I don’t remember much of my time in the emergency department. I think I was in a room with many people around me. Maybe I was in a large room with other patients and doctors and nurses. Connie was there as we waited for the results from my bloodwork and a CT (computed tomography) scan. When the doctor told Connie and me that I had a stroke, it did not register for us. I thought that the doctor was making a mistake and he mixed me up with another patient. Slowly the reality started to sink into my mind. Wow, I had a stroke.

It turned out that I had an ischemic stroke which they could see evidence on the CT scan. It happens when a clot forms in some other area, such as the neck or lining of the heart, and travels to the brain. The clot is called an “embolus.” Blood clots often result from a condition called “atherosclerosis,” the build-up of plaque with fatty deposits within blood vessel walls. About 87% of all strokes are ischemic. The clot “swims” until the diameter of the blood vessel is too small to permit the clot to flow. It blocks blood from flow past the clot. 

To imagine how it can happen is to think of a river flowing downriver similar to how the blood flows through the blood vessels. Somewhere upstream to the point where there is a blockage, the river diverts and the flow stops at the blockage. The water flows to other channels around the obstruction. 

In the brain, where the blood stops, the brain tissue is deprived of oxygen and nutrients carried by the blood. Nerve cells and the supported are injured. If the blood flow is not restarted soon, cells begin to die. The brain tissues can withstand three to six minutes without oxygen before irreversible damage occurs. As a result, nerve cells cannot communicate with other cells, and functions are impaired. 

We attempted to wrap our heads around the news. The doctor recommended that I stay in the hospital and they would monitor me. What I did not know, was 25% of stroke patients had a second stroke, 10% within the first three months. “Your risk of a second stroke is highest within the first two days,” says neurologist Blake Buletko, MD. “But you remain most vulnerable for up to three months and even up to one year after the first stroke.” During these first 3 months, the person’s risk of stroke is 15 times higher than the general population. One year later, the risk is reduced, but stroke patients are still seven times more likely to suffer a second stroke. Good thing I did not know the statistics because I would have worried about the possibility of having a second stroke!

The majority of stroke patients have some predisposing factors. They are many. High blood pressure (it doubles (at a minimum) the risk of stroke when uncontrolled) is one. High cholesterol can lead to plaque buildup in the arteries, decreasing blood flow to the brain and other parts of the body. Diabetes and associated high blood sugar damages blood vessels and increases the likelihood that blood clots will form. If you use tobacco products (primarily smoking cigarettes), it thickens your blood and the possibility that plaque will build up in the arteries. If you are obese, you increase your odds of having a stroke and is linked to diabetes, heart disease, and high blood pressure. Bad news! Cardiac abnormalities like atrial fibrillation can cause clots to form in the heart that then travels to the brain. I still had to figure when the stroke happened and why I had made the blood clot as I was wheeled out to spend the night at the hospital.

To be continued in a later blog. Please leave your comments!


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