Tuesday, October 06, 2009

The Single Scariest Moment of My Life

I just returned home from four days in the hospital, having been taken there by ambulance last Friday morning.

I should say at the outset that I'm not exactly a stranger to hospitals. I'm a Type 1 Diabetic and about 10 years ago I was also diagnosed with a mysterious condition that my doctors called Autoimmune Disorder, which basically means that my body's soldiers (the antibodies) sometimes can't tell the difference between healthy cells and antigens, and they consequently attack my healthy cells as if they were foreign. (Stupid antibodies.) There's a blood test that can show whether or not your body is producing these rogue agents, which are called antinuclear antibodies, but all the test really tells you is that your body is malfunctioning. It doesn't tell you why, or how that confusion will express itself next. Juvenile Diabetes, like the kind I have, is an autoimmune disease, for example. So is arthritis, which I also have. So is iritis, which is kind of like arthritis in the eye, and which I also had once before. The point is, I've had to get used to hospitals and doctors over the course of my life. Those are the cards I was dealt. I like to think of it as a fair trade-off for my winning personality and rapier-like wit. (Just kidding.) This time around, however, I was totally unprepared. Here's what happened:

Friday morning I woke up around 7am, per usual, to get ready for class... but I realized a few moments after waking that I was having an extreme hypoglycemic episode (low blood-sugar). That happens sometimes, and usually it is remedied with a little orange juice and about 15-20 minutes of time for my body to readjust. After I had my OJ, though, I wasn't feeling any better. I was still dizzy and had a splitting headache and felt nauseous. Still, I (slowly and clumsily) moved through my morning routine and eventually made it up to campus about 15 minutes before my 10:00 class. I went to my office, but as soon as I got there I realized that I was in bad shape and that I was going to have to cancel my class. So, I went downstairs to my classroom-- feeling extremely disoriented at this point-- and tried to tell my class that I wasn't feeling well and they would have to conduct class without me...

...only, I couldn't form sentences. First major sign of trouble.

I returned to my office and (thankfully) one of my students followed shortly behind me to check on me. I was in a very bad way. I couldn't get oriented, I had a SPLITTING headache, I was clammy and had the chills. My student gave me a Powerbar from his bag and my department chair stopped by my office and gave me some candy, but nothing was helping. The student eventually called the school nurse, who came over to my office and (of course) first checked my blood sugar. It was normal, but I was getting worse. [NOTE: this part is all a bit fuzzy in my memory, but this is what has been recounted to me.] So, they called 911 and I do remember an army of EMT's coming into my office. All I could think at the time was that the lights were really making my head hurt. The EMT's asked me a hundred questions and I couldn't seem to answer any of them. Now, it wasn't that I didn't KNOW the answers to their questions or couldn't formulate the answers in my mind, but I couldn't form sentences. It was like when you know there's a particular word you want to use but that word just temporarily disappears from your internal word-bank. Only this was the case with ALL of my words.

Despite my (incoherent) objections (which basically just amounted to me shaking my head "no"), they decided that I needed to go to the emergency room. I had really great EMT's, and they figured out from my sign language that I needed my cell phone and that they could find my parents' phone numbers in my phone. By the time we got to the emergency room, I was reduced to about three words-- "uh...", "I...", and "no..."-- but I was still totally conscious and, even though in pain and very disoriented, I was still totally aware of what was happening and I could comprehend the language that other people were using. When my dad finally got to the ER, the doctor sent him to me to see if I could talk to him, which I couldn't. They tried giving me a pen and paper to see if I could write, which at the time I was SO thankful for, since I knew that I wasn't crazy. But when I put the pen to paper.... nothing. That's when I heard the doctor say the dreaded word for the first time: APHASIA. Specifically, it was a form of "expressive aphasia," which meant that I couldn't really speak or write, even though I knew what I wanted to say. The doctor said there were basically two explanations for it: either I had some form of a stroke, or I had some infection that had spread to my brain.

