Jan 5, 2009 - More tests and going home

My level of frustration and aggravation was going up. When I went to the bathroom, I had to unplug the control unit on the IV, untangle all the tubes and cords and roll the IV stand along with me. It was a real challenge to pee with all of this mess tagging along.

The speech therapist showed up and did a pretty thorough evaluation. She wanted me to do all kinds of movement with my tongue against a tongue depressor. Then she had me repeat all kinds of funny phrases. I cannot remember any of them but "Peter Piper picked..." was not one of them. Hallelujah, she declared I could eat without choking! This meant they could remove my IV, which was my sole source of liquids and nutrition up to now.

Monday morning is a busy time as the full shift comes on duty. It seemed like it was hard to get anyone's attention to remove my IV. So I just waited in bed.

Matt Soper and James Ford, minister and elder from our church, stopped by to visit me. It was really good to see them. As they were leaving, Matt prayed for me. Then Anne asked them to stop by and see my roommate, a 28 year old man who was having complications with diabetes. I heard Matt talking to him and offering to pray for him. He responded "Please do, I LOVE prayer." This hit me that we had been in the same room with this guy for two days and did not know. I will remember to be more bold in the future.

Dr. Chiu had taken on my case as the neurologist in charge. I saw him over the weekend and he was very nice guy who seemed like he knew what he was doing. One of his associates came by to see me today. I asked him about getting back to cycling. His response was "exercise is good for you. Yes, you can do cycling when you feel like it." Anne blurted in "Wait a minute, you do not know my husband. He's crazy! He rides 50 miles and fast on a bicycle." The doctor responded "Oh, no I did not mean you could do that. You need to take it easy". I think I smiled on the outside, but inside I felt crushed. I did not want to live the rest of my life feeling like a semi-invalid. He did have some good news for me. He said they would release me to go home today. This sounded great.

The nurses came in and told me I was scheduled to get some more tests. I protested and said I had done all the tests the night before. They insisted the doctor had ordered the testing. So I was still hooked to my IV, had not eaten and had to do some tests.

We had brought my PC to the hospital and I had managed to get it connected to the patient network and read email. I wrote a little. Between the IV tubes, the bed and my malfunctioning right hand, it was a no-go. I think I finally set it aside. It had become very apparent that this hemorrhage had really affected my right hand. I could not control the touchpad well. My pinky and ring finger did not have any fine movement control.

Well the testing turned out to be real. They wanted to run some kind of ultrasound tests to examine my carotid arteries. The tech that ran the tests talked to me a lot about what he was doing. He also told me I was very lucky to have Dr. Chiu. He said he was very well read and one of the top stroke doctors in the country. I also learned that Dr. Chiu was the director of the stroke center at the hospital. This was all very reassuring. The tech told me that both my arteries were in great shape and there were no problems there.

After returning to my room, I decided to make some noise. I went by the nurse station and asked them when I was going to get the IV disconnected. One of the nurses got up and said she would take care of it. She followed me back to my room and took it out. Hooray! I'm free!

I figured out the hospital food system. They had this marvelous new concept - order food when you want it and they deliver in 30 minutes. Well, it actually took almost an hour, but I finally got some real food. I was only allowed the low salt menu. Bleah! But it was food. It had virtually no taste. I realized much later that most of the lack of taste was because the hemorrhage had wiped my ability to taste on the right side of my mouth and I could not sense temperatures either.

It was now about 4 in the afternoon and I was ready to get out. We signed all the papers and got my care instructions. I was now supposed to wait for someone to come get me with a wheelchair. Anne went down to get the car. I finally called her and told her I was busting out. She was all for it. I sneaked down the hallway and took the staff elevator to the floor where Anne was waiting. It was wonderful to slide into the seat of a civilian vehicle. I called the nurses station and told them not to bother with transportation - "Bob has left the building."

Jan 4, 2009 - second day in the hospital

During my first night at the hospital, they regularly checked my vital signs and made sure I was not showing any bad neurological signs. The night duty nurse became alarmed when my pulse dropped to 45. I wanted to say that was normal, considering my cardiovascular conditioning. It seemed to me if my pulse rate was 55 during the day, it could slow down when I was sleeping. Eventually a doctor told her it was ok.

On Sunday morning, two ladies came to see me and introduced themselves as physical and occupational therapists. They wanted to evaluate me to determine if I needed to start any kind of therapy. After doing all kinds of little tests, they said they wanted to watch me walk. We began walking down the hallway with one on either side. Without warning one of the ladies would swing her hip over and bump into me. They did this twice. I did not fall over so they decided I must be doing ok for now. It’s not like I was having major functional impairment. By this time I knew I had some numbness in my right hand, but I wasn’t doing any kind of critical assessment. I was just tired and wanted to sleep. The IV stand and tubes were annoying as well. It was difficult to get comfortable.

I hoped to get evaluated by the speech therapist so I could get released to eat something. Such was not the case. It did not matter a whole lot. I was not that hungry. The other big event for Sunday was a lot of MRI testing, with and without dye. I guess they were backed up. I did not get in for that testing until about 7p.m. It seemed like it took a long time. I ended up falling asleep in the MRI machine while they were running the tests. Some people get claustrophobic in these machines. I just get bored.

