Personal VAD & Stroke Stories - Page 11

VAD, Stroke, Spontaneous, M37

Here is the link to my story. I'm the cover story for Advance Physical Therapy and Rehab Medicine. You may have to sign in as a guest to read my article. Its the sept 17th issue.

If link doesn't work. www.advanceweb.com/pt click on my pic at top right hand corner.

VAD (bi-lateral), Spontaneous, F26

Three weeks before I went to the hospital I had a stomach bug and was throwing up. While throwing up my left side of my neck started hurting me. I thought it was just a pulled muscle. I swim three times a week, and I kept swimming. Then it started hurting more so I took a week off of swimming. Then after a week I went back to swim, while swimming my left shoulder and neck started hurting, at first it felt like a muscle cramp. Then it went down my whole left arm and then went to my right side. My arms got really heavy, numb, and tingly. Then I got dizzy, light headed, and nauseous. After that was happening for awhile I started having trouble breathing. That's when I went to the hospital.

They were really great and got me in right away. I had an MRI and the ER doctor thought something looked weird but wasn't sure, so I had another on done, that is when they told me I have VAD. But then it was only in my left artery.

A couple of days later when I was still in the hospital my right shoulder and neck started hurting really bad. So I got another MRI done. That is when they told me my right side just dissected. I was the talk of the hospital and was moved to ICU. We decided to try and avoid surgery. I am on blood thinners and on lovanox shots. Right now I am going to the doctor every two days to check my INR. I am hoping to get off the shots soon.

VAD, Stroke, Spontaneous (chiropractic manipulation), F28

It's so nice to have found this website!

My stroke happened very suddenly and very severely late Saturday evening of September 29th (very recently). I was hit with severe vertigo like symptoms, severe vomiting, face paralysis, blurred and unfocused vision, and falling to the left. My husband called the medics and once I arrived in the emergency department, I was shoved aside for hours. The doctor thought I was a drunk or drugged up on something. They tried every drug on the shelf to treat the vomiting and when that wasn't working, a ct was ordered.

It took 12 hours to get diagnosed, but it was clear - I had a stroke. It was caused by a severed vertebral artery, as a result of chiropractic manipulation. My symptoms at their worst lasted 18 hours. I stabilized quickly after that and went home 3 days later. Once the staff and doctor found out I had a stroke, they treated me very differently.

I'm angry that they didn't take me seriously in the beginning and I had to suffer for so long. I too became a person of interest! It's not every day you see a healthy 28 year old have a stroke!

VAD, Stroke, Spontaneous, M57

On Wed 29th August 2012 I was struck with a severe headache on the front left of my head and behind my left eye. It was so bad I had to leave work and go home. the next day I saw my GP who said I had a virus infection and sent me home. The headache continued to get worse and I was taken to hospital on Saturday 1st Sept 2012 by emergency ambulance.

I was found to have a BP of 212 over 10. I was already taking Bendrofluaside for hypertension. I was given Amlodapine 5mg and taken to CT scan and MRA. I was found to have a left VAD in the V1 area. I was shown to have a developing Infarct in the left potirior horn of the internal capsual, an old infarct in the left cerrebellum and an old infarct in the right inferior occipital lobe.

I was started on Clopidogrel 75mg and continued with my amlodopine.
I was discharged on Mon 3rd sept2012.
My headache had gone but I was left with balance and walking problems and also an intolerance to load noise.
I went to my GP on Tues and my BP was 176over 48 and my amlodopine was increased to 10mg once a day.
My balance has now improved but not my intolerance to noise. I have no other neurological deficit.

I hope this can be of help to you.

VAD, Stroke, Spontaneous, F37

"I don't like having to live a new normal," 37-year-old Meg Hunt told ADVANCE just 3 months after she narrowly escaped death following a stroke. Although the casual observer may not recognize Hunt as post-stroke, she continues to battle deficits that affect her daily function.

Before her stroke, Hunt was the picture of health. The married mother of two and full-time teacher was an avid runner, lifted weights regularly and frequently attended Cross Fit. "For me, 100-percent recovery means returning to those activities and doing everything I used to do," Hunt shared. "I expect myself to be as good as I was before." It is that perseverance and steely determination-with a dash of self-deprecating humor mixed in-that has helped her make a faster-than-average and incredible recovery.

Her Worst Nightmare

In the early morning hours of April 7, Hunt woke up to a loud buzzing in her head. She was confused, nauseous and unable to see. After insisting that her husband, a state police officer, call an ambulance, she was violently sick to her stomach. Hunt had a CT scan and other tests at St. Luke's Hospital in New Bedford, MA, and recalls being aware of her surroundings but unable to communicate. The last thing she remembers was being intubated and then wheeled to a medical helicopter for transport to Beth Israel Deaconess Medical Center in Boston, MA.

