When my friend Laura asked what was up with me medically, since I’d mentioned the Seattle hospital in a past entry, I e-mailed her this explanation of my recent medical misadventure:
The last weekend of July, I was climbing Rainier with my brother-in-law, Chris, who is married to my Chris’s sister, Stephanie. He has considerable mountaineering experience, and we had a great outing, climbing to 11,200 feet (about 3000 feet shy of the summit) before I felt like I needed to turn around because the gusty wind was throwing me off balance on steep snow slopes. On the way down, I was sleepy and had a mighty headache, but I usually do at altitude.
Chris and I camped down low, at 2000 feet, outside the park that night. In the morning, I awoke at 4:30 and sat up and immediately fell over to my left, onto Chris. He kept sleeping. I wasn’t sure why I woke up. I was having a little difficulty breathing, but I figured it was just residual from there being so little oxygen at altitude. I put my left hand in my right on my chest, and I could only tell that I was doing that because my right hand felt what felt like fingers. My left hand couldn’t feel it. I figured I’d slept on it wrong or it was cold. I finally fell back to sleep only to wake again at 7 to fall over directly onto Chris again. That woke him up, and he looked at me, pretty concerned. I must have looked pretty out of it. He got up and set up the stove, and I tried to pump breastmilk with a hand pump. I couldn’t use my left hand to put the pump together or to pump. It just wouldn’t do what I asked it to do. I got out of the tent and walked around. My left foot dragged through the rocks, kicking them. I could lift the foot, but I wasn’t getting enough feedback to know how high to lift it.
So, Chris and I decided that instead of hiking, as we’d planned, he would drive me back to Eugene, a five hour drive, so I could go to the hospital. On the way, when we got out to use a restroom, a woman who happened to be a nurse saw me and suggested I get to the nearest ER, which I did. They gave me a CT scan and suggested that I be airlifted to Seattle, where there’s a world-class neurology unit, since I’d probably had a stroke. So away I went in the helicopter. It was a beautiful flight, with clouds snaking up the valleys and rain hitting the windshield. I was glad that I was stable and aware enough to enjoy it. Unfortunately, we killed a seagull on the way.
In Seattle, the MRI confirmed that I’d had a stroke, and not a small one. The neurologist was sort of surprised that I was doing as well as I was, given the size of the stroke and the fact that the embolus had stopped blood supply to two areas of my brain. Over the course of four days, I had a contrast CT scan, an MRI, an ultrasound of my heart, one of my neck vessels, and one of my legs. The heart ultrasound, the echocardiogram, showed that I had a PFO (patent foramen ovale), which is a hole between the right and left atria. In young people who have cryptogenic (unknown cause) strokes, they often have PFOs. The PFO allows blood from the right atrium to pass to the left, instead of from the right atrium to the right ventricle and on to the lungs, where the lungs would filter most clots and bubbles. So my clot passed into the left side and up to my head. One-fifth of the population have PFOs, since it’s just a hole that’s open until you’re born to allow blood to bypass the lungs. With the first big breath after birth, lots of people’s close. Mine didn’t. I actually had another test this past Tuesday during which they passed an ultrasound device down my throat to see the heart better. That showed that I might have an atrial septal defect (ASD) instead of a PFO, which just means that instead of a flap that opens and closes, I might just have a doorway that’s continually open.
The good news, and there’s much, is that, first of all, I’m pretty much fine. I might not be as deft with my left hand as I once was, but I’ve never been ambidextrous. Typing is good therapy. I can run, dance, and pick up my son (which was my first concern). I’m a little short of breath, and my cardiologist here said that that’s probably because there’s a hole in my heart.
The rest of the good news is that I can have the hole repaired. My blood is fine, and not more likely than other people’s to clot. To close the PFO/ASD, they put in a little device like a double-sided umbrella which the heart tissue soon covers so it becomes part of the heart wall. That surgery is done with a catheter up through a blood vessel from the groin. It’s out-patient surgery, so it would only take a couple of hours. If I get it repaired, I’m no more likely than any other young, active, non-smoking female to have another stroke, so that’s what I’m leaning toward. Sylvan can’t be breastfeeding after the surgery, since I have to take another anticoagulant along with aspirin for the three months after the surgery, so I’m not sure when we’ll get it repaired – maybe next spring?