I was hearing that I might get released the next day. It seemed to me that my condition was stable but I would never heal sitting in the hospital. So I went to bed, exhausted and ready to see the next day.

Jan 3, 2009 – Day of the ICH (long)

ICH – Intracerebral Hemorrhage. That’s a mouthful and it’s hard to spell. It means bleeding in the brain. It happened to me about 10 am on January 3, 2009. As part of my recovery, I’ve decided to document what happened and the recovery process. This may last for weeks or months. At this point nobody knows for sure.

It started out as a group bicycle ride with Schlumberger Cycling Club. I was excited as it had been a while since I had ridden with a group and I was looking forward to it. I elected to ride the planned long route – 50 miles, beginning at Katy high school. I started out with the A group (fastest) and had to stop almost immediately because I had forgotten to start my new Garmin cycling GPS. Two minutes later I had it running and I was off. I caught up to the second fastest cluster of cyclists and could see the A group about a quarter mile in front. I decided to catch them and see how long I could keep up. It was a pleasant morning and the wind was not a factor on the first leg of the route. In no time I caught up and joined their pace line. Everyone must have been feeling their wheaties. We kept going faster and faster until we were cruising at 24 mph. I was doing fine and quite happy.

Then the beginning of bad things unfolded. We turned left and started climbing slightly. The worst part was the fairly strong northwesterly headwind. Our pace line had a very strong lead rider and he kept churning at 22-24 mph into the headwind. I was determined to keep up, but a little voice told me I could not do this forever. Finally after 10 minutes, I pulled to the side and slowed down. My left side was hurting and I wasn’t feeling very good. I rode on to the first rest stop and got something to drink and eat.

After a 10 minute rest, I rode out again and joined two other riders. We were going about 18 mph which should have been comfortable for me. Some really strange things started happening. My bike was weaving from side to side and once it felt like I almost lost control. No matter what I did, I could not keep it in a straight line. I pulled over and stopped for a rest. I had ridden about 26 miles. I decided that I was just overtired from exercise earlier in the week and I would just take it easier for the rest of the ride. I also had not slept well the night before, waking at 3:30 and never going back to sleep.

Now I was going about 9-10 mph into a fierce headwind. My bike suddenly shifted gears. It had never done this before and I did not know what was going on. I looked at the right shift lever and saw my right hand pressing against the shift lever – kind of laying there. It was really weird looking.
My hand was supposed to look like this:

Instead it lay there like this (pushing on the shifter):

I put the bike back in the right gear and rode on. It shifted again. I looked down and my right hand had done the same thing again. I tried again. About 2 minutes later it shifted again. I had the strong feeling that I could not finish the ride and something was really wrong. I got off the bike and just stood there, planning to flag down a support car. As if summoned, a support car appeared and pulled over. I told them I needed to be carried in – I was done for the day.

Back at Katy high school, I got out of the car and nearly lost my balance. I felt like I was stumbling around. A woman named Gina saw that things were not right and walked my bike over to the car for me. She kept asking me if I was ok. I said I was just tired and would rest a few minutes. I took off my cycling shoes and was able to walk around without stumbling. I still did not realize what had happened/was happening to me. In retrospect, I feel sure the hemorrhage started about an hour before when I was pushing so hard into the headwind with the A group.

So I got the bike loaded and drove home. That morning I had forgotten my cycling gloves. I bought a pair from the local cycle store group that was providing mechanical support to our cycling club. I didn’t have enough money to pay for them, and agreed to stop by their store to pay later. On my way home I stopped at the cycling store to pay and carried on a normal conversation with the clerk. The bleeding obviously was not progressing very fast.

When I arrived home, I unloaded the bike, took a shower and went straight to bed. I felt like I could sleep forever but I only slept 45 minutes. I got up, ate something and sat around waiting for Anne to get home from her bridge game. When Anne came home (around 2:30), we talked. I remember telling her how well the Garmin had worked that morning. She looked at me really funny and said “Your speech is slurring.” I blurted out “I knew weren’t listening to me!” Then it hit me what she said. We called Dr. Richard Jackson and told him about my symptoms. He advised me to go to an emergency room right away.

At the emergency room, I filled out the admittance paperwork and looked at what I had written. I knew my right hand was not working right. It looked like a drunk had written all the words and it was almost unreadable. It also looked like I dragged the pen around the page.

After reviewing my symptoms, it was apparent that I was triaged to high priority. We moved to testing right away. They did a CT scan of my head. After I got out of the scanner, they had a gurney bed waiting for me. They had seen something in the CT scan that they did not like. I think around 7pm, we were told that I had a small hemorrhage in the left side of my brain that was affecting my right side. I was now feeling numbness in parts of my right hand and very tired. They put me on an IV.

For the next two days, every nurse and doctor who came to see me would ask me to hold up my hands, squeeze their fingers, grin, and wiggle my fingers and toes. They were checking to see if I displayed in gross abnormality in my motor functions. The doctors decided that the bleeding was small and stabilized and I could stay in a regular hospital room. I was not allowed to eat or drink anything until the speech therapist could examine me and confirm that I could swallow without choking. They only work during the week, so I resigned myself to starving for 48 hours.