She doesn't remember the ride. Her next memory was of waking up in a hospital bed unable to see. She could hear people swarming around her. The only thing she could move on her right side was her thumb. Hunt was told she had had a stroke. Officially, she had a spontaneous vertebral artery dissection that was trying to heal itself when it caused two brain stem blood clots. When Hunt thinks back on the first sign of symptoms, she recalls seeing spots on New Year's Day. She was sure it was nothing.

Vertebral artery dissection (VAD) is a flap-like tear of the inner lining of the vertebral artery. Located in the neck, the vertebral arteries supply blood to the brain. VAD symptoms may include head and neck pain and common stroke symptoms such as difficulty speaking, vision loss and impaired function. The life-threatening tear can be spontaneous or traumatic. An increasingly recognized cause of stroke in patients younger than 45 years of age, VAD is often confused with the more common carotid artery dissection (dissection of the large arteries in the front of the neck).

Experts have varied opinions on the causes of VAD. Many believe that the condition's risk factors may include chiropractic manipulation, migraines, strenuous yoga and other exercise routines, to name a few. "There are theories about why this happens and how it happens but Archive ImageA Susan Sherman, PT, team leader at Southcoast Brain & Spine Center in Darmouth, MA, works with Meg Hunt on core exercises. the fact is, we don't know exactly how it happens," said Sandra Gibson, PT, Southcoast Brain & Spine Center in Dartmouth, MA. According to Gibson, it's important that people know to call a doctor when they have an unusually bad headache or numbness or tingling in the face. "Don't think that these symptoms will just go away with time or that they are nothing," she cautioned.

Battling Back

On April 11, Hunt was admitted to the inpatient unit of Braintree Rehabilitation Hospital in Braintree, MA. She was dealing with the loss of hearing in her right ear. She was on a Heparin drip until her International Normalized Ratio (INR) could be deemed normal. Her roommate was a fellow stroke patient but unlike Hunt, she was in her 80s. "Every patient is a lesson because they all have different backgrounds and levels of motivation," observed Kerri Kennedy, PT, Braintree Rehab. "From Meg, I learned about interacting with a younger patient and the emotional challenges that go along with it."

Kennedy found Hunt's case challenging because she doesn't typically have young patients in her setting. "I had to pick my brain to come up with new activities to challenge her," she explained. Following an evaluation with Kennedy, Hunt was issued a hemi walker. She could only walk 20 feet with the hemi walker before fatiguing. "I felt unsteady and like I had vertigo," Hunt said. "But mainly I was frustrated because I couldn't understand why I couldn't do more."

When Hunt arrived at Braintree, she was beginning to regain some movement on her right side. She had hip flexion and extension but no ankle flexion and she was vaulting on the left side to get her right side forward. She needed moderate assist for transfers and mobility. Because she was a fall risk, two aides needed to assist her when visiting the bathroom. "The toilet paper holder and the handle to flush were both on the right side and I had little function on that side," she recalled. "It was humiliating that I couldn't even do that part for myself."

Most of the PT sessions focused on strengthening her right leg with exercises such as squatting. She went to a walking group each day and worked on quad control and sit to stand. Her rehab sessions also consisted of functional electric stimulation to work her tibialis anterior and hamstring and an automated body weight supported treadmill training device for gait training. "It was challenging working with Meg because she wanted to work at a higher level than she actually could," Kennedy shared. "We did 30 minutes of mobility exercises each day but she wanted to do an hour. When I let her try one day, she fatigued around 35 minutes. It was a hard lesson for her to learn."

Hunt walked independently with a cane and brace upon discharge, with the goal of progressing to indoor/outdoor walking without a device. She was using a non-reciprocal pattern on the stairs and was determined to get back to normal, Kennedy explained.

Making Progress in Outpatient

"When you look at Meg's CT scans, it's completely amazing," said Susan Sherman, PT, team leader at Southcoast Brain & Spine Center. "You see her vertebral artery flow and then it just vanishes. It was a clean severance and it looks like a bomb went off." At Southcoast Brain & Spine Center, Gibson conducted the initial evaluation to identify her deficits and determine the plan of care.

When Hunt first arrived, she presented with significant disability on her right side. Her lower right extremity showed weakness at her hip and recurvatum at her knee. Her core instability was significant. "When she first arrived, she was not weight shifting to the right side completely and she had a little bit of toe drag," stated Heather Robinson, PT, Southcoast Brain & Spine. "Strength was an issue for Meg."

