My Beautiful Broken Brain
By Tim Mayhew
One year ago, I had a stroke while riding my motorcycle...
Chapter I – The Headache
I was leading a motorcycle tour through Southern California.
The tour routing had us hopping on the I-10 freeway for a quick 20-mile jaunt to our next major road. I rarely route tour groups onto the freeway, only when necessary to make time or get to our next road. For obvious reasons, we tend to avoid them, but it was a quick shortcut through Banning. We would drop out of the mountains into the desert and the tour group would make for Joshua Tree National Park.
As I was leading a group of about 15 bikes, I was in the left tire track of the fast lane and drifted left. I suddenly found myself riding 70 mph down a hard pack gravel shoulder, inches from the cement median. Thankfully, the shoulder was the same height as the pavement. The riders behind me were aghast, and it completely freaked them out. I was riding 70 mph down the gravel shoulder of the interstate. Complete surprise and instinct kicked in, I eased the Z1000 back onto the pavement, and we continued to Joshua Tree. At the time, I couldn't explain why I did that, lost concentration, boredom, drowsy, lack of attention. We made it without incident into Joshua Tree and I led the group to some fantastic rock formations.
While at Joshua Tree National Park, a severe headache began to develop, but I thought nothing of it. Headaches had become quite normal for me. Everyone gets headaches. It was common to get them on the first day of a multi-day ride. They were so regularly occurring, I never went anywhere without some Tylenol on me. I kept some in my car, at work, on the motorcycle. Headaches were so normal, I would take a Tylenol at the slightest hint of one. And they would go away. Simple.
But I forgot the Tylenol this ride, and asked my other tour guide, Mark, if he had any. He offered up two Advil, and so I took that, hoping for the best. The headache was severe but manageable. I led the tour group out of the National Park and a fast jaunt over to Palm Springs. By lunch, I had very little appetite and just felt off. Which was hard to describe, just, off. The headache was still severe, but the Advil took the edge off. Not once did I sense there was something unusual about this particular headache.
Chapter II – The Intervention
That night, the guys came to my room and held an Intervention. It was the first such Intervention we’ve ever had on a tour. I assured them I was fine, vehemently insisting nothing was wrong. The guys were collectively alarmed at my drifting off the road earlier in the day. It was uncharacteristic. I had been riding motorcycles for several decades, spent a cumulative month of each year riding on all manner of road, but there weren’t enough clues yet for the guys to figure out what was wrong with me. I was absolutely adamant. It was just a headache. I would be fine in the morning. The ride must go on.
The next morning, the headache was gone, yet I was running a bit late. The plan was kickstands up at 8. Ken, one of my most experienced tour participants who’s ridden over 40,000 plus miles with me, confronted me point-blank. He had been directly behind me when I drifted off the road yesterday.
"Why were you riding like that? What is wrong with you?"
Chapter III – The Mutiny
We retraced the exact tour route we had ridden 1 year ago and headed for the Palomar Observatory, the road was familiar and I knew what was coming. Palomar is a fun and smooth uphill originally graded out in the mid-1930s to pull the Westinghouse 200-inch diameter glass mirror to the top of a mountainous ridge line for the observatory. The curves are broad and smooth, loved by local riders. Halfway up the mountain side, I began to drift left again in a right-hander. As I neared the center line, another rider came down the hill headed toward me on the inside line. A collision was imminent.
Our two bikes clipped each other and both went down. The speeds were moderate and I quickly jumped back up, dusted myself off and up righted the Z1000 walking it off the highway. The other rider was stunned but also fully geared up and neither of us injured. I made sure the other rider was okay and gave him my insurance information, the accident was clearly my fault and I apologized. He was with his buddies and they arranged to retrieve his bike and get him home. The accident was quickly wrapped up, all parties fine, minor damage to the bikes, everyone was okay and cared for.
The Z1000 wouldn’t start and my only thought centered around getting it started. It was rideable and the sideswipe resulted in only minimal cosmetic damage to some of the plastic panels. I coasted down to the base of the hill and the bike dutifully started back up. As crazy as it may sound, I was ready to ride again. The tour group had started to assemble at the base of the hill and they refused to continue. It was a mutiny. One of the guys called his girlfriend and described what was going on. Her mother recently had a stroke and their observations of my behavior sounded precipitously familiar to her.
"He’s having a stroke," she said, "You need to get him to a hospital."
Jeff relayed to me the conversation.
"We think you’re having a TIA." They were guessing. But they were close.
I had never heard the term before. A TIA stands for Trans Ischemic Attack, a mini-stroke or a temporary blockage of one of the blood vessels in your head. I again insisted I was fine and wanted to keep going. It’s worth noting at this point, I felt nothing. The severe headache from yesterday was gone, no disorientation, no pain, no confusion, no vision issues, no arm weakness. Nothing. I felt absolutely nothing. The symptoms of what I thought a stroke was like were not there and I refused to accept anything was not right. I was ready to ride and as adamant as ever, I wanted to carry on.
But by now, my small group of riders were comparing notes and putting the clues together. They all banded together and agreed something was definitely wrong. To prevent me from taking off, one of the guys called a flatbed to transport the bike back to the hotel. When my back was turned, they pulled the key from the ignition so I couldn't leave. At the time I found this quite annoying and unbeknownst to them, had a spare key in my pocket on my leather jacket. The deal was I would go to the hospital and get checked out if there really was a TIA. If the docs said I was fine then we would resume the tour but the odd behavior was too much to ignore.
I continued to insist I was fine and felt nothing. I rode with the tow truck driver and chatted with him on the way back about mortgage loans and gave him my card. Upon arriving at the hotel, I left my phone in the cab of the truck which was another odd forgetful moment. The guys followed on their bikes and had called an ambulance yet kept that to themselves. No one mentioned it and the ambulance arrived a few minutes after the flatbed reached the hotel. Moments later, EMT’s knocked on my hotel room door and the fellas caught up them up on the symptoms I was exhibiting.
"We think he’s having a stroke."
The paramedic stared intently at my face and seemed to agree with the guys. There was no way. I felt fine.
I chattered away with the EMT's as if I were talking myself out of a speeding ticket. He asked me to repeat a simple sentence. I did that fine. He asked me to hold out my arms and close my eyes.
"Hold your arms straight out," he instructed. I did that fine also. He then stared intently at my face.
"You have a bit of a droop on the left side," the EMT said referring to my facial muscles.
Of the three tests, failing just one likely indicates a stroke.
Outnumbered, I thought they were all nuts and again persisted I felt nothing out of the ordinary but by now there was no arguing. I asked the paramedic if I could walk out to the ambulance on my own, stubborn to the very end. The request was denied.
They strapped me in, wheeled me out to the ambulance and rushed me to the hospital.
Chapter IV – The Phone Call
At the Emergency Room, I still thought they would take one look at me and let me go, instead they gave me a CT scan. Computerized Axial Tomography, better known as a CAT Scan is an x-ray that produces cross-sectional images of the body. The machine has a large donut shape with a long narrow tongue sticking out. They slid me off the gurney onto this narrow slab of a table-like surface and inched my head into the donut. The machine hummed and whirred as it rotated around the circle taking x-rays of my brain.
The doctor came in to tell me the results of the CAT scan.
“You've had a brain hemorrhage."
I stared at him in disbelief. I couldn't process what that meant. He was being serious. A brain hemorrhage? Minutes ago, I had been on my motorcycle merrily riding through endless twisty roads. But he didn't give me time to react.
"You're bleeding inside your brain." There was a pause.
"You’re having a stroke."
The word 'stroke' was too much to process. I didn't know what that meant. I knew what bleeding was and I knew what a brain was. And I knew those two words aren't supposed to be in the same sentence. But I wasn't yet told anything else. All I had to work with was bleeding and brain.
