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Monday, March 2, 2015

One Year Ago I Had A Stroke - Michael Elliott

Initial Symptoms
Tuesday March 4, 2014 at around 2:00 in the afternoon I was training a client.  I suddenly experienced complete loss of vision in my right field of view.  I thought to myself "is there something wrong with my contact?".  I poked at my contact for a bit and squeezed my eyes shut to see if my vision would be back to normal after opening them.  I continued training my client for around 5 to 10 minutes, then a headache started.  I told my client that something was wrong.  I sat down and Dan Goldberg saw me.  He saw that I didn't look right.  I told him what I was experiencing, and luckily we had an EMT (Dan Martin) working out in the gym at the time.

Dan Martin came over and put me through a series of tests.  Stick out your tongue.  Raise your arms.  Palms up.  Palms Down.  Push my hand down.  Lift your legs...  I would find within the next couple days that every doctor and therapist I would see would have me perform this test.  I believe Dan suspected I may be having a stroke, but because I passed all the tests and was not showing any of the common symptoms of a stroke, he theorized that I may be experiencing a migraine.  Because I have never had a migraine, Dan suggested I go to the hospital just to be safe.

Dan Goldberg drove me to the hospital.  I texted my wife and told her what I was experiencing.  I told her not to worry and that I would let her know what the doctors said when I get to the hospital.  The headache wasn't bad, just an annoyance.  My vision was coming back slowly.  Instead of completely black in my right visual field, it was now very blurry.  I found that walking was a little tricky.  I felt I would bump into walls and other people.

The Waiting Room
We arrived at Crouse Hospital emergency room and sat in the waiting area.  The first thing I noticed while waiting were the vending machines.  In the waiting room of a hospital emergency room they made soda, chips and candy bars available to their patients.  This made me angry.  Knowing that proper nutrition is the best line of defense against disease; seeing highly processed foods for sale in a hospital was sickening.

People watching quickly becomes a pastime when waiting in a waiting room.  I see a mother with her son sitting in front of me.  They are eating out of a McDonald's bag.  An example of poor nutrition possibly leading to them waiting in an ER waiting room.  A man in the corner looking like he's on deaths door.  A mother texting on her phone while her son plays a video game.  You wonder to yourself "why are these people here?  What is wrong with them?"  The funny thing about it was, at this point, I was not worrying much about what was wrong with me.

The 1st MRI
After about a 10 to 15 minute wait, the nurse called me back.  They asked some basic questions.  Took my blood pressure and heart rate.  Told me they were going to give me an MRI.  They explained the test to me, set me up on the machine and left the room (isn't it comforting when they put you in this big magnetic field machine then run out of the room!).  The test wasn't bad.  I just closed my eyes and did some deep breathing.  It was over with pretty quickly.

They walked me back to the waiting room.  I was there for about 5 minutes when a nurse came out and announced my name.  I stood up and walked to her.  Looking at me with a confused look she asked "you're Michael?".  I said "yes""Michael Elliott?"  "Yes."  We walked through the doors to a reception desk, where she asked the lady "Do I have the right patient?".  The lady behind the desk proceeded to ask me my name, then told the nurse that I was indeed the right patient.  At this point I had no idea the results of the MRI.  Looking back, I know the nurse had the results and was most likely expecting to see a much older man when she called my name.  When she saw me, a healthy looking 31 year old, she thought she had the wrong patient.

Tuesday Night, Wednesday Morning
They brought me to, what I call, a holding area.  A couple doctors came in to see me and explained what had happened.  They told me that I was going to be transferred to Upstate University Hospital.  They told me that Upstate was better equipped to treat stroke patients.  I was told that I would be in the "holding area" until they could transfer me.  At this point, probably around 6:00 or 7:00, my wife arrived and soon after my parents.

While in the holding area I experienced, for the first time, what having a low resting heart rate does to the machine you are hooked up to.  When your heart rate drops below a certain point the machine thinks you are dying, so it responds by beeping.  The nurse comes into the room and announces "wow, you have a low heart rate!".  She presses a button and leaves.  A few minutes later the beeping starts again.  This would be a common routine for the next couple days and nights.  Luckily my wife, Andrea, has no fear of adjusting the machine by herself.  As soon as the beeping started, she would press a few buttons, adjust the machine, and the beeping would be done.

Early in the evening the nurses checked on me often.  Every time they came to my bedside they would ask me how my headache was "on a scale of 1 to 10?""A 3 or 4" I would answer the first few times they asked.  "A 5" I would answer a little later on.  "My headache is a 7" I answered a nurse finally.  "Is it really a 7?" asked the nurse.  "Men are such babies" she said to my wife.  "Well, it's really not that bad, but I've had a headache for 8 hours and it's getting annoying." "OK, I'll give you some morphine" she says as she pumps the drug into my iv.  "Morphine?  Seems a little extreme.  A Tylenol would have been... whoa... i feel tingly... no more headache!"

