I’ve started back to work, as of last Friday. So that’s a good thing, right? For me, I think in some ways that’s when it gets harder.

I had a stroke July 25, which was missed by the emergency personnel, but then went back on July 28 with new symptoms and was admitted to the hospital for 10 days.

Now, I’ll be the first to tell you that I was tremendously, wondrously, gloriously lucky. The hospital’s occupational therapist and physical therapist checked me out and didn’t even think I’d need their services. So not only am I still alive, it looks like I have no permanent disability.

However, the one symptom that’s lingering is something of a problem: If I stand for more than a few minutes, I feel “woozy” — not exactly dizzy, but headachy, weak, and faint. Sitting for awhile seems to relieve it, and lying down definitely does. I haven’t yet gotten in to see a neurologist (which is a whole other annoying story that I should skip!), but I suspect that’s a leftover from my cerebellar stroke. After all, when I stand my brain needs new connections to keep my balance. I tried to step over the baby pen in the nursery on Sunday, and almost fell over. I’ve never been terribly graceful, but now I especially need to take care!

Anyway, I’m not someone who likes difficult decisions. Before the stroke, I had a headache that lasted three weeks, and every morning I had to figure out if I felt good enough to go to work or if I were just being a wimp. Then the stroke hit. Okay, now staying home was a no-brainer! Especially when I was in the hospital! But even after that, it was easy to understand I should take it easy and let myself heal.

But isn’t two weeks enough time? And how much do I need to do some standing and walking to help my brain build new connections? I did compromise by leaving early yesterday, and today I didn’t have to compromise — we got sent home early because of the earthquake! But it’s harder when there’s a decision. This is definitely not a contagious illness, so it’s all the harder to evaluate when I’m up to working and when I’m not.

Another thing is I almost felt guilty all that time off, having extra time to read and write book reviews. But since writing book reviews takes a lot more energy than reading — I’m still way behind with books I’ve read and want to review. So now my time off is up, and I am still behind. I don’t want to push myself extra. So that’s where not having energy for much more than work gets pretty frustrating.

Anyway, I already had vacation in Oregon scheduled for next week, so at least I will have next week off, decision-free! And it sounds like ALL my twelve brothers and sisters will be there with me at the end of the week for my brother’s wedding!

Today I was searching on the Internet for information about recovering from my stroke. My referral to a neurologist still hasn’t gone through. I’m doing very well indeed, but I have one disturbing symptom that’s keeping me from getting back to work: When I stand for more than about a minute, I feel woozy — not exactly dizzy, but headachy, faint, sick, and wanting to lie down. It’s not real severe, and comes on gradually, and generally feels better after a nap. But it is there, and I’m wondering if that’s my remaining effect of the stroke.

So, I Googled “Cerebellar Infarction” (the type of stroke I had). And then I got really distracted. Because I found out how lucky I was.

This article: Pitfalls in the Diagnosis of Cerebellar Infarction reported a study of people with Cerebellar Infarctions (like me), whose diagnosis was missed when they initially went to the Emergency Room (like me).

I got to that article from this one: The Clinical Differentiation of Cerebellar Infarction from Common Vertigo Syndromes. The article outlines the different common Vertigo syndromes and how Cerebellar Infarction is different. It said that only 0.7-3% of patients presenting with vertigo actually have a Cerebellar Infarction, but of those 35% get misdiagnosed.

I was sent home from the Emergency Department that Monday night with a diagnosis of vertigo, probably stemming from my migraines. They had done a CT scan, so I thought they were right, and I must be fine. I went back on Thursday morning (to a different Emergency Department) with additional symptoms (mainly a wicked headache and feeling faint plus right side tingling), and they did an MRI and learned I’d had a cerebellar infarction from vertebral artery dissection.

From reading the article, I can see how they missed the diagnosis. Once they found out I had a history of migraines (though never ever with vertigo), that presented an easy thing to blame. I did not realize that CT scans only catch 26% of cerebellar infarctions.

The article says that one tip-off of cerebellar infarction is being unable to walk without support. Well, I did walk from the Information desk at the library to the sofa in the back room. But I doubt I made it clear to the doctor that there was no way I could have done that without the help of my coworker. And I leaned on every desk or wall that I passed along the way, and was not able to walk straight. (By the time the doctor saw me, probably 45 minutes after the initial attack, the vertigo had just ended. So I was able to walk by the time they were done with me.)

