I'm Grateful

I need to tell you the end, first. I'm ok. I wasn't there for a moment, but I'm ok now. 

Eric and I planned a two-week camping trip to Banff and Jasper National Parks, waking up early on a couple of different winter mornings to get online to snag sought after camping sites in July. We were going to take two weeks off - the first time we'd ever gone on vacation for that long. As that time drew near, we knew we both needed the break. We were mentally exhausted. I was scrambling for balance, doing what I knew to do to force me to stop working - sign up for a marathon and print up a training plan that told me when I needed to close my computer and go for a run. That printed plan came with me to several countries, where I put in miles near beaches, across cities, around hotel gardens and on treadmills - whenever I could fit training in during the day, wherever was safe.

I took that training plan to Canada, and we spent two weeks hiking, running, biking and disconnecting in the mountains, seeing amazing places and recovering from dual heavy work seasons. I put over 100 miles on my legs. We came back to a house-full. Some of our favorite people arrived for a week of vacation of their own, using our house as their base.

We went back to work, and I continued my training plan. On a Tuesday evening in mid-July, I ran eight miles, then stood in the kitchen listening to young adults tell us about their day, and talk about their first professional jobs in nursing.

I woke up Wednesday morning and had a stroke.

It started with one arm not working, then falling on the floor of our bathroom because my left side didn't work, but me rationalizing, "I must be really tired." Then that resolved and I stood back up, but I couldn't seem to find my toothbrush and thought "well, I guess I'm not brushing my teeth today." 

The fall and dropped toothbrush woke Eric, who followed me around the house as I attempted to get dressed, fixated as I was on prepping for the training I was supposed to be facilitating over Zoom in a few minutes. He finally said "we have to go to the hospital right now." Disconnected from it all, I vaguely agreed, and finally looked in the mirror and smiled. Only half my face smiled back. I thought, "well, that can't be good." I tried to text my colleague and good friend, Sarah, to let her know that I needed her to cover our training and I was going to the hospital. What I texted was incomprehensible (Eric followed up with clarification and then took my phone).

Eric, who is the serious hero in this story, recognized the symptoms of stroke and that we needed to go, and now. He also knew that based on where we lived and his volunteer experience with the fire department, it was going to be faster for us to get in the car and go than wait for an ambulance. 

By the time we got to the hospital, most of the symptoms had passed, except I couldn't see well. We had gone to a hospital that specializes in stroke, and they put me through stroke protocols. I saw a neurologist right away who was pretty sure this was just a migraine, but popped me into a CAT scan just to be safe... then apologized when she saw the returned images. 

The team decided to admit me pretty quickly, but we ended up spending 13 hours in the emergency department while we waited on a bed to open and for someone to take me to get an MRI. 

The waiting was scary. We had a small reprieve - a friend of ours from our last church happened to be a hospital chaplain, and happened to be working at the hospital we were at. I'm not totally sure I remember what he said, but I was glad that Nathan saw my name on a chart, thought "surely this can't be the person I know," but came to check it out anyway. My symptoms had fully passed by that time, but I was overwhelmed and wanted to be in denial. I couldn't have had a stroke. I didn't want to be admitted to the hospital. Can't someone just let me go for a run and get back to work? I have things to do. Nathan talked to us for a while and I was glad Eric had someone there with him, because I am certain that I was no help.

ET fingers for constant monitoring

I spent a couple days in the hospital while the University of Colorado health system opened up a full-scale investigation into what caused this. Nothing fit - I didn't have any of the classic risk factors for stroke. The nurses told every specialist that came to see me that I was a marathon runner, and Eric was an EMT and that's how he knew to bring me in. "Marathon" and "EMT" are written in at least 15 different charting notes (I know, because the health system app shows you everything.) 

They tested me for everything. They took enough blood to send to multiple labs, checking for everything from auto-immune issues to clotting disorders to accidental ingestion of moon rocks. They sent me for tests and imaging and literally took an ultrasound to every major vein and artery from neck to ankle. 

Nada. Nothing. The negatives were impressive - I don't have lupus, HIV, hypercoagulation, DVT, SVT, genetic disorders or syphilis (and thank goodness on that one, considering all that time I spent in brothels during the Gold Rush). 

Finally, they ran one more test - a bubble study where they inject agitated saline to see where the carbonation goes. It came back inconclusive, and so another, more invasive version of the test was scheduled for the next morning. 

