Just A Migraine?

complex migraine stroke
Noggin, we have a problem.
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It's really weird to call 911 for yourself.

It sure wasn't how I expected the day to end. My wife and I had taken grandchildren to the park, and we gamely chased them around in the late-summer heat, jealous of kids who were clearly immune to it.

I had to sit a lot as a headache climbed the pain scale. Eventually my wife suggested taking me to our apartment to lie down while she returned grandkids. As my brain had already issued coastal warnings for the category four storm raging through it, I was grateful. On the way home, I told her this headache was…different.

I dropped into bed and started on my regular migraine process: limit sensory input. Dark, cooling breeze, low-noise fan. Nothing helped. The headache strengthened to category five and a panic attack started swirling in its wake.

So, I got dizzy, crawled to the bathroom, threw up and passed out twice before getting back to the bed. I picked up the phone and called my wife.

"I think I might need to call 911."

"Well if you need to, do it."

I hung up, stewed in misery and panic for a moment, then dialed 911. 

"911. What's the nature of your emergency?"

"I need help."

The 911 operator recognized after a few questions that my ability to reply was limited and dwindling. I mean I knew the basics: address, age, marital status and phone numbers. I knew who the president was. But when she asked me if I lived in an apartment or a house, I had no answer.

At some point the EMTs showed up and we all walked down to the gurney.

Three questions floated around my mind: 1) why are they yelling all their questions? I can hear them just fine. 2) why do they keep asking the same questions over and over? 3) why can't I answer anything they're asking?

OMG! I can't answer anything they're asking!

Think about that: I watched my ability to communicate disappear in real time. The panic returned after a brief coffee break.

My strategy for handling the headache was praying, and my strategy for handling panic was mindful breathing, neither of which were possible anymore. Now I want to answer questions, and that ain't gonna happen either! All communication - internal and external - was failing.

Quick vocabulary check! What words do we have on deck? 

"Weird" (this became my most used word for the next few hours).

"Ow" (my second-most used word during this nightmare).

"It's."

"Thing."

"Can't." 

"It." 

"Is." (Okay look, I already have "It's". This isn't fair!).

"Um."

"Hurts."

"No."

That's it. I had ten words.

This was my greatest nightmare coming true. I'm not at all afraid of dying, of spiders and snakes, of people or stuff. But I'm a writer. Words are my lifeblood. My worst nightmares are about folks being unable to understand me, or me being unable to communicate at all.

So sure! Give the writer ten random words and make him have a conversation with paramedics. Won't this be fun!

I actually watched myself lose a word. See, as this mess progressed, I started closing my eyes and yanking words out of my mind like pulling tree stumps out of the ground. At some point early in the inquisition I had the exact word to answer with.

I closed my eyes and saw my vocabulary as a book with page after page of blank white space. Then the word I wanted was right there in all its 12-point Times New Roman splendor. I moved toward it and it dissipated like smoke.

Finally, I just started crying. The EMT insisted on getting answers, and I could only wail in reply. I understand they have tough jobs, but ten minutes ago it was probably clear I couldn't answer you. Things weren't improving.

It wasn't any better in the ER. I couldn't follow the doctor's finger with my eyes - they remained locked on the spot he started at, yet he sternly demanded I comply. I was severely dehydrated, so they ended up chasing veins. My hands and arms were covered in needle marks like a junkie with poor eyesight.

My CAT scan came back fine. Gradually everything got easier and my words started returning. Pure relief. By the evening everything seemed to be back.

Diagnosis: something called a complex migraine. I'm no stranger to migraines (I found out during my stay that I've also had ocular migraines), so leave it to me to have a complex one.

But what was up with that whole vocab evac?

An MRI spotted the answer: a two-millimeter long white hyphen in my frontal lobe. I had a stroke thanks to that lightning storm in my noggin.

I guess the aphasia was a giveaway, but a stroke? Me? Really?

Doctors and specialists all ran through the checklist, and I didn't have any of the typical risk factors. I never smoked, never drank, no big family history of them. I had some blockage in my carotid artery but not critical. My blood sugar was up but not badly. Diet and lifestyle changes were enough to handle those. My blood pressure was in the 112/74 range.

I had a stroke because of a migraine. Huh. 

No facial sag, no limb numbness. Evaluators said I walked just fine and spoke just fine (well, *now* I do) and wouldn't need any physical or speech therapy.

But my short-term memory is about as reliable as a kid who promises to take care of the new puppy, I'm a bit slower in moving and talking, and fatigue has become a constant companion.

But the worst thing is how quickly I become overwhelmed by everything. Sudden changes in plans or requests for me to stop doing what I'm doing and do something else bring me to a complete stop. The stroke doctor said it might be another half a year before I get back to almost where I was before all this.

For example, in the middle of all this we were preparing to buy a new house. My wife had to do most of the work because I was often mentally useless in the process. Even now, I have spells where I just can't get on the same page with her, so we've agreed I'll try to let her know I'm having a bad moment. 

That's hard for me. Partly, it's because I may not know I'm having a moment—it's obvious to others, not me. But it also triggers a fear that I'm going to become too big a burden on her and she's going to leave. It scares me and has for a long time. Mindfulness has helped, but I'm still a little kid who's afraid I'll be abandoned. Open communication with her is the key.

As part of my healing, I'm focusing on writing. It's interesting that my speech was affected but my writing wasn't. I still find myself hunting for words occasionally when I'm talking to someone, but rarely when writing. 

So my healing path is the same one I fell off during this mess, communication. Rather than regret this event I mindfully accept it as an opportunity to learn more about myself and maybe help others.

Now if I could just forget the hospital sandwich that purported to be tuna salad. 

 

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