Reconnecting (0040)

.
Before my stroke, I was a highly active, some would say hyperactive person. I was pretty much a daredevil. I tried bungee jumping, parasailing, motorcycle riding. Once, my wife and I actually got in a cage to pet a full grown female tiger! (Personally,I still marvel that we did that! That definitely scared me. Also, by the way, Tigers smell bad! ) I loved to fly airplanes. I was a private pilot and spent most of my flight hours in a four passenger Cessna Skyhawk. I loved it. My wife was a bit of a daredevil two. She took flying lessons with me. Unfortunately, my kids weren’t quite so adventuresome. They refuse to get in a private plane with me!

Well, my son doesn’t even want to get into a commercial airliner. There wasn’t much that I wouldn’t try at least once.
With that type of personal history, more than a few people wondered why I seemed so euphoric in the hospital. My condition certainly precluded a lot of activities that I used to enjoy.



I spent more than a month in the hospital and in the rehabilitation ward, recovering from my stroke. One thing that amazed many people, including my family, including me…was my unusually good mood. Here I was – no income, in the hospital, paralyzed on the right side and unable to walk or use my right arm or hand. You would think that would be a very depressing thing. But I wasn’t depressed at all. My kids and my mother, at the time, attributed it to some really good rugs they must have been giving me. It wasn’t until I got back home that I realized that I was now taking the same drugs that I was taking in the hospital. There were no magic mushrooms to perk up my mood. Just stuff to keep the blood pressure down, fight off blood clots and keep the gout under control. That’s it.



What accounted for my unusual attitude in the hospital? If you couldn’t walk or use your right arm, scooting around in a wheelchair, and were now dependent upon the people around you when you were fiercely independent before – that would seem like a prescription for depression.



After talking with my stroke doctor, Dr. Hayes, I figured it out. I had lived a high-pressure lifestyle. The highs were enormously high. The lows were cavernously low. Very little time was spent in the middle ground. Although I love my kids and my kids love me, my romantic relationships managed to alienate them. My relationships were volatile. I was an all or nothing person.



The euphoria that I experienced after my stroke wasn’t due to drugs and wasn’t experiential. It was because, for the first time in my life, I really treasured those simple things in life that we take for granted in our daily lives, that we forget about when we are busy – family and friends. Disabled as I was, the workforce would have to wait. My kids, my mother, a few of my close friends were the most important things in my life. Their presence, their happiness and their companionship was what made me happy.



While I was sick I lost my house and most of my personal possessions! I only had a couple of van loads of stuff left. It was a very buddhist-like existence, forsaking the things of this temporal world. But I had family and friends. My partner Adam had been my friend for more than 20 years and he stood by me. My friend Arnie, ditto.



As my recovery progressed, I found a few more of those old friends. Bill, Tara, Andrew and Sheila, Jonathan, Mimi, Charlotta, Adam2 and Zannell, Frank, Manny, and more than I can even remember have stayed in touch and supported me throughout my ongoing recovery. That’s worth more than cash -- well, it’s worth more than cash as long as you can still afford to eat.



Good Drugs Dude!



Once you have an ischemic stroke, a stroke caused by a blood clot, you spend the rest of your life on drugs. Here is the cocktail they had me on in the beginning, and modified today.



Plavix is the first drug introduced. Plavix has largely replaced the previous clot reducer, heprin, which had far more side effects. Plavix reduces the chance of having a second incident.

Metforemin is a drug that replaces the need for insulin in type II diabetics. Diabetes is common in stroke victims as the damage to the brain frequently reduces the body's ability to regulate its own insulin production.

Lipitor, known technically as atorvastatin, reduces the amount of bad cholesterol, known as low-density lipoprotein, LDL, while at the same time, usually increasing the amount of good cholesterol, high-density lipoprotein, a or HDL. The build up of LDL in the blood stream often contributes stroke.

Lisinopril is in a group of drugs called ACE inhibitors. ACE stands for angiotensin converting enzyme. Lisinopril is used to treat high blood pressure (hypertension), congestive heart failure, and to improve survival after a stroke.

Vesicare, in my case, was prescribed but eventually eliminated. One of the side effects of stroke and paralysis of one side of the body is often incontinence (unpredictable urination). However, as my condition continued to improve, this drug was eliminated.





In my particular case, I have long had a history of gout, or the build up of uric acid crystals in the body originally, this condition caused the joints in my lower extremity, hips, knees and feet to swell and become painful as the uric acid crystals build up in the joints. There are two types of gout. Overproduction of uric acid and the inability to eliminate uric acid. In my case, it was not the body's ability to eliminate uric acid, but rather the overproduction of uric acid which caused the problems. I was prescribed allopurinol to reduce my body's production of uric acid.



Prior to my stroke, Gout had become a bigger problem. Instead of just accumulating in my joints, were eliminated, the uric acid started building up in my kidney. The resul was kidney stones. Most people get kidney stones as a result of a buildup of calcium in the kidneys, and various medical procedures including lithotripsy are required. With gout however the production of uric acid can result in uric acid kidney stones rather than calcium kidney stones. However, the symptoms are the same.



Post stroke, I was affected by kidney stones. However, the pain associated with the kidney stones did not occur as the nervous system was deadened on the right side of my body. Eventually I discovered the problem and went to a doctor who wanted to perform lithotripsy. After talking to many people who lithotripsy done, and upon finding out that it was indicated only for calcium kidney stones, I opted for the process of patiently waiting for them to dissolve. However, the doctor who was treating me for kidney stones also prescribed allopurinol, since I hadn't taken it for years. He also prescribed potassium citrate, which is often given in conjunction with allopurinol.



There's just one problem! Potassium citrate adversely interact with virtually every other drug that I was prescribed. I'm still not quite sure why, given a list of the drugs I was currently taking, the doctor didn't notice that. I'm even more distressed that the pharmacy which runs a drug interaction program didn't bother to tell me either! My normal blood pressure is around 120 to 140 over 70 to 80. On two separate occasions my blood pressure dropped to 60/40. That's nearly dead! It took two trips to the emergency room before the emergency room attendants discovered that the potassium citrate was interacting with the other drugs, all the other drugs, but I was taking.



Frankly, I'm lucky to be alive. People have died from such drug interactions.

(Reference exploding pill story here).

 Add section about strokes and depression.


Note: as write about cycle -- originally had ADD, very fast cycle. And the TIAs and stroke recovery progressed, cycles lengthened. Discuss amplitude pre-and post-stroke.