His words thudded down and filled the room like an inflating balloon pushing all the air out of the room. It was conversational, nonchalant.
He said the words, but it still didn't sink in.
I felt nothing. The thought kept repeating, aren't you supposed to feel something?
I can't be having a stroke. 45-year old guys don't have strokes. Everybody knows that. What I didn't know at that time was just how serious the situation had progressively become.
"We're going to admit you to Intensive Care." The words Intensive Care sounded serious.
I began to realize I was slowly being fed a string of very serious-sounding words.
I knew I had to call my wife but my forgetfulness had left my phone in the flatbed so I asked my nurse if I could use the hospital phone clipped to his belt. I didn't know if that was allowed, but he dutifully handed me the phone and stepped into the next room.
I dialed the number slowly, my wife answered and I informed her I was in the emergency room at a hospital. It was unusual for me to call her in the middle of the day when we should be out riding. I had been conducting professional tours for many years and would only call mid-day if something bad was happening.
“What’s wrong?” Sarah asked.
“I’m having a stroke.”
Silence. Nothing. No response.
Did she hear me?
Then I had to say the words out loud I had not been able to say.
“I’m bleeding," I paused, "Inside my brain."
It wasn't until I had to say it out loud that I finally began to realize what my tour mates & I had been dealing with was a serious life-threatening medical emergency happening right then.
Once I said the words out loud, I began to weep. I couldn't hold it together.
After ignoring the severe headache, vehemently denying my odd behavior for the last 24 hours, I finally had to admit what was happening.
Bleeding. Brain. Brain bleed. Brain hemorrhage.
My denial and stubbornness melted. Bleeding and brains don’t go together unless something is going very wrong. Everyone knows that. What I didn't know is that nearly 50% of people that have a hemorrhagic stroke die within a matter of days, of those that survive, only a mere 10% fully recover. But I didn't know that at the time.
Hemorrhage literally means "blood bursting forth." Inside the brain.
“Do I need to come down there?”
I was 500 miles away.
What she was really asking is if it was serious. We both knew the answer.
The response was simple & blunt. The small bits of information I had been given so far sounded quite serious.
Bleeding. Brain. Brain bleed. Brain hemorrhage.
“Stop what you’re doing. Gather up the children and come down here.”
Chapter V – The Healthiest Man in the World
I started to vomit and could not stop.
I handed the phone to the nurse so he could finish the conversation for me and inform Sarah where I was located. I didn’t know what hospital they had taken me to. He causally handed me a bag to vomit into and continued the dialog with my wife as he stepped into the next room.
I would learn later that vomiting is a pronounced symptom of severe neurological distress inside the brain. It's thought to be caused by the increased intracranial pressure from the leaking blood compressing the brain tissue. The released blood is pushing against the tissue and isn't supposed to be there.
The nurse would come in, give me some water and the vomiting would continue.
I couldn't stop. Something was wrong. The room began to spin.
The water I had taken in, I expelled all of it and focused my deepest determination on calm even breaths. I began to sweat profusely and sat upright in the hospital bed trying to stay calm. I had been separated from the other ER patients and placed in an adjacent ER room after the CAT scan with no one else around expect my nurse.
This can't be normal.
As I sat up, the lights in the room began to dim.
My vision began to fade.
There was only black; it came in from the sides, below and above, until all that was left was a tunnel of fading light directly in front of me. It was like a vaporous ink that began to fill the room seeping in from all directions except right in front of me. My vaporous ink pushed out all the light in the room and then lastly even the tunnel in front of me began to fade and go black.
You cannot have my vision.
I pushed the ink back with the deepest of will and focused on not panicking. Calm even breaths, my vision returned and the room became clear again. What just happened?
My nurse returned. “Don’t worry, we’ll get that nausea under control,” he said as he pumped some clear magical liquid into my IV. His voice was calm and even.
I didn't mention the room going black, it was too strange to try and verbalize at that particular moment.
Forty-five-year-old guys don't have strokes. Everyone knows that.
I was the healthiest guy in the world.
When I hit 40, I had decided to get back in shape and regularly worked out. I was doing 200 pushups a day and could easily crack out 20 to 30 chin-ups on a pull-up bar I had built in my garage. I had been doing P90X and HIIT workouts for several years and recently taken up jogging running several miles multiple times per week. The result was the same waist size I was in college. It was the best shape I had been in since my time in the Marine Corps.
None of that seemed to matter here.
My buddy Dave, one of the guys on the motorcycle tour, rode to the hospital, tracked me down and brought me my phone from the flatbed. The guys had figured out it was there and took it upon themselves to track down the driver and get it back. Dave sat with me in the Emergency Room as we waited for the transfer to Intensive Care.
"We have to stop meeting like this." I joked with Dave.
It was the second time Dave and I had been in an Emergency Room together.
Two years earlier, I was leading a motorcycle tour group through the Sierra Nevada Foothills on a narrow mountain road. I came around a blind hairpin corner and there was a pickup truck on the wrong side of the road coming straight at me.
The pickup truck slammed into me head on.
Dave was the rider right behind me.
I was riding a technique we call outside-in or Delayed Late Apex, entering the blind turn on the outside line and saw the truck coming right at me. I swerved right, missing tire to bumper contact by about 4 inches.
A local 18-year-old kid plowed into the motor head on. My left knee went through the headlight and the impact ruptured the popliteal ligament. I always ride armored up and the dual impact foam and heavy knee guard in my leathers saved my knee. There were black leather marks from my jacket across the top of his pickup hood although I have no recollection of the space of time between the impact and being on the ground.
Dave accompanied me to the Emergency Room back then & sat with me for the duration until my wife arrived to haul me home. The doctor had stuck a big hollow needle attached to a pressure gauge deep in my calf muscle and became very excited mentioning something called Compartment Syndrome, which was a new term to me.
Compartment Syndrome is when the blunt force trauma is so great to the extremity, the muscle tissue swells up so much, it exceeds the ability of the muscle compartment to contain the muscle. Basically, your leg bursts open.
That was the first time I had ever been in the ER in 30 years of riding.
Chapter VI – The Knock of the Silent Killer
They couldn't keep me at Temecula Valley Hospital.
I needed to be cared for at a stroke center where they specialized in brain injuries and they wanted to get me there as soon as I was stable. I was given another CAT scan the next morning to see if the bleeding inside my brain had stopped and it was agreed I could be moved.
I was transported by ambulance to Loma Linda Stroke Center in San Bernardino & was told that not every hospital is set up to treat strokes. Loma Linda had an entire wing devoted to treating brain injuries and the nurses were all specially trained in dealing with strokes. This was also a university teaching hospital and nearly every doctor I came in contact with was young and bright eyed.
Paramedics unloaded me from my second ambulance and in a burst of activity wheeled me into the Neurological Intensive Care unit where the nurse promptly wrapped a bright yellow bracelet around my wrist that read, “Fall Risk”. She informed me I was not allowed to get out of the hospital bed without help from a nurse. Wire leads were attached to my chest, another taped to my finger. Oxygen tubes were inserted into my nose. A blood pressure cuff was permanently attached to my arm. Every ten minutes or so it came to life, squeezing my bicep tightly as if to remind me of where I was. I was now connected to machines that beeped and hummed continuously.
Neurological ICU works like this: Every 15 minutes they shine a light in your eyes to make sure you’re still in there. 24 hours a day. 2 am? Light in the eye. 5 am? Light in the eye. Every 15 minutes. Still in there.
My ICU nurse gave me a printout on what a Hemorrhagic Stroke was. I had no idea. A blood vessel breaks inside the brain releasing blood into the surrounding brain tissue. During a stroke, treatment access time is essential: 1.9 million neurons and 7.5 miles of nerve fibers in the brain die every minute of a stroke. The brain tissue where the stroke is located is dying.The blood creates swelling and pressure, damaging cells and tissue in the brain. I read the words brain and damage. They didn't sound good when you put them in the same sentence. The bleeding inside the brain causes brain cells to die and the affected part of the brain stops working correctly. Whatever activity that part of the brain controls dies with it: memory, ability to see, detect hot or cold, controlling motion of an extremity, swallowing and even breathing.
While strokes are common, more common than heart attacks, hemorrhagic strokes are rare, the majority are Ischemic Strokes - a stroke involving a blockage. Only 15% of strokes are brain bleeds. Yet nearly half of stroke deaths are caused by the stroke I was having. A significant number of ruptured aneurysms or subarachnoid hemorrhage victims die before they ever reach a hospital. Of those stroke victims who do get immediate medical attention, about 50% die within the first month of treatment.
I realized as I lay there in Neurological ICU, my nurse shining a tiny flashlight in my eye every 15 minutes, with my printout, it stated 90% don't ever fully recover from this. A 10% chance, they were giving me a 10% chance of recovering from this (completely). I swallowed the thought. What I didn't realize at the time is the 10% wasn't referring to all stroke victims, it was referring to those that survived. It was 10% of those that did not die from the intracranial hemorrhage.
The information was a lot to process. I wondered if they had the right guy. There was no pain, no vertigo, no confusion, nothing. Shouldn’t this printout go to someone else? But I couldn’t argue with the concerned looks of everyone around me. I was in Intensive Care at a Comprehensive Stroke Center. Everyone around me had some type of brain injury.
Attending doctors read my chart and would ask questions. One doctor read my chart and her interest was the vein throbbing in the side of my temple.
"Has that always been there?" She wanted to know.
What is 'that'?
She asked for my phone, took a picture of my temple and showed me the photo on the screen that indeed she was correct, there was a twisty curving vein popping out of my temple. It was an odd conversation. Maybe that was normal in a stroke ward.
The immediate goal in ICU was to get my blood pressure down. Do you have a history of strokes in your family? I had no idea. Have you always had high blood pressure they wanted to know? I had no idea. Never occurred to me to test it. If you are taking care of yourself, eating right and staying healthy, why would you worry about high blood pressure? The thought seems foolish now, but at the time my logic made perfect sense.
Chapter VII – The Cut Straw
The doctor finally came in and began to explain what had happened to me.
“You've had a brain hemorrhage. We can see a one-inch long break in the blood vessel. You’re going to be here until the bleeding inside your brain stops.”
I again assured Ken I was fine. I then realized I had forgotten my phone up in the room, and I never forget an item like that. Hurriedly running back to the room while the tour group patiently waited, I located the phone and off we went. We headed south from Hemet and I led the ride towards San Diego. After about 30 minutes of riding, I blew a right-hander on Sage Rd, a relaxed southbound route out of Hemet, and went wide into the other lane.
Why did I do that? I wasn't sure. I had planned & led over 150 professional tours during the last 14 years across three states. Many of the riders I had with me have become good friends, some of my tour participants have ridden with me 30, even 40 plus tours. I concentrated on riding and holding my line. After I blew the corner, my buddy Dave pulled out in front of me and indicated to follow my line.
Later, I was told I was sitting on the bike looking like a wounded cowboy, leaning to the left while sitting on the bike, but I had no idea this was happening. It was just another day of riding. We reached Temecula and gassed up. Randy led the group south onto Rainbow Canyon. I again followed but soon drifted left and blew another right-hander. Now that was getting annoying. But it still didn't add up.
My Pashnit Tour group.
He described it like a straw with a one-inch cut in the side. The released blood seeps into the brain tissue. The blood released by the hemorrhage has a toxic effect on brain tissue and vasculature. The brain cells die when they no longer receive oxygen and nutrients from the blood, in turn damaging that portion of the brain. Whichever function of daily life that part of the brain controls is affected.
His casual use of the phrase 'brain hemorrhage' still didn't sound right. People don't talk like that. Those words shouldn’t be normal conversation. The cut straw sounded serious.
There was still a sense of disbelief this was actually happening in real life. To me. Forty-five-year-old guys don't have strokes, everybody knows that.
“At least a week.” He said flatly. “The bleeding should stop, and you should be released from ICU within 2-3 days” I would learn later the average hospital stay for a hemorrhagic stroke is 7 days.
"What happens to the blood?" I inquired.
"The blood will coagulate. Your body reabsorbs it as long as the bleeding stops, and the breech in the blood vessel inside your brain will then form scar tissue and heal."
CAT Scan of hemorrhagic stroke inside my brain:
Note the lack of brain symmetry on the left side.
The doctor pulled up an image on the monitor of what they could see on the CAT Scan. There was a scary mass of white located around the middle of my skull. It didn’t look right.
"That's not normal.” He tapped the glass of the monitor several times with his pen on the scary white mass on the screen.
He paused and stared at the screen for a moment. "It's big," he then added as if talking to no one in particular.
It didn't look right. The image on the screen showed a brain symmetry that was distended on the left side and didn't match. A big white blob was pushing the brain tissue aside. It was the scariest picture I had ever seen. You could clearly see the lack of symmetry inside the brain.
"It's unclear at this point how the brain will be affected."
It was a word that hung in the air, like a word balloon in a cartoon, but out of my reach.
It sounded important.
What does that mean?
My idea of a stroke was grandpa who has a lack of oxygen to the brain due to a blood clot, became confused and needed immediate medical attention. My idealized notion was further reinforced when they wheeled in an older guy next to me, just feet away, only a curtain separated us. He was very confused as to why he was at the hospital. His middle-aged son repeatedly explained he had a stroke. My elder neighbor had lost some degree of sight in his right peripheral vision. The doctor would stand by the side of the bed but he couldn’t see him. His confusion was palpable. He couldn’t process the reason why he was unable to see the doctor standing next to him.
The vaporous ink had come for his vision.
“I know you are there, but I can’t see you.”
Fear saturated his voice.
Each time the doctor visited him, he would repeat the words, "I can't see you.”
He would then ask the doctor to move to his field of vision directly in front of him.
“I can see you now.” He would say and the tone of fear in his voice would fade.
Strokes often affect vision if that is the part of the brain where the stroke took place. The damage caused by a blockage in the brain impacts the visual pathways of your eyes which can result in visual field loss and processing of visual information. The fella next to me was my exact idea of a stroke. It reinforced my theory there was nothing wrong with me. I still felt no pain. Still no loss of strength. No balance issues. I could talk, converse. The lack of any discernible outward symptoms made the experience difficult to comprehend.
A young bearded doctor took a special interest in me.
"You had a brain bleed stroke while riding your motorcycle."
It was as though he liked the melody of the words.
"What do you do for a living?”
I wasn't sure how that was relevant but you're stuck in a hospital, you answer their questions.
“I own a motorcycle tour company," I said. "I'm also a licensed Senior Loan Officer. I've done purchase & refinance loans for many years,” I hesitated then added. “For nearly 20 years, I've been running a massive website called Pashnit.com writing about motorcycle roads and travel while selling motorcycle parts & accessories to 58 countries. I’ve also been working nights as an auditor for Marriott Hotels on weekends for the last couple years."
He looked at me with a raised eyebrow, paused, then slowly digested the thought like a multi-course meal, chewing through each savory flavor.
His face began to change as he concluded his meal.
“You’re working four jobs?”
“Essentially yes.” I replied.
Bearded doctor didn't miss a beat.
“You cannot keep up this schedule with your blood pressure being so high.”
"You need to slow down."
The blood pressure cuff permanently attached to my arm came to life, tightly squeezing my bicep and measuring my blood pressure as if on cue. It was agreeing with him.
160/110 flashed up on the monitor.
"You can't leave until that comes down." He tapped the monitor with the same pen once more and then rushed off to the next patient.
Chapter VIII – The Break, The Burst, The Rupture
They wheeled in an ultrasound machine, I have three kids, I’m quite familiar with these. They wanted to look at my heart.
"You have high blood pressure so it’s routine that we also look at your heart."
Protest is not allowed in the ICU. My heart swished and pumped on the screen. Valves opened and closed. After numerous measurements and more concerned looks, I was informed that my aorta, the tube on top of the heart was twice the size of a normal person.
“You have an enlarged aorta,” the technician said as she looked at the screen, slid the wand around my chest and took more measurements.
I didn't know what that meant.
The machine beeped each time she did that and the fuzzy image on the screen stopped moving for a moment.
I had never heard the term before. The aorta should be about 2 cm or around an inch in diameter. The ultrasound showed my aorta was twice the size of a normal person.
"Yours is over 5 cm," the ultrasound technician added as she wiped the goop off my chest and packed up the machine. I had to look up how big 5 cm was and convert it to inches. Two inches didn’t sound right. I pictured a radiator hose with a bulge in it.
"That’s about right," the technician replied and left.
There's not much to do lying in a hospital bed so of course I looked it up: Enlarged Aorta. The word Aneurysm jumped out, that word I knew. Everyone knows that word.
Break, burst, rupture.
If it ruptures, the death rate was 80%. Most patients die before even reaching a hospital. After reading that sentence, I realized it was the second time I had read that phrase.
The other phrasing was 'In most patients, outcome is poor and surgical repair is successful in case of a ruptured aneurysm in only about 50% of cases.'
It wasn't a heart attack like when they magically zap you in the movies and everyone lives happily ever after and we go to commercial. In my TV episode, the aorta bursts, I bleed out inside my chest in seconds and my character falls over dead from the rupture. It was simple. The article said I would likely need open heart surgery to fix it.
There was a knock at the door. The Vaporous Ink was being pushed aside.
It was The Silent Killer asking to be let in.
Chapter IX - How to Fall in Love
My buddies from the motorcycle tour had taken over and coordinated with my wife to help get her and the kids the 500-mile distance to where I was. One of the fellas on the tour who worked in insurance arranged to provide her a rental mini-van. Another rider from the tour donated his hotel points to set her and the kids up with a hotel near the hospital.
She had dropped everything and drove the 8 hours to reach me not knowing what she would find. A husband in intensive care, a bleeding brain. All she had was an address of where I was located punched into a GPS.
Sarah finally reached me the next day.
I took one look at my wife of nearly 20 years, the mother of my children, and fell desperately in love. She was the most beautiful woman I had ever seen. Her face was warm, familiar and full of concern. She was finally here and everything was going to be alright. We had not seen each other in nearly a week.
She took my hand and enveloped it with both of hers.
Sarah looked down at me and only her eyes spoke.
"I’m here now.”
My hand full of wires and tubes, my bright yellow ‘Fall Risk’ bracelet, my bleeding brain.
A wave of calm settled over me.
After another day I was finally allowed to get out of the hospital bed and walk around for the first time in 4 days. Sarah and a nurse helped me sit up and place my feet on the ground. Days before I had been in the best shape of my adult life. Today I needed help to sit up. Shuffling down the hallway of the stroke center pushing the IV Pole and all its wires, I was allowed to walk to the elevators. Then they made me go back to the hospital bed.
My doctors didn't seem particularly interested in letting me go home. Each day in ICU started with a CAT scan to ensure the bleeding had stopped and the angry white mass inside my head was dissipating. Back inside the donut while the machine took more pictures of my bleeding brain.
Each morning, there were rounds, several doctors would stand around me and the in-charge fella would describe my condition. Did I hit my head when I crashed on the motorcycle? Can we see your helmet? Do you know where you are? Do you know what day it is? What do you do for a living? Do you have a history of strokes? Anyone else in your family have a stroke? Anyone else have high blood pressure?
But there was no obvious smoking gun and no one was definitively sure about the ‘Why’. We need a reason for everything, knowing ‘Why’ is a very human trait.
Why did this happen? It just happens. What’s going to happen next? We’re not sure. Why am I here? You just are.
There were lots of questions. There were no answers.
The news that I was in Intensive Care sent a wave through my family, co-workers and motorcycle friends. Tim had a stroke, he’s in ICU. I had to contact my work and let them know I wouldn’t be in on Monday. The announcement was specific but accompanied by little explanation.
There was no answer.
Just the word: Stroke.
It was a heavy word.
Randy and Jeff, two of the guys that had been on the motorcycle tour came to visit me in the stroke center. It was Jeff that had connected all the pieces. I received them with great enthusiasm. Our conversation centered around how they should have figured out what was happening to me faster. There was a collective sense of regret within the tour group. In hindsight, it was easy.
The guys repeatedly relived the sequence of events during the motorcycle tour and went over the clues, my blowing only right-hand corners, the wounded cowboy, forgetting, lamenting they should have gotten me to a hospital sooner. It was only after the pieces all fit together that it finally sunk in that the tour guide, the man in charge, the guy they had ridden with for thousands of miles was having a stroke while leading the tour.
When they learned it was the rarer brain bleed stroke, it finally sunk in how much danger I was in while we were on the bikes. Their sense of disbelief seemed to mirror my own. It was painfully apparent only after the fact at how potentially serious the situation had become during the ride. Jeff later relayed that during their visit, my blood pressure read 150/110 the entire time they were there.
I assured them there was no way they could have known the healthiest guy in the world could or would have a stroke. After all, we all know healthy 45-year-old guys don’t have strokes.
Chapter X - The Alternate Time Line
It's worth mentioning in this story that my plan for the final day of the tour, was to embark on a 12-hour 625-mile ride home through the eastern Sierra Nevada Mountains & high desert skirting along the edge of Death Valley making my way northward. I rode this exact route one year prior when I had conducted this tour the previous season. It may seem like a long day but I had recently completed two Iron Butt rides, the first was 1000 miles in less than 24 hours and the second was 1687 miles in 36 hours. The Iron Butt rides were addictive and I had looked forward to the 12-hour planned ride.
The previous year had proved it to be a phenomenal experience, remote high desert, lined with mountain peaks of the Eastern Sierra Nevada, miles of wide-open road. I recalled it took several days to recover from the vibration in my hands, the constant wind noise, the wind blast against my chest. I had left at 5am and rode all day on my naked Kawasaki Z1000 street fighter. The dawn-to-dusk motorcycle ride had been purely rapturous.
My business partner who's been a registered nurse for 35 years responded later that if the guys hadn't figured out what was happening to me during the tour, had I attempted that 625-mile solo ride given the medical emergency that was occurring inside my brain coupled with the strenuous nature of my planned ride, I likely would have died.
When the bleeding is in the lower brain (brainstem) like the stroke I was having, where most of the automatic body functions are regulated, the result is becoming unresponsive or going into a coma. Symptoms of a brain hemorrhage may progress slowly over many hours or even days. Alternatively, symptoms may come on very abruptly and rapidly worsen. My motorcycle buddies could not have known that nearly 50 percent of people that suffer a hemorrhagic stroke die in a matter of days.
As I lay there confined 24 hours a day to my hospital bed and relived the sequence of events, my mind began to wander. Tim Mayhew, age 45, died on a Monday in May while riding his motorcycle in the Sierra Nevada Mountains after suffering a brain hemorrhage. It's believed Mayhew went a coma during the ride, or lost consciousness due to a brain bleed stroke.
I was supposed to die that next day. That's what should have happened.
In the movies, they have those parallel time lines. In one, the guy turns left and everything turns out okay, and the other time line he turns right and something completely opposite, something catastrophically tragic happens. No rhyme or reason to any of it. As I lay there lost in my daydream, I realized I was in the time line where the guy lived.
The fact my tour participants refused to continue riding during the motorcycle tour likely saved my life.
Chapter XI - The Better and The Worse
There was another strange thought I had while lying there in the Loma Linda Stroke Center, unable to do anything, lost in my wandering introspection.
For Better and For Worse.
I had said those words seventeen years ago but I had never dwelt on what they meant.
I began to realize.
This is The Worse.
Sarah would come to the hospital each day, sit with me and hold my Fall Risk hand, then the kids would come in one at a time to see me while the oldest watched the younger one. My poor wife tried to manage three kids hanging out in a hospital all day long, then meet with my doctors to discuss my progress.
My wife's private conversations with my doctors centered around the long-term effects of the bleeding inside my brain which were unclear at this point.
Bearded doctor continued to stop by and check on me from time to time. He told my wife they were giving me a 10% chance of making a full recovery. He worked to inform her how the stroke, which is considered a brain injury, would affect my behavior, my memory and my emotions. It was clear the stroke was causing Dysarthria, or slurred speech and I would need to go to Speech Therapy to re-learn how to speak.
Bearded Doctor told her whatever he struggled with before, will get worse. For example, attention span. Worse. If he struggles with multi-tasking, Worse. Understanding directions. Worse. Memory. Worse. Processing emotion. Worse.
He conveyed to her it still isn’t fully understood how the brain recovers from a stroke. The way the stroke affects the brain could exacerbate the things I struggled with before the stroke took place. While it's well known the brain has the ability to re-wire itself, creating new pathways around the damaged brain tissue, simple tasks could become difficult. Some abilities may not return to the way they were or may not return at all.
I felt lost in a cloud of guilt that I had put my family through this experience. My youngest would come to my hospital bed, draw me a picture and say, "This is for you Daddy." Seven-year-olds should not be in hospitals. At all. Ever. I worried I was somehow traumatizing my kids seeing their dad laying there hooked up to wires and tubes. The idea seems silly now, but my thoughts were filled with guilt.
There was a sense of helplessness, everyone else is in control and the open stroke ward was a constant buzz of activity that operated 24 hours a day. At night the place reminded me of a frat house. There was a residual buzz of a headache which gave my nurses who had read my chart a concerned look each time I mentioned it. They all knew about the severe headache that preceded the hemorrhage. At least they weren't shining a light in my eyes every 15 minutes all night long.
The older guy with the ischemic stroke next to me left and they replaced him with another fella that was missing half his skull. He looked as though Hannibal Lector had taken a meat cleaver and shaved off 1/3 of his skull like something out of one of those medical shows you see on TV. It made me realize, this is what they do here. This was a day in the life of a Stroke Ward. Everyone here had some type of brain injury.
After seven days at the Loma Linda Stroke Center, the daily CAT scan was clear and my discharge was finally granted. My team of eager young doctors wanted to know what route we were headed home and sternly suggested we take a route where there was a hospital nearby. It would be a 7-hour jaunt to travel the length of the state.
Young bearded doctor came to see me one last time.
"Consider a different career field," he said referring to mortgage lending and my night job as an auditor, "One that is less stressful on that brain of yours."
Still not allowed to walk without assistance, I was finally disconnected from my tube full of magical clear liquid and the wire leads on my chest and fingers were removed. I needed help to stand up after 7 days in the hospital bed and I was gently eased into a wheelchair by my nurses. Sarah, the kids and I were finally allowed to leave the stroke center. Sarah bought a blood pressure cuff for my wrist and would check my blood pressure constantly. I surmised as part of a coping mechanism. But by now I had been placed on high blood pressure medicine and my numbers never moved beyond 120/80.
The trek home was exhausting. The miles and miles created a new level of discomfort and tiredness. I was told this was normal and after laying down for a week, I would need to get my strength back. This was the first odd side effect to the stroke, fatigue, which was completely new to me. I had never experienced fatigue before. It's best described as an extreme level of tiredness but you haven't done anything. Those two didn't seem to go together.
Chapter XII - The Look
The doctor's orders upon my discharge were simple, I wasn’t allowed to drive for at least a month, I wasn't allowed to work. Just rest and allow your damaged brain to heal. Because of the enlarged aorta and the still unknown danger to my heart, there was an additional list of activities I could not do. No yard work, no chopping wood, no running, no working out, even no using a pick axe was on the list. Incidentally, I had been working on a landscape project out in the backyard at the time of the stroke, and my pick axe was patiently sitting out in the backyard.
When we arrived home, I was completely spent. Like I had worked in the fields, walked to school uphill both ways and dug ditches for the last week. The fatigue was disconcerting, like being introduced to someone you’ve never met, then told you have to be best friends. However, I was assured this was the brain saying it needed me to rest and I was supposed to listen.
My slurred speech needed to be addressed and a litany of doctor visits ensued. I was sent to speech therapy to help me with the Dysarthria, the goal being to re-learn how to talk and annunciate properly which seemed to be a strange phrase. A stroke can affect the brain’s ability to speak, understand speech, read or even write. It’s worth mentioning a stroke does not affect intelligence; I had no problems understanding spoken words or writing out my sentences. I was slurring my words as I spoke and the speech therapy was necessary to practice annunciating words. It's also worth mentioning I thought I sounded fine.
To prove her point, the speech therapist recorded me reading from a book, played my voice back to me and I still couldn't hear what they heard. But my wife and the speech therapist both looked at me with The Look. There was no arguing with them, one was the speech therapist and the other was The Wife. Both had 20 years of experience with their respective titles and they were both always right. The Look said it all.
Regular appointments at speech therapy to re-learn how to talk had Sarah driving me around like a child plus meeting with our general practitioner. The first question our doctor would ask me, do you know what day it is? Maybe that's the first brain injury question on the list. In truth, I had no idea, but there was no way I would admit that.
Not working resulted in a complete loss of normal rhythms or sense of time. How do you know it's Wednesday? Because your work week provides that normal rhythm. I quickly learned to look at the calendar in the waiting room of the doctor's office as we walked in. Ha! Take that brain.
I was given numerous tests to gauge the severity of my stroke, but the general consensus was that it was mild. The location of the bleeding inside the brain can be directly related to the abilities that are affected as each area of the brain has a different function. My bleed was located at the base of the brain. I was told the signals that are sent from the back of the brain to the front could be affected.
Emotions are one of those signals.
I didn’t yet understand what that meant.
Stroke Tests went like this: Name as many words as you can in 60 seconds that start with the letter L. I did my best to beat the test smartly employing mnemonics to come up with enough words to impress the doctor with my amazing mental prowess. Our doctor calmly wrote all my words down and I struggled to impress her.
In my brashness, I thought I did great awaiting approval from our doctor and my wife like an eager puppy.
Instead, my wife gave me The Look.
I struggled. In the span of a minute, I could list a mere 14 words that started with L. It was supposed to be a simple exercise.
I wasn’t brash.
The Look said I was the guy with the broken brain and they knew it.
I was assigned exercises to practice saying words and sounds. My homework was to practice talking three times a day. The speech therapist gave instructions for exercises to do with my tongue and lips but I wondered why. After all, I could not hear my slurred speech although everyone said I was.