That's when I started to panic. That's also when the conversations between my doctors and my parents were taken outside of my earshot.

The next twelve hours were as follows: Blood tests, which revealed that I had a high white blood cell count, which meant there was some kind of infection somewhere in my body. Then, antiviral and antibacterial IV-drips. Then a CAT scan. More blood tests. Different antibiotics. Then, an MRI (terrifying, claustrophobic, extremely loud, and awful). More blood tests. Discussion of a spinal tap (which, thankfully, never came to pass). X-rays. More blood tests. More drugs that I can't pronounce and I don't know what they were for.

But as this was all going on, I slowly started to recover my ability to speak and, by the time I had returned from the MRI, when they handed me a pen and paper again and asked me to write something down-- "just write anything," they said... talk about pressure-- I was able to scrawl: "I teach philosophy at Rhodes." Things were looking up. The most dramatic symptoms were fading.

I was in the hospital (on the "stroke" floor) for another 4 days... and, they're still not exactly sure what happened. My MRI and CAT scan came back (mostly) clear-- no bleeding on the brain, so no anuerysm or serious stroke-- and whatever infection had caused my high white blood cell count responded to the antibiotics quickly. The neurologists said that it is still possible that an infection caused my symptoms, but that the symptoms themselves were more consistent with a transient ischemic attack or TIA (commonly known as a "mini-stroke") which leaves no permanent damage and therefore does not show up on scans. Anyone can have a TIA as a result of a temporary spasm in one of the arteries that feeds blood to the brain-- in fact, people have them all the time with hardly no symptoms at all-- but Type 1 diabetics are more prone to them.

Given my own medical history, I tend to be rather stoic about these things, but I have to say that for those hours that I couldn't speak or write, I was in a total panic. My dad told me that the neurologist had a conversation with them explaining that aphasia is particularly difficult for intelligent people, and that although my speech could come back within hours, it could also take weeks or months. They didn't want to say this in front of me because they were afraid that my fear and frustration might impair my ability to recover. The brain, like the rest of the human organism, is a strange and mysterious thing.

As people who know me know well, my WHOLE LIFE is speaking and writing, and I think that this experience was the closest encounter I've ever had to actually having to consider what my life might be devoid of all the meaning that I've invested in it. I am, of course, very happy that things have turned out okay, but I expect it will be a long time before I fully recover from this scare. If ever.

I also realized in the course of this event what a tremendous network of friends and family I have. I really can't thank them enough for all of their help and support over the last several days. Nobody wants to need their friends like that, but it sure is nice to have them when you need them. And my family was consistently calm and reassuring, even when things looked very, very bad and even when I was obviously starting to panic. (They also saved me several times from having to eat disgusting hospital food.) Finally, I would be totally remiss not to thank my student, Walter Clapp-- a senior Philosophy major-- who is the real hero of this whole story. He was the one that noticed that something was terribly wrong with me in class on Friday morning, who followed me back to my office, called the nurse and then the ambulance, who travelled to the emergency room and explained everything that had happened that morning to my parents, and who even stayed at the hospital long after my family had arrived to make sure I was okay. He is the very definition of a good samaritan, and I will be eternally grateful for his kindness and care.

I'm home recovering today, but hope to be back in the swing of things tomorrow... with many, many debts of kindness to repay.

14 comments:

Ideas Man, Ph.D. said...

I cannot imagine how terrifying that must have been.

Glad you are recovering.

Much love

hawkbrwn said...

oh i hug you and hug you and hug you and thank the hell for walter.

blessings to you too, walter. good man.

KHG said...

This is really scary. Normally, I'd be interested in all the details you've given from your "insider's perspective" on aphasia, but right now I'm just concerned for you. Do you mind if I ask about continuing treatment? Are they going to put you on anything to try to prevent any further incidents? I sure hope so!! Have a good recovery today, and take it easy while you get back into the swing of things. Much love and hugs!

