My Stroke ( part VI)

There’s a nearly complete gap in my memory between the time I spent fishing with Bob Rowley on the Bad Axe River and the time two days later when I contacted Dr. M.’s office to mention that my “diakaesis ” interludes had markedly increased in severity over the previous several days, and did not appear to be abating.

Here’s what I do remember:  I struggled monumentally to cross a plowed-over field  with  rows  of eight-inch furrows I could only surmount by   belly-crawling over them. Upon coming within casting range I have a distinct memory of not even attempting to get up on my feet, but rather of grabbing my rod, which I had been dragging along with me, to present my fly,  from a sitting position. The fly was a size 16 caddis emerger, as recommended by Mat Wagner, owner of the nearby Driftless Angler fly shop.

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Mat Wagner, owner of the Driftless Angler  in Viroqua, Wisconsin, is a transplanted Coloradan who set up stakes in the Upper Midwest after succumbing to the irresistible appeal of spring creek brown and brook trout. Mat is a true master of “technical” angling  (translation, the use of ridiculously small flies to tempt trout on a stream’s  “uncastable’ stretches.

A trout had just slurped something off the surface less than ten feet in front of me. As I raised my rod to cast, it did something most peculiar. Instead of propelling my fly line seamlessly behind me, and then, with a flick of my wrist,  shooting my line forward, my rod simply shuddered  as my fly line grew taut. It took a few moments for me to realize my fly had become snagged on some godforsaken clump of chokeweed about 15 feet behind me.

It was the final straw; I had neither the energy nor the will to attempt getting on my feet and backtracking to unsnag my fly.  What happened next was that my guardian angel in the guise of  Bob Rowley came upon me after his exploratory foray upstream, took stock of my predicament, helped me get on my feet and then insisted I use his rig, upon which he had tied the identical fly.

I’m assuming  we then underwent the ritual of insisting the other do the honor, that Bob finally prevailed, and that I managed to cast my fly somewhere in the vicinity of a rising trout, because the next thing I remember is Bob snapping a picture of me holding a decent-sized brownie.

Again, my recollection  becomes foggy. I would assume that at some point we headed back to  Viroqua and had an early dinner somewhere, hopefully at Dave’s Pizza, which offers a daily, inexpensive buffet of damn’ tasty thin-crust pizza.

My next memory is of pulling back the blankets of my bed back at the motel, probably the Midway Motel, owned by Hasmukh Patel, who relocated from West Devon St. in Chicago to Viroqua some years back. Now here’s another distinct memory. I don’t know why this particular memory stands out. All I can say is that my next memory is of Bob shaking me awake the following morning, and of me feeling like I was slowly rejoining the world of the living after having  been put under general anesthesia.

 

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This photo, taken by fishing buddy Bob Rowley, is proof I caught a trout on our ill-fated trip to the Bad Axe  River, even though I don’t remember catching it.

Again. I would assume Bob and I had breakfast, most likely at the Country Kitchen, which offers delectable cinnamon buns, supposedly based on an Amish recipe. Perhaps we stopped by Paul’s place to fish his superb stretch of the Spring Coulee. We wouldn’t have caught anything because, otherwise, Bob would have snapped a picture of it. Then we would have headed home, and I would actually have gone to work the following day. My memory kicks in again when, as I earlier alluded to, I called Dr. M’s office from the JCFS school parking lot.

After listening to my recap of the events of the past five days, Dr. M.’s nurse was blunt: “Go straight to the hospital and get an MRI. Dr. M is putting in the order right now.”

I am going to send this post, my first of 2016, on its way, and then I will start working on “My Stroke, PartVII.” But, I would like to elaborate on two topics that you, gentle reader, may feel have been less than adequately resolved.

First, considering that Bob Rowley was my constant companion from the start of our expedition to the finish, you might wonder why I haven’t called upon him to fill in the gaping holes in my poorly recollected narrative. I have seen Bob several times since our last trip together; indeed, we have been discussing returning to the Driftless Area this coming spring. But Bob has not made a single reference to that ill-fated outing, and for my part, I have yet to raise the subject. Perhaps, as they say, it’s too soon.

And then there’s the issue of my memory gaps. Since my major stroke, I have suffered a degree of short-term memory loss of the “I-left-the-house-without-my-wallet” variety. However, with the exception of those first few days following the onset of my second stroke, I have not experienced the sort of memory loss capable of gobbling up entire days. I do have a theory of sorts, if you will kindly indulge me:

During those several days I was actively “stroking,” so to speak. Blood was leaking out of my torn carotid artery even as my body tried to seal up the tear through its arsenal of clotting factors.

This was not some placid anatomical backwater; this was sheer turbulence. Connective tissue (“scaffolding,” if you will) would start taking form, and then the force of my pumping blood would tear it down. When this happened, blood clots were released, many of which quickly dissolved. However, some remained intact long enough to create mischief. Among these larger clots were a few that remained within my carotid artery, which meant they would continue traveling upstream until they clogged one or several of the networks of fine arteries supplying oxygen to my brain.

My first post-stroke MRI revealed extensive damage to my right parietal lobe, the area of my brain that controls an integrates muscle movement in the left side of the body (among other things). However, small areas of my frontal lobe also were damaged. This damage, as with the damage to my parietal lobe,  occurred without warning, creating  what one radiologist characterized to me as “chaos within the brain.

At the onset of my second, major stroke, which I suffered at the Charleston, S.C. airport the predominant symptom was my total inability to move my left leg. Eventually I regained the ability to manipulate my leg, but at a diminished capacity.

In related fashion, my stroke left me with diminished short-term memory. My layman’s theory is that amidst the chaos and turmoil created by the destruction of multitudes of neurons, including those involved with memory, my brain responded by virtually  shutting down memory functions, just as it responded to parietal lobe damage by virtually  shutting down leg functions.

 

 

 

 

 

 

My Stroke (Part V)

At the conclusion of “My Stroke, (Part IV), my fishing buddy Bob Rowley and I were heading up to Bad Axe River, just south of Westby, Wisconsin, and smack in the heart of the trout-rich Driftless Region. Bob was accompanying me under duress, so to speak, because I had suffered a major stroke the previous day, and I definitely looked the part. I was walking as if I had a club foot, my left arm was bent in a way that made it look as if I were doing a left-handed Pledge of Allegiance, and the left side of my face was drooping in an alarming way.

Bob really had no choice but to accompany me, if for no other reason than to rush me to the nearest emergency room, should the need arise. I had suffered a major stroke the previous day back at the Charleston, S.C. Airport, a reality that I was bullishly refusing to acknowledge.  (See My Stroke, Part IV, for a fuller account)

The only trout I caught on the ill-fated “stroke” trip.

The drive was uneventful. Bob talked about his last days at the ChicagoTribune (He was laid off the same day as was fellow Trib editor, my wife, Suzanne.) He talked about the challenges of his new job as executive director of  government and community relations at Elmhurst College. I talked about the never-ending roller-coaster ride that defines the life of a special education teacher in an inner-city alternative high school. This, in turn, was our springboard into the complexities of education, the evolution of the brain, and the comparative virtues of raising boys versus raising girls (Bob has daughters; I have sons).

It was around 3:30 when we arrived at the North Branch of the Bad Axe. I had felt perfectly fine during the drive, but once I got out of the car I realized things were not going to go well. Observing me with both hands on my left leg as I tried to twist it enough to swing it out of the car, Bob asked for about the twentieth time, “Are you okay?”

“My legs are a little stiff,” I glibly replied. Bob studied me the way a state cop  might study a motorist  unable to produce his driver’s license, while I tried with partial success to impersonate someone whose only problem was minor leg stiffness.

Finally, with a sigh of resignation, Bob said, “Don’t hesitate to ask for help.”

In front of us was a long, broad pool, narrowing to riffles (or what fly fishermen call a “run”) before disappearing around a bend. What we both beheld were the characteristic “dimples” of surface-feeding trout. They were sporadic, but a hatch of some sort or another definitely was on.

“Why don’t you try you’re luck here, and I’ll see what’s going on around the bend,” Bob charitably suggested.

“Nah, Bob. Let’s both work it.” Bob was being too nice.

“I told you on the way up that I’m in the mood to do some exploring,” Bob shot back.”

“Only if you insist, “I responded,” while urging him to return to the pool if his exploration failed to bear fruit.

I watched as Bob headed downstream, walking parallel to the pool, far enough from the bank to avoid spooking the trout I would soon be stalking. Just before reaching the bend, he turned and said, “Give me a holler if you need anything at all. I’ll stay in earshot.”

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A field in fallow

I gave him a wave of encouragement, and then he was gone. I turned my attention back to the pool.   In classic Driftless Region fashion, its seemingly still water shimmered in the sun. Only the sight of a fallen leaf floating  slowly but steadily downstream confirmed that this was a stream with a current. Occasionally, small clusters of clouds would pass overhead, at which point, the the opaque water would turn transparent. Even from a distance, I could clearly discern the steamers of watercress undulating in the current.  Lush vegetation —  asters, clover, water hemlock, burdock, willows — extended all the way to the bank, except where enterprising fishermen had hacked clearings with unobstructed casting lanes.

The pool  was about 20 feet away. I assumed it would be an easy walk, even with my cane, but what I didn’t anticipate were the furrows. Whoever farmed this land had planted, harvested and then plowed under alfalfa or some similar nitrogen-fixing crop. In agricultural parlance, the farmer had decided to let this stretch of pastureland “lay farrow” to replenish the soil. All well and good, but the furrows, a byproduct of plowing the field under, were about eight to ten inches high, and I was not able to step over them.

“What a friggin’ joke!” I muttered aloud. (Little did I know that I would be in store for a whole treasure trove of similar nasty surprises now that I was stroke impaired.) No matter how valiant my effort, I could lift my foot no more than six inches. Okay, let’s all relax and strategize, I said to myself and to whatever unseen forces were converging upon me. I came up with the bright idea of lifting my leg as high as I could, planting my left foot into the furrow, and then thrusting myself up and over. I did successfully lift my leg about six inches (henceforth, all future  activities involving the elevation of my left leg would be be encompassed by the “six-inch rule”) and even managed to wedge it into the loose clots of dirt constituting the wall of the furrow. That left me standing precariously in the “Crane” position of Karate Kid fame. By contrast, my Crane was a graceless old coot with a one-note repertoire – the flailing of arms in windmill fashion as the hapless Si-Dai tumbles to the ground.

Determined to remain pro-active,  I took the opportunity to issue a progress report on myself:. Goal: to surmount those accursed ridge lines of dirt-ball-Mt.Everest wannabes,Progress toward attaining goal: I was right where I started, sitting on my butt.

I turned my gaze to the pool. The feeding activity had slowed, but I could still observe sporadic dimples. It was at that point that I was blessed with a dual revelation: a) What was happening to me probably was not mere “diakaesis.” b) If my goal is to catch brown trout, I should probably seize the moment because I may not be back up this way any time soon.

Very well, I will crawl to the bank of the pool, and crawl to the bank I did, the way a soldier would crawl if  bullets were whizzing over his head, or more accurately, the way a one-legged tadpole, abruptly washed ashore, would try to squirm its way back to the water. Oh, and did I mention that I was executing this ridiculous maneuver with my fly rod in my hand, positioning it off to the side each time I had to drag myself up and over a furrow, clearly cognizant of the strong likelihood that the rod’s cruel interaction with the earth was a broken rod tip waiting to happen?