Sarah downloaded a brain games math app and I was told to practice my basic arithmetic.
Doing basic arithmetic like addition and subtraction proved strangely difficult. For example, add 32 + 18. It's 50, you can see it. 30, 10, 2, 8, 50. Simple, right? Now try 76 + 27. Your brain should say: 75, 25, 1, 2, 103, Done. You see the pieces.
I couldn’t do that.
Mine went 6 and 7 is 13, hold onto the 3, carry the 1. Put the 7 and the 2 together. That’s a 9. Wait, what do I do with the extra 1? I have an extra 1. The countdown timer on the game is ticking down. Faster. I became lost. How do I put this 9 and the 3 together? And where does this extra 1 go? The countdown timer on the game is ticking down. Faster. Anybody know where this extra 1 is supposed to go?
It didn’t make any sense. Why can’t I do this?
I couldn't juggle the pieces. I couldn't hold on to the piece and conceptualize the next step.
I was lost.
Second grade mental math got more and more frustrating for someone that had built a career out of working in mortgage banking and finance. I got so frustrated with the basic arithmetic game, I soon gave up and flat out refused to do it much to the chagrin of my wife.
Chapter XIII – James Bond Never Cries
Strokes can affect the way your emotions work. The term is called the Pseudobulbar Affect, or PBA and it refers to uncontrollable crying or laughing as a rare side effect of the damage inside the brain. PBA is thought to result from disruptions of neural networks that control the generation and regulation of motor output of emotions. Your emotions are located in the front of your brain and damage from the blood released inside the skull into the brain tissue can affect control of your emotions. I thankfully did not have this extreme version but there was an odd variation of it that left me befuddled.
My wife has an IT job where she works part time from home and dramatically altered her scheduled to get the kids to and from school and manage my care. I spent my days watching horrible daytime television as I was not allowed to do anything.
The SPCA commercial came on with the sad doggies shivering in the snow. The calm even voice of the narrator described the plight of the sad doggies and how they needed my money so they could save even more sad doggies. Poor doggies in the snow. They looked so sad. The narrator asked for more money. Then more images of sad doggies appeared. They looked so sad.
I sat there on my couch and realized I was crying.
Poor sad doggies.
My emotional reaction to the commercial was annoying, odd and just plain weird. This was the first odd side effect.
I had seen that commercial a hundred times and it never bothered me. Watching TV became progressively more frustrating because I couldn't get through the commercials without crying about something stupid. The drug commercial with Grandpa taking a wonder drug that allows him to play with the grand kids on the beach. The background music plays, the calm even voice of the narrator extols the latest wonder drug and encourages me to ask my doctor for buckets of this new drug. Then Grandpa plays with the grand kids in slow motion.
Everyone holds hands and skips off into the sunset.
The Subaru commercial came on where the dad buys the car when the daughter is really young, then images flash as the kid grows up with dad and car, ballet recital, softball, track meet, Subaru. Then dad hands the daughter the keys to the same car when she gets her license. She hops in and drives happily off.
My oldest had recently turned 16.
I sat on my couch and cried.
Okay, that’s new.
I became so frustrated, I gave up on watching daytime television and pulled out my collection of James Bond movies. James Bond never cries and there were no sad commercials. Sarah brought home a book on James Bond and I devoured that until tiring of James Bond battling in space with Jaws. I went to tinker in the garage on my motorcycle. For whatever project I was fiddling around with, I couldn’t find my 10mm wrench.
I needed this one tool. I looked and looked though my tool box and got so flustered, I started crying because I couldn’t find my 10mm wrench.
It occurred to me to ask my wife to help look for my wrench, but my emotional reaction was too odd to try to explain to her.
I was starting to figure out what bearded doctor meant by the word affected.
I was still under house arrest, no driving, no working.
You’ve had a brain injury, orders were to rest as we went back and forth to doctors. There were continued visits with the speech therapist, appointments with the neurologist and our cardiologist to find out if I would need heart surgery.
We had a special placard for the hospital parking garage because I was a neurological patient and the attendant parked your car if you had that designation.
She began to recognize me.
Chapter XIV – My Beautiful Broken Brain
My annoyance with watching daytime television continued. The SPCA commercials wouldn't stop, nor did my overly emotional reaction. After completing James Bond week, I thought there are no sad commercials on Netflix so that seemed an easy solution. I typed in the work ‘Stroke’ to the search box on Netflix and a single movie came up.
‘My Beautiful Broken Brain’ (which is also on YouTube) on Netflix is an autobiographical documentary about English filmmaker Lotje Sodderland who at age 34 has a sudden and massive hemorrhagic stroke and her subsequent year-long recovery relearning how to read, write and speak. The storyline includes getting in touch with filmmaker David Lynch who helps with her recovery.
If you came of age in the early 90's, you may remember what a crazed cult phenomenon Twin Peaks was and how David Lynch became a phenom. I watched the movie and cried and cried.
I thought if I turned it off and came back later, I would do better if I focused more, but no chance. To my dismay, the reaction was the same.
There is a part in the movie where the therapist asks her to point out her shoulder. The main character Lotja points to her arm. The therapist says, “Close,” and Lotja then points to her shoulder.
That was it! That was the epiphany!
That one small scene summed up the entire stroke experience for me.
None of this made any sense.
The healthiest man in the world, forgetfulness, confusion, arithmetic, L words, sad doggies. Bleeding. Brain.
The whole point of that scene was her brain didn't know. It was just that simple. The entire stroke experience was wrapped up in that one small scene. I cried and cried for the duration of the movie.
I couldn’t turn off my emotional response to the film.
I soon figured out my friend Mr. Waterworks only came to visit me when there was some sort of stimuli or trigger.
No trigger, I was fine.
But the Subaru commercial, there was your trigger, it was designed to elicit an emotional reaction, thus you buy their car. Sad doggies, you send them money. It worked a little too well on me.
We took the kids to the movies and I cried all the way through the previews. Then again at the happy ending once the movie wrapped up.
I couldn’t turn it off.
The trigger wasn't always as well defined & predictable. The wife and I have this weekend tradition, we take the kids to the local bread store and buy a loaf of fresh bread. We ordered, sat down, and the kids munched on their pastries, the wife her coffee. They forgot to give you the loaf of bread my wife said. So off I went to retrieve the loaf.
A few minutes later Sarah came looking for me wondering what was taking so long. She informed me I was standing in the wrong line, I was supposed to be over there. And I started crying because I was in the wrong line. This isn't normal behavior, this sort of reaction. How do you explain a grown man crying because they were standing in the wrong line. I hid it the best I could from my wife (it's too weird to try to explain this behavior to her), and also got some napkins to dry my eyes and focused on calming myself by the time I sat back down.
From everything I've read about strokes or brain injuries inside the brain, this is normal, or rather can be normal. But there is no magic pill to fix this, Prozac could even out my emotional reactions or an anti-depressant, but I wasn't depressed, I was getting a loaf of bread.
The wrong line incident was one of the more bizarre and unpredictable happenings that occurred in the healing phase of the stroke that seemed to defy any logical explanation. It went all the way back to bearded doctor months earlier showing me the image of the stroke inside my brain and telling me they weren't sure how the brain would be affected.
Being in touch with your feelings sounds great on a personality profile of a dating site but that didn't make my reaction to the trigger any less annoying. I had no idea how to adjust to my new reaction to emotional stimuli.
I finally purchased some white handkerchiefs like my dad always carried around when we were kids. I put one in my back pocket and resolved to always carry a handkerchief in case I encountered an emotional situation I couldn't process.