Anyway, the really sobering part of the article was this: In the study of misdiagnosed cerebellar strokes, 40% of the patients died! Out of the remaining 60%, half of those had “disabling deficits.” So as it looks like I will get through this without disabling deficits (assuming the wooziness clears up), it looks like I am in the “Lucky” 30%.

Now, the study was based on a small sample. But the fact remains: I am glad I asked for prayer after I went home from the Emergency Room! And I am all the more thankful to be alive and thinking and functioning!

So I am going to have to stop thinking about this, though. After researching it and reading the articles this morning, I really didn’t feel good and slept all afternoon! But let me go on record as being thankful to God that my life was spared!

So, on Thursday, July 28, I had a 9:00 doctor appointment as follow-up for the vertigo that had brought me to the emergency room the previous Monday. My clinic is quite close to my work, so my plan had been to go to the appointment, then see how I was feeling and probably go straight to work afterward.

But when my alarm woke me up, I had an awful headache. I managed to get myself out of bed and knew immediately that I would not drive myself to the appointment, but would go to the emergency room instead. I did manage to use the bathroom, and I didn’t exactly have vertigo like before, but I definitely felt like I was going to faint. I rushed back to the bed and laid there with my heart pounding, wondering what to do. Then I noticed that my right arm and right leg were numb and tingling. Had I been sleeping on that side, so they were just “asleep”?

Some said I was smart to go to the Emergency Room. Well, that part didn’t take a decision at all. I absolutely knew this fit the criteria on my discharge papers that I should go back. But should I call the paramedics, or should I get a friend to take me?

Where I was maybe not so smart was that I decided I did NOT want the paramedics to come when I was still in my Sleep Shirt. And they wouldn’t have room for a stretcher in my bedroom, with all the books on the floor! So vanity made my initial decision for me. I was feeling slightly less woozy, so I got up and put on some clothes. I did not go so far as to take a shower — I was really afraid I’d faint if I tried that.

I did wake up my one-day-less-than-17-year-old son to tell him I was going to the Emergency Room rather than to work, so I didn’t know when I’d be back. I wasn’t quite sure he really heard me! (This was early for a teenager.) I put together a little bag with some changes of underwear just in case they admitted me.

Okay, next step: I thought I’d get some breakfast. Maybe I’d feel better after eating? My standard breakfast is oatmeal, so that takes a little time to cook. I went to the sofa and laid down every minute or so and managed to get the food made. As I was eating, I noticed that the right half of my face — particularly my lips — was numb and tingly. That freaked me out completely. Now I was sure I was going to the Emergency Room.

I still wasn’t sure though, whether I could have a friend take me or if I should call the paramedics. I decided to call my doctor’s office, since I definitely wasn’t going to make that appointment. By then, I was feeling considerably better. I think the tingling had mostly passed, and I was lying down on the sofa when I made the call. They cancelled the appointment and told me to go to the hospital, and that I could have a friend drive me.

I called a couple friends, and found one who was able to take me and left right away. (Thank you, Kathe!) I tried to figure out what to bring and made sure I had everything I wanted. Then I thought I’d print a map for her to the nearest hospital. Somewhere while I was printing out the map, I started feeling awful again. I actually called Kathe, and if she hadn’t been only two minutes away, I would have called the paramedics. But she showed up right away. She helped me walk unsteadily — I couldn’t walk in a straight line — to her van, and I asked to lie down in the back seat instead of sitting up. She got me to the hospital quickly.

And they got me in right away and looked me over. (Fair Oaks is a great hospital!) At first they didn’t seem very alarmed. They had access to the CT Scan that was done on Monday, so didn’t think it needed to be done again. But since I had that tingling on my right side (and that continued), they decided to do an MRI.

While they were doing the MRI, I was praying that if something was there, they would FIND it. Because I absolutely knew that I was not okay and I would have a really hard time believing these were new migraine symptoms.

Later, when they did send me for a CT Scan, I figured they must have found something. Sure enough, they told me I’d had a stroke, and they were going to admit me “overnight for observation.” Okay, I guess they tell you “overnight” at first to let you down easy! I was super glad I had taken the time to eat breakfast, because I didn’t get any food until after they admitted me at dinnertime. They did four tests that first day. I think the other two were a sonogram of my heart and an MRA (magnetic resonance angiography) of my head.

