Seizure After Stroke

Something I haven't talked a lot about is my life with seizures. My last bout with them was about three months ago and boy were they a doozy. If it hadn't been for the quick actions of my husband, a co-worker, and the neurological ICU team at Memorial Hermann, I'm not sure what the final outcome might have been. Seriously.

There was nothing at all significant leading up to this last event. The last seizure I had prior to this was two years ago. A strict medication regimen, an attempt at maintaining low-stress (insert laugh track here), and staying away from my known triggers seemed to be keeping the boogers away. At the very end I'll tell you what we think the culprit(s) was (were), so stayed tuned.

I went to work on a Tuesday, just like any other normal day, and started my normal work routine. Computer. Spreadsheets. Printing. You know, stuff. It was about 9:30 in the morning and I felt the familiar signs. For me, it's like a rush of warmth, dizziness, and sleepiness that starts in the back of my head and slowly spreads to the front. Eventually a wave of darkness takes over and along with it - motionlessness. Like being trapped in my prison. Most of the time I have the wherewithal to be able to call out for help. Of course, this time was different because I was all alone in my office. So the next best thing I could do was call my husband.

By the time Victor answered the phone I was non-responsive, only answering in short grunts and breaths. Alarm bells started going off in his head and he kept talking me through the seizure. These are what they look like - peaceful, sleeping Laura. But it's really a disconnect in my brain. A hardwired reset that takes everything back to zero. After a minute or two he started to panic. I had never been out longer than that and he was still counting the seconds. I believe this episode lasted closer to four to five minutes. When I came to, my speech was slurred and my right side was nearly paralyzed.

I knew better than to panic. Past lessons taught us about TIA's (trans ischemic attacks) and we were no stranger to them. Eventually I became clear headed enough to give him my nearest co-worker's phone number who showed up in a matter of minutes. Once my friend arrived, he decided the best course of action was to call an ambulance and they transported to me Memorial Hermann.

In the ambulance, I told the paramedic I felt another seizure coming on. This one was totally different. My body seized up in ways it never had before. Over and over and over. I remember the air getting pushed out of my lungs so forcefully that the noise coming out of me was nearly unrecognizable as my own voice. I was administered some medication and shortly after it stopped. I wasn't scared. I wasn't concerned. I was nearly relieved it was over.

My husband and both my bosses met me at the hospital. I was immediately admitted to the neurological ICU. I had scans completed, blood drawn, and evaluations done. A possible clot was found in my brain. The only question about it was whether or not the area was a congenital defect - the blockage wasn't a blockage but an area where the veins actually just stopped - or a blockage. No one could tell. Go figure.

We decided to accept the clot buster medication known as TPA. If I had a stroke, it could save my life. If not, I might just be easily bruised for a while.

A little while later I had another seizure. Victor was with me in the room. He noticed my left foot twitching shortly before my whole body convulsed. It was the same macabre dance as in the ambulance. He ran to get the doctors and nurses. They administered some drugs and kept asking me a bunch of questions. I think I answered them, but I don't really remember. Later, after the seizure, Victor overheard a nurse saying something an anxiety attack and had to bite his tongue. That must have been some anxiety attack.

I was in the hospital for two days. They wanted me to go home with a walker. I was able to walk, though very unsteadily. I was out of work for two weeks and so was Victor so he could take care of me. I couldn't shower myself for a few days and needed assistance. I couldn't go up and down the stairs alone for a few days. I was extremely unsteady for about a week.

Eventually my nervous system calmed down. My balance returned. My strength returned. Was it muscle memory?  I don't know. The official diagnosis was Todd's Paralysis - a temporary paralysis after a seizure. No stroke, thank God.

The cause? We'll never know for sure but here's the theory:

1) I took 100 mg of my anti-seizure medication. I took it in the form of 50 mg pills. My pharmacy, without telling me, switched me to 100 mg pills. For a short time (anywhere from 1 week to 3 mos) I was double dosing myself. I have taken the double dose of that medication before back when I was having a lot of seizures, but it's been a while. As soon as I realized my  mistake I corrected it. I told the EMT and all the doctors at the hospital about the mistake.

2) My insurance company no longer wanted to pay for the name brand of another medication I take that peripherally helps with seizures. It is not that medication's main function, but is a happy side effect. The insurance company asked the pharmacy to switch me to the generic.

