could knock down with a couple of Advil, but god forbid my platelets should get too thin or whatever. Vicodin is nice, don't get me wrong, but when you have to take them for real pain, all the time, it gets a little depressing.

Anyway, that's my life as it stands right now. Thanks for paying attention. Here's the links to those videos, which feature my pretty face talking all about my stroke, my hospital stay, the nursing staff who to the last woman saw my genitals, rehab, and the trip home.  I'll do another one, I think, to describe what a stroke looks like, how to detect stroke in others, and what to do (that's easy: dial 911).

Link 1:

Link 2:

Link 3a:

Link 3b: