What is a Basilar Artery Stroke? Understanding Causes, Symptoms, and Recovery

Recovery After Stroke

What is a Basilar Artery Stroke? Understanding Causes, Symptoms, and Recovery

A basilar artery stroke is a type of ischemic stroke that occurs when the basilar artery, which supplies blood to critical areas of the brain, becomes blocked. This artery is part of the posterior circulation system and plays a vital role in delivering oxygen-rich blood to the brainstem, cerebellum, and occipital lobes. A stroke in this artery can be severe, often leading to significant neurological damage due to the areas of the brain it affects. Let’s explore the causes, symptoms, diagnosis, and recovery process associated with a basilar artery stroke.

Causes of Basilar Artery Stroke

Like other ischemic strokes, a basilar artery stroke occurs when blood flow to part of the brain is obstructed. This can happen due to:

• Atherosclerosis: The buildup of plaque in the artery walls can narrow the basilar artery, restricting blood flow and potentially leading to a stroke.
• Blood clots: A blood clot can travel from another part of the body, such as the heart, and lodge in the basilar artery, causing a blockage.
• Vertebral artery dissection: This condition occurs when a tear in the lining of the vertebral artery (which connects to the basilar artery) causes blood to pool and clot, reducing blood flow.

Symptoms of a Basilar Artery Stroke

The symptoms of a basilar artery stroke can be wide-ranging and severe, as the stroke impacts vital functions governed by the brainstem. Common symptoms include:

• Sudden dizziness or vertigo: Often one of the first signs, as the brainstem is responsible for balance.
• Double vision or loss of vision: The occipital lobes, responsible for vision, are affected by this type of stroke.
• Difficulty speaking or swallowing: The brainstem controls essential functions, such as speech and swallowing.
• Weakness or paralysis on one or both sides of the body: Depending on the severity, this could affect just one side or result in complete paralysis.
• Severe headaches: Sudden and intense headaches, particularly at the back of the head, may accompany this stroke.
• Loss of coordination: The cerebellum, which is involved in coordination and balance, can be affected.

These symptoms may develop rapidly or gradually, which can make diagnosis challenging in some cases. Prompt medical attention is critical to minimize damage and improve outcomes.

Diagnosing a Basilar Artery Stroke

Early and accurate diagnosis of a basilar artery stroke is crucial to effective treatment. Common diagnostic tools include:

• MRI (Magnetic Resonance Imaging): An MRI can show detailed images of the brain, helping doctors identify the stroke’s location and severity.
• CT Scan: While less detailed than an MRI, a CT scan can quickly detect bleeding in the brain or blockages.
• Angiography: This imaging test examines the blood vessels and can reveal any blockages or abnormalities in the basilar artery.
• Doppler Ultrasound: A non-invasive test that uses sound waves to visualize the blood flow through the arteries, helping to detect clots or narrowing.

Treatment Options

Once diagnosed, the treatment of a basilar artery stroke focuses on restoring blood flow and minimizing damage. Common treatment options include:

• Thrombolytics: Also known as clot-busting drugs, thrombolytics like tPA (tissue plasminogen activator) are often used in the early stages of an ischemic stroke to dissolve the clot and restore blood flow.
• Endovascular procedures: In some cases, mechanical thrombectomy (a procedure to remove the clot) may be performed by threading a catheter through the arteries to reach and extract the blockage.
• Antiplatelet and anticoagulant medications: These drugs can help prevent future strokes by reducing the risk of blood clots.
• Management of underlying conditions: High blood pressure, diabetes, and high cholesterol are common risk factors for stroke. Managing these conditions with lifestyle changes and medication is essential for preventing future strokes.

Recovery and Rehabilitation

The recovery process following a basilar artery stroke can be long and complex, as it depends on the extent of the damage. Stroke survivors may experience varying degrees of physical, cognitive, and emotional challenges. The key elements of stroke rehabilitation include:

1. Physical Therapy: Physical therapy focuses on improving strength, mobility, and balance, often involving exercises that help retrain muscles and regain motor control.
2. Occupational Therapy: This helps stroke survivors relearn daily tasks such as dressing, eating, and writing. Occupational therapists also help with cognitive impairments and adapting to any disabilities.
3. Speech Therapy: If the stroke has affected speech or swallowing, a speech therapist can help regain language abilities and improve communication skills.
4. Psychological Support: Depression, anxiety, and emotional instability are common after a stroke. Counseling or support groups can help address these mental health concerns, fostering emotional recovery.

Outlook for Basilar Artery Stroke Survivors

Basilar artery strokes can be life-threatening, but with prompt treatment and comprehensive rehabilitation, many survivors are able to regain some or all of their abilities. Recovery may take months or even years, but continuous progress is possible with the right support and persistence. It’s also essential to adopt lifestyle changes to reduce the risk of a recurrent stroke, such as eating a healthy diet, exercising regularly, managing stress, and adhering to prescribed medications.

Conclusion

A basilar artery stroke is a serious medical event that requires immediate attention. Early diagnosis and treatment can make a significant difference in the outcome, and rehabilitation plays a vital role in helping survivors regain independence. With the right medical care and support, many individuals can lead fulfilling lives after a basilar artery stroke, embracing their recovery journey one step at a time.

If you or someone you know is at risk for a stroke or has experienced one, stay informed and proactive about stroke prevention and recovery strategies. Early intervention saves lives, and rehabilitation restores hope.

Norman Vandal’s Recovery Journey

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Highlights:

00:00 Introduction
07:56 Hospital Assessment and Initial Rehabilitation
13:28 Basilar Artery Stroke
15:38 Medical Advice and Dietary Changes
26:18 Emotional and Psychological Impact
38:21 Driving and Independence Challenges
50:58 Learning and Adapting Post-Stroke
56:33 Losing A Loved One While Recovering From A Stroke
1:01:14 Reaching Out To People In Times of Loneliness
1:08:24 The Hardest Thing About The Basilar Artery Stroke
1:16:23 The Good And Bad Days In Recovery
1:21:43 The Lessons From The Basilar Artery Stroke

Transcript:

Introduction – Basilar Artery Stroke

Norman Vandal 0:00
Hello everybody, and welcome to episode 324 of the recovery after stroke Podcast. Today, I’m excited to bring you the inspiring story of Norman Vandal, a stroke survivor of a basilar artery stroke. In this episode, Norman shares his journey from the initial symptoms of his stroke, through the challenges of rehabilitation and his determination to regain independence.

Bill Gasiamis 0:28
He talks candidly about the emotional ups and downs of recovery, his time in stroke rehabilitation, boot camp, and the lessons he learned along the way. Norman’s story is one of resilience, grit and commitment to reclaiming his life after stroke, his experiences will resonate with anyone who’s been through the stroke recovery process or supported a loved one through it.

Bill Gasiamis 0:54
You won’t want to miss this powerful episode packed with insights into stroke rehabilitation, overcoming fear and rebuilding after a stroke. Before we dive into Norman’s story, I’d like to remind you of how you can support the podcast. If you find these episodes helpful, inspiring or insightful, please consider supporting the show through Patreon, at patreon.com/recoveryafterstroke.

Bill Gasiamis 1:22
Your support helps keep the podcast going and allows me to continue sharing these powerful stories offering hope and practical advice to stroke survivors and their families. Thank you for considering it. Norman Vandal, welcome to the podcast.

Norman Vandal 1:39
Thank you.

Bill Gasiamis 1:41
Thank you for being here. Tell me a little bit about what happened to you.

Norman Vandal 1:43
Well, I don’t know if you’re familiar with the Thanksgiving holiday in the States. Kind of a celebration of the harvest and so on. And I was scheduled to go up to dinner with my daughter in law’s mother and my family, and they live in Shelburne, which is about 60 miles away. And my contribution to the meal was to make some mashed potatoes.

Norman Vandal 2:13
I grow a lot of potatoes in the potato piece field near here, and I always contribute potatoes. So I got up in the morning and peeled some potatoes and boiled them, and a while later, when when they were done, I took them over to the counter, and I was starting to mash them, and my right leg started to feel a little bit strange, like, if it was a four cylinder engine.

Norman Vandal 2:41
It was maybe running on three and a half cylinders, You know. I could still walk and move it okay, but it had a kind of odd numbness to it. I’m quite conditioned to feeling sciatic pain from arthritis in my spine. And I assumed it was some variation of sciatic pain. It persisted. It didn’t get worse.

Norman Vandal 3:05
I finished making the potatoes and got in a truck and left, and on my way to Shelburne, I stopped and put gas in in a gas station. And I was, you know, very comfortable doing that, but I could still feel the weirdness in my leg, and I started to drive, and I got probably about two thirds of the way there, and it started to happen in my right arm.

Norman Vandal 3:31
So now my right arm and right leg are feeling weird, and I knew something was wrong, and I knew that, since it was all on one side that it was most likely a stroke. So I continued to drive, which I’m not sure was the smartest thing, but I had to get somewhere. And so I drove, and I got to to my daughter’s daughter in law’s mother’s place, and I walked in and said, Carol, ‘here are your potatoes. I’m having a stroke.

Norman Vandal 4:06
And she said, you are. And I said, Yeah. How do you know? Well, I explained, and she said, Well, what do you want to do? And I said, I need to go to the hospital now. So she got an ambulance to come, and they, you know, fired me up to the University of Vermont Medical Center, and I was admitted immediately, and they started doing imaging.

Norman Vandal 4:31
And during that time, it was getting progressively worse. Not that I was entirely noticing it but my children, who were now there with me, started to notice it. They brought me food to eat, and I was really unable to hold a utensil and eat.

Norman Vandal 4:56
And my daughter said to me, she said, you know, Dad, you can’t eat. Your hand isn’t working. And I was like, Oh, no kidding, you know, really. And I noticed that my leg wasn’t functioning really well either. And she noticed it before I actually felt it. And then I realized what was happening to me.

Norman Vandal 5:20
At that point, I started to get pretty concerned, you know, because this was happening slowly, and that felt strange to me, because I never heard of a stroke taking that long to happen, the full effects of the stroke. I mean, this started about 8:00 to 8:30 in the morning, and it really wasn’t until 7:30 or so that night when it had done the most damage it was going to do.

Bill Gasiamis 5:50
So how long did you take to get to hospital though, how long?

Norman Vandal 5:55
It was very quick, because the hospital was like 10 miles from the house, and the ambulance came right away. It probably took me maybe 35 minutes.

Bill Gasiamis 6:08
When you went to hospital and said, I think I’m having a joke. Did they agree with you? Did they treat that seriously when you said that?

Norman Vandal 6:18
You know, they started imaging right away so I’m assuming that they did. You know, it’s interesting. And I don’t know if your other people who write in other patients feel this, but I was really, I was kind of out of it, you know, really sort of confused as to what was going to happen next and where was this going, and so on.

Norman Vandal 6:42
And plus, my children were there, and they were very capable. Both, very very intelligent adults. And they were pretty much dealing with the doctor, and I was basically in bed, you know, almost being introspective and trying to figure out what the heck was going on..

Norman Vandal 7:02
But they did the imaging right away, which leads me to believe that, yes, they knew. And from my description of it being one on one side, they knew I was having a stroke, you know.

Bill Gasiamis 7:15
So just all the things that I think are weird is that even though you were having a stroke, and you suggested that you’re having a stroke, and they were doing the imaging.

Bill Gasiamis 7:25
They gave you food. And stroke survivors, or stroke patients, while they’re in that state of having a stroke, may have some challenges with their swallowing, and therefore, food is probably not the right thing to do unless they’ve assessed you. Perhaps, did they assess you?

Norman Vandal 7:43
No. No, they didn’t. They didn’t assist me at all, you know.

Bill Gasiamis 7:49
Assess. Did they assess you?

Norman Vandal 7:52
Pardon? They assessed me?

Bill Gasiamis 7:54
Yeah, did they assess you?

Hospital Assessment and Initial Rehabilitation

Norman Vandal 7:56
Yeah, eyes and, you know, and so on. And, you know, movement, and could I cross my legs and that sort of thing, you know. And I have a feeling that they must have felt that it had done its damage, and it was minimal, you know. I guess, I found, as I said, when I wrote to you about my experiences, you know, which was very brief.

Norman Vandal 8:24
That I had a lot of questions, you know, and you’re asking some of the questions that I had. And because I’m in a very rural place, the hospital communication isn’t always the best, and I’ll explain that a little bit better further on. But by the time the stroke had done its damage. I was unable to move my right leg, if at all.

Norman Vandal 8:56
I could pick it up slightly. I was able to cross my legs, which they asked me to do. I could lift my right arm, but I had no dexterity or movement in my hand. I had no facial paralysis. I had no cognitive damage. I was able to speak. I had a little bit of numbness on the right side of my mouth that I could tell that it was affecting my pronunciation.

Norman Vandal 9:27
But I don’t think it was noticed by other people. And that’s sort of a syndrome that I felt all the way through the stroke, and still do, because people say to me, man, you’re doing really well. And in my mind, I’m saying, Yeah, but you don’t know how I feel, you know?

Norman Vandal 9:44
And that’s probably a standard thing, you know. If it looks good, we’ll call it good, but in my mind, it’s not where I want it to be, you know.

Intro 9:47
If you’ve had a stroke and you’re in recovery, you’ll know what a scary and confusing time it can be. You’re likely to have a lot of questions going through your mind, like, how long will it take to recover? Will I actually recover? What things should I avoid in case I make matters worse? Doctors will explain things but obviously, you’ve never had a stroke before.

Intro 10:16
You probably don’t know what questions to ask. If this is you, you may be missing out on doing things that could help speed up your recovery. If you’re finding yourself in that situation, stop worrying and head to recoveryafterstroke.com. Where you can download a guide that will help you. It’s called seven questions to ask your doctor about your stroke.

Intro 10:38
These seven questions are the ones Bill wished he’d asked when he was recovering from a stroke. They’ll not only help you better understand your condition, they’ll help you take a more active role in your recovery. Head to the website now recoveryafterstroke.com and download the guide. It’s free.

Norman Vandal 10:54
So I stayed in the hospital there for three nights, and the plan was to send me to a rehab center called Fanny Allen, which is part of the UVM network. This is a teaching hospital. It’s a hospital with a good reputation, but Fanny Allen has a superb reputation, but people call it the boot camp.

Norman Vandal 11:23
And there is a reason. There was a young man in the bed next to me in my room who was very young, like in his early 40s, and he had a stroke, and his condition was about the same as mine.

Norman Vandal 11:40
You might have had a little more serious paralysis, and he was waiting to go to Fanny Allen, the same way, and we were both concerned as to who was going to go first, because there’s a lot of demand for people to go and a lot, and I was really fortunate to be be able to get in there right right away, because I feel that that’s what really saved me in a lot of ways, you know.

Norman Vandal 12:10
Yeah, so when I went to Fannie Allen, I was checked in, and I was assessed by a PT and an OT. And there was a different neurologists there working with me. And the following morning I moved into in the evening, and the following morning I started into pretty heavy duty PT, right away. I couldn’t walk.

Norman Vandal 12:35
I could walk barely with a walker, but it was just no control, really, and it was something they didn’t want me to try or do. But immediately they got me into walking briskly on treadmills using a harness suspended from a harness, and that way, if I fell, I was caught. And I, honestly, I knew sort of intrinsically or even philosophically that this was the best thing for me. This boot camp.

Norman Vandal 13:11
But it was frightening. I mean, it really in some mornings I had like a scheduling, a protocol for the day, and some mornings I felt like hiding under the covers. I mean, it was just grueling, absolutely grueling, tiresome.

Basilar Artery Stroke

Norman Vandal 13:28
More, you know, both physically tired, but just almost emotionally tired, you know. Just really, really a feeling I’ve never had before. I had really, really good people. But to backtrack a little bit. When I left, I met with a neurologist at UVM a couple times who was taking my case, and she told me that I had a stroke because of blockage in my basilar artery on my left side.

Norman Vandal 14:07
Which affected my right, you know, motion and so on of my of my right side, she gave me some targets that I had to try to achieve, you know, sort of in my own personal life habits. And I had an A1C of about 6.1 which meant I was essentially type two diabetic.

Norman Vandal 14:38
I had an LDLC, you know, cholesterol that was up around 120 and my blood pressure, typically was maybe 160 over 80, you know, for blood pressure, and I’d been dealing with that my entire life, but not dealing with it as seriously as I am now, I can tell you, you know, and I should have dealt with it more more seriously.

Bill Gasiamis 15:05
Those medication you were taking?

Norman Vandal 15:09
Yeah, I had been taking medication for blood pressure and for cholesterol and I had been taking a statin, which I probably should have stayed on, but I dropped off of the statin because it was giving me muscle problems, and that’s happening to me right now, on a statin that I’m taking.

Medical Advice and Dietary Changes Due To Basilar Artery Stroke

Norman Vandal 15:38
I know the seriousness of taking a statin, and I’m going to be back on and I’m right now I’m on a hiatus to try to get this back and to leg pain to go away. The neurologist at the Fannie Allen explains something to me, and I don’t know if this is something you’ve heard from other people or sort of dissected from conversations about statin.

Norman Vandal 16:03
But explain that what the statin does, aside from from lowering your cholesterol, you know your your your bad cholesterol and elevating the good cholesterol, explain that what happens to plaque in your arteries, that it it, it can have a rough surface, and if it does, it interrupts the flow, and it’s sort of like a stream going over stone.

Norman Vandal 16:30
You know, wild river, and it makes eddies and disturbances in the flow, and that causes differences in velocity, which makes more plaque developed. And he explained to me that that maybe the best part about taking a statin is that it’s been shown to smooth out those blockages, which makes them more stable and that when that was the assumption, yeah.

Bill Gasiamis 16:57
The challenge with statins is actually very controversial these days, and a lot of people are talking about how statins perhaps are not the right solution for high cholesterol, at the same time, what they’re talking about is also they’re saying that high cholesterol is not necessarily the problem causing plaque deposits in the arteries.

Bill Gasiamis 17:23
And the fact that there are plaque deposits in the arteries can only really be shown with the correct scan of those arteries, so imagine that your neurologists have consulted some cardiologists, and they’ve checked out your arteries to see whether or not, in fact, they are blocked up, or whether they are free-flowing, whether they have cholesterol deposits in there or not.

Norman Vandal 17:50
They do.

Bill Gasiamis 17:51
So, they do so, there tends to be a approach by the medical professionals that all people who experience a stroke because of an ischemic reason. So for like a blood clot of some prescription should go on a statin as a preventative A and for people who have plaque deposits, they should go on there to reduce the significance of the plaque deposits.

Bill Gasiamis 18:23
Now that is potentially and I’m not a doctor, so please nobody take my advice, but just think about my conversation, just as that a conversation, don’t do anything based on my discussion. So they have this very big umbrella for why a statin should be given, and some people receive it when they shouldn’t be taking the statin.

Bill Gasiamis 18:54
Especially when they haven’t got cholesterol deposits and their and potentially their their blood clot may have been caused by a a genetic condition that has a blood clot disorder associated to it, rather than a blockage or rather than cholesterol deposits, so that’s where the controversy kind of comes in.

Bill Gasiamis 19:24
Now, one of the things that doctors don’t say is that cholesterol can be resolved and sorted out, and so can the reduction of cholesterol deposits in the blood vessels by changing one’s diet and by removing certain inflammatory foods that create that are likely to support the creation of cholesterol deposits.

Bill Gasiamis 19:47
And as a result of that, making those changes and supporting yourself to decrease the cholesterol deposits in your blood vessels naturally, then in combination with a statin, then at some stage you should be able to get to the point where you no longer require a statin. So the challenge is not so much for people who are 75 years old or over.

Bill Gasiamis 20:16
It’s for people who are put on statins at the age of 40, because statins are also suspected by some to have to be contributing to down the road neurological diseases such as dementia and Alzheimer’s, because what apparently is the case, apparently, but I haven’t researched this enough, but this is just some stuff that I’ve read from time to time.

Bill Gasiamis 20:45
Is the cholesterol, the good cholesterol, which is, in fact, there is no such thing as bad and good cholesterol, but that’s just how they’ve labeled these types of cholesterols. The good cholesterol is what the brain needs to keep itself healthy.

Bill Gasiamis 21:03
It’s a fat and it uses that as a fuel source and energy, and depriving the body for 30 the brain for 30 years as a 40 year old of good cholesterol ends up causing neuro neurological problems down the road.

Norman Vandal 21:21
Yeah, like you said, maybe dementia or something, is there clinical evidence of this now?

Bill Gasiamis 21:28
Certainly is clinical evidence. Now one of the best places to start a to start being curious about the the way one should look at brain health, there’s a book by a doctor called Dr David Perlmutter, and I’ll have the links in the show notes. Dr David Perlmutter. It’s called Brain Brain, I’m just going to find it online.

Bill Gasiamis 22:06
And he’s a neurologist, board certified neurologist, and he has a clinic where he deals with people who have Alzheimer’s and dementia, and many many years ago, he wrote his first book, and it was about trying to show people how to go about decreasing the bad markers in their blood work and increasing the good markers in their blood work, and the book is called.

Norman Vandal 22:38
Predominantly dietary?

Bill Gasiamis 22:39
Is that all dietary. So none of this is my conversation with you about it is, none of this is designed to divert people away from the medical assistance that they are receiving, or their medication, or any of that stuff, because when there, when there isn’t another way out of this.