But I soldiered on, surmounting one furrow, then another, and, lo and behold! I was looking at the final furrow. I elbowed my way up its eight-inch elevation, only to notice a landscape feature that wasn’t apparent from my original vantage point — a foot-wide mud slick, pocked with  the sunken impressions of cow hooves, that ran parallel to the furrow. Had I been on two feet, I easily could have stepped over it. Unfortunately, my left leg was far too weak to support me as I attempted to get back on my feet. I beg you to try this little exercise in the comfort of your home if you truly desire to appreciate  my shock and dismay as I suddenly realized I may never again accomplish the  simple task of standing up from a sitting position. Okay, here’s the exercise: First, sit on the floor. Next, stand back up, using only your right arm and right leg for support.

But being pro-active by nature, I was not ready to toss in the towel. I rolled over on my back, propped myself on my right elbow, and finally pushed myself into a sitting position .Feeling almost euphoric, I reached for my rod,. Euphoria quickly turned to perplexity as I looked behind me to observe about fifteen feet of fly line trailing behind it. Holy crap! My fly apparently snagged on something unbeknownst to me, and now what can I possibly do?

“You okay, Tom?

Bob had reappeared.

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These muskies, which I caught in October at Random Lake, Wisconsin, have no business appearing in this post. They are, figuratively and literally, fish out of the water. But I have been eager to share these pics with my brother, Bill.

 

 

 

Next posting (My Stroke, Part VI)

 

 

 

My Kids

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Dr. Kent Nolen, West Town Academy principal, with graduating senior and high-honors recipient Antoine, and his proud mom. June, 2014.

I was making good progress on the “My Stroke” posts — that is until three days after Labor Day when the school year kicked in. As many of you probably know, I left the magazine industry (in the nick of time, I realize in hindsight)  back in 1992, and eked out a living as a freelancer while I returned to school to earn, first a degree in teaching and then a degree in special education. I then obtained a certificate of advanced studies in special education and almost immediately went to work, first as an instructor for college-aged students with multiple disabilities run by National Louis University, and then to a therapeutic day schol, where I worked for five years, and finally to Youth Connections Charter Schools. In a nutshell, YCCS takes the students that CPS (The Chicago Public School system) has given up on.

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Three 9th-grade princesses: Iyana, Marcella and Tamika. JCFS, 2011.

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Graduating seniors Celica and Tavaris WTA, June, 2014.

Currently, I work as a special ed teacher at West Town Academy in Humboldt Park on Chicago’s West Side. All of our students wear a school uniform — green shirt emblazoned with the school logo and khaki pants. Discipline is strict, but “consequences,” (i.e., detention, in-school suspensions) become fewer as the weeks progress and students start building positive relationships with their teachers.

Graduating senior Marissa flashes the best smile in the universe.

Graduating senior Marissa flashes the best smile in the universe.

And at West Town Academy, as at most “alternative” schools, the degree to which a student trusts his or teacher makes a huge difference because many of our students have been betrayed on multiple occasions by people with whom they have placed their trust.

To truly illuminate the beautiful, complex souls, not just of my West Town Academy students, but also of all the students with whom I have worked, is far beyond my capabilities, so I will be content to show you just a small sampling of them.

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Classroom Aide Nate Wadley and myself. JCFS Knapp School, 2014.

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Three 9th-grade princesses: Iyanna, Jasmine and Tamika. JCFS Knapp School, 2011

My Stroke (Part IV)

Those of you who read my “stroke” posts most likely picked up on the underlying theme of “denial,” which wove its way through all three narratives with the subtle nuance of an anaconda. With this in mind, I will cut to the chase and tell you that, despite my mounting alarm over the frequency of  “diakaesis (my neurologist’s term for the tendency of a stroke victim’s brain to “replicate” a stroke in response to stress, sleep deprivation, illness, etc.), I was unable to acknowledge the real stroke I suffered until nearly a week had passed.

Indeed, the depth and scope of my denial was such that I cajoled a good friend to accompany me on a fly-fishing outing to Coon Valley even as my unhealed, torn, right carotid artery was actively throwing a steady stream of clots toward my already compromised parietal lobe.

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Bob Rowley on Spring Coulee Creek, May, 2010.

Bob Rowley, former longtime national affairs editor at the Chicago Tribune and currently director of media relations at Northwestern University, has been one of my all-time favorite fishing buddies. He was an emerging fly fisherman when I first started fishing with him in 2008. But Bob quickly developed his skills because he already possessed the requisite qualities necessary to master the arcane art of fly fishing — wide-ranging curiosity, an explorer’s spirit and a deep reservoir of patience and persistence.

Bob is the most socially connected guy (not to mention the best networker) I know, but at his core he is a spiritual man. We would drive the five hours to and from southwestern Wisconsin’s trout-rich Driftless Area discussing topics in theology religion and ethics, while Bob would periodically take calls (when I was driving, of course) from his many friends and colleagues.

Back in 2011, Bob and I set up an expedition to scope out Bad Axe Creek, a productive trout stream in the heart of The Driftless. Needless to say, I didn’t expect to be actively “stroking” during this outing!  But, as they say, “It was what it was.”

So, it came to pass that on a balmy, early July Saturday morning Bob knocked on my door, took one look at me and said, “You don’t look at all well, my friend.”

No surprises there. Unbeknownst to me, as I alluded to previously,  some of the clots being thrown by my carotid artery were traveling upstream and blocking blood flow to my brain long enough to do damage before finally dissolving.
” Oh,I’m fine!” I insisted.

