When celebrities die, the world seems to suddenly become more aware of the many maladies that kill humans. I think that’s probably a good thing, because we need the occasional reminder of our mortality to keep us centered, but also because following the death of a famous person we get a series of reminders of what we need to look out for regarding our own health. Famous deaths, in a strange way, have a secondary effect of making us healthier.
While we don’t know yet exactly what killed actor Luke Perry, we do know it was due to complications from a stroke. The buzz around his death is that most people think stroke is a disease that old people get, but unfortunately that’s just not true. There was a good article in the New York Times this week about how stroke effects younger people.
In my work I meet a lot of young stroke survivors including some in their 20s and 30s. While it’s not too common, it does happen. The article calls out undetected birth defects, blood clots, and aneurysm as reasons for stroke in young people, and there have also been some high profile drug interaction causes like in the case of the oral contraceptives Yaz, Yasmin, and Ocella which were not found to cause stroke but which were taken off the market because of side effects that may have led to stroke in some women.
And then there is the dreaded spontaneous arterial dissection, something that I learned far more than I would have liked when in 2017 at age 50 I suffered a stroke as a result of a dissection of my carotid artery. Because you probably have no idea what a dissection is, here’s a definition:
“An arterial dissection is a tear in the lining of an artery. When a tear occurs in a major artery in the head and neck — the carotid or vertebral arteries — that transmit blood to the brain, this is called a cerebral arterial dissection.”— University of California San Francisco
In layman’s terms, for various reasons an artery can tear without warning and as a result blood flow can be cutoff to the brain or a clot can travel to the brain causing a stroke. Fun, huh?
In my case, I was in Tucson helping my parents move on a lovely April day and unbeknownst to me I began slurring my words. When I say unbeknownst to me that’s because I honestly have no recollection of it. I continued to move items from the truck into the apartment, and apparently my niece thought I was joking around and slurring my words on purpose in an attempt to make fun of someone. Unfortunately, that wouldn’t be abnormal behavior for me. A few minutes later, back at the truck, my brother in law responded much more dramatically. He noticed that the entire left side of my face had dropped, and he yelled for my wife.
Moments later I do remember being back in the apartment and telling my wife I was fine. In fact, I insisted I was fine. But my wife was by my side six years earlier when I had a heart attack and tried to play it off so she was having none of it. She also knew about FAST.
- Face Drooping
- Arm Weakness
- Time to Call 9-1-1
I had the F and the S covered, and she took care of the T. Within minutes, the paramedics arrived and while my symptoms had gone I got a ride to the hospital to be safe (I was a heart patient after all). Because the stroke was short-lived, doctors figured it was a Transient Ischemic Attack (TIA), often called a mini-stroke. These are fairly innocuous, but could be a warning sign of something worse to come. But tests confirmed I had a full-on stroke, and nobody could tell me why.
I don’t want to minimize my stroke, but I got lucky. Unlike Perry, my stroke was small, came and went quickly, and in the end I have had no noticeable deficits. My face and speech returned to normal, I experienced no arm or leg weakness — hell I didn’t even have a headache. In 2011 I had a nearly 100 percent blocked widow maker artery and my heart has pretty much bounced back. I had a stroke and have had no lasting effects. I am clearly a lucky dude.
Perry, however, was not so lucky. As we learn more about his stroke I suspect the reason for its size and devastation will become more clear. For my part, it took five days in the hospital, three specialist followups back home in Phoenix, and multiple invasive tests to diagnose with some certainty (not complete certainty) that my stroke was a result of a dissected carotid artery.
Honestly, we still don’t know exactly. The hospital doctors couldn’t determine why following the stroke my carotid artery was 100 percent blocked. Neither could my cardiologist. She sent me to an electrophysiologist to see if it was due to a clot from atrial fibrillation (AFib) or another heart rhythm issue. He ran some tests and those came back normal. I then went to a vascular surgeon, who said that because of the shape of the blockage in my carotid artery it was likely a dissection, but he couldn’t be sure. Oh, he also said there was no way to fix my carotid artery because it was too dangerous to try to open the blockage so I would simply have to live the rest of my life relying on the other arteries delivering enough blood to my brain. (This is cool, but apparently the body learns to compensate and even creates new arteries to get around the blockage).
Because of my heart history, the biggest worry for me was that the carotid blockage was caused by the same thing that caused my heart attack — calcium buildup from fat and cholesterol in my blood. This was infuriating to me, and really scary, because since my heart attack I had changed my lifestyle and been working hard to maintain good cholesterol. If my efforts had been fruitless I may have been fighting a losing battle all these years.
Strangely, the possibility that the stroke was due to plaque buildup put me into a major funk. I had beat the heart attack in 2011, but if I could still drop dead any second from a stroke or another heart attack despite all that I had done to negate this possibility, I was a lost cause. After my heart attack I was oddly calm. I got lucky, and I moved on. I really didn’t overthink how close I came to dying. But the stroke knocked me for a loop.
I started to dwell on death. I began researching cemeteries because I wanted all those details to be taken care of before I croaked so my wife and family wouldn’t have to worry about it all. I went as far as to research various alternatives to burial like burial at sea and natural or green burial. I found out I could be cremated and planted with a tree, or turned into a diamond (although asking one’s spouse to wear your dead ashes around their neck after your gone is a bit selfish). I even dragged my wife to visit a few cemeteries in the area, but in the end the cemeteries in Arizona were depressing as hell and I eventually changed my mind altogether and decided I wanted to be cremated and have my ashes spread at Powerhouse Park in Del Mar, Calif. (my favorite spot on earth). So I got that going for me.
The possibility of the stroke being caused by more plaque buildup led to me having an angiogram to check inside my heart and arteries. So it was back to the hospital to have a camera inserted through my groin and up into my cardiovascular system, and the good news was that my arteries were all very clear. All the work I had been doing to keep my cholesterol down had been working.
That was sweet relief, but it didn’t provide an explanation for the stroke. Next stop was a neurologist, and more scans, and then something really odd happened. The new scans, taken just a few months following my stroke, showed that my once fully blocked carotid artery was now flowing nicely. It had spontaneously cleared on it own. This phenomena all but convinced my neurologist that I did indeed suffer a dissection, since many dissections spontaneously heal on their own. The body once again outsmarted medicine.
This all leaves me with no clear answer as to what caused the dissection, as I did not experience any trauma like an accident or a roller coaster snapping my neck too forcefully. And while I ended up having a good outcome (just like I did with my heart attack), it still left me a little uneasy about how delicate our bodies can be. But hey, what can you do?
These days I don’t think about the stroke much. When I meet stroke survivors who have been left with deficiencies, I feel a little guilty in the same way I feel guilty when I meet heart attack survivors who had to get cracked open for a bypass. And, as this blog post might suggest, I am always taken back to that day in April 2017 when someone famous has a stroke.
The bottom line here is that I am probably still alive thanks to luck, and the quick thinking and persistence of a smart spouse. So I suppose the lesson is to know the signs of stroke and heart attacks and be vigilant. If you suspect you are having a stroke or heart attack, get thee to a hospital post haste even if you aren’t sure. The life you save just might be your own.
And RIP Dylan McKay!