3) This all happened at the same time.

In the end I was on three months driving restriction, which was awful on everyone in the house. I had to increase my seizure medication after all. And if I don't answer my phone, all my co-workers start to worry about me. But it could always be worse.

I want to give a special thank you to my company for feeding me for the first week I was out. And for everyone who helped give myself and all my kids a ride when we needed help. And especially for all the patience and understanding during my time of recovery. I am truly blessed and thankful for your all.

Till next time, friends...

Long Term Effects of a Stroke

Life has been very busy for us over the last two years, which about how long it has been since I have written any of my blogs. Shame on me. I have fallen into that trap known has "Writer's Block" (which is really just laziness) and blamed life events on keeping me away from my keyboard. My son is graduating high school, my youngest is starting high school, my marriage needed a little TLC, I started a new job with a great company, and I had a little set back with my health.

One of the effects of my stroke is right side weakness and pain, commonly referred to as neuropathy. The neuropathy is a bit more uncommon in stroke cases, but obviously it does happen. Everything has been under control for the last few years but I have noticed increasing weakness, pain and even some swelling in my right hand.

To start with, I sprained my right wrist in a car accident three or four years ago. And within the last six months I had a rather hilarious encounter with the stairs, a sock and a tile floor in which my wrist was the butt of the joke. So there was a question as to whether or not injury played a part in the new pain. I had an upcoming neurologist appointment so I spoke with her about it.

The neurologist told me I there were a few options. I could have carpal tunnel, arthritis, an old injury that didn't heal correctly, or it be symptoms of my stroke getting worse. We set up a time for an electromyography (EMG) and an x-ray of my hand.

The EMG was not my most favorite test. It consisted of have mild-ish electric shocks run through your hands and arms and a needle poked into your muscles. You have to have both arms done as a comparison to each other. The test came back normal. No carpal tunnel. That's great news, considering I spend most of my day in front of a computer screen and want to someday be a known as a professional writer. The x-ray also came back normal.

This means the ultimate news is not really good news. The effects of my stroke have started to get worse over the last year. That was a hard pill to swallow. That means no cure? No surgery? No magic pill? My mind couldn't totally wrap around that concept. I wanted so badly for there to be a definitive answer and I'm left with, "Sorry kiddo. Better luck next time."

Sometimes I feel like things like this would be easier to accept if I had done something to cause the situation I am in. If I lived in a life burdened with high cholesterol, heart disease, high blood pressure, diabetes... But I have none of those things. I had a faulty heart and no one is to blame for that.

So what's next? I honestly don't know. I keep all my appointments. I am trying to maintain a healthy lifestyle, maybe exercise a little more. Monitor my hand strength and agility. And don't dwell on the things I cannot change.

Till next time friends...

No Pain, No Gain

It has been a couple weeks since the cardiologist told me to start pushing myself when it comes to overcoming my chronic chest pain. I'm finding that it's not that difficult to get my heart rate up, but all this physical activity is taking its toll. Not only do I have the chest pain to contend with, I have neuropathic pain from my stroke to battle against as well. The right side of my body is in a constant state of "Ouch!" and that ain't good. Especially the more active I get.

My morning routine consists of a short, targeted strength training workout (Denise Austin's Get Fit Fast) and walking the dog. If I choose not to do the strength training I do yoga and got my stretch on (JJ Gormley's Yoga Complete for Every Body). And I do this nearly every single day. So pushing myself means what, exactly?

I have a fitness tracker to help keep me motivated. I do my best to walk to the dog farther now; at least one mile every day. Either one long walk in the morning or two short walks throughout the day. If I am lacking in steps for the day I will hop on our stationary bike to try to catch up. I put on some music while I'm cooking dinner and dance in the kitchen while slicing and dicing. Other than that, I'm not really sure what else to do. I'm a broke writer working from home, for Pete's sake.

I raise my heart rate too much, my chest pain gets too severe to continue normal activity. And when I'm very active for more than a couple of days in a row, the right side pain is so severe I have to spend several days laid out to recuperate from that. So then the fitness tracker is useless, all the work I did previously is useless and I just have to start all over again in a few days. My whole system has become moot.

