The young family across the street from us walked hand-in-hand – all eight of them – to our driveway, and my husband walked down the steps to greet them. They were strangers to us, but two days before, the six children and their mother had gathered on the small back porch, witnesses to our family crisis.
“When you had your heart attack,” the father said, shaking my husband’s hand, “I was at the store. My wife called saying y’all were looking for aspirin, but I couldn’t get here in time, so I told her to take the kids inside and start praying.”
Which they did that morning and every night at supper after that. They didn’t even know my husband’s name.
Truth is that on that Tuesday morning in the middle of our vacation, my husband had a stroke. And a seizure. He is alive and well today to tell the story, though he doesn’t remember it. He doesn’t remember how we found him unresponsive on the deck of our family beach house – lips blue, face ghostly, body rigid – and doesn’t remember my screaming, our daughter flagging help in the street, our son-in-law running toward where my sister stood three houses away, yelling for her to call 911.
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The children witnessed my extended family running toward us, saw my husband wake up, thank God, flailing his arms at everyone around him, looking to take a punch – which is so not him. What they didn’t see, thank God, too, were his eyes – unseeing as we all gathered around him and tried to calm him as we waited on EMTs.
We would spend two days in New Hanover Regional Medical Center as doctors tried to figure out what happened. Records show that he presented in the ER with an “altered mental state.” An MRI confirmed the stroke.
That he has no residual effects from any of it is nothing short of a miracle. He is back at work and in perfect health, as if none of it ever happened. But I remember.
Signs of heatstroke
In times of crisis, look for the helpers, Mr. Rogers always said, and after the ambulance arrived, I moved away from my husband’s side, knowing I was not one of them. Around me my nephews poured cool water over his body. A doctor who happened to be driving by tried to calm him. A male nurse on vacation rubbed his shoulders. I closed my eyes and breathed deeply. “Care for him,” I prayed, for there was no better thing I could do.
“Your husband exhibited the classic signs of a heatstroke,” says Dr. Bobby Park, a partner with Wake Emergency Physicians, PA, a private practice which supplies emergency room staff to all seven Wake Med emergency rooms, in addition to several other hospitals in the area. “When I hear he is agitated, all limbs working well, a change in mental status, that tells me it’s a heatstroke.”
Heatstroke. A rare occurrence that can be fatal, but something entirely preventable. The curious thing is that he also had a cerebrovascular accident (CVA), the medical term for stroke.
I sometimes call my husband The Skipper. He’s on his seventh sailboat now, Fortune’s Fool V, and most weekends in the past year have found him on the deck of the boat piddling with his love.
On July 8, the heat index climbed close to 104 in New Bern, where our boat is docked, and the Skipper forgot to hydrate well. (He forgot to tell me he was even going to the boat before heading to the beach, but that’s another matter.) The next day he developed a headache, and on the morning of July 12, he drove to the grocery store and purchased an over-the-counter sinus headache medication. Within 30 minutes, the house shook like it would during a sonic boom and unbeknownst to us, he was down on the deck, closer to signing off from this life than I can bear to think about.
Dehydration and heat exhaustion
He had all the signs of dehydration, says Dr. Park: headache, thirst, elevated body temperature. The headache, though, was his only complaint. We weren’t with him for those minutes before it happened, so we don’t know if he showed signs of stroke: slurred speech, numbness on one side of the body, drooping face.
There is a grave difference between heatstroke and heat exhaustion, says Dr. Park. Every summer, as temperatures hover near 100 degrees, he sees many cases of heat exhaustion but fewer heatstrokes.
“Athletes, construction workers, people who spend hours at a time in direct sunlight and don’t drink enough water start cramping up,” he says. “They get dizzy, have a headache, cold sweats, may even pass out. That’s heat exhaustion.”
Heatstroke, he says, involves changes in mental status. Other organs – like kidneys – can be affected. If untreated, it can cause death.
“It is really unusual for anyone to have BOTH a heatstroke and MRI-confirmed CVA,” Park adds. “In fact I’m not aware of anyone else having that presentation for me in 18 years of doing emergency medicine.”
The sinus medication was most likely the tipping point – at least for the heatstroke. Decongestants are stimulants which can cause higher blood pressure and a faster heart rate, Dr. Park says. Already overheated and dehydrated, the medicine just increased the demands on his body and tipped him over on the heat-exhaustion/stroke side of things.
Despite all, it’s easy to find the blessings – minutes later, we’d have been gone from the house. Seconds later he might have fallen down the stairs. And there are so many lessons. We’ve learned about the app on our phones where we can store our medical history. We’re reminded that we have subscribed to a service that keeps our medical power of attorney and HIPPA permissions at hand for doctors to access easily should either of us be incapacitated. (In the midst of the trauma I had forgotten that.)
Our children, busy with their own lives, are paying us a bit more attention.
We are still seeking answers, and while we wait for appointments, The Skipper has found a new appreciation for water. And honestly, I have a new appreciation for the Skipper. I’m grateful for the helpers, for children who spend a hot summer morning when they could be in the ocean, praying for a man they don’t know. I’m humbled that their parents saw fit to bring them over, to see my husband standing tall and well, so much himself. I hope they remember their role in his recovery, because I will never forget.
Susan Byrum Rountree writes from her home in Raleigh. She can be reached at email@example.com.
Signs of a stroke
▪ Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body.
▪ Sudden confusion, trouble speaking, or difficulty understanding speech.
▪ Sudden trouble seeing in one or both eyes.
▪ Sudden trouble walking, dizziness, loss of balance, or lack of coordination.
▪ Sudden severe headache with no known cause.
What you should do
Call 911 immediately.
Signs of heatstroke
▪ High body temperature (above 103°F)*
▪ Hot, red, dry or moist skin
▪ Rapid and strong pulse
▪ Possible unconsciousness
What you should do
▪ Call 911 immediately.
▪ Move the person to a cooler environment.
▪ Reduce the person's body temperature with cool cloths or even a bath.
▪ Do NOT give fluids.
Source: Centers for Disease Control and Prevention
- Stroke kills on average, one American every four minutes.
- 795,000 people in the U.S. each year have strokes.
- Stroke is the leading cause of serious long-term disability.
Some causes of stroke:
- High blood pressure
- Atrial Fibrillation
- Sleep apnea (people with sleep apnea have an increased risk for hypertension, stroke, arrhythmia)