Friday, July 10, 2015

A Head to Heart Conversation

New Hope for Migraine Sufferers from a Most Unexpected Source

I've suffered from migraine headaches for over thirty years. They began when I was a teenager. At the time, I didn't know what a migraine was. I just knew that every couple of weeks I would wake up feeling out of sorts. That would lead into what's called an "aura" - a feeling of lightheartedness accompanied by bright spots in the eyes and usually followed shortly thereafter by pain - lots of pain. 
The only thing I could do was lie down in a dark room and try to sleep for a few hours until the worst of it subsided. 
I was perhaps 16 years old, and I knew nothing of neurologists and pain medications.
It was only several years later that I heard someone talking about symptoms like mine and was told that I likely had migraines. 
There followed nearly thirty years of struggling with this very challenging condition. 
I've tried maybe a dozen different medications including opiates and anti-depressants. 
I've tried adjusting my diet and I've tried going to a chiropractor.
Nothing ever offered more than a brief respite.

A Life Changing Event  

And then, on Monday, March 30, 2015, at approximately 11:30 in the evening, I had a stroke.
I was sitting in my living room in a recliner speaking with my eldest son (he’s 24) when I blacked out for a second and then lost the ability to use my right arm. It just slid away, across the book in my lap, and fell limp on the armrest. I felt some tingling, like it had fallen asleep, but otherwise nothing. I couldn’t feel my arm. I touched it with my left hand and it was like I was touching a foreign object. And I couldn’t move it.
This all happened in moments. My son was still talking. My answers stopped making sense. I realized I was no longer able to speak. I was completely aware of my surroundings and I knew what I wanted to say, but I couldn't make my mouth articulate the words. I suppose I should have been scared, but right at that moment I was more frustrated than anything else.
Since I do occasionally grunt monosyllables as answers, it took a couple of moments for my son to realize something was wrong. He asked if I was alright. I managed to shake my head “no.”
I forced out the word, “Call.” That was all I could say. I was trying to tell him to call for help but I could’t get the words out. Finally I got out the word, “Mommy.” And he quickly called my wife from the other room. (I say ‘finally’ because it seemed forever to me. But it took only seconds.) She immediately called the local volunteer ambulance service and they were there in minutes. All this time I was attempting, futilely, to speak and move my arm.
I got to South Nassau Hospital’s ER stroke unit by midnight. (30 minutes from the initial event.) It felt much longer to me. All my senses were out of whack including my feelings of time and hot and cold. When they brought me in it was like something out of the movies, with a team of doctors and nurses surrounding me as I was wheeled into the ER. Within minutes I was taken for a CT scan of my brain and then returned to the ER. A senior neurologist rushed in and gave a lightning quick briefing to me, my wife and our cousin (a nurse practitioner) who had come running when she’d heard what happened. The best treatment was a medication called tPA, which had a very narrow window of time and physical conditions in which it could be used. Fortunately I was considered a prime candidate. 
It was explained that tPA was the first, best treatment for my condition, and that if a blood clot or other similar blockage was causing my symptoms, the tPA would help break it up. 
"Draino" for the brain. 
The medical staff began prepping me, opening three separate IV lines. This, I was told, was because tPA's blood-thinning properties would make any such invasive procedures impossible for the next 24 hours. 
At 12:25AM, after a hasty (but coherent) consent and just 55 minutes from the onset of the event, they began infusing me with the medication.
I lay on the bed quietly, unable to speak and with a paralyzed arm. The neurologist had said I might see some improvement any time from hours to even months after receiving treatment, or possibly not at all. 
Oddly enough, I was not frightened. Perhaps it was because of the part of my brain that was injured - the parietal lobe - or maybe because of my faith. I felt calm and even confident that all would be well.  
It took an hour to complete the tPA infusion.
Roughly an hour later I began to regain some movement in my arm. And when the nurse asked my wife a question I was suddenly able to blurt out an understandable answer. 
I felt so incredibly relieved! I could speak - and move! I was going to recover!
But within a couple of minutes my hopes were dashed when my speech vanished once again. Intellectually I knew I shouldn't feel so badly, and that I needed to give it more time. But to lose something so precious twice in one night was very hard. 
And then a short while later, one of the nurses needed to check something and raised the top part of the bed to lift up my head and torso. I seemed to feel something change in my head, and my speech started to return once again. 
But when they lowered it back down I couldn't talk!
A few minutes later they raised it again and once again my speech started to improve. This time I asked them to leave the bed in that position!
Throughout this time I was also seeing improvement in my arm. 
By 3:30AM, or about four hours from my the onset of the stroke, I was able to speak in sentences and to hold things in my hand. 
The longest four hours of my life. 
Ultimately, with great kindness from the Almighty, I recovered with only minor lingering effects. 
I was hospitalized for about a week. They ran all kinds of tests trying to figure out why this had happened. Aside from needing to lose some weight I didn't match the profile of a typical stroke patient. I was only 48 years old. No history of high blood pressure or high cholesterol. In fact, my arteries were noticeably free of plaque, aside for some minor age appropriate amounts. 
But an Echocardiogram and a later TEE (Trans Esophageal Echocardiogram) showed a congenital problem in my heart. I had an Atrial Septal Defect, a hole between the left and right upper chambers of the heart. This allowed the "used up" blood on the right side to leak into the left side of the heart, normally reserved for clean, oxygen-rich blood. 
The doctors theorized that a tiny blood clot formed somewhere lower in the body and, instead of being filtered out through the lungs, jumped through the hole to the "clean" side and was pumped from the heart directly to the brain, causing a stroke. 
I was advised that closing this hole was the recommended way of preventing another stroke. I made an appointment to meet the doctors at New York Presbyterian Hospital's Cardiology Center. I was ultimately introduced to Dr. Robert Sommer, a veteran cardiologist. 
He laid out the process in great detail, explaining how they would use a catheter device to install a patch into the heart, a process that used to require open heart surgery but could now be done in under an hour. 