Total Catch 22. The more I work the more pain I'm in the more I have to rest the more I have to work the more pain I'm in the more I have to rest...

I'm kind of honestly at a loss as to what to do. I think the next step is just to check in with neurology and see if there is another increase I can do with the Lyrica to help with the pain management. Other than that...?

Things are Looking Up

Recovery has been a long and (very) difficult road for us. If there was a roadblock to encounter, I found it. But it looks as though (fingers crossed) things are finally on the upswing. After that last coiling procedure, I have had less pain, I had a successful neurologist appointment last month and I am enrolled in college again to complete my bachelor's degree.

I had a coiling procedure in my heart last September to block the flow of blood to some extra veins in my heart. I do feel a lot better most of the time. I have only needed my nitroglycerin pills twice since then and both times were when I just wore myself out; which isn't hard to do. I definitely have less chest pain but I still get short of breath and tire easily. I have hope, however, that I can continue to build my endurance by simply continuing with my exercise routine and building upon that. I started gardening, which is a whole other story in itself, so that helps keep me active. As if the kids, the dog and the normal foundation of my life weren't enough.

Last month I had a six-month follow up with my neurologist. We made some changes to my medications. We decided to increase my Lyrica and get rid of the Neurontin. The insurance company, however, thought they were smarter than my wonderful doctor and took an extra month to approve the medication increase. So I spent a short while with no pain relieving medication at all while they farted around. But everything is fine now and I do feel slightly better. I have a hard time telling if the extra pain in my right arm and leg is due to my being more active lately (which I am doing on purpose - I am so sick of being static) or if it is genuinely increasing on its own or if I am only growing more tolerant of all the medications. The other plus has been a decrease in my migraines. I had one not too long ago, but it only lasted four days; so that wasn't too terrible. I think my diligence for to sticking to my migraine diet helped that.

Everything seemed to be going so well that my husband, Victor, and I sat down and mapped out a future plan that includes me going back to school to finally finish my Bachelor's Degree. Granted, it won't be in forensic science like I originally thought it would be, but I have to continue on the path that I have ended up on. I have been writing seriously for about 18 months now and it is time to get a formal education in English and Creative Writing. I have a few ideas of what I want to do with my degree when I am done and am very hopeful that I will continue to get better and be able to take advantage of the situation. And it has been so important to me to finally finish my degree.

You're looking at the newest Undergrad at University of Houston Victoria, majoring in Creative Writing. I hesitated to tell anyone because I was so upset when I had to quit school back in 2012 due my memory loss and then quit my job due to my seizures. But now seems that I have a good handle on things. The memory is still a problem, but it has gotten better and I haven't had a seizure in 11 months. 

Go me!

Reduction in Headache Days

Something I have always struggled with is controlling my migraines. I am one of those unfortunate few whose migraines are triggered by nearly everything. Sights, smells, diet, hormones; you name it. I have tried nearly everything to control these outbreaks, too, because having a migraine two or more times a week is clearly unacceptable. I have tried all of the preventive medications (and currently still take one) and even did Botox for Migraines.

The current predicament I am in now is that because of my heart issues I can't take traditional migraine medicines like Imitrex, Maxalt, and Amerge because they are Triptans and constrict blood vessels. Constriction of blood vessels would be counterproductive to what my heart medication is doing, opening my blood vessels, and may cause undo harm. The last time I took a Triptan medication it caused severe chest pain and shortness of breath, so I am rather inclined to agree with this line of thinking.

That leaves me with fighting my migraines on my own. One of the things I have done before is the Migraine Elimination Diet. I did this when I was a teenager to find out what it was in my diet that was causing my migraines (for me it is MSG and sodium nitrate). When my headaches start to get out of control again, I resort back to this and I always end up feeling better.

It is nearly impossible to avoid all of these ingredients all of the time. For example, Autolyzed Yeast Extract is in nearly everything we eat and this is important because Autolyzed Yeast Extract can contain MSG (Monosodium Glutamate). Onion is another hard one to avoid because onion powder is in nearly all the foods we eat. I just read my labels and do my best. You'll find that a lot more restaurants have started posting their ingredients now, so you can go out to eat well prepared.

