As the 5th anniversary of the day I had a stroke looms, I find myself thinking about the stroke, my experience at the hospital and the challenging first days of my stroke/aphasia journey. I just reread the discharge instructions from the hospital and subsequent summaries from doctors that referred to my stroke as “MCA cryogenic “. (Absolutely nothing about being unable to speak. ugh)
At the very beginning, my family, especially my mother and sister, were very upset with the surgeon whom they assumed did something that led to the stroke. My husband wanted to know how it happened. At the time, I really didn’t care about the why. Of course, we were not ever going to get any real answers from the doctors. And still today, 5 years later, the doctors consider my stroke as cryogenic or without a known cause.
The surgeon required me to do lots of testing prior to surgery. This is standard for all his patients I’m told. I had to do extensive blood work, EKG stress test and x-rays of my neck because of stenosis I have after two car accidents. My blood pressure had to be monitored. (I had never had high blood pressure previously, but due to the amount of pain I was in, my BP was slightly elevated and I was put on medication.) Everything was fine and I was cleared for the surgery. I was so excited. But who is excited to “go under the knife”? I was because I had been in so much pain for a long while. I did a lot of preparation for my recovery from the surgery. I was ready. If you don’t know, it’s a long, painful recovery that requires wearing an abductor sling for 6 weeks (mostly immobilizing your arm) with about 3 months of physical therapy. Most people feel their shoulder is back to normal in 6 to 9 months.
Prior to the surgery, the PA listed all the risks of the surgery and I signed that I was informed. Stroke is one of the risks of any surgery but I was told it’s a very low risk.
Today I know all the statistics. There are confusing statistics about stroke as a consequence of non cardiac surgery. The statistics are from 0.1 percent for individuals with no risk factors to 7 percent for individuals over the age of 65. https://pubs.asahq.org/anesthesiology/article/134/3/480/115070/Stroke-in-Surgical-PatientsA-Narrative-Review
I also know all the risk factors for having a stroke - https://www.cdc.gov/stroke/risk_factors.htm
Personally all the risk factors I had were addressed and stable before the surgery.
If you’ve already had a stroke, risks of having a stroke during or after another surgery. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6297334/
From the American Heart Association website…”Having a stroke puts you at a higher risk for a second one, however, stroke survivors have the power to reduce their risk for having another stroke. There are things you can do to reduce your risk, starting with identifying what caused your stroke and uncovering all of your personal risk factors.”
My first neurologist was involved in research to reduce the occurrence of further strokes by taking eloquis, a drug similar to warfarin but apparently without many of the side effects. Eliquis is used to lower the risk of stroke or a blood clot in people with a heart rhythm disorder called atrial fibrillation. For cryogenic stroke, AFib is thought to be a major contributor. Of course I was urged to take part of this study (but I didn't).
Since the stroke I have had many tests, wore a heart monitor and then had a loop recorder implanted in my chest which I had for 3 years. No indication of AFib.
Now, five years later, no one seems at all curious as to why I had the stroke… except for me.
I truly feel that there was something about the surgery which caused my stroke - the anesthesia, nerve block, the medication they gave me right afterward. Now I go out of my way to avoid any anesthesia or surgery. That is how I mitigate another one. But I would love if someone, one of my doctors, would classify the stroke as perioperative so the statistics would show the real numbers as I’m sure I’m not the only one who is missing in the data.
Until next time........
Hi Cheryl. Thank you for another interesting and informative post. I think my mother has been recently put on eloquis. It has been a difficult week for us. She had fallen last Saturday and broke a hip and had a partial hip replacement on Monday. She is 92 with heart problems -diagnosed with an aortic aneurysm when she was about 70. She had decided that she did not want surgery. The surgery would be risky with potential of a stroke. She was seen by a surgeon but not a cardiologist. The family physician refused my request for a cardiology consult, that they were all very busy. It's been a long hard road and too long a story. Now finally in…