Stroke

At first his words didn’t register….I didn’t understand as he tried to tell me how he could not move his left arm and his left leg.  He couldn’t flex his fingers, or bend his foot at the ankle.  We mentioned it to one of his doctors and, after yet another MRI it was determined that he had had another stroke.  It had likely occurred when a clot developed in his arm after a routine blood draw while he was on the respirator and traveled to his brain, resulting in the stroke.

He seemed so small and lost, sitting in that chair in his ICU ‘room’.  He was extremely quiet, and I knew what he must be thinking.  He had always worked, and took great pride in providing for his family.  I knew he was worried about how we would make it if he had to leave his job.  I immediately began telling him how we would be just fine, I’d work more hours, we’d cut corners…..I desperately needed him to be positive, and not become depressed.  He was adamant as he said, “You are NOT going to make me quit my job!!”  I told him I had no intention of doing that, I just wanted him to know that we would survive if it were necessary.

The first few meals I spoon fed him.  Then they brought him pork chops.  It was a cruel twist that he is also left-handed, so it was very painful to watch him maneuver the knife and fork with his only cooperative hand being the weaker one.  He was determined to learn, however.  After a few more days he was ready to go to a regular room.  As we waited for Transport to take him to his room, we received the news that his platelet counts had dropped to 25,000, from about 250,000, and doctors were concerned that it had something to do with his blood thinner.  Up to this point I had been stoic around my husband at all times.  With his condition being resistant to coumadin, there weren’t many other options in the way of blood thinners, and as I pondered the horrible consequences of him having NOTHING to thin his blood, I began to panic.

I don’t recall the treatment they used…likely it was Prednisone, but gradually his platelet count began to climb again.  He began receiving physical therapy on his arm, hand and leg, and slowly began taking walks.  He had gotten into a routine with the physical therapist where they would walk around the perimeter of the 3rd floor.  One Saturday SHE was the one keeping up with HIM, and she mentioned that he was getting so much faster.  “I have to” he told her, “it’s halftime!!”.  I knew then that he would be fine.

His at-home therapy included working on his fine-motor skills, since he needed to write and use tools, etc. for work.  He spent hours writing, and had this little machine that would provide resistance when pressed down by his individual fingers.  He was constantly exercising those fingers.  Before we knew it, he was making plans to go back to work, and for the next year, we settled into a new normal, as we dealt with the limited mobility and memory issues.  His lowered heart function also meant that he tired very easily.  When he came home from work every evening, he was exhausted.

The end of November, one year later, I would learn the value of ‘practice makes perfect’, and we would begin another chapter with yet another crisis.

 

Sedation and Gratitude

It is hard to describe the emotions:  Fear, most definitely.  Lost, absolutely.  The person whom I had relied upon for over half my life was not able to help me if the car broke down or if one of our sons got hurt.  Even when he was in Korea, we could at least keep in touch via e-mail.  For the first time ever, I would have to rely totally on myself for life’s little emergencies.

Once again, no matter what else was going on outside of the hospital, at 10:00, 2:00, 5:00 and 8:00, I was in the ICU.   For the first several nights he had two nurses caring for him.  It was gratifying to watch how they were so coordinated in what they did.  My oldest son, who always has a million questions, was true to form:  he asked if the blood transfusions that his dad received were already thinned….I had never given that a thought.  The nurses were always so patient with him as they answered every question.

It was during this time that I decided, in order to keep my sanity, I needed to search for gratitude.  I began each day with a grateful heart, being thankful that we had all made it to another day.  I learned how to keep up a positive front for our boys, telling them it would be all right…when inside I had no idea if it would be or not.  Over time, I began to believe it myself.  I was grateful for the random kindnesses of strangers…..the man who took the parking space that I was waiting for:  I had only 10 minutes to get to my husband’s bedside, and when he quickly moved into my space, the frantic look on my face as I honked furiously prompted him to back out and look for another space.  Anyone who gave a kind word or a smile was a recipient of my gratitude.  I then ended each day being grateful that we had all made it through.

There were difficult times:  when they had to let him off the sedative for a ‘sedation vacation’.  He would try to get the tube out of his throat by gagging, or trying to cough it up.  It was very difficult to watch.  Sometimes when I was alone in the middle of the night, it seemed like I was the only one whose life was falling to pieces.  It’s a very lonely feeling.

After what seemed like weeks (it was 5 days), he was finally weaned off the respirator.  I will never forget the look on his face as he came out of sedation.   He had gone in for a routine procedure and 6 days later wakes up, not realizing how hard he had fought, how hard the many dedicated doctors, nurses and staff worked for this day.  I could read his face as if he spoke the words, and I automatically said “the boys are fine…we are all fine”.  He nodded his head, and the relief showed in his face as he closed his eyes for a brief rest.

When I came to see him at the next visiting cycle, he was sitting up in the chair in his ‘room’.  I was amazed to see him up so soon.  As I walked over to give him a hug, he looked at me and said, “I can’t feel my left side”.

Stents and Complications

It was a huge relief to find that they would be able to put stents in the graft that hadn’t ‘taken’.   We had to wait a bit for my husband to get his strength back, and so, at a follow-up visit to his cardiologist almost two months later, it was decided that he would be put on the schedule for the procedure.  It just so happened that it could be done the next day, and so we agreed that sooner was better.

The procedure itself was routine.  Afterward, he was brought into a room on the cardiac floor to recover.  I noticed that his coloring wasn’t too good…he still had a grayness to his skin.  As he came out of the anesthesia, he began to complain of chest pains, and told me he was going to be sick.  I noticed how clammy his skin was, and his nail beds had begun to turn blue.  By this time, his cardiologist had been called, and the room suddenly filled with people. 

Thankfully, his cardiologist knew immediately what had happened…part of the artery had collapsed while he was putting in the stents, and when he inflated it, it had stayed open.  The artery must have closed again, and it would be simple to go in and stent that area.  So, they take my husband back to the cath lab, and again I wait, with my cousin by my side. 

It seemed to take forever, and indeed, it took much longer than it should have.   When one of my husband’s doctors came to talk to me, I discovered why.  When his cardiologist went in to stent the collapsed area, my husband developed a clot, which broke loose and went directly into his heart.  It damaged a great deal of his heart muscle, and it would be difficult to tell if he could regain some of his heart function.  He was in critical condition, and would need to stay on the respirator until the next day.

I felt so sick inside, and was struck with a blinding fear like I had never had before.  For the first time ever, I understood that my husband might die.  I sat there, wrapped in a blanket, and listened to life go on around me.  Somewhere in the depths of the hospital the Lullaby Song played, announcing that the world had yet another new member.  While MY world was teetering on collapse, others around me had the NERVE to laugh and be happy, have babies and continue their lives.  I could not think…I was comprehending nothing but the fact that my husband might not come home to me and our sons. 

It was the longest night I had ever lived, yet when I saw my husband the next morning, he did look better.  Once I was told that he would come off the respirator, I called his parents to let them know how he was doing.  I was in the waiting room with some family members not five minutes later when one of my husband’s doctors came in to talk to me.  His doctors felt that his heart was too weak for him to breathe on his own.  They decided that if he spent a few days on life support and let machines breathe for him, his heart would have the best chance to improve.  With my own heart heavy in my chest, I went back in to see him again, before he was given a sedative and sent back into sleep.

Veterans and the Ties that Bind

They were young and full of life, with the hope of nearly endless tomorrows.  They were brave.  They acted quickly, and without complaint.    They knew what they needed to accomplish, and they did so without a thought to their own personal comfort and safety.  They would perform countless acts of heroism, sometimes in the process losing limbs, vision, hearing…..sometimes losing far more.  They are our Veterans, and today we honor them.

My father-in-law told us of an emotional exchange held today at church, when the Pastor asked those who were Veterans to please stand so that the congregation could honor them.  One of his long-time friends couldn’t bear to stand and receive this recognition.  When asked why, he reasoned that although he didn’t have the heart to stand today, he WILL stand when he can do so with all those who didn’t come home.