Suzanne, who had gotten up with me, begged to differ, offering Bob an alternative diagnosis. “We think he had a stroke,” she opined, a tinge of alarm in her voice. “It probably would not be a good idea for you guys to make the trip at this time.”
“No problem, we could easily reschedule,”Bob quickly replied, struggling mightily to affect a look of casual indifference. He followed up immediately with, “Do we need to take you to the hospital?
We went around and around like that for awhile, but, needless to say, I was having none of it. “If you want to take a rain check that would be fine with me,” I said to Bob, “but I’m going to go up there one way or the other.”
Wow, what a jerk I was! Basically, I was threatening both Bob and my wife that, a): I could travel to the far corner of Southwest Wisconsin in the company of someone who could at least keep an eye on me; or b): I could just go my own foolish self.

Given these stark options, and reinforced by Suzanne’s confirmation that I was stubborn in a particularly bullheaded manner, Bob really had no choice but to proceed with the trip as planned. “Are you sure that you’re okay?” Bob asked, as I walked unsteadily to his car.
Enroute to The Driftless, I gave Bob the whole spiel about diakaesis and reassured him that my current “stroke-like” symptoms, which were replicating a severely impaired gait with remarkable accuracy, would probably dissipate before we returned home.

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Bad Axe River, near Westby , Wisconsin.

A particular kind of stroke

Even today, more than four years removed, I think back to that Saturday and wonder, “What the hell could I have been thinking?”  I insisted to Bob that I was totally hunky-dory; in fact, I was actually in day three of a very particular kind of stroke. (They come in all shapes and sizes.)

Let’s try this analogy: Picture a bag of marbles with a tear at the bottom  roughly the same diameter as a marble. Lift the bag and one or two marbles might squeeze through, but the remaining marbles will bunch together, forming a natural barrier — that is, until the aggregate weight of the marbles slowly forces the tear to widen, at which point one or two more marbles likely will slip through.

Needless to say, a rupture (or in my case, a tear) is not conducive to a stable environment. It was just a matter of time before I would, metaphorically and figuratively speaking, lose all my marbles.

My first warning of the looming Big Stroke was the momentary blackout I experienced the previous week while driving a rent-a-car from the Charleston, S.C., airport to Savannah, Georgia, to attend middle-son Christopher’s graduation from the Savannah College of Art & Design (popularly known as “SCAD”). Just as back on Easter Sunday in 2010, my “out-to-lunch” moment caught the attention of my passengers, in this case, Suzanne, and sons Brendan and Kevin. But this time I had my “moment” while doing 60 on S.R. 17 outside Sea Breeze, South Carolina.. I remember wondering why I seemed to be driving up a gently ascending scree slope as opposed to, oh, say, pavement. Instinctively, I turned gently toward the right, and eased back into the driving lanes.”You went off the road!” one of my sons exclaimed.

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The long curve of S.R. 17, near Seabrook, S.C. where I had a stroke -induced blackout while driving a rent-a-car loaded with family members.

Given that I was now the Denial King, it should come as no surprise  that I convinced  both my family and myself that there was no cause to do anything but drive into Savannah and celebrate Christopher’s graduation. Please refer to “My Stroke (Part III for a photo of me with my newly graduated son.

Mercifully (I guess), the big stroke held off until we arrived at Charleston Airport. Brendan, who was driving,, pulled up to the Avis check-in kiosk about forty five minutes ahead of our flight. Again, just as back on Easter Sunday in Evanston, I attempted to get out of the car and my left leg simply refused to cooperate. But we were running against the clock and I  was not going to let an immobile leg jeopardize my family’s chances of making our flight back to Chicago! My sons finally helped me out of the car, at which point I promptly fell down.

Somebody, either from Avis or from the airport,showed up with a wheelchair, and I was whisked all the way to the walk-through X-ray scanner. All I had to do at that point was get out of the chair and walk through the scanner, a journey of about four steps. Alas, I couldn’t get out of the chair (not for want of trying!), so I had to undergo the body search.

I can’t even recall  if the procedure was performed by a man or a woman. What I vividly remember is peeking around the “privacy” curtain to observe my traveling companions. Our flight was scheduled to depart in under twenty minutes; at that point,passengers probably were boarding the plane. All three — Suzanne, Brendan and Kevin — looked utterly dejected, which I assumed was because they likely would miss the flight, That they might have been equally, if not more, concerned about my well -being never crossed my mind, which begs the question: Where was my head at?

Remarkably, we made our flight. Of course my body search revealed nothing incriminating, so TSA handed me over to one of the airport’s volunteer wheelchair pushers, who briskly traversed the mile and a half or so (at least, it seemed like it!) from the the security checkpoint to the boarding gate. At that point, I made a seemingly miraculous “recovery” by getting out of my wheelchair, and walking, albeit unsteadily, the length of the boarding apron, onto the plane, and to my seat. How was this possible?

Quite simply, it’s testimony to the ability of the undamaged neurons in my brain to quickly forge new neural pathways and attempt to pick up the load and cover for the neurons destroyed by whatever clot, (or clots) robbed them of vital oxygen.

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I caught  and released 18 brown trout on this stretch of Spring Coulee Creek about a month before my “big” stroke. Fishing buddy Bob Rowley was working a stretch farther downstream.

I had been “lucky” (if that’s the word to use) that the clot (or clots) broke up before destroying progressively larger regions of my poor, beleaguered brain. However, these incremental losses of irreplaceable brain cells add up over time, and given the sudden paralysis that struck my left leg upon arrival at the airport, my best course of action would have been to head for the nearest emergency room.

But, alas, by deftly combining denial and monumentally misplaced priorities, I was able to board our scheduled flight to Midway Airport, insist on  schlepping our luggage to a CTA Orange Line train (to save money), and then, upon arrival in Evanston, schlepping our luggage and all, six blocks to our house.

In my next posting, I will pick up where I left off with Bob Rowley. as well as attempt to answer the question: How severe does a stroke have to be before someone finally decides to friggin’ do something about it

Escape To Ivanhoe (Unabridged)

10818694_10204814895790316_1073184767_nI’ve already subjected you to a three-part “My Stroke” extravaganza (and Parts IV and V are in the works), but I honestly didn’t think I’d have so much to say about my stroke. Indeed, when I initially launched flyfishingpoststroke, I intended my blog to be exactly as advertised — the ruminations of a guy who loves fly fishing and who, incidentally, had a stroke. But all that changed after I published my first posting. I started getting feedback: heartwarming, compassionate, concerned.  A remarkable group of people — small in number, but huge in the capacity to inspire — were taking me under their wing.

Suddenly, the act of putting out a blog has became very personal. And here’s the truly amazing thing. Mind you, I’ve felt compelled to write as far back into childhood as I can remember, but like so many writers, I often struggled to find something to write about, something that would pull me in with it. Finally, I can announce, almost without blushing, that you, beloved readers, have illuminated the perfect subject to write about — me!

Anyway, I really do have more to say about my stroke (or, more accurately, strokes), but I’ve just returned from Cincinnati where my sister Mary threw a rockin’ Labor Day party, during which time I also learned that my Northwestern Wildcats upset 24th-ranked Stanford.

That Saturday night revelry was followed Sunday morning by a brief  stopover at Ivanhoe Country Kennels, my brother Bill’s Lebanon, Ohio-based “Bed-n-Breakfast” for dogs and other pets. explain.

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This chunky bass (above) took a Seiko worm. The bluegill (below) took an imitation grasshhopper fly pattern off the surface. Bill’s wife, Karen, a world-class marathoner, beams in the background

Bill loves dogs, particularly springer spaniels, the hard-working affectionate bird dogs for which he has acquired national renown as a breeder and trainer. I come to Bill’s place because  I consider it a sanctuary, a “No-Stroke Zone.” Once I enter his property my stroke has to stay outside,  counting cars, smoking cigarettes, or whatever strokes do when their owners enter No-stroke Zones.

How can I legitimately designate Bill’s place a No-stroke Zone? Because bill has on his property a one-and-a-half-acre pond with all the vital prerequisites required to level the playing field for a stroke survivor: easy access to the shoreline, eager and aggressive fish, and a place for someone who’s wobbly on his feet to park his butt.

By virtue of being a a small business owner, Bill is a very busy man, but he always manages to steal a few minutes to join me whenever I’m able to make the five-hour journey from Evanston. Typically, he’ll sneak up behind me and take a pot shot at my angling prowess before officially welcoming me and then settling in to talk sports, and books (we both share the guilty pleasure of IMG sundevouring superbly crafted, action-driven page turners by authors such a Dan Simmons and Don Winslow), trade family gossip or ruminate on the state of the world.

And I should note that Bill’s demeanor during these shared interludes is, well, I have to go with “laid back,” that old 1960’s chestnut that  perfectly captures a man completely comfortable in the moment. I am fully aware that the demands of running a kennel housing a hundred-plus dogs  are unwavering, and those who spend more time with Bill than do I will argue that “taskmaster ” better descrbes him than does “laid back.” Be that as it may, I can only report that I’d be hard pressed to draw a distinction between our pond-side sessions and those far-off days when, as kids, we would lie on suburban lawns and watch the clouds roll by.

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Certified No-Stroke Zone

Sometimes, Bill will have his fly rod in hand, as he did on that given Sunday. We fished a bit on the sort of hot, sunny, windless summer day that, according to conventional wisdom, is anathema to angling success but within the space of about an hour I caught a couple of nice bass with a spinning rod and a Seiko worm, before switching to a fly rod and inducing a couple of big bluegills (“slabs,” in angler parlance) to pop a floating grasshopper pattern.. As for Bill, I lost count of how many fish, he caught with his “terrestrial.” (The catch-all name fly fishermen ascribe to ants, beetles, hoppers and other bugs that get blown into the water during high summer.),

But, alas, time rolls on and I had to summon Suzanne, who had been sitting with Bill’s wife Karen in the pergola Bill built on the shady side of the pond, and say our goodbyes.

My stroke will soon rejoin me like a unwelcome friend who shows up unbidden at three in the morning begging for a place to crash for a few nights, but, who, instead, gloms to your side, annoying you to varying degrees most of your waking moments, and, definitely, definitely, in it for the long haul — except,  that is, on those occasions when you can gain sanctuary. .

My Stroke (Part III)

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Cape Hatteras, N.C., 1978. While brooding over this water-damaged evocation of nostalgia (in the truest sense of the word), I couldn’t help but wonder — is being pigeon-toed a precursor to stroke? Below, left: Me, post-stroke, with son, Chris, in Coon Valley, Wisc.

On a balmy October day in 2010 about two weeks after I created a big commotion at the Bluebird Cafe during family brunch (as described in my previous post). Suzanne and I were gadding about in the Indiana Dunes. We had beheld Mt. Baldy, supposedly the largest dune east of the Mississippi, as well as hiked the mile-and-a-half West Beech trail. I can’t say that I found this activity particularly challenging, but I do recall  having to endure a persistent  sensation that wasn’t exactly a headache and wasn’t particularly pleasant. I would liken it to some sort of waking dream where reality is slightly heightened —  I don’t know, maybe like being trapped in a a photo realism world?

Anyway, when we got back to our B&B around 4:30, I announced that I was going to crash for a few minutes while Suzanne read out on the veranda.  Next thing I knew, Suzanne was jostling me awake, saying, “It’s almost seven! Aren’t you hungry?”

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In fact, I was starved. Acting on the recommendation of our host (“It’s the best-kept secret in all of Chester!” he proclaimed) we found ourselves at a bustling nearby seafood joint — live music and all.

So there I was, feeling content and rested, glad to be having some time alone with my wife. Indeed, it was all good until about midway through our meal when I reached for my glass of wine. What happened next was akin to some bizarre episode of deja vu. Just as at the Bluebird Cafe two months previously, my arm inexplicably swung across the table, sparing my entrée, but sending my side of mixed greens, along with the freshly replenished breadbasket, crashing to the floor.

“I’m starting to have a real problem with this,” I muttered to Suzanne. “Seriously, am I really to believe that this is diakaesis, or whatever the hell Dr. M calls it?”

“Demand that you see him!” was Suzanne’s immediate response. “And don’t settle for just the nurse.”

This was sound advice, given that his nurse had a phone voice, which, in my opinion, was deep, polished, ideal for the radio. Conversely, in Suzanne’s opinion, her phone voice was flirty.

After going a couple of rounds with said nurse, I wrangled an appointment to see the man himself about two weeks after my return from The Dunes.  “Must not be back from his golfing junket,” I recall Suzanne muttering. I had urged his nurse to insist that he order an MRI (magnetic resonance imaging) scan, which to my totally untrained eye seemed superior to the CT (X-ray computed tomography)  scan as an imaging tool. ,

“I’ll certainly will ask him,” his nurse purred, “But I suspect he’ll want you to have a CT scan.”

Doesn’t hurt to ask, right?

“Dr. M has ordered a CT scan of your carotid artery and of your brain,” his nurse informed me the following day. “He feels that CT images do a better job of highlighting abnormalities, particularly in the carotid artery,” she explained.

Scan 2

More from the nostalgia bin: Suzanne and I in 1980 as struggling Northwestern University grad students in love. (Below) Suzanne in 1980 ready to take on the world

Scan

On the appointed day, Dr M reassured me that after a thorough review of the images ( from two days previously), he had found no evidence of a new event. “You’re a fascinating case,” he told me, flashing his Chesire smile. “You’re presenting with stroke-like symptoms in a manner wholly atypical of someone with your type of stroke.”

Dr M added that he even took the liberty of sharing my images via his secure line with several colleagues with particular expertise in interpreting radiological imagery. “Their consensus was absolutely no evidence of recent infarct or anything else that might be of concern to us.”

I should note that last April, back in the emergency room, Dr M told me that, if conditions warranted it, he would consider having a stent placed in my carotid artery to seal off blood flow to the area around the tear. He added that his radiological interventionist, Dr G, was one of the nation’s most esteemed .

Be that as it may, what I’ve cpme to learn about doctors is that, as a patient, you have approximately a four-second window of opportunity between their “wrap up” and handshake to press them on such ticklish topics as, “Can I get a second opinion?” or “Can you prescribe something for the pain?”

It should come as no surprise that Dr M didn’t roll that way.  His modus operandi was to run through the medical stuff and then kick back and shoot the breeze like a man without a care in the world, until some member of his entourage bursts into his office and says, “I’m so sorry to interrupt, but Dr. M, your patient backlog has just passed the hour mark!”

I had decided that given the alarming frequency of “diakaesis, I must insist that he have the stent put in. Unfortunately, he made like the Mad Hatter and vamoosed before I could even open my mouth.

My Stroke (Part II)

flyfishing - poststroke

When we last visited, I had presented the portrait of a 57-year-old man (myself) who brooded over heart attacks, cancer and diabetes,  but who ended up surprising the living crap out of himself by having a stroke. (For what it’s worth, one of my home-state senators, Mark Kirk, had a nearly identical, right-side carotid, dissection stroke.)

I noted in my previous post  that Dr. Richard Munson, the attending neurologist at the time I was admitted to the ER, informed me that  after reviewing images from the CAT scan conducted on me minutes after I was designated CODE STROKE,  my cerebral infarct (aka stroke) was triggered by a tear, or dissection, in my right carotid artery that subsequently started “throwing clots” (Munson’s words), one of which took a totally unauthorized detour to the area of my brain known as the “right parietal lobe.”  Now I wouldn’t presume to speculate on…

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My Stroke (Part II)

When we last visited, I had presented the portrait of a 57-year-old man who brooded about  heart attacks, cancer and diabetes,  but who ended up surprising the living crap out of himself by having astroke! (For what it’s worth, one of my home-state senators, Mark Kirk, had a nearly identical, right-side carotid, dissection stroke.)

I noted in my previous post  that Dr. M the attending neurologist at the time I was admitted to the ER, informed me that a tear in my right carotid artery had triggered my stroke, but Dr. M reassured me that he anticipated a complete, or at least, near-complete recovery.” He further reassured me that based on the data regarding dissection strokes, the odds of me suffering a second stroke was remote.  After my huge sigh of relief, I recall telling Dr. M something along the lines of, “Well, if I had to have a stroke, I guess this was the best kind of stroke to have.”

Now, let me try to put his reaction to my little show of bravado into truly meaningful context: Purely by the luck of the draw, Dr. M was the neurologist assigned to Evanston Hospital ER duty the day of my stroke. He and I quickly developed an easy rapport and I was both flattered and comforted when he asked if he could take me on as one of his patients. Ultimately, I would regret placing my fate in the hands of this witty, twinkly-eyed, somewhat-disheveled  man (whose reputation as a “stroke doctor, I would soon learn, was legendary. But I can attest in hindsight that no pronouncement was (and is) so true than Dr. M’s  muttered response — “Actually, there’s no such thing as a ‘good stroke,'”

I was discharged from the hospital three days after my stroke, and was eager to return to the Jewish Child & Family Services Therapeutic Day School to resume my teaching duties.  For my part, I felt invulnerable. I felt like I had dodged a bullet. However, Suzanne was considerably less sanguine about my prognosis, persuading me to take the rest of the week off. expressing no sympathy over my argument that I had never missed a day in the nearly four years I had worked at the day school.

The following Monday I  was back in the classroom pontificating about my stroke to those  students who weren’t surreptitiously playing World of Warcraft  on their iPhones. Somewhat to my chagrin, however, my fellow teachers seemed less than awe-stricken by my highly detailed account of my life-altering experience and how I had caught a chilling glance of my own mortality, etc., etc,

Indeed, in those halcyon days following my stroke, I felt like I was living my life with an intensified sense of purpose. “Okay,” I would periodically say to myself, “Now at least I‘ve come face-to–face with my wake up call –- not a heart attack, not cancer, but a stroke. Who would have figured at my age? So, yeah, I get the message. Time to get serious about my salt, sugar and cholesterol intake. Time to maybe step up my exercise regime. And, for sure, time to make an appointment for the sleep lab. (I  suspected, as did my wife, that I suffered from sleep apnea, a condition linked to increased risk of stroke.

Yet, post-stroke life didn’t seem markedly different than life before the stroke. Suzanne was worried sick, of course. “Maybe we should hire somebody to cut our grass, she asked me a couple of weeks after my stroke.

“I’m not going to pay somebody to do a job I actually sort of enjoy,” I snapped back. She nearly had a panic attack when I announced a shortly thereafter that I would be driving solo to southwestern Wisconsin to hook up with a couple of fishing buddies. I pulled of that trip without incident.

Not even the recurring “fluctuations” that I started experiencing within a month of my stroke caused me undue concern. Dr. M had cautioned me back in the hospital to be aware of two significant post-stroke complications. The first complication is the risk of post stroke depression.  No surprise there.

The second complication is the tendency of a stroke victim’s body to respond to illness, extended fatigue or high levels of stress by “reenacting” stroke symptoms. “You might feel like you’re having another stroke,” Dr. M explained, “but in reality it will  be your brain,  ‘misfiring,’ so to speak, After all, it’s still reeling from the major insult it sustained.” The symptoms will be short-lived, he added, and they will affect the identical parts of my body affected by my stroke. Of course,” Dr Munson added, “if you experience new symptoms, or you have the same symptoms and they don’t’ go away after a short time, or they intensify, you must come immediately to the emergency room.”

With the benefit of hindsight I should have asked questions, specifically, how long is a short time? Can you quantify “ intensify?”

My Stroke (Part I)

Of all the afflictions that I feared might eventually lay me low, (or lay me down under), stroke wasn’t even on the list. Topping my list were the two biggies: cancer and heart attack.  Likewise, I imagined that it was just a matter of time before my doctor called me on the phone (You never want the your actual doctor calling you direct!) and announcing, “Thomas, I’m looking at your third consecutive glucose reading above 120, so why don’t you stop by, sooner rather than later, so we can put together a game plan for how you and your adult-onset diabetes can co-exist in a way that best facilitates you staying alive.”

Conversely, I tended to associate “stroke” as some sort of coup de gras, converting very elderly infirm, unfortunate bastards into human vegetables until someone has the compassion to pull the plug. I was aware that that strokes were very bad for the brain but I hadn’t a clue regarding the etiology of a stroke or its prevalence within the human population.

Having suffered two, possibly three strokes, I now realize in hindsight that I had experienced several transient ischemic attacks ( popularly known as “mini strokes”) prior to my first “real stroke” A transient ischemic attack blocks blood (and hence, oxygen) from reaching the brain for a fleeting few moments, but not long enough to destroy brain tissue. A sufferer of a TIA may or may not feel symptoms. In my case, I recall several instances of being seized with the sudden feeling that my left arm and leg had gone weak and numb. The sensation was as if the ground I was walking or standing on had suddenly tilted. In a couple of instances, I found my self groping for something to hang onto lest I Iose my balance.

gr3

This MRI image of my brain taken in April, 2010, after my first stroke, shows area of destruction to my parietal lobe. Surrounding undamaged neurons in the vicinity would “pick up the added load,” and allow me a full recovery, my neurologist reassured me.

Now, wouldn’t you think if something that weird happened to your body, you’d want to get it checked out, like immediately? But I simply did not equate those events with stroke. In fact, I didn’t even think I was having a stroke when I finally had a stroke. It was Easter Sunday, right after 11:00 a.m. mass, and I, along with Suzanne and youngest son Kevin, was enroute to the Davis Street CTA train station to pick up Suzanne’s friend, Pat, who would be celebrating Easter with us.  I distinctly recall approaching a red light and then, as if caught in some of sci-fi time warp, suddenly finding myself driving merrily along a half-block beyond the intersection.

“You just ran a red light!” Suzanne, announced in a remarkably restrained tone of voice.

“How strange was that?” I thought to myself. But I took a quick inventory of my faculties, and concluded that whatever just happened was some sort of anomaly, some momentary neurological crossed signal.

I insisted I was okay, and in fact, I picked up Pat and drove her back to the house, all the while making small talk. It was all quite uneventful until I parked in front of the house and then tried to get out of the car.  I swung out my left leg, planted my foot on the pavement, and then, just as I had thousands of times before, proceeded to ease myself out of the driver’s seat and assume a standing position. The problem was, my entire leg seemed to have deactivated. “Uh, I need a hand.” I muttered to no one in particular.

Suzanne had hopped out of the passenger side and now stood in front of me.

“That’s it. I’m calling 9-1-1,” she insisted.

“Just help me out of the car,” I replied. Again, absent any pain, I assumed I had just experienced something weird but fleeting, akin to what I experienced when I ran the red light minutes earlier.

