First Update - Day 6

Hello everyone,

If you are checking this blog, you are aware that our husband and father, Burt Stern suffered a stroke on Tuesday night, August the 24th.  The last six days have been very difficult for all of us, but we have really appreciated all of the support that you have given us.  The outpouring of care has been wonderful.

To help disseminate the information on Burt's condition and recovery we have created this blog.  We will post daily updates on his progress so that you know everything that we do, when we do.   You can subscribe to the blog so that you are emailed our updates automatically as soon as we post them.  This is not to say that we don't appreciate your calls and messages of support, because they mean the world to us.  Rather, we are in the hospital most of the day where our phones are off, so this is just the easiest way to keep everyone regularly informed and up to date.

Beyond that, this is also a place where you can leave your messages for Burt.  At first we will have to read them to him, but in time he will be able to read them himself.  One of the few things we can do now is give him support and encouragement so I know those messages will really help him.

The blog is called 'how Burt's doing' and here is what we know.  This will be a longer update than usual as it is the first, and they will be much shorter than this in the future.  To start from the beginning, Burt suffered an ischemic stroke on Tuesday night while volunteer ushering at Tanglewood, the Boston Symphony’s summer home. Another usher saw him slumped over and immediately came over.  People who were sitting next to him said he had only slumped a few minutes before.  Had this happened fifteen minutes later, Burt would have been driving alone on a dark country road, so we were very lucky.

He was taken straight to Berkshire Medical Center in Pittsfield Massachusetts.  It is a great hospital and they are taking great care of him.  Its stroke unit is in the top 5% in the country, so we feel fortunate that he is there.  He was given the clot buster t-PA 2 hours and 15 minutes after his stroke.  This is within the required 3-hour timeframe that it needs to be administered in.  We will not know what effect this will have for some time.

The stroke occurred because his blood thinning medication was not doing its job.  2 weeks before the stroke his blood was at appropriate levels, but when he came into the hospital it was as if he was not even on blood thinners.  We are not exactly sure what went wrong, but the best guess is that one of the recent naturopathic supplements he was on impeded the efficacy of his blood thinner.  Burt has learned his lesson and will never eat another vegetable.

In terms of the stroke itself, a blood clot formed in his heart and travelled up the carotid artery to the right side of his brain.  It is classified as a moderately large stroke and unfortunately landed in a rather dense area where a lot of white matter (the major neuro cabling) is located.  The surface of his brain is untouched, so he have hope that certain alternate neuro pathways might form.

This part of the brain predominantly covers motor function and he does not currently have control of the left side of his body.  His left eye has some control but the left part of his mouth is drooped.  He has some control of his left hip, so we are holding out hope that with therapy he will eventually be able to walk again, perhaps with a cane.  His inadvertent nerve response on his left leg is functional so that might also translate into control with therapy.

His left arm is not responsive and is locked in a spasm across his chest.  We hope that it comes back but the likelihood of him regaining a lot of use of it is under 40% and small motor function is lower than that.  In the last few days he has regained some sensation in his left side and can now tell when he is being touched and where.  This is a very good sign and means that he should be able to avoid one of the worst side effects of stroke, called neglect, where survivors become unaware of the affected side of their body.

So far, Burt has been unable to swallow.  This is a common side effect of many strokes and all of his doctors agree that this should come back.  His gag reflex is intact and he is able to catch and cough up any saliva and get rid of it with his trusty suction tube.  He had minor surgery today to have a feeding tube put into his stomach.  After six days without food, he is very hungry, so this will give him the much-needed nutrition to keep up the fight.  His first meal is scheduled for tomorrow, but he is still focusing hard to pass his swallow test so he can have some apple juice.

Burt's mind is still very much intact.  He is very tired and hard to understand at the moment, but he knows who he is and where he is.  He can still remember his life and still has his sense of humor.  He has been the only one in critical care who makes his nurses laugh.  We hope to see him with a bit more energy and able to make more eye contact soon, but it is great to know that he is still in there.

After six days in critical care he was moved down to the stroke unit today following his surgery.  They woke him up every hour in critical care, so now he should finally be able to get some sleep. Being in stroke care will also allow him to receive visitors. We still think he could use a few days before he should see anyone, so please call us to figure out a good time to visit.

The first 72 hours are where the highest risk of additional strokes and secondary complications occur, so we are happy to be out of the scariest part of this.  But while this is the end of one phase, it is still the beginning of a very long journey.  As we are learning with strokes, it is not a marathon nor a sprint, but rather a march, so progress must be gauged in weeks and months, not days.  Over the next few weeks we hope Burt regains some strength and awareness to get him ready for the lengthy rehab process.  The doctors expect him to stay in the hospital for a month or longer, and he will need to keep going to rehab for a considerable length of time after that. 

Please check in daily for further updates and leave your messages of support for Burt, we know he will appreciate them, both now and in some of the trying times ahead.

Thanks for being there,

The Stern Family