Pain, work and hope: The journey after stroke

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Editor’s note: Kelsey Pennock’s father, Scott Pennock, suffered a severe stroke in 2015 when he was 56, resulting in partial paralysis and severe aphasia.

Instead of a birthday present, Gordon Dixon received a stroke.

Dixon was celebrating his 40th in Acapulco, Mexico, surrounded by friends and filling his days with water skiing and sun. As a family practice doctor and father of three, Dixon enjoyed the vacation the trip provided from the cares of life.

As he stepped onto the dock from the boat he’d been riding in, Dixon began to feel a little strange. Soon after, he had trouble speaking. With a jolt, he realized he was having a stroke and as he went for help, passed out.

Dixon was taken to a hospital where he said he saw his own X-ray images and knew he needed TPA, a clot-busting drug necessary within the first three hours of stroke to save brain cells. However, due to the stroke, he was unable to form the words.

His friends were told Dixon would only be flown to America if the group paid $28,000. His friends pooled their money and Dixon was transported to Texas, where care was administered 16 hours after the stroke had occurred.

Medical emergency stories like these are often wrapped with paper and neatly tied with a bow. An event occurs and results in either death or eventual recovery. However, the tale is rarely that simple.

Eastern Idaho Regional Medical Center is the only Primary Stroke Center in the Greater Yellowstone region, according to its website. Stroke Program Manager and registered nurse Cheri Arnold said she sees around 30 new stroke patients a month at EIRMC and had a total of 339 stroke patients in 2017, an averaged of almost a stroke a day.

Of those patients, she said about 16 percent were discharged without any symptoms and about 29 percent were discharged with moderate to severe symptoms, leaving 55 percent somewhere in between.

While strokes typically happen to those over the age of 65, Arnold said she’s seen a spike in stroke diagnosis for patients in their 30s, 40s and 50s.

According to the American Stroke Association, strokes are the fifth highest cause of death in the U.S., killing nearly 130,000 people in 2016. From 1999 to 2016, stroke mortality rates fell 39.4 percent; however, stroke remains the leading cause of long-term disability. More than seven million Americans are stroke survivors.

The American Stroke Association defines stroke as “a disease that affects the arteries leading to and within the brain,” causing the permanent death of brain cells. Strokes result in a wide range of effects depending on the location and size of the damage.

“There’s a lot of variability with stroke patients,” EIRMC speech therapist Crystal Arave said. “Some are very mild and may not have any symptoms whatsoever, all the way down to patients who can’t speak, can’t eat and are severely impaired.”

Common side effects of a stroke include difficulty swallowing, fatigue, paralysis, muscle weakness, incontinence, vision problems, emotional and personality changes, aphasia and memory loss. Webster’s New World Dictionary defines aphasia as a “total or partial loss of the power to use or understand words.”

“It’s not just something that happens and then it’s done,” Arnold said. “For these stroke patients, it’s oftentimes long term, where they have long-term effects and rehab and personality and cognitive issues.

“So we see them here, but really their story just began here, and it goes long beyond the doors.”

Full of exhaustion and work, disappointments and new dreams, the end of relationships and the growth of others, the journey after a stroke is as unique as the physical effects it can have on its victims.

Vernon’s story

On December 19, 2012, Vernon Gaffner was hosting a Christmas luncheon for his coworkers at his home in Idaho Falls. Then 72, he still worked as a dentist with his wife, Carolinn, at his side taking care of the bookkeeping.

“The only thing in life that I really did was dentistry. I never could imagine what to do when you got retired, what in the world would you do?” Vernon said.

As the party continued, he grew tired and went to rest. When he got up, his toe was dragging on the ground. As he went up the stairs, his left leg collapsed. Carolinn called 911 and they went to the hospital, where they were told Vernon had a minor clot that would dissolve on its own in a few weeks with no lasting effect. Instead, the effects worsened.

After two-and-a-half months of work with a physical therapist at Promontory Point Rehabilitation, Vernon said he was told he would not improve any more than he already had.

“The day the guy told me ‘What you’ve got right now is what you’ve got, it’s as good as it’s ever going to be’… I shed a few tears, I was kind of choked up about that,” Vernon said.

Six years later, Vernon’s left arm remains paralyzed, his fingers clenched in a fist. After extensive physical therapy, his left leg supports him for short distances when he walks with a cane but he still has a hard time staying balanced. He struggles with memory and swallowing is a daily battle.

