Hippocrates, “On the Sacred Disease,” Men ought to know that from nothing else but the brain come joys, laughter, and sports, sorrows, despondency and lamentations, all these things we endure from the brain. Somewhere between the ER and the Neuro ICU, I must have fallen back asleep, as I don’t remember being transferred. The ER having stabilized my condition after my IV tPA was completed, had released me to the next phase of my journey. My Neuro status had improved dramatically since my earlier arrival to the ER, in that my Stroke score had dropped from a 23 to a 16. This score is based on the NIHSS Stroke scale which evaluates the acuity of stroke patients, determines appropriate treatments and predicts patient outcomes.
The NIHSS (National Institutes of Health Stroke Scale) is a systematic assessment tool that measures stroke-related deficits in acute stroke patients. It takes about 7 minutes to complete, scores on the levels of consciousness, language, neglect, visual field loss, extraocular movement, muscle strength, ataxia(movement disorders), dysarthria(speech) and sensory loss. My ER score at 23, demonstrated a fairly severe stroke, just like golf, the lower the score the better the outcome, 0 is normal with a score of 42 being the absolute worst stroke possible and still be alive.
My stroke was the result of a blood clot that travelled up to my brain inside one of my major arteries, my middle cerebral artery. Research shows that a stroke occurs four times more frequently in the left side of our brain, which predominantly controls language. Mine took a left turn and went to the left side of my brain. Damage to the brain via the middle cerebral artery would predict my impairments: problems with movement, problems creating or understanding speech, problems with vision and recognizing physical boundaries. But wait! I had the miraculous tPA medicine, how would this drug affect my outcomes?
In the ICU, I had 30 minute assessments performed by the nursing staff for the first 12 hours of my stay. I was already able to move my right leg and arm, my vision had been restored in my right eye, I could feel the pin pricks to my right side, I could understand the nurse’s questions, but getting the words out was next to impossible. So tPA had helped reduce the severity of the blood clot, by dissolving it on site. But there was still damage to the brain cells from the clot’s initial assault. That is why TIMING is so critical in getting to the ER, defining the stroke, blood clot vs brain bleed and getting the drug started.
Surrogate Writer, PMD
Step out of your old ways, habits, and steps. Do what you’ve never done before but should have. Walk in the newness of the Spirit. Isiah