Chapter XV – The Bolt, The Bag & The Berry Blast
After a month, I was finally allowed to drive and went to the hardware store to buy a specific bolt for the motorcycle but by the time I came home, I set it down somewhere and could not find it. I looked and looked and finally became so frustrated I simply went back to the hardware store and bought another one. Ha! Take that brain.
It was maddening. I could not remember where I had set it down and was confused as to why I could not find it. Occurrences like that made no sense. Several months later I found the bolt still in the bag sitting in the middle of my workbench right there in front of me. I have no idea why I could not find it.
I would take the garbage out as any good husband should, but by the time I walked back in the house, I had forgotten I did that and breezily carried on with my day.
“Are you going to replace the bag?” Sarah would ask.
“Oh yeah, I knew that.”
"Can you do <insert task here>?" But by the time I walked away, I had forgotten what my wife asked me to do and had to turn around and sheepishly ask her what the task was.
This went on repeatedly day in, day out and my poor wife had to dig deep to conjure up a new level of patience for me.
The stroke had a pronounced effect on short term memory and an inability to retain multi-step verbal directions. An example of this played out much to my consternation as I waited to order our lunch at a walk-up window with my youngest.
I asked her what type of fancy drink she wanted. She replied and as soon as I turned away and refocused on something else, I could not remember. So, I asked her again. She repeated her order and the same thing happened.
I asked her four times in a row before I gave up.
Now being only eight, she dutifully restated her request, after all, she’s getting candy in her Berry Blast. She hasn't figured out how annoying that is. After the fourth attempt, I still couldn’t remember what she said. I made her stand next to me as I was about to place the order, had her say it out loud and I repeated it. Ha! Take that brain. We received our fancy drinks and merrily ate ice cream.
I was filling out a form and had to write down my address. I wrote it down and realized it was not correct. I couldn't remember my house number, I wrote down 3366 but it didn't look right. This was a completely random moment and I had written my address hundreds of times before. Why it escaped me, I cannot explain. I couldn't remember this one bit of information. It was locked away in a drawer and I couldn't get the drawer open.
My first reaction was to text my wife and ask her what our address was but that seemed too odd of a question in a random text plus she might give me The Look. I resolved to wait till I arrived home from work and look at the side of my house where the numbers are. I came home and read the numbers off the side of my house: 3566.
The drawer opened. Ha! Take that brain.
There were other moments. I forgot my zip code. I forgot my ATM pin number. That one got me exceedingly frustrated and so worked up by such a simple thing, I started crying over a pin number. I'd used the same number for years. A few days later, the number came back to me and I remembered it. What I recalled was the position of the keys on the keypad and the sequential order of punching the four digits, but if you asked me to recite the actual number, it was gone. I was left with a fear of reaching the front of the checkout line and not being able to recall the number. The thought was nerve-racking.
What happened if I reached the front of the line with a full cart, unloaded all my groceries, the checker rang them all up, and I couldn't recall my pin number. It was as if the brain had two methods of remembering this required memory, and one of those methods was lost so we revert to the other method to compensate. What I did remember was the sequence of the keys to be typed. I did the one thing they tell you never to do. I wrote the number down. All activities had to written down. Grocery lists, to-do lists, schedules, I carried a steno pad with me everywhere and made lists of every possible task eventually filling every page.
I would take my blood pressure pills, Metroprolol & Benazepril in the morning and then five minutes later, couldn't remember if I had taken them. I spent the day trying to remember & never did figure it out. I finally gave in and purchased one of those plastic pill organizers that old people have.
Short-term memory, or lack thereof was a continued issue. 'I can't remember' became a new common phrase in our marriage. I told you such-and-such. It drove Sarah batty. I had no memory of that conversation or it was a vague remembrance with no details.
I was introduced to someone and they told me they had five adopted children. A month later in casual conversation, I asked her, so do you have any kids? I was having a conversation with my wife in the kitchen and couldn't recall the word I needed for my sentence. I simply pointed to the object and asked, What is this called? That's the counter, my wife replied.
Chapter XVI – Once, Twice, Thrice
My neurologist was intent on finding the smoking gun and much like Bearded Doctor, I liked him instantly. He sent me to get a very detailed MRI of my brain and he threw in kidneys for good measure. I was not aware that high blood pressure will also destroy your kidneys. I was inside the donut for over an hour while they scanned every nook and cranny of my beautiful brain. The technician would come on the intercom and say, now don’t move for the next 20 minutes, or we’ll have to start again if you move. I remained perfectly still for the duration and the sound of the MRI machine is deafening. The machine knocks out a loud sound as it uses a magnetic field and radio waves to produce detailed pictures of the brain.
Some weeks later we were notified of the surprising results.
It was my third stroke.
"Old hemorrhages are present within the left basal ganglia and right caudate/corona radiata. Focal hemosiderin deposition is also present within the right thalamus."
Hemosiderin is a stain in the brain tissue left behind after a brain bleed, visible even after the blood is reabsorbed. Kind of like when you spill ketchup on your shirt and can’t get the stain completely out. You wash the shirt, but the stain doesn't completely come out.
The neurologist summed it up more simply, “MRI of brain shows 2 prior hemorrhages (one the recent and one older) and one tiny one.”
I’ve had three strokes? It was unbelievable. How is that possible?
But there was no definitive answer other than the most recent due to my high blood pressure. The neurologist continued on the hunt for some genetic predisposition to blood vessels that broke easily but came up empty. There is a type of stroke called a Silent Stroke, it takes place in a part of the brain that may not control a significant function like motor control of your limbs, sight or memory and thusly goes undetected. But the news it was my third stroke was met with more disbelief.
Nothing like the movies. Real life didn’t always wrap up in 28 minutes.
With the last of the MRI’s over and the neurologist running out of tests to do on me, it was time to get back to normal life. After about two months, I started doing mortgage loans again and went into my job to visit with my coworkers to chat and catch up. There was a collective sense of surprise and disbelief that someone as young and healthy as myself had experienced a stroke.
It was also time to get back on the bike, and in August, two and a half months after the stroke, I led a Pashnit Motorcycle Tour on a borrowed Honda VFR800. My wife was quite worried and questioned if I was ready to get back on the motorcycle. As usual, I was adamant and didn’t give it a second thought.
The triumphant return was as glorious as you can imagine, back on the bike with 10 riders in tow.
"You're much slower," the guys chided me.
"If you see any wounded cowboys, let me know." I fired back.
The motorcycle tour went like clockwork and we celebrated when we reached the Pacific Ocean with the time-honored Pashnit Jump Photo.
We had one last issue to deal with, wondering if I would need open heart surgery. Meeting with the heart surgeon, his initial reaction to the original ultrasound was cryptic and he ordered a CT scan with contrast.
The author celebrating a return to normal life.
This scan involves two huge vials, each about an inch in diameter. After starting an IV into your arm, they fire up the machine and inject a contrast dye at very high pressure into your arm, it makes your whole-body tingle and tastes like metal. The dye contains iodine, a substance that x-rays cannot pass through. It circulates through the blood stream and is absorbed in certain tissues, which then stand out brightly on the scan.
Then they take pictures of the heart as the dye pumps through my enlarged aorta.
Chapter XVII– A Normal Life
After months of uncertainty, we met with the heart surgeon to review the results of the CT Scan. I was ready for anything but was expecting to be told I would need open heart surgery.
"Ultrasounds can be very inaccurate," he said, "They told you the aorta was about 5 cm, it’s actually 3.8 cm, only mildly enlarged, barely 4 cm would not require heart surgery at this time."
“Go back to your normal life.” He added with a satisfied smile.
I couldn’t get out of there fast enough. Say not another word and I practically ran out of the cardiologist's office. Best news I had in months.