“I suppose some day, whenever I die, it will be because I choke to death,” he said.

Vernon said he identifies as “one of the most gregarious people possible” and one of the hardest parts of the stroke has been his limited mobility and energy to visit others.

“There aren’t any people. It’s just me. And my wife. And my kids,” he said.

Because of the stroke, Carolinn said their social life has become doctor appointments, physical therapy and doctor appointments. She said their three daughters used to spend time with them doing activities such as boating, skiing, camping and tennis, but since the stroke, they don’t see their kids as much anymore.

The Gaffners had to stop working because of his disability and the full-time care she provides for him.

“He kept saying to me ‘Help me put a mirror in my hand. As soon as I can put a mirror in my hand, I can go back to work. Help me put a mirror in my hand.’ And he could not grip anything,” Carolinn said.

Carolinn said Vernon’s stroke happened in the part of the brain responsible for short-term memory and he often has trouble remembering what she tells him about their kids or appointments. She said while it’s been frustrating, she’s learned patience in repeating herself.

“He can tell me every phylum, family and species of plant, all the bones, all the things he learned in college and in dental school from way back when but he can’t tell me what he did yesterday,” Carolinn said.

The Gaffners have had to adapt in order for Vernon to function. He engages in home exercises like walking on the treadmill, using equipment from therapists, and doing range of motion exercises and he wears a brace at night to help his left hand uncurl. Carolinn said the furniture in the house is all arranged in a certain way in order for Vernon to be able to grab onto it and get around.

However, there are challenges that come with their age. Carolinn is 76 and can no longer help 77-year-old Vernon get out of bed, forcing them to purchase an adapted bed that can lift him up. In the morning, Carolinn said it takes them two-and-a-half hours to get him out of bed, in the shower, and ready for the day. Because of the arthritis in Carolinn’s thumb, Vernon uses a button hook to button his shirts and a special tool to put on his socks so Carolinn doesn’t have to bend over.

“We just take it one day at a time and do what we have to do,” Carolinn said.

Gordon’s story

In the time following Dixon’s stroke, he participated in intensive therapy in Michigan, Salt Lake City, Pocatello and Canada. Three years after the stroke, his wife divorced him.

Studies show that although the majority of stroke survivors remain married, stroke can bring marital instability, with divorce rates higher than those for the general population.

“It’s because the spouse has to learn to live with someone different,” Dixon’s speech therapist and friend Matt Stevens said. “There’s a grieving process that they go through, there’s that shock of the injury. They’re elated that they’re going to survive, but then there’s that grieving process of saying goodbye to the person they used to know and learning to live with someone who’s a little different.”

In 2013, Dixon remarried a woman who had worked as his secretary before the stroke. Today, after more than a decade of therapy, he works part-time with his family practice in Blackfoot and with the Mountain View Hospital Wound Care. He still enjoys water-skiing and fly-fishing and said he salsa dances with his wife. Leaning back in his chair with his leg crossed across his knee, Dixon looks as if nothing happened.

However, aphasia continues to plague him.

Aphasia is a common communication disorder among stroke patients that impairs the ability to speak and understand others without affecting the level of intelligence. Dixon works alongside a trained nurse who understands his speech patterns and double-checks all of the numbers he says. He said he still has a hard time speaking and understanding when he is tired or people talk quickly.

“My speech is really, really hard,” Dixon said.

Stevens said Dixon’s immense progress since his stroke was due to his young age, high pre-injury IQ, no previous health problems, good medical care and his motivated work habit.

“He never has given up,” Dixon’s mom, Janet Dixon, said. “Gordon started walking when he was 7 months old. I thought ‘My word, sit down kid.’ The first time he rode his trike down the basement stairs, he was 18 months. And the first time he stopped traffic, he was 2. My point is, he was born motivated.”

Dixon said those who are disabledcan still participate in hobbies such as art, gardening, shooting or fishing and it’s important to always be doing something.

“Usually (with) aphasia, (people are) looking for the TV, Coke and popcorn. I said ‘No. Let’s go bowling or (do) something else,” Dixon said.

When asked about coping with his stroke, Dixon said it “sucks” but he continues to work hard and get better.

“It’s OK, you know. Just courage and strength,” Dixon said.

 

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