You can do everything right and still not be able to prevent a serious stroke

Why do we think we can control the outcome?

There were certainly warning signs. Ten years prior my dad had what they call a “mini stroke”. Actually, it was several mini strokes in a row. 

Upon extensive testing, we learned my dad had been experiencing atrial fibrillation, a serious heart condition that causes the heart to quiver and not pump the blood properly out of the chambers. This can lead to blood pooling and coagulating, setting up the right conditions for blood clots to travel to the brain. 

The mini strokes didn’t cause much in the way of permanent damage. He experienced weakness in his left hand and slurred speech but recovered quickly and returned to his regular life. He had a pacemaker put in to manage the atrial fibrillation. He was promptly put on blood thinners to avoid any clotting. A belt AND suspenders, if you will. But why stop there? This was an opportunity to reset. To get things right. Knowledge is power and he had the opportunity to influence future outcomes, or so he believed. He overhauled his diet, started walking 5-10 kilometers per day, and lost a bunch of weight. He was living his best life.

June 15th started out like any other day. It was a Saturday. A slow start. He watched some of his favourite cooking shows and went out for a long walk. When he came back he decided to quickly run the garbage downstairs to the bin. While in the garbage room, he ran into a neighbour who has been terrorizing the condo board and other residents. He and my dad got into a heated exchange. My dad returned to his apartment, very upset about the interaction. He went to his room to change out of his walking clothes and into something more comfortable. That’s when he collapsed. 

I was out to brunch with my girlfriends, like any other Saturday. Except this wasn’t going to be any other Saturday. Shortly after I got home, I got a text from my mom that read, “I think your dad is having a stroke”. I asked her if she called 911. She hadn’t. Why would she be texting me before calling 911? I told her I’ll be there in 5 minutes. 

I beat the ambulance. It was obvious my dad had a serious stroke. He was barely conscious. He couldn’t talk or move on his own. But he was alive. I had enough time to pack a bag for him and gather all his medications. When the ambulance arrived, they confirmed the stroke immediately. They packaged him up quickly and off they went. 

When we got to the hospital, we weren’t allowed to see him. Nobody could tell us why or when we would be allowed to see him. It was almost 3 hours later by the time they invited us back into the ER. We had no idea what to expect. When we got back there, we were surprised to see him in as good of shape as he was in. He was alert and could move his limbs. He couldn’t really speak, but he could sing! The neurologist met with us. He explained that there are often early interventions that can be done to minimize the impact of a stroke. Unfortunately, in my dad’s case, none of those interventions were options. They couldn’t administer the drugs because he was already on blood thinners. They couldn’t go in and try to remove the clot, because of the shape of the clot, they were concerned some might dislodge and cause further damage. All we could do was wait and see. 

What they failed to explain to use is something called a stroke evolution. I guess it was implied in the “wait and see” comment. A stroke evolution comes after the initial event. The stoke itself is the clot that cuts off blood flow to that part of the brain. The evolution is related to how much brain tissue dies as a result. The stroke evolution takes up to 72 hours before you can understand the full effects of the stroke. This would have been really important information to communicate up front. For the next 3 days, we watched my dad’s condition gradually get worse. He couldn’t speak (or sing) at all anymore, he couldn’t eat, he was incontinent, his vision was impaired, and he lost the use of his entire right side. 

The neurologist described this as a 'runaway case'. Seeing my dad in this condition made me realize that you can do everything right and not prevent the stroke one little bit. We don’t have the control we think we do. There are too many factors that are beyond our control. But if I were in his shoes, would I have done anything differently than him, knowing what I know now? I don’t think so. Because believing we can control or influence the outcome in some way allows us to live our lives to the fullest and feel hopeful about the future. The alternative would be listening to the tick, tick, tick of the ticking time bomb waiting to go off. It’s easy to want to blame the terrorist neighbour for instigating the stroke, but clearly this stroke was coming for him. At least he was at home and not out for his long walk when it happened.

My dad survived his stroke. That feels like a miracle. It’s been 6 months. We have experienced dark days and we have found some unexpended beauty within it all. But most importantly, we’ve learned some poignant lessons that I hope to share along the way.