Insurance totaled out my Kawasaki Z1000 and I decided to buy a bucket list bike, a Suzuki TL1000R and set about a nationwide search to find one. The bike popped up in Sioux Falls, IA and I paid to have it shipped to California. Buying a 15-year-old motorcycle sight unseen is a bit like gambling, but the TL1000R arrived in pristine condition and had just 15,000 miles on the clock. As we unloaded it and rolled it up my driveway, that was the first time I had even sat on a TL1000. Triumphant in my purchase, I led a motorcycle tour of the Sierra Nevada Foothills with the new TL1000R days later.
My return to normal work allowed me begin running again. I started by jogging a single mile. Although it wasn’t really jogging, more like panting and walking combined. I worked up to completing a single mile, then two, then three and reveled in the runners high it produced. Eventually, I progressed to running 9 miles and marveled at the thought that weeks earlier I had been laying in a hospital bed and not even allowed to walk without help.
With the cautionary words of Bearded Doctor still echoing in my ears, in October, I went to take a civil service exam and in December right before Christmas as my 46th birthday arrived, I was offered a position as a Healthcare Enrollment Counselor. The new job allowed me to quit my night job on weekends as an auditor that I had worked the last 5 years. I was able to tell my boss I wouldn't be working on mortgage loans full time any longer. However, I kept my mortgage license and started doing mortgage loans part time. I strangely became busier than I had been before the stroke and completed multiple purchase loans for friends and colleagues.
I soon started the corporate training for my new job and Sarah was insistent.
“Are you having any problems learning the material?”
But remembering details of an academic nature was not a problem. The magic ingredient to remembering was repetition.
The new job was quite difficult at first after being self-employed for the last 12 years and there was an immense amount of material to learn about health care enrollment. However, most work tasks are of a repetitive nature and we learn by doing.
I told no one about the brain injury, my time in ICU, or my new-found difficulty with multi-step directions and I wondered if they would notice. I quickly learned to carefully take notes as people spoke, I wrote everything down as I worked so my short-term memory issues didn't play into the job task.
What I did struggle with was process. Process is do this step first, then move on to the next step. Certain job tasks were only done once every six months, for example, being presented with a scenario and being told to solve it. The solving was easy the first time but there was no repetition to compensate for the lack to being able to memorize the steps needed to solve the problem. Six months later, that same scenario came up and I couldn't remember what I did the first time to solve the problem. I had to ask for help a second time and hope no one would notice I'm supposed to know how to solve this.
I had the great fortune of being placed with a corporate trainer who showered me with kindness and patience. I was too afraid to tell her about the brain injury, but I quickly informed her, I'm going to ask you the same question three times, it's going to seem weird but by the third time I do this task, I'll get it. It was the repetition that compensated for the lack of remembering what the answer was outright. I experienced a great deal of apprehension about being found out. I worried most about affecting my chances of being promoted in the future. Nobody is going to want to hire the guy with the broken brain. And I settled into being too afraid at work to tell anyone about the brain injury or asking for any special consideration.
I finally shared my stroke experience with a co-worker I had become friends with. She had noticed my memory difficulties. I had become known as the guy that would ask the same question repeatedly. Someone finally asked my friend at work, why does he ask the same question over and over. Oh, he has a learning disability, she retorted covering for me. Oh, that make sense, they replied.
Months later I was promoted and this time around was very up front with my new boss explaining the stroke experience plus the memory and processing difficulties that came with it. It wasn't that I couldn't learn the material, that wasn't the issue, I simply needed twice as long to learn the new material as the average person, but over time began to excel at my new job.
The short-term memory issues didn't magically go away. If my wife sent me to the grocery store, she had to provide a list if it was more than three items. I mixed things up and was confused why she was annoyed. I was sent to the store to get cauliflower, and came home with cabbage. To make the story more interesting, I wrote down cauliflower, and still picked up cabbage. Both white, both round, not sure why I did that. I wasn't very good at that task prior to the stroke and in the aftermath, the ability to remember lists of things was just gone.
Ordering food at a restaurant, I am not allowed. Instead, my wife writes down all the orders for the kids and then sends me up to the counter to read off the order verbatim.
Chapter XVIII - The Better
A year later, I’m still learning to compensate for what may seem like oddly simple tasks like keeping track of 10mm wrenches and the waste bag replacement. I have learned to walk back into the kitchen to see the empty trash can still sitting there where I left it moments earlier. It seems innocuous but imagine me in your house only completing half the task over and over. I've learned to limit my exposure to triggers that can cause an overly emotional reaction and I can make it through the Subaru commercial without my friend Mr. Waterworks visiting me.
This story is worth sharing, even the embarrassing parts about 10mm wrenches and dog commercials. It goes without saying that if you are ever riding with someone who’s having a stroke, it may not be as obvious as it says in the brochure. A severe or sudden headache, a drooping single side of the face and slurred speech are obvious signs of a stroke, as is disorientation and loss of the ability to speak and extreme confusion at one’s surroundings.
The other day, I thought I would watch My Beautiful Broken Brain once more.
I pulled it up on Netflix and this time made it through most of it without crying through the whole film. Except for the part with the shoulder, I cried a little. I'm not sure why, that one scene seems to sum up the whole stroke experience.
Any story of adversity and recovery requires an incalculable amount of thanks extended to those who got you there.
My family, co-workers and many motorcycle friends who felt compelled to help the Pashnit guy as I lay there bleeding inside my brain. There is no amount of thanks to my motorcycle buddies who rode with me one year ago and were unwittingly thrown into making a life and death decision. They could not have known preventing me from making my 625-mile ride planned for the following day likely prevented the end of a friend, a dad, a husband. They put the pieces together that I had to go to a hospital and could not continue riding, despite my adamant denial and protest. There was no way they could have known the level of danger I was in.
There are no thanks I could adequately express for the nurses and doctors that took care of me who voluntarily choose a career path of working with people with broken brains. My poor wife who was handed this man with the broken brain and sent home.
There are no words in the English language capable of expressing that level of thanks.
How to do you put a price on the ability to continue with life?
How do you say thanks for that?
I'm still not sure.
But I thought I would try anyway with 12,451 words of thanks.
A few days ago, I led a motorcycle tour through Northern California and the Trinity Alps. Our ride was 1000 miles of non-stop twisties with 9 bikes in tow. Incidentally, I still ride with the same guys from the SoCal Stroke Tour one-year earlier. Three of the nine guys on the NorCal ride this last weekend had been on that stroke tour and had been inadvertently faced with making that decision to get me to a hospital. This latest ride gave me a chance to reflect on the last year as life has slowly gotten back to a normal tempo. Riding will do that, hours at a time, absorbing the stellar scenery awash in a calming sense of all-absorbing peace, the rhythm of the motorcycle leaning side to side through the endless curves.
We stood on a mountain top in the Trinity Alps reveling in the beauty of the nearby jagged peaks with the sun shining down. Moments later, clouds rolled in and it began to snow. Lightly at first, then a full-on blizzard ensued, the road and hillsides soon became painted in white. We quickly rode off the mountain summit wiping off helmet visors coated in slushy white to drop down below the snow line. The group shared a good laugh at dinner that night about our mountain adventure, while the ample food, conversation and libations flowed. The tour rode past enthusiastic rivers, small remote towns, smooth meadows adorned in spring green and an endless blue ocean passed by our group of ten. The scenes and curves stretched for 1000 miles and the new TL1000R happily hummed a steady v-twin throaty growl.
I arrived home, jubilant, completing the journey I had started one year earlier.
After 3-days of dawn to dusk riding and before I could take my leathers off, I walked into the house, and gently kissed the most beautiful woman in the world. I enveloped Sarah tightly telling her how much I loved her and thanked her for taking care of me.
This is The Better.