Bill Gasiamis 23:03
You don’t have another solution, cholesterol medication or or statins, is definitely supporting the patient from having a condition right now that is going to be dangerous to the health. So it’s really important that you know blood pressure medication, unless your blood pressure stabilizes and becomes normal by itself.

Bill Gasiamis 23:28
It’s important to have it, because it’s going to help you right now in the acute phase of high blood pressure, for that not to accelerate, become worse and then cause a brain hemorrhage or a heart attack. So there is a need for the medications.

Bill Gasiamis 23:43
Certainly, there is a need for medications, and they are proving to support people, stay healthier, live longer, avoid stroke, certainly. So the question is what can you do to support that process as well?

Norman Vandal 24:00
Well, I had these the goals of an A1C of 5.7 and right now I’m 5.1 so I’m no longer even close to being diabetic. I’ve lost 35 pounds. Excellent, excellent, great. I my my LDLC bad cholesterol is 39.

Bill Gasiamis 24:27
Excellent.

Norman Vandal 24:27
I’ve had to even ask the doctor if I’m alive, with a 50, I’ve never heard of anyone with a 39 cholesterol, and my blood pressure averages about 135 over 65.

Bill Gasiamis 24:41
Yeah, that’s so important, that’s great.

Norman Vandal 24:44
So I’m doing, I’m doing, you know, this, this is this both frightened me and and as a monkey on my back, as far as recurrence is concerned, you know.

Bill Gasiamis 24:57
Got you moving in the right direction.

Norman Vandal 24:59
Sure. Well, my children say to me, well, don’t you remember the doctor saying this? Don’t you remember this happening? And I and I say, No, I was lying in bed wondering if I was going to live the rest of my life like this. This was, this was traumatic and very frightening.

Bill Gasiamis 25:16
What I’d love to know Norman is, how did you lose 35 pounds? What changes did you make?

Norman Vandal 25:23
I’ll tell you why. Well, I changed my diet pretty radically. I was not I thought I always ate pretty well, but I did I ate too much, and I did eat too much of foods that I wouldn’t exactly call healthy, I wasn’t a fried food eater, you know, like to go to a chicken, you know, fried chicken, or get fried fish, fish and chips, or things like that.

Norman Vandal 25:51
But I did eat a fair amount of meat, and, you know, now I meat, but most of the meat that I eat, almost all of it, is venison, which is very healthy, very low and very healthy, you know. But the thing is, in my in my stay, I’m trying to stay chronological here and not and not forget anything that I wanted to say to you.

Emotional and Psychological Impact of The Basilar Artery Stroke

Norman Vandal 26:18
But the diagnosis that I got was, of course, like I said, an ischemic stroke from blockage that was in began in the basilar artery. And so at Fannie Allen it definitely was a boot camp.

Norman Vandal 26:34
One of the things that they made me do that was absolutely frightening was they would tie a belt around my waist and a rope dragging behind me, and put a 30 pound weight in a bag, and they would make me walk, this is when I started to have some control walking.

Norman Vandal 26:53
And had me walk around the circuit in in the hospital, in between these two lines on the floor, I had to walk as fast as I could, and it was just totally frightening, I mean, it’s a hard floor, you know, tile floor. And I thought ‘Man, I’m just gonna, you know, I’m gonna fall, for sure. And of course, the PT was next to me to catch me.

Norman Vandal 27:15
But I was doubtful that she could, she could do it if I really fell, you know, so that’s just one of, one of the things. And I am so fortunate being, and I’m a strong, a firm believer in doing this extreme activity right away, this physical activity, in this, I think, is so important, I know it was for me.

Bill Gasiamis 27:38
Do you still do physical activity?

Norman Vandal 27:41
I do. I still do walking on a treadmill and but I actually live in a very rural place, and I do a lot of things outside, and I am constantly moving constantly. I’m not a couch potato, or I don’t watch much much television, I don’t spend an inordinate amount of time on a computer. I’m always moving, I’m keeping that up, I’m doing that.

Norman Vandal 28:12
Now, there was a, there was a neurologist at Fannie Allen who came in to see me one evening, and he said ‘I want to talk to you about something, and I said ‘Sure. And he said, I’m going to draw a chart on a board, a graph, and he said ‘It’ll have a vertical axis and a horizontal axis.