CF-ICT said...

Miss Leigh,

CFOX here. So sorry to hear of this, and so glad to hear you're well. FWIW, I have a history of episodic migraines that also are accompanied by spells of aphasia (going back to adolescence, last one in 2005). My experience has been as you describe: some ability to think/employ motor skills, and a near-total inability to deploy language, whether spoken or written. You literally can't put thoughts to symbols; they simply don't come into alignment. Bewildering and terrifying in the way you describe, particularly for folks like us who define ourselves by our intellectual abilities. Take care of yourself, Leigh.

Dr. Trott said...

I'm glad to hear you are ok. Take care of yourself. Did they ever figure out if it was auto-immune related?

T.D. said...

Leigh, Oh my god! I'm so relieved you are okay. How very scary! But what a total blessing that, of all people, Walter was around to make all the right calls. Phew! Sending the love from out West.

-Teresa Delfin

Tracy said...

scary, scary shit. you better take care of yourself, dude, because as we have discussed, while you are avowedly incapable of violence, I am willing and able to deliver bitch slaps when necessary.

Amit said...

Wow, Leigh! Quite an experience and account. Glad you're up and blogging. Will catch up when convenient for you. Much love.

kgbubble said...

Leigh,

KG, here. I am so so sorry you had this experience. I will want to pick your brain even more about it later, but for now, just so sorry. I wish I could have been with you. My dad has gone through this, from mini strokes... mostly, and thankfully, while I was home with him for a month last year, so we know it well-- the frustration, the fear, the panic....and the victory of recovery! I've really tried to make sense of it with him, but he's older and not as tuned into to his intellect anymore as you are.

What is the protocol from here? No white matter at all? Medications? any residual effects, other than fear? can you still connect with that place, or is it already distant? We've had some success at prevention with a few medications and environmental controls... so dig, and try till you find a good match. you're going to ride this like no other, reigns in hand, swift as the wind, I trust.

Lastly, I love you! I'm so glad you're okay.

christophresh said...

I want to give Walter Clapp a big ol' hug.
You first, of course.

The Clapp said...

Dr. J,

Thank you so much for the kind words! I am just relieved that things are looking up! I also need to send back my thanks to people like you in my life; people who have opened my eyes and shaped me as a person. I know you remember me saying that philosophy is not just a major, it is a way of life; and by the powers of association, you are thus responsible for a good portion of my ethical self. So you be proud of yourself first, and keep on truckin', because there are Plenty more farm raised Texans that need some enlightenment!

Also: restwellsleepwelleatwellbe well :)

See you soon!


-Walter

DOCTOR J said...

Thanks for all the nice words, friends.

@Katie: The follow-up treatment, such that it is, is basically to proceed as if either cause (TIA or infection) could have been the cause. So, I'm on antibiotics for the next 10 days and I have to take aspirin (a blood-thinner, as you probably know) every day from now on. And, of course, vigilant attention to any signs of a repeat.

@CFOX: I had no idea! I would really like to talk more with you sometime about your experience with aphasia. Like, in particular, when it happened to you the first time, did you immediately know that you COULDN'T speak? It took me several hours before I realized that I couldn't.

@Trott: It doesn't appear to be autoimmune-related, other than the fact that autoimmune disorders predispose one toward both infections and TIA's.

@Kristen: See my answer to Katie above about continued treatment. Also, has your dad had any residual effects from his TIA's? How far apart were they?

@Walter: Thanks again. I would be ptoud to take some reponsibility for your "ethical self"... though it seems like it was pretty well-developed before I ever got here!

Eralda LT said...

That's terrifying! Glad you're better. Take it easy though :)

Chet said...

Dude. You got to quit the wild life of vice. Fr our sake. No more crack smoking. Or midnight dragracing. Or kitten tossing.

Your well-being is too important to us. Glad to have you back in the world of the spoken. Your voice is too lovely to ne silenced.