When a Smashed Bottle is Cause for Gratitude: 17 years After Stroke

Yesterday, as Jack & I were finishing a late brunch, I glanced at the paper. January 30. My stroke anniversary date — seventeen years since my life was upended by stroke and antiphospholipid syndrome (APS), the nasty autoimmune disease that turns my blood to sludge.

Back then, it felt like my life was over. I never would have guessed I had even seven years left, much less seventeen. I fought brain fog, fatigue, a shredded memory, attention deficit, garbled speech. Because my right hand has almost no feeling, I couldn’t type or tie my shoes, or turn a key in the lock. I lived on a tightrope, dependent on high doses of blood thinner to prevent another stroke but with the constant threat of bleeding.

I grieved not just the loss of capability, but the loss of myself. After a year, I could no longer remember who I’d been before.

But slowly, with time and therapy—and much hard work—I regained some of the capabilities I lost. I cultivated some new qualities, chief among them greater patience with myself. With Jack’s help, and the optimism learned from my father, I found the grit to travel off the beaten path. I found the courage to feel lucky, to tamp down the fear that life-threatening accidents lurked around every corner.

Yesterday, when I realized what day it was, I sat at the breakfast table and gave thanks for the marvels of those seventeen years. Walking the floor with four new grandchildren. Standing soaked in the mist and awe of Brazil’s Iguaçu Falls. Basking in the silence of a dervish’s dance. Celebrating twenty-five years and more than fifty countries visited with with Jack. Finding time and voice to write.

I took a breath and a long, calm moment to feel grateful on that, the anniversary of one of the worst days of my life.

Back to reality, I cleaned off the breakfast table. Jack had cooked, so it was my turn to do dishes. I carried the condiments to the kitchen counter next to the refrigerator. Reaching into the refrigerator with an almost-full bottle of salsa, I looked away for just a moment, forgetting to use my eyes to see what my hand cannot feel. That’s when the bottle slithered from my grasp and exploded on the tile kitchen floor.

The sudden thunk, the splat, the flying tomato gore, chunks and shards of glass sailing all the way into the dining room.

Micro pieces of glass as fine as sand were everywhere, even stuck to the bottom of my shoes. There followed the conundrum of “how to clean up glass while on blood thinners.” The answer, of course: very slowly and carefully—with lots of paper towels and help from Jack and his powerful shop vac.

With the mess finally cleaned up, I headed to my office to work. My cell phone rang, a doctor’s office. I noticed the time: 2:10 pm.

A woman’s voice: “I had you down for an appointment at two o’clock.”

Me: “Oh, I think there’s a mistake. I am sure I made that appointment for Wednesday.”

Her: “Yes. Today is Wednesday.”

I looked up, for a moment as lost in brain fog as I’ve ever been.

Even after seventeen years, some things can’t be fixed.

All I can do is chose to live in gratitude for what remains. And I do.

Why You Need to Know about Antiphospholipid Syndrome—APS

burgundy_ribbon 2 enhancedWhen I was diagnosed with antiphospholipid syndrome in 2002, I  felt like I’d fallen into a bad sci-fi movie. I’d never heard of APS; even most of my doctors had never heard of it. I had a hard time finding information about it. There was no “national society of …” The best source of information I found was NORD—the National Organization for Rare Disorders.

Although APS is still listed in the NORD system, it turns out that APS really isn’t rare. At the time, 16 years ago, it wasn’t very well known. But research and increased awareness have greatly expanded our understanding of APS.

The reason you should care is simple:

Antiphospholipid Syndrome—APS—is dangerous and much more common than first thought.

 

It’s now estimated that one to five percent of the general population has APS.

That’s about two to six million women in the US, comparable to the number of women living with cancer.

There is now an organization, The APS Foundation of America—founded in 2005—that promotes antiphospholipid syndrome education, public awareness, research, and patient services.

These statistics from the APS Foundation of America demonstrate the seriousness of APS as a health problem—particularly, though not exclusively—for women:

  • APS is the No. 1 cause of strokes in young people.
  • One third of strokes occurring in people under 50 are due to APS.  Mine was one of those.
  • Estrogen in the form of birth control pills and hormone replacement–perfectly safe for most women–can be deadly for women with APS.
  • 20% of blood clots in large veins (deep vein thrombosis, including pulmonary embolism) are caused by APS.
  • 10-25% of women with recurrent miscarriages have APS.  If properly diagnosed and treated, many of them will be able to deliver healthy babies. That was not the case in years past. Undiagnosed APS is  the reason I was not able to have children.
  • APS is a major women’s health issue: 75-90% of those affected by APS are women.