The Migraine Connection 

Then he mentioned something that stunned me. He said that I precisely fit the profile of patients they had been treating - stroke patients who are relatively young and have no outstanding risk factors, but who have a specific type of heart defect - and suffer from migraines. 
He said they're not yet certain precisely what the connection is. The theory is that small amounts of some toxin or waste product or other agent which is normally filtered out before the blood reaches the brain is bypassing the filtration process by way of the defect, causing brain to react with migraines. 

By repairing it, they can cut off the flow of the harmful material and thereby eliminate the symptoms. 
It sounded too good to be true. Then he added that 80% of their patients that had the procedure, and who had previously suffered from migraines, found that the migraines diminished or disappeared completely. 
This information, plus the knowledge that I would be helping prevent a future stroke, convinced me to go ahead with the procedure. 

On June 23, 2015, Dr. Sommer surgically repaired the defect in my heart. Using a device produced by Helex Co., he was able to place a patch inside the heart consisting of two discs, one on either side of the effected area. 

New Lease on Life 

Since then my head has felt completely different. I've had no migraines, and the 'almost headache' heaviness that I perpetually felt is gone for the first time that I can remember. 
Let me say that I would never have chosen to have a stroke in order to solve other health problems. However, that did ultimately lead to the discovery and treatment of my heart problem. 
Obviously not every migraine sufferer has a congenital heart defect. And so little is definitively known about migraines that much of what I was told was couched in terms like "we think" and "we believe."
But I can't ignore the results. 
I hope and pray that this is the beginning of many many healthy, happy migraine-free years to come. 

Danny Kay is marketing and advertising professional as well as a writer, designer and photographer with nearly 30 years of experience. He's worked with businesses and organizations of all sizes, up to Fortune 500.

He can be reached through his website,, or at

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