If I’ve learned one thing about strokes, it is that there is less known about them than almost any other affliction you might have. The two most vexing areas of uncertainty for the patient are what actually caused the stroke, and what damaged functionality can be repaired and how long it will take.

What Caused the Stroke?

Doctors can tell you what happened inside of your brain, but they can’t say for sure why it happened. Even modern Magnetic Resonance Imaging (MRI) and Computerized Tomography (CT) technologies can only show the damage, but they can’t actually see what happened or why.

All they know for certain is a vein or veins have been broken or blocked, and there is a bleed which has damaged the surrounding nervous system connections. Common causes are high blood pressure, a blood clot, a vein defect, or external damage.

That’s about it, and it’s not much.

The CT machine on the left is much smaller than the MRI machine on the right, and operates much faster but produces less detailed images. The MRI machine can produce claustrophobia in the patient because of the time spent inside the chamber.

When my stroke happened the neurologist at the hospital said that it was probably caused by a block when a vein collapsed in on itself. After the MRI and CT scans, he didn’t change his diagnosis, but he was still guessing.

That is a type of stroke that typically strikes old people and I fall into that category. I visited my regular neurologist a few months later, and he agreed with the diagnosis. What else could he do? He had no more insight or diagnostic tools than anyone else . . . until I saw him again some months after the first visit.

On that visit he noted that I take a blood thinner (Eliquis) to prevent blood clotting, a nasty side effect of atrial fibrillation. It is normal to stop taking the medication for two or three days prior to a surgical procedure in order to prevent excessive bleeding.

I have done so a few times, under the direction of my cardiologist, and I had done it again in preparation for a dental extraction that was done 9 days before the stroke. As I had done before, I resumed the medication immediately upon completion of the procedure.

The neurologist now decided that the culprit was a blood clot that formed during the time I was off the medication, even though the time for effectiveness of the medication is well outside the period I was off of it. My cardiologist opined that it was possible, but not likely that he is right.

But he’s guessing too, and you know what? It doesn’t matter because I, like most stroke victims, had the stroke and there is not a damn thing anyone can do about it!

When Will I Be Fixed?

The damage from a stroke is in the form of broken nervous system connections between your brain and the muscles that control your body. The result varies from muscle weakness to complete paralysis.

In my case I had a little of both. My right arm and hand were completely paralyzed, my right leg was severely weakened, and there was some weakness in my right jaw, causing slurred speech.

Almost my first question was, how much recovery can I expect, and when?

The doctors at the hospital merely shook their heads and prepared to send me home. Meanwhile, my wife, Nancy, arranged for me to spend three weeks in Dominican Hospital’s Advanced Rehabilitation Unit (ARU).

The therapists there had varying opinions about those same questions. Some said six months, others said eight, and so on. But the honest ones said, “I don’t know, it all depends.”

On what does it depend? The answer was usually something like, “Oh, any number of things.”

The truth is that therapists work from training and experience, and they understand the probabilities of success or failure of each rehabilitation technique. They also stand to be surprised because what has always worked in the past doesn’t work in a given case. And what has never been tried before works quite well.

Everyone is different and every stroke is different, and everyone has to handle it their own way. Different strokes for different folks, as they say.

My Take

For me the stroke is just a fact. It happened and when it did, I fast realized there was nothing that I or anyone else could do about it. Its cause is just speculation, and its remedies are uncertain. So, all I could do was learn as much as I could about the therapies I could work on and just do them.

Some things have been successful, others have not – so far. I say “so far” because there is no known end date for the therapies to work, and some conditions revert back to their previous condition, and then return. And some things happen for unknown reasons.

Yes, it’s frustrating sometimes, but there isn’t anything doctors can do, and only so much that therapists can help me to do. The stroke and my recovery from it are now part of my life, the life that I am living on life’s terms.

I’m just grateful to be alive and able to keep going.

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4 thoughts on “UNCERTAINTY!

  1. John,
    I think your writing style has not suffered a bit from your stroke. Clear, conversational. It’s good reading my friend.

  2. Thank you again John for such an articulate explanation of how many of us feel about our bodies, our maladies and the painstaking ways we try to understand.

  3. Your stroke has not robbed you of your ability to write interesting, cogent and readable prose. This post is another example. While many people in your situation just “give up” you have worked incredibly hard to maximize the quality of your life, and the life of those around you as well. Your posts address the people who have worked with you in your rehab, but do not address the hours of hard work that you put in, and the resolve it must take to deal with the frustrating limitations imposed on you by your stroke.

  4. Second all the previous comments, John. A well-written exposition of things I didn’t realize. In your case it’s about stroke causes & recovery outlooks, but much of what you’ve said applies to so much more. We’re all “living on life’s terms” aren’t we?

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