Robinson believes in a functional approach. "A patient who safely works on balance on an unsteady surface is going to make a faster recovery than working on a solid surface," she explained. With Robinson, Hunt worked on weight shifting and balance on a trampoline and progressed to catch-throw on a bosu. According to Robinson, younger stroke patients rebound more quickly. "Some older patients do very well but it may just take them longer," she stated. "Balance is generally more of an issue with older patients but when safe, I have them participate in the same activities."

But Hunt's deficits did not end with her core and lower extremity. She was having difficulty completing daily activities, such as blow drying her hair, which required regaining strength and coordination in her upper extremity. Hunt has been going to PT and OT sessions twice each week since her discharge from Braintree Rehab. "We initially worked on functional activities such as bending over to put on her shoes and socks, tie her shoes and grasping a coffee mug to bring it to her mouth," stated Brian Knutsen, OTR/L, CHT, president of Buzzards Bay Hand Therapy LLC in Marion and Lexington, MA. "Now that she has progressed, we are working on more refined movements."

Her OT sessions have mainly addressed proximal stability of the shoulder, gross upper extremity strength and fine motor control and coordination. "When Meg first came to me, she was relatively acute after her stroke," Knutsen relayed. "I expected her progress to be slow and steady as is common with neuro cases. Meg's rapid progress was an interesting challenge for me. I constantly updated her treatment plan to stay relevant and keep up with her recovery." Knutsen has had Hunt work on work-specific tasks such as sustained shoulder positioning while she holds a dry erase marker to prepare her to write on a board in a classroom for prolonged periods.

"We worked together as a team for Meg's recovery," said Sherman. "Each of us has her own styles and beliefs. I focus on core stability, Heather has a functional rehab approach and Sandy uses a neuro-developmental approach." Hunt refers to her PTs as her "3 brains." Because she is unable to work right now, Hunt likes to think of therapy as her job. "Recovery depends on the patient, the severity of the stroke, her fitness level prior to the event and how much exercise she is doing on her own." Robinson observed. "Meg caught on to the exercises relatively quickly, partly because she was an athlete prior."

The therapists have given Hunt a home exercise program. She supplements the program by going to the gym and doing Pilates privately four times a week. "Meg has rapidly run through all of the developmental sequences which is a reflection of her perseverance and dedication," Sherman observed. According to Gibson, the therapists will continue to see Hunt twice a week. Patients are reevaluated every 30 days to reassess goals and treatment plans.

At this point, Hunt has hardly any recurvatum on the right side, she can bend her knee smoothly and kick through, and she's not keeping the knee flexed at mid-stance, according to Robinson. Her weight shifting has improved and her core has gotten stronger. "It's amazing to see what Meg has been able to accomplish and recover through hard work and dedication," Sherman said. "In my 26 years as a therapist, I've never seen a patient who has worked harder or has been as involved in her own recovery."

Hunt's personal goals at this point are somewhat more focused. "I would like to be able to write out a check and type on the computer without fatiguing," she stated. And, of course, the goal to get back to running is never far from her thoughts.

"Many patients following stroke are very focused on their ultimate prognosis," Knutsen said. "This is a challenging question for the therapist to answer especially early on in the rehab process." Knutsen feels confident that Hunt has every opportunity to make a full recovery given her rapid recovery, positive attitude and commitment to rehab. "Meg was in the best shape of her life," Sherman told ADVANCE. "If she had had any less core stability and lower extremity and cardiovascular strength leading into the stroke, the outcome would not be the same."

Rebecca Mayer is senior regional editor of ADVANCE and can be reached via email.

VAD, Stroke, Spontaneous (after chiropractic neck adjustment, F44

This is written by my 16 yo daughter who has been by my side through this whole thing. I'm not quite ready to relieve the experience by writing it down yet.

Please click on the links.

Stroke Part 1
Stroke Part 2
Stroke Part 3

VAD, Stroke, Spontaneous, M35

On October 10th, 2 days before my 35th Birthday, and 3 weeks ago, I was sitting with my boss eating some lunch. I thought it was weird that my left side peripheral vision went away. Not thinking it was something serious, we left the restaurant. I dropped him off at his car, and began noticing a serious headache. I stopped and grabbed some Excedrin and went about my day, still thinking what happened while eating lunch was weird, but not ready to take medical action. When my left had went completely numb for about 5 minutes, that is when I drove straight to the hospital.

