Young Stroke Survivor Series: James

Meet James, who at the age of 47 suffered a stroke. Despite the stroke, he has been able to return to the outdoors he loves. He is also studying to become a PA so he can help others who have suffered from stroke.

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Zeit Medical: Could you describe your life before the stroke occurred?

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James: Sure. Before the stroke, my life was quite active and diverse. I'm a Native American artist who traveled extensively to Native American art shows and western markets, showcasing my work. Additionally, I was deeply involved in endurance sports, particularly kayaking and hiking, and frequently embarked on long trips for outdoor adventures like ultra-distance kayaking. I spent a considerable amount of time immersing myself in nature, especially chasing rivers and navigating whitewater. While these activities presented certain risks, they also brought me immense joy and fulfillment. I don’t like to live a life asking myself “What if?”

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Zeit Medical: How old were you when the stroke happened?

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James: I was 47 years old when the stroke occurred on July 18th, 2022.

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Zeit Medical: Could you walk me through what happened on the day of the stroke?

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James: Certainly. I was in preparation for a two-week kayaking trip along the Green River in Utah. One morning, while out jogging around 6:00 am, I suddenly felt weakness in the left side of my body. Despite not experiencing numbness, I noticed a significant loss of strength. Drawing upon my past experience as an EMT and wilderness medicine knowledge, I recognized the signs of a stroke. Realizing the urgency, I called a family member for assistance instead of waiting for an ambulance due to their unavailability. Upon reaching the hospital, despite walking in, it was evident from my high blood pressure that I needed immediate attention. For any person that would just walk in and say “I'm having a stroke,” there's going to be some pushback from the reception. So I went in and they asked me to sign my name. I said “I can't hold the pen. I can't sign my name.” I'm limping and someone had to help me sit down. My blood pressure was 254 and I don't remember what the bottom number was, but once they saw that I was immediately rushed back. Anybody that works in the ED knows that when you hear the word “stroke” you drop what you're doing and everyone rushes in. Less than an hour from getting to the ER I was given TPA. It’s a miracle drug. It’s a clot buster drug, and I was able to regain almost full function of the limbs within an hour and full return back about 24 hours later. I stayed overnight and then was released the next day. I know this was on Monday and I was released about 4:00 on Tuesday. It was my choice to be discharged from the hospital sooner than recommended by the attending doctor, and in hindsight that was probably a mistake.

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Zeit Medical: What did the MRI or CT scan reveal?

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James: The scan showed an ischemic stroke in the right thalamic region, but no prior strokes were detected. The exact cause remains unknown, although I suspect that it could be related to an epic tooth infection that elevated my blood pressure.

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Zeit Medical: You mentioned leaving the hospital sooner than recommended. Why do you think that was a mistake?

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James: In hindsight, I regret not opting for inpatient rehab as advised. The education and therapy provided could have better prepared me for the challenges post-stroke. Instead, I relied on self-discovery and conversations with friends and professionals, missing out on important insights and support.

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Zeit Medical: What were some of the challenges you faced during your recovery?

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James: One major challenge was sensory overload, which became apparent during subsequent activities. Despite experiencing a bit of difficulty walking initially, I focused on my own physical therapy to prepare for a trip I was determined not to miss. This trip, which I embarked on six weeks after the stroke, symbolized my determination and recovery milestone. While still in the hospital I had set a goal to hike what is known as the Doll House Hike in the Maze District of Canyonlands National Park at the end of my upcoming kayaking trip.

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Zeit Medical: Could you elaborate on the sensory overload you experienced?

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James: Sure. While I successfully achieved my goal of watching the sunrise from the top of a canyon during the Doll House Hike  exactly two months after the stroke, I encountered sensory overload during the trip, which later posed significant challenges. During the trip, I began experiencing overwhelming sensory overload, particularly in group settings. Evenings with the group became challenging as I felt dizzy and struggled to concentrate, almost as if the inside of my head was spinning. Initially, I brushed it off, attributing it to our remote surroundings. However, upon returning to town and dining together, I found it increasingly difficult to focus or engage in conversations. This sensory overload persisted, affecting my ability to interact with others and even conduct business at art markets. It was a major hurdle that lingered for several months after the trip. Seeking advice from friends who work with stroke victims, I realized I needed to confront and adapt to these challenges rather than avoiding them. I deliberately exposed myself to various stimuli, including attending noisy scout meetings and using VR headsets to simulate crowded environments. This proactive approach helped me gradually desensitize and rewire my brain, especially during the crucial early months of recovery when progress is most significant.