To do the full Migraine Elimination Diet you are supposed to eliminate all these foods from your diet for a set amount of time. I have read anywhere from two to four weeks is sufficient. Then you reintroduce each food, one at a time, every few days. If one of these ingredients or foods is a migraine trigger for you, you should know within a few hours of consumption. If not, you will feel fine.

Migraine Diet
By Laura Romero

I included a list of foods that are a good alternative or that would help reduce migraine days by giving you the supplements you need to fight the pain as well.

Other than eating regularly, getting plenty of rest and exercise and staying hydrated, that might be about all you can do when you are fighting migraines at home. There are plenty of supplements out there to research and I have friends that swear by them (always talk to your doctor). I personally don't take anything my doctor doesn't recommend because I already have a full cocktail of prescription medications, being a stroke survivor and living with a heart defect. So why keep tempting Mother Nature?

I feel the need to state that this is just my personal way of dealing with my migraines. I keep my doctors fully informed of any changes in my diet and health and you should too. I am not a professional. Seek a professional opinion before going on any diet or exercise program. And good luck.

Fun Friday

My husband has Thursdays off right now so we used that day to run our errands. I also enjoyed an evening out listening to my son's band concert. (He was amazing, as always.) So while Thursday was a little bit busy, it was nothing out of the ordinary. Until that night. I was sitting and watching television after the kids had gone to bed. Nothing unusual there, but suddenly I felt an incredible pressure on my chest; like someone was standing on me. Then it felt like someone was squeezing my rib cage together.

I got up and walked over to husband, who was standing in the kitchen, and told him I didn't feel well. It didn't occur to my to take my nitroglycerin because I wasn't in severe pain. There was just a squeezing sensation. A little later I felt dizzy and there was a throbbing in my temples followed by a headache. Then I couldn't talk. My speech was slurred and I was having severe difficulty finding my words. My right arm and leg were weaker than usual and were experiencing pain.

I suppose any other person would have gone to the hospital right then and there. But not me. These symptoms, especially the aphasia, come on pretty frequently and without warning. So we decided to go to bed and wait it out. When I woke up, I felt pretty much the same, sans headache, and still couldn't speak.

Victor took an unscheduled day off, helped me get the kids ready for school and acted as my interpreter all day. We called the neurologist. She suggested the symptoms were brought on by a seizure or by a migraine and to monitor the symptoms. If they got worse, head to the ER. We called the cardiologist. He said that it sounded like on aura brought on by the headache and that he would head to the ER if symptoms did not resolve in the next few hours.We waited about another hour and decided to go to the hospital because the aphasia had never before lasted more than an hour and we were heading into hour 12.

I hate heading to the hospital whenever I experience a neurological event. One of two things always happen. One, I am not taken seriously. Or two, I am made into a science experiment. On Friday, I they took Door Number One.

After all the tests (electrocardiogram, chest x-ray, CT-scan of the brain, blood work), I am told everything is fine. There was no reason for my symptoms and I can go home as is. With no relief for the chest pain and no explanation for the event. They tried to relieve the pain with both morphine and toradol but to no avail. All I was told was that when patients come in with chest pain with no reason that can be pinned down, they usually chalk it up to stress and anxiety.

I'm not going to deny that I have stress in my life. That would be stupid. I have three kids, a husband, a mother in law and a dog to take care of. I do all the laundry, all the cooking, a large majority of the cleaning, I can't drive till October, I hate being a housewife but I love writing everyday, and I probably won't ever get to back to work ever again. But my kids are a huge help around the house, my husband takes me out whenever he can, and I don't feel particularly anxious and overly stressed. In fact, I have had less migraines in the last few months than I can remember ever having in recent years thanks to changes in diet and household environment. I have had a definite problem with chest pain since my heart surgery in 2010 that we are just now getting under control. And we are only just now starting to under the repercussions of my stroke in 2010. So while stress may have played a part in Friday's events, I feel like it was not the whole story.

This week I am focusing on creating a healthy environment. I feel better when my house is clean and smells nice therefore I am taking that little extra effort to make sure that my house is the way I like it. I am making doubly sure I am eating right, drinking plenty of water, exercising and keeping a daily journal to help get out anything that is bothering me. At this point, I will do anything to keep my heart and brain healthy and working together like clockwork.

National Stroke Awareness Month

May is National Stroke Awareness Month!