With Kevin’s help, Suzanne eased me out of the car. I had regained enough mobility in my left leg to limp to the porch and to maneuver up the five porch steps. I insisted on entering the house unassisted, which I did, albeit with a limp. I turned the corner from the hall to the living room, and there was the couch, which suddenly seemed like exactly the right place to be. I pivoted to sit on it, and next thing I knew, I was sitting on the floor. “I’m fine!” I again insisted as I managed to heave myself on the couch.

“Look up stroke symptoms on the computer,” I heard Pat tell Suzanne. Admittedly, I was starting to be concerned myself, but I could smell the baked ham on slow cook and it was making me hungry. My oldest son and his wife, along with his wife’s mother and sister, would be coming over in less than an hour. Suzanne had set the table before we had left for church. A large basket overflowing with Easter candy served as the centerpiece. My mind, which still seemed perfectly intact, could not wrap itself around a scenario in which I would trade a visit to the hospital for food, drink and family.
“The warning signs of a stroke are a sudden numbness or weakness of the face, arm or leg, especially on one side of the body,” Pat intoned loudly and slowly from the adjoining office room. “Also, sudden confusion, trouble speaking, understanding, walking or dizziness.”

And then, with an annoying extra measure of loudness and emphasis, she delivered what I’m sure she thought was the capper. “Sudden   loss   of   balance   or   CO-OR-DIN-A-TION!”

Pat wasn’t done yet. “If you’re with someone who may be having stroke symptoms, immediately call 9-1-1 or the EMS. Expect the person to protest — denial is common. Don’t take “no” for an answer. Insist on taking prompt action.”

“Does it really say that?” I asked.

“Yes, it really says that,” Suzanne responded.

But, even as I continued churlishly discounting the information Pat and Suzanne were relaying to me,  I was already reconciling myself to the realization that I was going to be spending my Easter Sunday in the hospital.

I worked out a compromise. If Suzanne would forego dialing 9-1-1, I would allow her and Pat to drive me to the emergency room. Through the course of the 15-minute trip, I cracked jokes about growing old, offered a critique of President Obama’s first year in office, and riffed on the rewards and frustrations of fly fishing (I was still counting on going fishing two weeks hence. However, I was no longer in denial regarding my need to go to the hospital. My goal at that point was to be pleasant to the two women accompanying me. After all, I realized, both of them also were giving up their Easter Sunday.

Here’s the deal when you check into an emergency room with suspected stroke: Things start happening very fast. A nurse helped me onto a gurney and wheeled me to radiology, where, within ten minutes, i was administered a computerized axial tomograph (CAT scan. During this interval various medical personnel asked me who I was,what day of the year was it, and why I was in the ER, while others would ask me to squeeze their hand, lift an arm, follow the arc of a penlight — all designed, I later learned, to roughly gauge the extent of damage wrought by my stroke.
It took only about twenty minutes or so for the attending neurologist, Richard M (see note at conclusion of this post), to inform me that, based on the images developed from the CAT scan I had very likely suffered a dissection stroke.

As Dr. Mexplained to me, a tear had developed on my right carotid artery. In the aftermath, most of my blood continued flowing unimpeded to my brain, but a small quantity of blood begin pooling inside a pouch, or flap, what Dr. M termed a “false lumen.” This accumulated blood then formed clots. It was just a matter of time before one or more of those clots broke loose, traveled upstream and clogged one of the smaller arteries coursing through my brain, specifically, the artery supplying blood to my right parietal lobe.

The damage impeded my ability to locate parts of my body in space, as well as elicit response from my limbs. This explained the sudden onrush of symptoms that compelled my trip to the emergency room –sudden paralysis of my left leg, arm and hand, as well as a pronounced  droop of the left side of my face.

“There’s encouraging news in all this,” Dr. M reassured me. “You suffered a moderate stroke, but you’re young  (I was 57), and the area of damage is relatively small. I see no reason why you shouldn’t anticipate a complete, or at least, near complete recovery.”

He then delivered even better news. “Based on the data regarding dissection strokes, the odds of you suffering a second stroke is remote. This is why I am recommending a protocol of primary stroke prevention, as opposed to secondary stroke prevention, which I would usually  recommend to my stroke patients. In other words, your chances of another stroke are the same as for the general population of men in your age group with similar risk factors. Of course, you want to keep your blood pressure and chlorestoral in check, and maintain a regimen of moderate exercise. Other than that, you’re pretty much good to go.”

He did opt to put my on Warfarin, a potent blood thinner for three months, which likely would be followed by a regimen of daily aspirin therapy, assuming a follow-up Magnetic resonance angiogram (MRA) of my carotid artery indicated nothing of consequence.

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June, 2012, just two days before my second (or third) stroke. I am posing with my three sons and Suzanne in Savannah, Georgia, where Chris had just graduated from the Savannah College of Art & Design. (Note the facial droop.)

I was released from the hospital three days later. Remarkably, I appeared to have incurred no deficits of any kind. As an outpatient, I performed so well on my physical, occupational and cognitive evaluations, that additional outpatient therapy was deemed unnecessary. I was back at work the following week.

Sounds like I really dodged a bullet, doesn’t it? ARE YOU KIDDING? Stay tuned for part II (Spoiler alert! The picture of me in this posting will totally let the cat out of the bag!

Note: I was determined to identify my former neurologist by name because, notwithstanding the occasional “fibs,” “stretchers,” “re-imaginings,” or “reality enhancements” that pepper my postings, I intend this blog to be an unblinking, thoroughly credible (hopefully) series of vignettes detailing the life of a stroke survivor who loves to teach, fish and write (in that order).

Despite the best of intentions (not to mention a formidable depth and range of expertise), Dr. M  played a pivotal role in withholding critical treatment strategies that may have prevented the “big stroke,” with its nasty smorgesbord of deficits from which I will never recover.  I was persuaded to adopt a pseudonym only by a trustworthy, longtime friend whose understanding of the medical profession gar exceeds mine.