A few hours in the "holding area", and at least an hour or two since a nurse had checked on me, my parents and wife grew impatient.  Andrea, or my mother (I don't remember who), went into the hallway and asked the nearest nurse when I would be transferred.  The nurse came into the room and said "you're still here?".  That was comforting!  Knowing they literally forgot about me!  At the time I didn't care.  I was tired.  It was after midnight and I just wanted to sleep.

Just before 2:00 Wednesday morning I was transferred to Upstate University Hospital.  A doctor there gave me a cognitive test to see if I was still with it.  He asked me what day of the week it was.  "Tuesday... Oh, wait, it's Wednesday.  Trick question, it's 2:00 in the morning!" "Who is the president?"  "Umm... That guy my father doesn't like... Obama!"  It was taking me way too much effort to think of these answers.  I felt fine, but I was actually wondering if I wasn't thinking properly.  It was 2:00 in the morning, and if you know me at all you know my brain shuts down around 7:00 in the evening.  My wife calls it "sundowners".  "Do you know where you are?"  "I was just transferred from Crouse Hospital to Upstate University Hospital."  The doctor said I was fine and to get some sleep.

When It Hit Me
Wednesday was a day full of tests.  I had another MRI, a CAT scan and a myriad of other tests.  Test after test was done and all results came up negative.  They had no answer to why I had a stroke.
At one point in the afternoon a doctor came to my room and said "Because of your stroke...".  He continued to talk about something, but I didn't hear a word he said.  This is when it hit me.  "I had a stroke?  I had a stroke??  I didn't have a stroke.  Old people have strokes.  Unhealthy people have strokes.  How could I have a stroke?  Why did I have a stroke?  All these test and they don't know why I had a stroke?  Why don't they know why I had a stroke?"

The 1st Transesophageal Echocardiogram
A Transesophageal Echocardiogram (TEE) is a test that uses sounds waves to create a video of the heart.  This test is done by feeding a probe down your throat.  You need to be an active participant in this test, so you cannot be sedated.  They give you a "mouth wash" to gargle which numbs your throat.  Then they feed the tube down your throat so they can get images of your heart.  Though your throat is numb, this test is a very unpleasant experience.

They were testing to see if I had a Patent Foramen Ovale (PFO), which is a flap-like opening between the atria (two upper chambers) in your heart.  The theory was that I had a clot that passed from the right atrium to the left atrium through a PFO.  Clots usually pass from the right atrium to the right ventricle then to the lungs.  The lungs act as a sort of filter for your blood which breaks down the clot.  If you have a PFO the clot can pass from the right atrium to the left atrium, bypassing the lungs, then back into your blood stream.  This blood clot can make it to your brain, causing a stroke.

During the TEE I was given an injection of "shaken" saline solution, which is full of bubbles.  I was then instructed to cough.  "Cough cough."  "No, didn't see anything.  Cough more forcefully." I was told.  "Cough!  Cough!"  "Still nothing.  Cough as forcefully as you can."  I was told.  "COUGH! COUGH! COUGH!"  They took the probe out and said the doctor would be in to see me in a little bit.

Negative.  Another negative result.  They did not find a Patent Foramen Ovale (PFO).  Although they did not find a PFO I would find, weeks later, the TEE to be an important test to find why I had a stroke.

Going Home With No Answers
I spent two nights in the hospital.  I was discharged from the hospital Thursday afternoon.  I was sent home with no answers to why I had a stroke.  I had been poked, prodded and tested numerous times with no positive results.  They drew five vials of blood with the thought that maybe I had some type of blood disorder.  I had lost peripheral vision in my lower right visual field.  Because of this I was told I cannot drive for three months.  I would then need to be tested by an Ophthalmologist to be cleared to drive.  I was instructed to take a "baby" aspirin every day to reduce my chances of blood clotting.

Walking On Egg Shells
Not knowing why is the worst thing in the world.   Was it something I was eating that caused the stroke?  I eat pretty well.  85% of my diet is vegetables, fruit and natural meats.  I do cook with butter.  Maybe I'm eating too much butter?  I eat a lot of eggs.  Are all the articles I have been reading about how eggs are actually very good for you wrong?  Did the dietary cholesterol cause the stroke?

Maybe it's my way of exercising.  Was it CrossFit?  Is everything I have been teaching people over the years been this dangerous?  Does high intensity exercise cause strokes?  Has my whole career been leading to this?