I guess it is only appropriate because it was in May four years ago that I had my first stroke. It was in August that same year that I had my last one. Recovery has been a very long road and I'm not done yet, but I faith that one day things will get back on an even keel once again.

So how did I know I was having a stroke? I didn't. I was 29 and completely healthy. I had a migraine the previous night and was still feeling bad that day, but I had a history of migraines and thought nothing of it. My right arm starting tingling and my hand was feeling numb. My right arm and leg felt like they weighed about 20 pounds. The right side of my face felt numb. I felt dizzy and lightheaded. I was slurring my speech and felt very drowsy. I went to the hospital. The admitting nurse believed that I had a stroke and pushed me through. However, when I went to the back, the doctor didn't take me seriously. He barely touched me during his very brief examination. My pupils are two different sizes, a condition known as anisocoria. Every single doctor I have come across has questioned me about my pupils. Except this one. Because he didn't care.

My final diagnosis from this particular doctor from this particular hospital low potassium and a sinus infection.

It was nearly 48 hours later that I got the final diagnosis from my neurologist via MRI that I had indeed had a minor stroke. Over the next few months I was subjected to numerous tests to discover the reason as to why. The cause of my stroke was an un-diagnosed congenital heart condition. I had a hole in my heart that produced no murmur, no chest pain, no shortness of breath, nothing. What it did do, was allow blood clots to flow up to my brain, causing a stroke.

In August 2010, I underwent open heart surgery to correct the situation and suffered another stroke during the operation. When I woke up, I had no feeling in my right hand, parts of my face and couldn't talk. Now, four years later, I still have a loss of feeling in two of my fingers, parts of face, and I still garble my words from time to time but that is nothing compared to the phantoms pains I have in my right limbs. I now have chest pain and shortness of breath, but the causes of those remain a mystery. Good news is, I have an appointment tomorrow with my cardiologist to be reevaluated. Again.

That's my stroke story. What's yours?

Let's Get Physical

I had a frank discussion with my neurologist about my physical well being. Over the last three years, my right side has progressively gotten weaker and weaker. Because of the neuro-pathic pain (a present from  my stroke) that we just haven't been able to get a handle on, I have gotten less and less active. It can now be a struggle to do my daily activities due the pain and weakness I am experiencing.

It's a vicious cycle that I haven't figured out how to break. I try to work out and go for walks. In fact I walk my daughters to school on average about three times a week. The walk is one mile round trip. Granted, after half a mile, I am already ready to call it quits, but I try and fail and try again. Thus prompted the discussion with my doctor. Something has to change. I am on lifelong medication, some of which has made me gain weight, and I need to get more active to lose the weight to keep a healthy heart and reduce the risk of another stroke.

We decided on a round of physical and occupational therapy to help my body get back to where it needs to be. I had my first appointment last Thursday. It was my evaluation day. After that, the insurance company gets to decide whether or not to continue paying for the therapy. The evaluation went well. I have lost a lot of strength in my right side as well as range of motion. Cindy, my therapist, was great. She was knowledgeable and patient. She answered all of my questions. I honestly couldn't have asked for better.We didn't get to the occupational therapy, something I will have to address at my next appointment, but I was sent home with plenty of exercises to do everyday to help build my core strength and my balance back up.

All that's left is waiting to be sure there are no hiccups with the insurance company. I spoke to them on the phone to confirm my benefits and they gave no indication that there would be any refusal for treatment. The only reason it is even on my mind is because I was asked to fill out more paperwork to send off to them. I had physical, occupational and speech therapy right after my initial stroke in August of 2010. I was 29 years old at the time. I recovered remarkably well, considering. I am also worried because my occupation is "homemaker". It wasn't a job that was important enough to fill out the JOB section of the insurance company's questionnaire. Never mind the fact that the reason I have no job is stroke related.

It's the after effects of living with a stroke that seem to have done me in. The neuro-pathic pain, the seizures, memory loss and problems with retention have led me to quit school and my job. But I can't quit the most important job I have, that of raising my three kids. They are counting on me and I can't let them down. So even though it really hurts, you'll have to excuse me. I need to go do my exercises now.

E-mail your members of Congress and ask them to stop therapy caps for Medicare patients who have had a stroke.Without therapy, vital skills could be lost.