 

The hallmark of APS is a tendency for blood clots to form when they shouldn’t. Patients who’ve had repeated blood clotting episodes should ask their doctors about testing for APS.

Learn more about antiphospholipid syndrome on my APS resources page.

But if you or someone you love has APS, don’t despair. APS is treatable, primarily with drugs like aspirin, Coumadin (generic warfarin), and other blood thinners.

Related Posts:

 

Coming up:

  • APS symptoms
  • How APS is diagnosed
  • How APS is treated
  • Resources for APS patients
  • Blood thinning: it’s more complicated than it looks
  • Living with Coumadin
  • Why I rejected the new blood thinners like Xaralto.

 

The Edge of My Mind: Where I Stand 16 Years After Stroke

 

FOG SS_186908249It’s happening again. I’m at the edge of my mind, teetering toward the void of missing synapses, staring into the white fog of absence. Of absent memory, yes. But it’s more than that: it’s an absence of self. I feel my self slipping, like a hiker on a mud-slimed path. I balance on the far edge, lean back, beg my mind not to fall into the void—again.

In reality, I’m standing at the refrigerator door, looking at the object in my hand, an everyday object, something I want to cook. But I don’t know what it is. I think, trying to summon the information. Think, think, think. Nothing.

This is what stroke does. Still, after 16 years and a near-miraculous recovery.

After my stroke, I couldn’t remember my husband’s name or how to dial 911. I couldn’t control a fork to feed myself, couldn’t comb my hair, tie my shoes, or button a shirt. I couldn’t recite the alphabet or say what I wanted.

I was one of the lucky ones. Today I can do all of these. But I still can’t work in my profession of marketing and communications. (I don’t think fast enough, write fast enough, react fast enough, work fast enough.) I can’t calculate a tip in a restaurant or balance a checkbook. I often stutter and stumble when I talk, forget tasks, appointments, names, faces. Standing at the coffeepot, I can’t remember that my husband, thirty seconds ago, asked for just half a cup. And now, forgetting his coffee entirely, I carry the object in my hand into the den and ask him, “what is this?”

He looks up, startled, then answers: “asparagus.”

Yes, of course.

Still, some sixty or more percent of stroke survivors would trade places with me in a second.

Like me, they are unable to return to work. But unlike me, most of them can’t drive, type, articulate, live almost normally in the world. Many still—months and years after a stroke—can’t walk without assistance, can’t feed or dress themselves.

Yes, I am lucky and I know it. But still ….  My stroke was caused by an autoimmune clotting disorder called antiphospholipid syndrome (APS). This means that my own risk of a repeat stroke is very high, around 60-70%, experts say.  Each time I totter on the abyss I wonder, like feeling the beginning of a temblor in earthquake country: is this it? Is this another big one?

Don’t let stroke happen to you or someone you love.

Eighty percent of strokes can be prevented. May is Stroke Awareness Month. What better time to learn the risk factors for stroke and share them with someone you love?

Learn more about stroke:

What the *^## is Antiphospholipid Syndrome–APS?

I felt like the doomed heroine of a bad sci-fi flick, zapped by zeta rays from planet Krypton when, a few weeks after my stroke, I first heard my unpronounceable, incomprehensible diagnosis: ‘antiphospholipid syndrome.’ I’d never heard of APS. Nobody I knew had ever heard of APS, even most of my doctors had never heard of APS. Many of them still havn’t.   Excerpt from Anne’s memoir

Anne AS log min text rev 3APS is sometimes called “sticky blood” because it causes an increased tendency to form blood clots in the veins and arteries. Clotting can lead to serious health complications ranging from miscarriages and migraine headaches to blood clots in the legs, in the lungs, heart attacks or, in my case and many others’, stroke.

Here are some important facts about Antiphospholipid Syndrome:

