Editors' Note: Guest blogger Elsbeth Goff is presently unemployed and learning of the trials and tribulations of an out transwoman trying to find a job. A recent stroke has further complicated her life, but then without it, things would be just too easy now wouldn't it?
One of my favorite philosophers once said "That which does not kill us, makes us stronger."
It seems kind of trite now a days, being quoted by cartoon characters and cheesy movie villains when they want them to sound profound. It kind of takes the polish off of a phrase when it gets reduced to banality by misuse.
There is the essential kernel of truth to the statement though, if you stop to consider it. Strength comes in many forms besides the physical. Most queer folk have become mentally stronger from the abuse they have had to put up with in a society that does not understand or accept them. Many transfolk become a much stronger person after going through transition. Everyone can become stronger if they learn to recognize the signs of a stroke, or if it is too late and you have had one already, to stay focused on the recovery and the joy of just being alive after suffering one that could just have easily killed them.
Strokes are responsible for a third of the deaths in the United States each year, yet few people know the signs or symptoms of stroke. I know I didn't even though my mother had a stroke which raised my risk factor substantially. Since I was also on estrogen, it pretty much made me a likely candidate for having one on top of other risk factors in my life.
No matter how high or low the numbers, everyone is at risk for the more common type of stroke, which is caused by a blood clot that travels through the blood vessels to the brain and blocks a capillary or small blood vessel in the brain and robs it of the nourishment it needs to live. This type is called an ischemic stroke. When that area of the brain starts to die, then you start feeling the symptoms. The sooner you can get to the hospital and start treatment, then the more function you are likely to recover afterward. However, if this happens in an important part of the brain, like the brain stem, then the result may be instant death, paralysis, or even going into a persistent vegetative state. Mid-brain strokes can be the most deadly or debilitating of all strokes, though any stroke can cause enough damage to really mess with your life if left untreated long enough. Mine was a mid-brain stroke, in the brain stem where the bodies autonomic functions reside.
I am a walking advertisement for what not to do when you have a stroke. First off, I did not immediately call EMS when I realized I had a stroke. First I called the stroke hot line to see if maybe I was mistaken, then I called my doctor, who promptly called back and told me to call 9-1-1. Of course by this time I was bawling my eyes out from fright, and remembering things that my mother had gone through when she had her stroke, so I was a mess.
Second, I did not recognize the symptoms and seek help as soon as I figured something was wrong. I had been weak before, and clumsy is my middle name almost, so when I stumbled around getting to the bathroom or going and getting me something to eat, I figured it was just because I was tired and may have had a fever. The numbness and tingling in my hands kind of worried me, but I figured if I slept through it everything would be fine in the morning. Now when I got up late Wednesday night and tried to play a game and found my left hand had lost it's fine motor control, I did start to get scared. In hind sight, I figure I had the stroke probably Tuesday night or early Wednesday morning, but I can't be sure, I hadn't slept on Monday night at all so I was sleeping through the day on Tuesday. All through Tuesday and Wednesday I just put off my tiredness to missing sleep on Monday.
Third, I let my personal situation interfere with my common sense. I am unemployed and uninsured right now. 'Dammit, I can't afford to be sick, ' I kept telling myself. I easily could have died and no one would have been the wiser for any number of days. From being a type 2 bi-polar I might be suicidal, but the death I want is on my own terms, not from illness or accident. Even if a person can't afford medical care, they generally can't afford the consequences of not taking care of a stroke more so.
Thinking back, I think I had a glimmer of an idea of what was happening to me, but then it was something I didn't want to face, so I ignored it and wished it to go away. I told myself if I wasn't better by Thursday that I would call my doctor, but that was an excuse to not face the problem at that time. I was in a sense putting off making a life and death decision later rather than facing it at that moment.
I think that I think too much sometimes.