Baby Steps

I (finally) had my follow up appointment with my neurologist on Tuesday. My husband came with me, mostly because I am still not allowed to drive, but also as support. I like it when he tags along because he is one of my biggest advocates. He is all about helping me communicate with the doctors to try to move forward and find a solution to my problems.

As it turns out, there only three medications out there that can help with the neuro-pathic pain I have on my right side. I have tried all three. Amitriptyline I can no longer take because one of the side effects is seizures. Well, I already have those. Don't think I would like to have any more. Lyrica, the second one, is one I have taken before and complained about endlessly. I took Lyrica about two years ago when I was trying to finish my Bachelor's degree. I didn't like the initial side effects. It made me very loopy for a very long time, until I got used to it. Then it made me gain a lot of weight. My previous doctor took me off of it because he thought it was responsible for my memory problems. It wasn't. There was no change to my short term memory issues after we changed my medications around. Neurontin is the third medication for the pain. It isn't working at all. The Lyrica did it's job. When I think back on things, I remember being much more active than I am now. I was in less pain. Not pain free, but better off than I am now. I think that is a better place to be. So we decided to try the Lyrica again.

I have to go through the loopy stages, which I really hate, but I hope and pray that it will be worth it. One of the added benefits is that it is also an anti-seizure medication. So if all goes well, I may even have a reduction in the amount of seizures I have. It's hard not to get my hopes up about it, but it sure would be nice to be able to take myself to the grocery store, the library, the mall, my friends' houses, anywhere really. I even had hopes of going back to work, but I know that is probably not ever really going to happen. So I'll just keep on keeping on with the writing.

I got the courage up to submit two shorts to a competition recently. Mine weren't chosen, but it was fun writing them. I also participated in the National Novel Writing Month (NaNoWriMo) in November. I didn't make it to the desired 50,000 words in 30 days. In fact, I only wrote 6,337 but it was a lot of fun writing it. And I'm not finished, just distracted. I will complete my novel and continue on to finish my non-fiction piece as well. I am finally feeing good about things.

The Scarecrow

We had a change of insurance this year and with that change I opted to find a new neurologist. I grew tired my last one because he began to treat my problems by shoving more pills at me instead of listening and trying to correct the problem. I know that I have some weird problems and I know that I am an unusual case, but if you're not capable of dealing with it, I would much rather be passed on to a colleague than just passed by.

After my stroke, I developed chronic pain in my right side. It is constant but varies in intensity. Some days I can barely walk, but others I can be pretty active. My new neurologist is not willing to rule out a form of epilepsy due to stroke. And finally, my migraines have worsened considerably over the last three years. So you can imagine why I can be a bit of an enigmatic patient.

I am still leery of my new neurologist because she seems very focused on getting one particular new medication to work for me. But she did take me off of two other ones. And as far as I am concerned, the fewer pills, the better. She did refer me to a headache clinic because she realized that my migraines were out of her realm of expertise. I am grateful for that. And when I do go in to see her, she sits and talks to me like a person should. She never rushes, interrupts or makes assumptions. She listens and makes me feel like she may really have my best interests at heart. In between appointments, her nurse calls to check on my progress. So I think I'm going to stick with her a while longer.

My headache specialist has been really impressive. He made me feel normal. I wish he dealt with chronic pain, too. I got re-approved for Botox for migraines. I am really excited about that because Botox was the only thing that helped to prevent my migraines. He is also trying to find out what is causing all my headaches. I have them nearly everyday. And for anyone that has had migraines, I hope you can empathize. For anyone that hasn't, I hope you don't think I'm just whining about a headache. This doctor has told me that if we can get down to the root of the problem, we can help make my days more pain free. That would be grand.

Pain is the biggest side effect I have from my stroke. I remember it setting in right away. I remember being in recovery and being pain. According to the neurologist it happens, but it is highly unusual. So I thought maybe if I deal with the things that aren't so unusual, I can slowly start feeling better. I'm working on my migraines and my chest pain. Writing helps me work on my agraphia, which is trouble writing after a stroke. I am doing really well with my aphasia as well. Every once in a while I slip and say something really off the wall. But my brain seems to be making the new connections I was promised it would.

"Brains are the only things worth having in this world.” 
― L. Frank Baum, The Wonderful Wizard of Oz