When I had dinner, my roommate on the other side of a curtain said it smelled delicious. She asked what it was, and said she was on a liquid diet, so she was enjoying my food vicariously. I asked how long she was on a liquid diet, and she said For the duration! It turned out (from her phone conversations and such) that she was dying of cancer, but had just had surgery to drain her stomach from fluids that were making her sick, which had her feeling much better. She told friends that earlier that week, she thought she was dying, but thanks to the surgeon, now she was hoping to walk unassisted in her son’s wedding next month. She was an inspiring Christian lady, and definitely nipped any desire I had to complain in the bud right at the start!

The next day was my son’s 17th birthday, so I was sad to be in the hospital, but still rather dazed. (And his Dad had picked him up the day before, so I knew he was in good hands.) They didn’t let me eat, because they had two more tests scheduled. This was an MRA of my neck and a TEE (transesophagal echocardiogram?) of my heart. For the TEE, I had to swallow an ultrasound probe, so they could get an ultrasound of my heart taken from the esophagus. They were still looking for a reason I’d had a stroke. Oh, and they sedated me for the TEE, so though I remember the unpleasant experience of swallowing the tube, I don’t remember anything else about that procedure.

Anyway, the good news was that my heart is strong and healthy. However, the MRA showed the cause of the stroke. I’d had a Vertebral Artery Dissection. The neurologist described it to me as a brusing of an artery in my neck.

I immediately made the connection with the lowgrade headache I’d had for the last four weeks. I had noticed one thing about it that was different from my other headaches — I was super sore in my neck, right behind my ear. I also remembered how my neck had been hurting pretty consistently since ALA, when I tried to sleep on the plane and slept in a bad position. (That decision not to bring my neck pillow was a bad one!) I had chalked the headaches up to lack of sleep, but I now think it was a bit more than that!

That second day had some additional drama in that my roommate really wanted to be discharged. She had tickets to see Hairspray, and she explained to the (male) nurse that it was super important for her to really enjoy what was left of her life, so she would probably leave whether she were discharged or not. We were all very happy when she was indeed discharged!

Now that they knew what was going on with the stroke, they had me on a Heparin IV and Coumadin pills. They said I would stay in the hospital until the Coumadin was at a therapeutic level. Fortunately, I hadn’t had any more numbness or tingling since the first day. I had decided that in the hospital was a good time to stop my caffeine addition (three caffeinated drinks a day), and I had only had one meal Thursday and Friday anyway.

But Saturday and Sunday were taken up with awful headaches. I took as much morphine as they’d give me, and then they switched to Dilaudid. I felt better Monday, then started having the awful headaches again — throbbing, super-painful headaches that went away after about ten minutes — but then came back again. After a very bad day with that, the doctor reasoned that the Dilaudid might be causing the headaches, and switched to Percocet. After about a day, those super-intense headaches completely disappeared, thank God!

So from there, it was a matter of waiting for the Coumadin to get to a therapeutic level. I didn’t have a lot of energy, but managed to do a little walking. Dear friends came at different times, and I also got calls from friends, so I felt loved and supported.

Finally, on Saturday, August 6, my 10th day in the hospital, I got to go home!

I began writing Sonderbooks 10 years ago this month! (Wow! I just realized that!) It began as an e-mail newsletter of book reviews. I noticed quickly that I got the most reactions from reviews that included my personal thoughts about the book. Later, I made a website, sonderbooks.com, and finally in 2007, I added a blog. I figured the Sonderbooks blog would be for the book reviews, and I added this Sonderjourneys blog for more personal thoughts. At the time, I was thinking of all the traveling and picture-taking I did while living in Europe. A blog would have been a perfect way to talk about all the castles I visited.

However, I don’t travel so much any more, and when I do, it’s often book-related. I decided to blog about this year’s ALA Annual Conference on my Sonderbooks blog, since the whole event was about books.

But Sonderjourneys is a good place to blog about life journeys. My last entry was my Christmas letter at the end of 2010. As you can tell, I was hoping that 2011 would be a happy start to a new life as a divorced woman.

And, yes, it has been good. Early on, I had some rather annoying trouble with ovarian cysts. Didn’t feel much like blogging about them. But ALA Annual Conference was fabulous, so I put that in the Sonderbooks blog. I did finish my book and have been sending it out to agents. I also finished a second book that includes my passion for math — a book about using math to make codes with colors and patterns. I’m very happy with it, but I still want to find an agent who likes my fiction, so I’m starting by sending out the novel.