At the hospital they found out that through the CAT scan I did not have a major stroke, but could have had a mini-stroke. The doctor had a sonogram done of my neck, and suspected a dissection. He kept me overnight, and after an MRA of my head and neck the neurologist determined that I had vertebral artery dissection. He also said that I only had one vertebral artery that ended in my Basilar artery, which makes it more dangerous, because the dissected artery is the only one feeding my cerebellum.

Ever since this happened to me I have been on heprin and coumadin. After reading some of these posts online, I can understand the weird feelings I am having constantly. Dizziness, sharp pains in my head, neck pain, and many other things. I have done lots of research, and have not found anyone else that had the missing 2nd vertebral artery, who has also had a spontaneous dissection. They say 5% of people have just one vertebral artery, so I am sure that it is not a common occurrence. My doctors are concerned about my condition, and have been very specific about doing to much activity or having to much stress.

If anyone else has had a similar condition to mine, I would love to hear about it, because I have found little info on this. Of course I worry about that artery being cut off, but I don't want to be paranoid. So any positive feed back will help.

Thanks for this website, I hope be able to share good news soon.

VAD, Spontaneous, F34

I started having pain Wednesday morning after sleeping on the couch. To me, it just seemed like a crick in my neck. So I did what you do, take tylenol and went about my day.

The next day, it was still present. 4/10 out of pain, but still present. I went to work and felt pain with driving, but after work I still went to my fiddle practice and then drove home. I slept again on my right side to avoid causing more pain on the left side of my neck and shoulder area.

Friday morning felt a lot worse, but I still went to work and did what I did before. I made a Chiropractic appt and he did an adjustment, but it felt much worse. I saw a second Chiropractic doctor that same day, but it felt better for a little bit, but felt much worse later. I was an terrible pain and went home early from work. I rested all of Saturday and didn't do anything at all. It was hard to lift things because of the pain, I had trouble moving my neck left or right because of the pain.

By Sunday I felt good enough to see friends and didn't have a lot of residual pain, except when I craned my neck Left to look over my shoulder for my blind spot while driving. Still I slept on my right side. By Monday, it felt ok, except for the same pain when looking over my left shoulder. This time it migrated by Tuesday to the other side of my neck on the right with a very tender spot to the touch higher on my neck, although the Left side felt better although looking all the way to the left and right was still painful. It got progressively worse and by Friday evening despite warm compresses, despite analgesics, it just felt 9/10 pain along my shoulders and neck.

It just didn't feel right. So I went to the Emergency Room and explained what I was feeling. Luckily I had an ER doc who took my concerns seriously to look into it rather than just muscular but to rule out any neurological/vascular problems that could be causing my pain.

By Saturday early morning, after a CT with contrast, I was diagnosed with VAD and started on Heparin. By the next day, I could move my neck without severe pain. It is now Monday and there is still recovery, but I have learned a lot about that even as a nurse, the worst neck ache of your life is a good thing I went that day.

Turns out that the blood vessel was 75% occluded because of the thrombus that was between the two layers of the intima and media and hadn't been thrown a clot yet. I think it was bleeding a little bit, explaining my pain on the right side and that tender spot on my right neck dissipating with Heparin treatment.

I am thankful, blessed, and very happy to be ok with all function intact.

VAD, Spontaneous, F48

Hello, I not only want to share my story, I also need some answers. On Sept 15, 2012 I woke up with a severe headache-right side base of skull and shooting up the right side behind my ear. I never imagined it was something serious, so I just took Ibuprofen .

After 9 days, I finally went to the ER and was blown off. They told me I pulled a muscle, gave me Vicoden, muscle relaxers and told me to follow up with my primary. I knew they were wrong and asked for a MRI. They told me they don't do MRI's in the ER---What?? I called my primary, she said to go to physical therapy, which I now know may have killed me.

fI called a neurologist and made an appt. but was told I needed my primary to order a MRI first. Round and round we go. My primary called me perturbed that she had to order the MRI and informed me I was not a priority because this was not life or death, but she finally relented and ordered the MRI. This is now Oct. 2. So I get the MRI, go home to lay down and at 6pm my primary calls my husband and tells me to get to the hospital NOW, there is a room waiting for me.

I cried, I think out of relief that someone finally believed that there was something bad going on. Turns out I have a VAD on the right side 90% blocked, but they don't want to put in a stent, just go home and wait for it to heal. Finally had my follow up Nov 15th and turns out it is now 100% blocked but 2 weeks ago the pain had moved to the other side of my head. Same exact pain, I called the doctor when it started, but the nurse told me that it was probably my sinuses.

