On a sub-freezing January morning in 1985, I received a phone call from my aunt. The hospital had called to say that her sister, my mom, had been brought to the ICU by the police, unable to speak. Alarmed and frightened, phone calls quickly passed around and the family gathered in the emergency waiting room waiting area, piecing together the story. A neighbor had gotten off the bus in front of Mom’s driveway early that morning and saw her car door was wide open, with grocery bags inside. Mom was lying in the driveway, eyes open, unable to speak. It must have been a stroke. It seemed she had lain there throughout the bitterly cold night.
The emergency room in Brooklyn, NY was awful. Doctors wouldn’t see us. Harried nurses scurried through with nothing to say. Knife wounds and accident victims were pushed ahead of us. We waited hours, helpless and frightened until we were finally allowed in two by two. Sometimes conscious, she answered yes or no questions by blinking her eyes at us. Speaking, moving, swallowing, bladder control and more were gone. She was admitted, intubated, and diagnosed with stroke and pneumonia. Mom’s brand new calf-length down coat had probably saved her life.
We learned that stroke is generally the result of either a blood clot or a leak in the blood vessels of the brain. Either one will kill brain cells, causing brain damage to a specific area. The abilities that were performed by the damaged part of the brain are lost. Paralysis, speech disorders, impaired thinking processes and damaged memory are often involved. Recovery of lost ability is unpredictable and depends on a host of possibilities such as age, severity, how quickly treatment has been administered, and which part of the brain has been injured. Doctors explained that brains cells do not regenerate, but sometimes new areas take on the function of the dead cells and new pathways are created. Rehabilitation is based on the training and repetition that can help forge these new pathways.
In the following weeks, we saw some hoped-for improvements: Mom was awake and lucid for longer periods, strength began to return, and her feeding tube was removed as her swallowing mechanism improved. We arranged a long term rehabilitation program in Manhattan.
Rehabilitation was distressingly difficult. She was exhausted much of the time, and weaker than we could ever have imagined. Her emotions were unpredictable; she cried easily and had to work hard to regain bladder control. Her speech was poor and she was paralyzed on of the left side of her body, leaving her unbalanced and helpless. Therapy was grueling: daily occupational therapy and speech therapy, with physical therapy twice a day. We took turns visiting and meeting with her caregivers. Her progress was distressingly slow, but encouraging. Her speech slowly improved, and she began to walk weakly with a four-pronged cane, since her arm paralysis prevented her from using a walker.
And then one day, much of her progress disappeared. We visited to find a stuttering, weeping woman who could barely walk or control her bladder. She had had a series of mini-strokes, the result of mismanaged medication, which had robbed her of so many hard-won recent victories. Traumatized and confused by the change in her abilities, we tried to buoy her spirits, but she was truly disheartened. We cheered her through tiny steps, one mini victory at a time.
When the 3-month program was complete, she returned home, but life was never the same. She needed a home companion every day, and we took nights and weekends in turns, driving in to sleep over every day. Our proud mother with her pristine home could no longer hold a conversation, read a novel, or do a crossword puzzle. Stroke had taken more than her walk and her speech; it had changed her personality and her life. Over the following years, she faced serious health setbacks due to the weakness and imbalance resulting from stroke. Although someone was always with her, Mom lost her balance one day, falling and breaking her hip. Recovery was excruciatingly slow. Eventually she fell in the bathroom, striking her head on the tub and causing a concussion from which she never really recovered. I had never thought we had a strong family, but I learned something new. We held each other together, and persevered. We rearranged our lives, gave each other breaks, attended stroke therapy groups, and consulted one another regularly. We learned how to depend on one another. The results of stroke are far reaching and permanent, and families need to band together to help one another deal with the changes that will affect everyone.