I’m also super pleased to be back at the library. I’m enjoying the big beautiful regional library where I work now. I’ve been learning all the resources in the Virginia Room at our branch and researching my own genealogy and having a lot of fun with that.

And I’m particularly looking forward to going to my brother’s wedding the last week of the summer in Oregon — or at least I really hope I can go!

Because last week I had a stroke.

So I figure that recovery may end up being a fairly big journey. Time to blog about life again.

First, yes, I am young for a stroke. I’m 47. Here’s a wikipedia article on vertebral artery dissection, which is they think what started mine. They’re not sure what caused the vertebral artery dissection.

My personal theory involves wondering if something got started on the trip to ALA. My headaches (which I’ve had all my life) were doing unusually and amazingly great until I went to ALA Annual Conference. Now, I didn’t get enough sleep during the conference. I also slept badly on the plane — with my neck at a bad angle that set it aching. And then I carried around big heavy bags of books. I remember that hurt more than it felt like it should have — from my shoulder all the way through to my neck.

Anyway, I started with a lowgrade headache that lasted four weeks and wasn’t affected by anything I tried taking. A few things like Vicodin allowed me to sleep, but then the headache would be right back where it started. I found that working through it seemed to work better than staying at home lying in bed — if only for the distraction value. When I laid in bed with nothing else to think about, I felt worse than when distracted by questions to answer and the like. But some days, it was hard to face work, and it was always hard to get out of bed with a headache.

So last Monday, I went to work with that same lowgrade headache. The pain wasn’t any worse than it had been, but I was finding it very difficult to concentrate. I was thinking about asking to go home (but not wanting to use the leave), but went ahead and had dinner and was sure I was going to make it through the day.

Then — just sitting calmly at the Information desk, in between customers, simply talking with my co-worker — all of a sudden I was hit with incredible dizziness. The room was spinning. I could hardly see straight to close the windows on my computer of my e-mail. (I think I got one window closed and then gave up.) I put my head down, and my co-worker came back from answering a patron question and then helped me walk to the back room and lie down on the sofa. I couldn’t walk in a straight line and the room was still spinning.

I was hoping that lying down would take away the dizziness, but it just did not. Any movement of my head whatsoever sent the world spinning again. I was also in a cold sweat. After 5 or 10 minutes I got to thinking about what I’d been told about birth control pills putting a person at higher risk for stroke (I’d been on birth control pills for the ovarian cyst problems.), and asked my boss to call the paramedics.

When the paramedics came and asked me to do something that involved moving my head, I began vomiting up my dinner. This was not fun, and quite freaky. I’ve had hundreds of migraines in my life, but never with vertigo like that.

And riding in the ambulance was nothing as fun as it used to look on my favorite childhood show, Emergency! The movement made the dizziness worse, but they did give me a shot of an anti-nausea drug in my IV. The dizziness stopped right about exactly when the doctor came to see me in the emergency room, wouldn’t you know it!

They did a CT scan and an EKG. They did some neurological tests and I heard them say that markers for a stroke were negative. Everything came back negative. So we were thinking it might be some disturbing new variation of my migraines. I was supposed to follow up with a neurologist. I found a nice friend willing to drive me home. (Thank you, Marilynne!)

The next day, I was pretty out of it. Now I was not feeling like pushing myself. I still had a headache and felt pretty yuck. I didn’t even have the energy to make the doctor appointments I needed or get the prescriptions filled. Fortunately, I wasn’t having any more nausea or dizziness.

On Wednesday, I still wasn’t feeling great, but I did manage to call and learn that Tricare wanted me to make an appointment with my primary care provider before I could make one with a neurologist. So I made an appointment for Thursday morning. Another friend (Thank you, Kathe!) took me to pick up my car at work, and I told them that I would hope to come to work after the Thursday morning appointment. I got home after picking up the car and went to sleep, but otherwise did think I was feeling better, though I still had the headache.

Thursday was when everything hit. I’ll write more in another installment…

Life is interesting, isn’t it? I couldn’t have predicted any of this at the start of the year. But God does continue to feel near — in a way He never did before the whole awful divorce journey. One wonderful verse he’s given me is Hosea 4:17 — “Therefore I am going to allure her; I will lead her into the desert and speak tenderly to her.” Sometimes, when God leads us into the desert, it’s so we’ll hear his words of love more clearly. May that happen here.