So the doctor tells me at my follow-up that stenting is very risky and they don't want to do it. The other side does not appear dissected, however there is "something" going on with that side that requires further tests. He also tells me my memory, speech problems do not appear to be from the VAD. My extreme high blood pressure is also unrelated.

I am frustrated beyond belief. I have read others having memory, speech problems due to this. What about the blood pressure. I am now on blood thinners and blood pressure meds, as well as pain meds. My blood pressure got as high as 210/140. Can anyone relate. For some reason it feels better knowing someone is experiencing the same things as me.

 What about the stenting? Is it so dangerous as to not do it? And what if there is something wrong with the other side? Can you live without either VA? Please respond.

VAD, Bi-Lateral, spontaneous (chiropractic manipulation), F36

I had suffered from migraines most of my adolescent years, but they had slowed to just every 5 years or so once I got into my 20's. One of these 5 year flare-ups happened and I thought I would try treating it without meds and would try chiropractics instead. I went to the chiropractor a few times a week for neck and other manipulations. One morning I went to my appointment and had an excruciatingly painful migraine afterward. I eventually called saying I was in terrible pain. They suggested I came back in. The chiropractor adjusted my neck and I remember a strange pain in my left ear, said "ow" and found myself losing consciousness. Luckily I managed to physically push the chiropractor away from me before passing out and stopped him from continuing to adjust as he nearly tore my carotid artery in addition to the bilateral VAD. I immediately started vomiting, was dizzy, and shaking. The chiropractor said this was a common react ion as he believed he had just stimulated the Vagus nerve. As my symptoms worsened, I decided I wanted a ride home so my sister came to get me. Once she was there, he suggested we go to the ER, but didn't say why.

Upon arriving at the ER, they had their suspicion of what was wrong and immediately sent me for a CT scan. This confirmed the VAD and they started me on the Heparin and sent me to ICU. I was monitored closely and the next morning my MRI revealed no stroke. I was very lucky. I spent a week in the hospital and the past few years continued neck pain and migraines. I struggled with anxiety, side effects of Coumadin, and the emotional challenges of dealing with all that had happened. This was all 2 and a half years ago, 6 months ago I finally got up the courage to start going for regular massages and was able to endure the anxiety of someone touching my neck. I am thankful that I took the steps to go for regular massage and finally am not having chronic neck pain.

After reading so many stories of others not knowing they had the VAD, I feel very fortunate that mine was diagnosed so quickly and there were no real serious consequences from my injury.

For those of you who don't realize the risk of VAD from chiropractic neck manipulation, I highly suggest you research before you or your friends or family consent to neck manipulations. Just being female puts you at a higher risk. There are many other risk factors to consider in addition to gender. Please educate yourself to the potential dangers of chiropractics.

VAD, Bi-Lateral, Spontaneous (after chiropractor visit), F33

My daughter, Gabrielle, age 33 with a one month old daughter and four year old daughter went to her OB/GYN saying that her hips were hurting from after the birth of her baby, so her doctor referred her to a chiropractor. She wanted to go to a physical therapist, but he referred her to a chiropractor instead.

When she went to the chiropractor, she said she was scared to be there because she had never been before and she didn't want him touching her neck, but he arrogantly said, "I'm the professional" and cracked her neck anyway. Immediately, she had severe head pain and neck pain, but he told her that was normal.

When she got home, the pain became worse and she called the chiropractor's office complaining of the severe pain. They said that was normal and to put ice on it and it will be fine. She called after a few days and complained about the pain, but no one ever told her to get it checked. My daughter always researches everything, so she went online and typed in her symptoms and "Vertebral Artery Dissection" kept coming up that she worried that it could be that.

Her pain became so bad that her husband took her to the E.R. She mentions to the E.R. doctor what she thought it could be. He said he would give her a CT scan but a VAD would be so rare that he doubts it would be that. Most doctors don't listen to their patients, but THANK GOD this awesome E.R. doctor DID.... and immediately diagnosed her with vertebral artery dissections on both arteries. He started her on Hepron and took her to the ICU where she stayed for 2 weeks.

She was released on coumadin and bed rest for the next 3 to six months. Doctors say she is still at high risk for a stroke if the blood thinners don't stay stable and of course there's always that thin line of if her level is under 2.0, she could have a stroke or if it's over 3.0, she can bleed internally... so stressful!

Her head pain is still severe at different times every day, but rarely is under a 6 (rating 1 - 10). She can't pick up her infant or breastfeed now and the inability to be able to bond with her new baby is torturing her the most.

I'm so sorry you all are going through this horrible deal... I will pray for you all along with my daughter. It's such a sad deal that some arrogant chiropractor can strip a young mother from her newborn baby!