What exactly is woven into the fabric of the bonds that these young people have held through the years?  Bonds that keep one’s fallen friends alive in memory with such clarity, it’s as if they were taken away only yesterday.  Courage, certainly.  Teamwork….the effort of coming together to accomplish a goal.  I think there are also the emotional ties that bind.  The feeling of belonging to something that is larger than life.  The feeling that what you are doing will make life better for someone else.

When our youngest son made the decision this Summer to join the Navy, my husband sat him down and told him that this career will not make him rich in a monetary way.  In order to receive wealth from this way of life, he must reach inside himself and find the emotional benefit from serving something much bigger than himself.  The solemn pride of giving back to a country that has made him what he is today.

My husband knows of what he speaks.  For 20 years he served this great nation.  He earned many awards, including a safety award for safely bringing under control a malfunctioning liquid oxygen hose, without injury to himself or anyone else.  Had he not stepped in to action, he would have been killed, along with those who were nearby.   He retired with many accolades and commendations, all of which he is too shy to really take credit for.  I am just privileged he would let me be his voice.

His reaction is what I think may be the strongest thread in the fabric of the ties that bind all these wonderful, brave, talented young men and women through all these generations.  That would be to say, “I was just doing what I was supposed to do”.

Medicinally Induced Shenanigans

About the 4th or 5th day post surgery, my husband started to come out of some of his heavier medications, and we were able to finally talk to each other.  Our first conversation went like this:

He:  “Why am I here?”

Me:  “You had a heart attack and they had to do a triple bypass”

He:  “A HEART attack?!?  Oh my….oh no!  OH NO!!  I am so stressed!!  I’m having chest pains!!  Oh NO!!!”

Very.      Long.        Pause…….

He:  “Now, why am I here?”

Over time his doctors began to be concerned that he couldn’t seem to absorb what had happened.  A certain amount of retention failure is normal due to the medications, but his seemed out of the ordinary.  He was taken in for an MRI, and a psychologist was called in to evaluate him.   Nothing was found, and eventually he began to improve.

During this time I discovered that the combination of pain medications, the residual anesthesia and general trauma of surgery would turn my normally agreeable husband into a belligerent Man-Toddler.  One night, in his delirium, he decided that he no longer needed his central line…and so he removed it.  Himself.  The combination of blood thinners and his layman’s removal technique had caused quite a stir in the ICU that night.

Like the mother of a toddler at preschool pick-up time, I was regularly met with stories of his misadventures of the night before.  He was not a willing participant in the use of the spirometer, and developed pneumonia as a result.  I felt horrible that I had not pushed him enough to use it, and now we had another hurdle to overcome because of that.

Despite all of the challenges, around the 7th or 8th day, he seemed strong enough for a regular room.  It was a proud moment for us, and we were giddy with excitement as we waited for someone from the Transport team to take him to the cardiac floor.

As he got settled into his new room, the nurse came in and took report from his ICU nurse.  It was during this time that he began having difficulty keeping his oxygen levels up, and I could see the fear in his eyes as he began to be in some distress.  Suddenly the room filled with people as they prepared to take him back to ICU.   They weren’t going to wait for Transport to take him…..he needed to go back…..immediately.  They began yanking tubes out of the wall and flew down the hall with my husband.

This episode bought him some time with a large oxygen mask that fit over his nose and mouth.  He did not like it, not one bit.  As long as he was calm, all was well.  If he got agitated, one quick swipe of his hand and he’d have that mask off faster than a Major League catcher.  His nurses were constantly watching him out of the corner of their eyes….when they saw that hand go up, they would say….”Mr. Purnell…..”  He would then smile sweetly…..and scratch the side of his face.

One day we had a showdown:  I had fought him all morning to keep that mask on.  He kept taking it off.  One of his nurses had come in to adjust his oxygen, just as my husband had thrown off the mask for the hundredth time.  The nurse held out his hand.  My husband gave him the mask.  The nurse put a nasal canula on him and left the room.   My 47 year old belligerent Man-Toddler husband looked me square in the eye and stuck his tongue out at me.

We graduated to a regular room a few days later, with no complication.  We were still dealing with some of the effects of the medicines and he would often test his boundaries, but each day got better.

Near the end of this hospital stay I got some news that would let me know that our journey was far from over:  tests showed one of the grafts hadn’t taken.