So, now you know what not to do if you think you are having a stroke. At least hopefully you will learn from my foolishness. If you start to have the following symptoms, get help immediately, do not pass Go, do not collect two hundred dollars, for your life is worth more than that whether you want to believe it or not.
- Walking- If your balance seems off, or if you seem to be tilting to one side, this is not a good sign.
- Talking- If your speech seems to be slurred, or there seems to be difficulty in enunciating words, again this is not a good sign. This is true especially if you look in the mirror and one side of your face is droopy, or your smile is crooked. Since I live alone, and did not receive any calls that day, I couldn't tell how my speech was affected until Thursday, when I tried to call about my possibility of having a stroke.
- Reach- Having problems with seeing is common in strokes. I did not have any serious vision problems, but I also had trouble setting things down with my left hand, which was partly a mix of coordination and visual acuity trouble that faded away as time went on.
- Feel- If you have a fairly bad headache, along with the other symptoms, then that is not a good thing. I woke up early morning on Wednesday and thought that my head was going explode. I put it off to sinuses, because some of the pain was in the middle of my face just behind and above the eyes. However it also hurt behind my right eye which was not a place I usually get sinus pain. The headaches still come and go, so like my equilibrium and fine coordination problems, the pain is still with me.
- Weakness- If you suddenly feel weak, especially if it is on one side of the body, it is not a good sign. For me I was weak pretty much all over, but my left hand and leg were affected more so than the right.
- Inability to Write- Now my writing is normally pretty abysmal, but what was normally bad just got worse. This is one of the reasons I know that my right hand and arm were affected as well as the left, though to a lesser degree.
- Vertigo and/or Gait Imbalance- Feeling dizzy and nauseous is a fairly common symptom, and I am still being affected by it. At first it was almost constant. It has gotten to be an occasional occurrence now, most of the time without the nausea. All in all, not a lot of fun, though at times I will just sit back and pretend I am on a trip without the drugs. Whoa dude!
Now if you find you have any of these symptoms together, even if they go away after awhile, call 9-1-1 immediately. With a stroke it is better to be safe than sorry. Once you have a stroke, then the likelihood of getting a further visit from the stroke fairy goes up drastically. It is best to avoid the first so you don't have to worry about the second.
So, what are the risk factors? Many of them are the same as for heart disease; high blood pressure, high cholesterol ( especially LDL or the bad cholesterol.), smoking, and heavy drinking. Also among the risks are diabetes mellitus, Atrial fibrillation, sickle cell anemia, and heart or artery disease. Poor diet has also been found to play a roll, especially diets high in saturated and trans fats. Again, as with heart disease, physical inactivity and obesity are high on the list of risk factors.
Generally, the older you get, the more at risk you are. The young though are not immune from strokes however. Depending on family history and other risk factors even children can suffer a stroke. It also seems that the stroke fairy has a bit of racial bias, as African-Americans are at a higher risk than their Caucasian friends, and generally when they do have a stroke, it takes them longer to recover.
So, guess what queer community, the stroke fairy plays no favorites. No matter who you are, who you love, who you might want to be when you grow up, you are all a possible victim. Most people do not think about having a stroke, getting run over by some clod in a Suburban who was yakking on the phone was something I worried more about than a stroke. My first visit by the stroke fairy changed that though. I know the clod is still out there yakking away, but the consideration I give to the risk is a lot lower now. I am teaching myself what to look for now, so that I won't get caught unaware again. Learn your risk, learn the symptoms. Decreasing your risk is the best thing you can do for yourself. Knowing the signs of a stroke runs a close second.
My stroke didn't kill me. Did it make me stronger? I would have to say the answer is a qualified yes. I am weaker physically, but in starting the work of recovery and dealing with whatever disability I might come out of it with I would have to say my ability to deal with such adversity is stronger, as well as my resolve to not let it sideline me any more than it has. Knowledge about the symptoms and the risks also make me stronger. For the small amount of effort it takes, it is a strength we all should all have.