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Zeit Medical: Have you set any specific goals or milestones for yourself during your recovery journey?

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James: In the short term, I focused on rebuilding my physical strength to prove to myself that I could still embark on challenging trips. For instance, I completed a solo 90-mile kayak trip down the Colorado River only 4 months after my stroke. However, my long-term goal emerged during my hospital stay when I reflected on my past as an EMT. I decided to pursue a career in medicine, specifically aiming to become a physician assistant in neurology. I'm currently in the early stages of this journey, having started pre-med courses recently. It's a commitment I made to myself, driven by a desire to make a positive impact on others' lives through healthcare.

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Zeit Medical: That's an incredible dedication to your goals. Can you share more about how you've navigated challenges like attending classes and working in group settings?

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James: Despite the difficulties, I've persisted in pursuing my education and gaining clinical experience. While attending classes, I've used earplugs to manage noise sensitivity and sometimes sat outside the classroom to take notes from lectures. My instructors and peers have been understanding, allowing me to participate in smaller groups or one-on-one scenarios when necessary. Additionally, I've sought clinical exposure through medical transport services and simulated patient scenarios, adapting to ensure I can contribute effectively in a professional setting despite ongoing challenges.

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Zeit Medical: It sounds like you've encountered various obstacles but remained resilient in your pursuit. What advice would you give to other young stroke survivors facing similar challenges?

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James: Educate yourself about your condition and seek support from others who have experienced similar struggles. Joining support groups, whether online or in person, can provide invaluable insights and emotional support during difficult times. Remember that recovery takes time, and it's okay to reach out for help when needed. Surround yourself with people who understand and encourage your journey toward healing and adaptation.

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Zeit Medical: Are there specific resources or organizations you found particularly helpful in your recovery?

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James: Personally, counseling and online support groups like the Young Stroke Survivors on Facebook have been invaluable. While everyone's journey is unique, connecting with others who share similar experiences can offer validation, guidance, and encouragement. These networks provide a sense of community and understanding that is often essential in navigating the challenges of stroke recovery.

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Zeit Medical: Your journey and insights are truly inspiring. Is there anything else you'd like to share or emphasize for our audience?

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James: I want to stress the importance of perseverance and self-advocacy in the recovery process. Depression, in particular, can be a significant challenge, but recognizing it and seeking support is crucial. Remember that progress may be gradual, but every step forward counts. Stay focused on your goals, and don't hesitate to lean on others for help and encouragement along the way.

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Zeit Medical: Yeah, well, as I mentioned earlier, I believe your firsthand experience will greatly benefit your future patients. They'll appreciate having someone who truly understands what they're going through.

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James: Thank you. If there's anything else you'd like me to elaborate on, particularly regarding how stroke affects younger individuals, I'm happy to discuss it. Sometimes the conversation tends to focus more on older stroke survivors, but I think it's essential to address the unique challenges faced by younger patients as well. So, if that's something you'd like to cover, just let me know.

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Zeit Medical: Absolutely, I think we've covered a lot of ground.

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James: Sounds good. One aspect of my experience that wasn't touched upon is the dietary advice I received after my stroke. The prescribed heart-healthy diet, while intended to promote recovery, had unintended consequences for someone like me who was younger and physically active. I found the restrictions overly stringent and actually lost a significant amount of weight due to the limited dietary options provided. It's something I think other young stroke survivors might relate to and should be considered in discussions about recovery. Additionally, I've been able to resume activities like multi-day kayaking trips, which have been instrumental in my recovery journey. Being outdoors and engaging in physical activities has been incredibly therapeutic for me.

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Zeit Medical: That's a crucial point. The assumption that one dietary plan fits all stroke survivors, regardless of age or lifestyle, can lead to unintended consequences. Your experience highlights the need for personalized dietary guidance tailored to each individual's unique circumstances. The lack of resources and understanding for younger stroke survivors is something that needs more attention. I'm glad we had the chance to discuss it. It's essential to recognize that stroke recovery is not one-size-fits-all, and younger survivors may have different needs and challenges compared to older individuals.

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James: Definitely. I appreciate the opportunity to share my story and shed light on these important aspects of stroke recovery. And I'm looking forward to pursuing my career in medicine to help others facing similar challenges.

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Zeit Medical: Your journey is incredibly inspiring, James:, and I'm sure you'll make a fantastic physician assistant. Please keep me updated on your progress, and I look forward to hearing about your future successes.

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James: Thank you for your support and for giving me the chance to share my experiences. It's been a pleasure talking with you.

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