Through a long absence, have not been to me
As is a landscape to a blind man’s eye:
But oft, in lonely rooms, and ‘mid the din
Of towns and cities, I have owed to them,
In hours of weariness, sensations sweet,
Felt in the blood, and felt along the heart;…

It’s 1:00 on a Sunday. I have just completed my hourly round of walking. As I looked into my backyard from the kitchen window just now I felt the return of a sensation of openness I associate with being aware of the possibility of poetry. Wordsworth knew it, wrote of it often, the best known example being his “Lines Composed a Few Miles above Tintern Abbey, On Revisiting the Banks of the Wye during a Tour. July 13, 1798.” My epiphany just now came as I realized to my utter surprise that I had been without that familiar sensation for a time—I don’t know how long, but I associate that vacancy now, as I describe it, with my remembered aphasia. The epiphany just now has been a cause for real joy as well as a moment of solidarity with the great world and a poet whose description of it remains vivid for me.

I’ve had a stroke. It came out of nowhere and paralyzed me for a while during which time I was fascinated by various objects I handled. I contemplated my breakfast bar for seemingly endless minutes as I stood frozen by my kitchen table. Strangely, I was aware of the passage of time, as twenty, then thirty, then forty-five minutes elapsed before I reached for the kitchen scissors to open it. Then, in another twenty minutes or so I lost interest and wandered empty-handed into the dining room adjacent, where  I remember falling. I lay there on the dining room rug a while until my strength returned; then I got up and moved to my recliner in the living room. I must have collected my tablet because I remember watching a couple of episodes of a TV series I was interested in until my spouse returned from her swimming class at the Y.

I hadn’t called her, as she immediately pointed out much to my chagrin, but as I struggled to tell her what had happened to me I realized I had been unable to do so. I could formulate the idea of what had happened, but the words wouldn’t come. Long and short, we trekked down the street to the SLU emergency room and spent a night with concerned staff who found me a room in the hospital before morning. A CAT scan and MRI were performed almost immediately. I remember being given aspirin and heparin. Then we waited. An initial reading did not reveal a stroke, but a reading next morning revealed what the night’s reading had missed, a small stroke in my brain’s left frontal lobe. Fortunately, my motor skills were not affected, and the aphasia gradually diminished during the time I was hospitalized. Indeed the neurologist who examined me as I was preparing to be discharged said to me that he would not have believed I had had a stroke but for the MRI. I returned home with a loop recorder to monitor my heart rhythm and a feeling of gratitude that I had dodged a bullet.

Doctors at the hospital had suspended my regular blood pressure medicines (in order to flush out my brain I was told); so that my return home was accompanied by a kind of euphoria that vanished as the days went by. My new medicine routine includes generic Plavix plus aspirin (the Plavix to stop after thirty days and the aspirin to continue). And I’ve now added a statin to my daily maintenance meds. I’ve always had good low cholesterol, but since I’m now a stroke survivor my cholesterol needs to be even lower. Future blood work will determine the statin’s effectiveness. But resuming my regular blood pressure regimen has caused my blood pressure to drop abnormally, a condition with which I’ve been struggling ever since. Doctors have cut my beta blocker by half and taken me off the diuretic I had been taking since my earlier bout of heart failure. It remains to be seen whether I will need further adjustments. Currently, though my blood pressure has returned to more or less normal levels, I am experiencing a period of dizziness each day (with its accompanying fear of falling) from the time I take my morning meds until late afternoon. The hospital neurologist told me I could drive and return to the gym immediately upon returning home, but I’ve not felt like doing either. I’m walking around the house now, as my Fitbit reminds me to do. That seems effective in fighting off dizziness, but so far at least, the dizziness returns when I stop walking. This may be caused by the Plavix I am taking, that’s my current hypothesis; but if that is true I shall have to endure the daily dizziness until I complete the required 30 days of Plavix (another seven days or so).

My risk of secondary stroke is highest for thirty days, but I remain at risk for the rest of my life and particularly for the next five years. This is especially true for me since my stroke was cryptogenic; its cause remains unknown. Of primary concern is the possibility of undetected atrial fibrillation; I learned in the hospital this time that the left atrium of my heart is enlarged. But the possibility also exists that the PFO in my heart may have allowed a clot to escape and reach my brain. The loop recorder I am wearing should over time detect atrial fibrillation (or not), a result I am coming to think of as the lesser of two evils, since recent research seems to indicate only limited benefit to patients my age from PFO closure.

I am now trying to image the healing of my brain. I see a lesion left by the stroke. I can’t determine its size, but remembering the MRI and recalling that I never lost motor control, I think my stroke involved only the speech centers of my brain and may have left only a small lesion. I recall battling to regain the ability to find words for my thoughts and being overjoyed when it returned so that I glozed on and on each time I was given a stroke test in the hospital. What do I now carry in my brain’s left frontal lobe? That will be the question that preoccupies me as I face the days ahead. I look forward to getting back to exercise, because I don’t want to lose the strength and muscle tone I built up during my pulmonary rehabilitation phase. I recall the euphoria I experienced during my first few hours at home and my then conviction that recovery from my stroke would be a piece of cake. Not so, I fear. I have a long and uncertain recovery time ahead of me. Now, today, I awoke feeling invigorated. I had slept all night without frequent trips down the hall to the bathroom. My goal today is to walk 250 or more steps each hour as I am reminded by my Fitbit to do. Life is still good.