For a few weeks I was walking on egg shells.  Every moment of every day I was questioning.  Maybe it is something I'm being exposed to.  Is it my computer or cell phone that's giving off some sort of waves that's weakening blood vessels?  Is there some sort of radiation from the microwave that's weakening blood vessels?  Is it car exhaust?  Is it chalk dust from the gym that I am inhaling?  Every single thing I do and every single thing I am exposed to, I was questioning.

When your career is based on health and fitness and you go through something like this in your personal life, you start to question everything.  You start to wonder if all the information you have been giving people over the years is actually hurting them, rather than helping.

A Dark Place
Outwardly I put on a happy face, but inside I was in a dark place.  My wife, Andrea, and my son, Chase, are the reasons I did not fall into a depression.  When you are married the words "for better or for worse" are in your vows.  This was definitely a "for worse" time for me personally.  I am not the type of person who outwardly talks about my feelings.  I deal with stuff inwardly.  Doing this causes me to be short, and somewhat mean, to the people nearest to me.  Andrea was the one who had to deal with this on a daily basis.  I would find myself being angry at her for no reason.  I guess this was my way of letting out my personal frustrations.  I am thankful that Andrea is such a great and patient person.  Without her I am not sure how I would have made it through that time in my life.

Finding A Good Doctor
Fortunately my career puts me in front of many very good people who were quick to offer their help to me.  I was able to get an appointment with a great Ophthalmologist, Dr. Barry Rabin, MD from "Eye Care For You", within a week of being discharged.  I had been training his wife, Susan Rabin, for a little over a year at that point.  Because I couldn't drive she was nice enough to drive me to and from my appointment with her husband.  This is when I learned that I had 20% vision loss in my lower right visual field.

A couple I have known and trained for many years, Jim and Peggy Carrick, were nice enough to get me in touch with a great doctor, Dr. Blanchfield, MD.  Dr. Blanchfield had a theory to why I had a stroke.  He then scheduled me to see a great Cardiologist, Dr. Berkery, MD.  I met with Dr. Berkery on April 15th, 6 weeks after my stroke.  He was sure that I had a PFO.  He wanted to do a TEE.  Remember the TEE, the Transesophageal Echocardiogram?  The test that was performed at Upstate University hospital that was negative?  Yes, that same test.  I said "OK, when can we schedule it?"  He said, "can you come tomorrow?"  "Heck yeah I can come tomorrow!  Just tell me what time."

The 2nd Transesophageal Echocardiogram
Why would I have to have the same test performed if the first test didn't show anything?  I mentioned above that the patient has to be an active participant in this test.  During the test at Upstate University hospital, I was told to cough.  This time Dr. Berkery explained to me that I would need to create a high amount of pressure in my abdominal cavity then release that pressure.  I would have to perform a valsalva maneuver.  A PFO will open when this pressure is released.  Anyone who is familiar with weightlifting knows what the valsalva maneuver is.  If you are not familiar, imagine yourself sitting on the toilet and having to strain as hard as you can to push out... well, you know.  Creating this pressure is much different than coughing!

During the test Dr. Berkery told me to perform the valsalva maneuver, then release.  As soon as I exhaled Dr. Berkery announced "there it is.  I don't know how they didn't see that?!"  We repeated that same process a few more times then the test was done.

I did in fact have a PFO.  I learned that when you are in the womb your heart is separated.  Soon after birth your heart fuses together.  Sometimes the heart does not completely fuse, which leaves a flap-like opening between your right and left atria.  Between 20 to 25% of people have a PFO.  Most people never learn they have a PFO unless they have a heart issue or a stroke.

I had a clot in my blood stream.  The clot went from the right side of my heart, through the PFO, to the left side of my heart.  The clot then went to my brain which caused a stroke.

Life Changing
You often hear about life changing events.  This was truly a life changing event for me.  In a lot of ways I was very fortunate.  The clot went to my left frontal lobe, which caused 20% vision loss in my right visual field.  If that clot had went to a different part of my brain I could have lost my ability to walk, talk or use my arms.  I could have lost my life.

When you come face to face with your own mortality, it changes you.  At any moment I could have a stroke.  I do not walk around in fear.  Instead, I try to enjoy every day.  I try to make sure my wife knows how much she means to me.  I try to be the best father I can be on a daily basis and enjoy every moment with my son.

Don't take today for granted.  
We don't know when or how our life will end.  Make sure the people close to you know how important they are to you, and enjoy every day.

1 comments:

Mike
Having just read what you experienced after your stroke, I remembered what I experienced after I broke my back and neck when you were all young. I thought it was by far the scariest moment of my life. Then I have children grown to adults and I realize that when they have problems such as yours, Ryans and Kates, my fear for myself was nothing. I am extremely proud of you and yours for how you dealt with the challenges presented you. It's good that you could share this with an open heart.

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