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.