They found an inch-long hole in my heart.

Apparently, this hole has always been there, not causing any issue... until it did. In "things I didn't know until now," everyone has a hole in their heart in utero - it allows for more efficient blood flow since fetuses have no use for lungs, so the hole bypasses the lungs. At birth, the hole is supposed to naturally close and it does... except for 20% of us where it doesn't. For most of this 20%, its a nonissue and there's nothing to do about it. Until I threw a mystery clot. Docs had no other answer for "why was there a clot" except that high stress, lots of travel and birth control increase your risk for clots, and some combination therein caused some kind of tiny clot to form somewhere. That clot, were it not for the hole, would have gone to the lungs and was small enough to be naturally filtered out - they know this because the optic nerve, where the clot finally stuck, is incredibly tiny, and the damage to that nerve is faint, incredibly small and isn't causing lasting symptoms. 

Definitive diagnosis. They released me from the hospital with a recommendation to get that hole patched up at my convenience. They suggested I take a day off running and then wait until the next weekend to do my long run. They prescribed one med and a baby aspirin. For all the fuss, they were rather casual about the fix.

Two weeks later, I went back to the hospital for an 11am check-in and a 1pm appointment. I was released at 4:45pm with the hole filled, a quick outpatient procedure through a vein that deployed a two-sided patch that opened like an umbrella, clamped together and covered the hole completely. They told me to stay on the meds I was previously prescribed for several months to help my heart heal, keep taking the aspirin forever, and wait until the next day to go for a run. 

I'm ok. This could have been way, way different. That knowledge has taken some time to adjust to, and while my physical health is overall fine, psychologically, this had an impact. I was afraid I was going to die. My situation is different than the "average" stroke, but the follow-up from nursing teams includes scary stats about the risk of having strokes - and worse strokes - in the future. I had panic attacks for a while, particularly when out for long runs where there wasn't enough to distract me and get me out of my own head. I stopped taking the follow-up nursing calls because they were tail-spin inducing. It was helpful to hear from the cardiologist that despite the repeated voice messages and dire warnings, I did not need "cardiac rehab," and, in his professional opinion "it would bore you to tears, walking on a treadmill with a bunch of old people when you could get more out of just going for a run." Bless him.

Physically, it took me about a month to recover from the heart patch - I could run, but my body needed time to adjust to blood flowing in a different manner than it was used to. On top of that though, the anxiety disrupted several long runs on what had already been a tight training schedule with little wiggle room. I finally decided to defer my marathon until next year, recognizing that I was just not going to be ready. 

If the worst that came out of this was one deferred marathon, I'm incredibly lucky. I'm working on gratitude for that. Gratefulness has required more learning than I anticipated it would.

It has taken a while, and the whole thing has been hard to process. I felt like I had done something wrong, and I had failed in some way that caused this to happen. Then it felt like a body betrayal for a while and I was angry that my body would do this to me, and I was angry this happened. I was fearful to tell people - I was afraid people would hear "stroke," and start looking for reasons to confirm that I was brain damaged, not able. I was afraid I would be sidelined and written off.

I didn't tell many people - it took a long time to find the language for what happened, even after I got over the rest of it. I didn't even call my mom when I was in the hospital - which was probably a mistake - but she was out of the country and I didn't know how to say what was happening... and I think I was hoping it would all go away and I could just call her and tell her about this funny ridiculous mistake that happened.

Three months on, I'm still more likely to end "I had a stroke" with, "but don't worry, it didn't take" because that's kind of funny and lets me minimize. I'm learning to say "but I'm ok, and I'm grateful." And I am - I'm grateful for the health care staff who took me on as their personal mission to figure out what was happening. I'm grateful for a relatively simple solution that allows me to live life like nothing happened. I'm grateful we had health insurance to cover the bills. I'm grateful for the friends and family who checked in on me and cared about me. Most of all, I'm grateful for Eric, who stepped in and took action, and has been by my side through all of this - the physical, the mental, the emotional. 

I'm grateful.

PS:  In case you are wondering, both cardiologists I worked with are marathon runners. They knew what I meant when I asked about "training, and understood I would not just be "going out for a jog." When I went for my three-month check-in, the cardiologist responsible for my follow-up was mad that he was on-call that weekend and couldn't run Pikes Peak. Maybe we'll be on the mountain together next year.