  • APS is a blood clotting disorder that causes the blood to clot when it shouldn’t.
  • It does this by signaling the immune system to make antibodies to attack blood proteins called phospholipids (phos-pho-lipids). These proteins help moderate the body’s natural blood-clotting process so it stops when it should. Thus the name: anti (against) phos-pho-lipids.
  • I think of it this way: the APS antibodies are like out of control PacMen, dashing through my blood gobbling up the good little minions who help put the brakes on my clotting system.
  • In the UK, APS is called Hughes Syndrome, named after Dr. Graham Hughes, the professor and Lupus specialist who first described APS in 1983. I rather wish we called it Hughes Syndrome in the US, too. It’s a lot easier to learn and think about something I can pronounce.APS awareness month stamp
  • APS is a common cause of miscarriage, blood clots in the legs (deep vein thrombosis), the lungs (pulmonary embolism), the heart (heart attack), and the brain (stroke).
  • APS is also an autoimmune disease, because the antibodies that attack our blood proteins are attacking parts the ‘self’ instead of invading organisms like virus and bacteria.
  • Like lupus and other autoimmune diseases, APS can “flare” at times, causing weakness, fatigue, achy muscles and joints, especially when we’re tired or stressed.
  • Because most patients with APS take some kind of bloodthinner, we must try hard to avoid bleeding accidents. For some of us, this is one of the most vexing aspects of the disease: walking a line between blood that’s so “thick” it causes clots, or so “thin” it causes abnormal bleeding.
  • APS is sometimes found in conjunction with other autoimmune diseases, particularly lupus.  It’s estimated that 50% of Lupus patients also have APS. (Johns Hopkins Lupus Center)
  • APS can also occur on its own. This is called primary APS.

 

Learn more about antiphospholipid syndrome on the APS resources page.

Coming up—Information on:

  • APS symptoms
  • How APS is diagnosed
  • How APS is treated
  • Clearing up confusion about APS: Questions I frequently hear from other  patients
  • Resources for APS patients
  • Blood thinning: it’s more complicated than it looks
  • Living with Coumadin
  • Why I rejected the new blood thinners like Xaralto.

 

My Introduction to Antiphospholipid Syndrome

EDITED APS living with

 

My experience with Antiphospholipid Syndrome—APS—began thirteen years ago with the cataclysm of a stroke. As the new year opened, I was 48 years old and the picture of health: a trim, fit, non-smoker with perfect blood pressure and no obvious risk factors any disease I knew of. I had a challenging consulting practice in marketing and public relations.  My grandparents and great-parents had lived to healthy old age; I imagined that would be my future, too.

Then—out of the blue—I was slammed by a full-on a stroke. On that eerie morning when the stroke hit, I was lost in a mental whiteout, unable to remember my address, my husband’s name, or how to dial 9-1-1. I had no idea what was wrong. Alone in the house and profoundly confused, but not yet panicked, I managed to get help by dialing “O” for an operator. The terror set in when I tried to speak and realized my words were nothing but gibberish. My heart thumped. Oh, God. She’s going to hang up. She must think I’m a kid playing with the phone, or a crank, or a drunk. Instead, the operator traced the call and sent an ambulance.

When the paramedic told me he thought I was having a stroke, I thought he was nuts.

Of course I’m not having a stroke, I wanted to tell him. Strokes are for the elderly, for smokers, for overweight couch potatoes. I’m forty-eight years old, fit, and perfectly healthy. Perfectly healthy people don’t wake up one morning and have a stroke. But the words were trapped in my head.

At the hospital, the ER neurologist was also stumped. She’d learned that I was taking birth control pills, which can be a risk factor for stroke. But when all my tests of heart and lung function were normal, she still wasn’t satisfied. Somehow she doubted birth control pills told the whole story.

Three weeks after the stroke, she sent me to a hematologist who, after more blood tests and a very detailed health history, diagnosed Antiphospholipid Syndrome­–APS–on the spot. How? For at least 20 years, he told me, I’d had subtle symptoms that pointed to an autoimmune illness and APS.

As part of APS Awareness Month, here are some topics to be aware of:

  • What is APS?
  • APS symptoms
  • How APS is diagnosed
  • How APS is treated
  • Resources for APS patients
  • Blood thinning: it’s more complicated than it looks
  • Living with Coumadin
  • Why I rejected the new blood thinners like Xaralto.

 

I hope you’ll check back. And, if you or someone else in your life has APS, I’d love to hear about your experience.

 

 

San Francisco Forum on Autoimmune Disease Set for Aug 20

Here’s a great opportunity to learn more about autoimmune disease: a free public forum in San Francisco on Saturday, August 20, at the Westin San Francisco Market Street Hotel. Details at:  http://sanfranpublicforum.eventbrite.com/

Rita Baron-Faust, Author of The Autoimmune Connection, will speak on “Women and Autoimmunity: Making the Connection,” and Virginia. Ladd,  President and Executive Director of  AARDA (American Autoimmune Related Diseases Association), will talk on “What You Need to Know About the Future of Autoimmune Research and Its Impact on Patients.”

The forum is free, but advance tickets are required by registering here.