Norman Vandal 28:33
And they said the vertical axes is percentage of use, from where you are to 100% use, and the horizontal axis is time. And he drew a curve on it and he said ‘This is a curve that most people see, and it was fairly steep in the beginning, then it leveled up, and it didn’t go up to 100% of use.

Norman Vandal 28:59
And then he said, from watching you, studying your stroke, seeing the way that you apply yourself, he drew a curve that was much steeper, meaning that I would get to use quicker, and that sort of heartened me, but I also sort of doubted it, because it was so much work just getting where I was.

Norman Vandal 29:22
And he explained that in the first six months, that was my prime window, but that recovery would be a year, that where I would see recovery, but it would slow down, and I was pretty heartened by that, and I thought about that curve a lot, because I’m, I’m really big in, in into visualizations.

Norman Vandal 29:46
If I can see things and turn them into narratives or or pictures, I’m able to understand them better, and so that that was important to me.

Bill Gasiamis 29:57
Let’s take a quick pause here, but we’ll be right back with Norman’s incredible recovery journey, shortly. Before we continue, I want to remind you about my book ‘The Unexpected way the stroke became the best thing that happened. This book is not just my memoir, it’s a practical guide for achieving post traumatic growth after stroke.

Bill Gasiamis 30:17
You’ll read stories of stroke survivors who, like Norman, turned their trauma into an opportunity for growth. You can find it on Amazon or by visiting recoveryafterstroke.com/book.

Norman Vandal 30:31
One night, I was lying in the bed, and a man came in a doctor, and he said Dr so and so I’m a psychologist. And I said, Well, I really no offense, but I said, I really don’t think i need a shrink right now, and he said ‘Oh no, no, no, I’m not here to shrink you, he said ‘I won’t do that, he said ‘I just want to tell you a couple things about stroke that I think will really help you.

Norman Vandal 30:59
And I said ‘Okay, that make that makes sense, you know? So he said, the first thing is you’re going to feel tired, and he said very tired, he said ‘More tired than you’ve ever felt in your life. He said that and, and it’s going to be a lot, you know? He said, You’re going to feel that, that tiredness a lot.

Norman Vandal 31:21
And then the second thing was something I was noticing, but I couldn’t quite understand. He said, You’re going to, you’re going to cry a lot, and I was surprised, and I thought, you know, he’s right, because I am, and I found that for a long time that was happening to me.

Norman Vandal 31:44
I was sort of feeling almost mood swings, you know, where I would just be, everything would be fine, I’d be happy going along, and some inconsequential thing would happen, and I would be in tears.

Bill Gasiamis 31:58
You know, or do what that was called?

Norman Vandal 32:01
No, is there a name for it?

Bill Gasiamis 32:03
Yeah, Pseudobulbar affect.

Norman Vandal 32:05
Pseudo-Bulba Ethic?

Bill Gasiamis 32:08
Pseudobulbar affect, affect.

Norman Vandal 32:09
Affect? okay, sure.

Bill Gasiamis 32:13
Pseudobulbar affect, and it’s a very common condition, and sometimes, instead of crying, it’s the uncontrollable laughing in inappropriate moments, and some people have reported being funerals and laughing when they’re not meant to be and then they’re having to excuse themselves and not be in the room or wherever they’re.

Norman Vandal 32:38
Is there a length of time that seems to persist or?

Bill Gasiamis 32:42
Well, for me, it was pretty extreme early on, for the first, say, two to three years, and then it started to settle down. But every once in a while, a little while ago, I did my book launch, and I was in front of a room presenting and talking about my experience with stroke, and it was a 45 minute entire presentation, the whole thing, 45 minutes from beginning to end.

Bill Gasiamis 33:14
I think I cried four times, and it was unexpected, and I couldn’t stop it from happening, I didn’t think it was going to happen, but there are some little triggers, and one of those triggers is the people in the room, a lot of them are family and friends and my close part of my close community.

Bill Gasiamis 33:35
And as a result of that, it was really difficult to be up there and try to get this presentation out, and I cried way more than I would have liked to, but somehow I got through it, and most days it’s not there anymore that whole unnecessary crying has gone and settled down.

Bill Gasiamis 33:57
Although I do cry more often watching movies than I ever have in my life, those types of things, and, of course, the children. When my kids, who are adults, you know, when we talk about something that’s really close or dear to us, or something moving, I previously, I would have been able to very much hide my emotions, whereas now.

Norman Vandal 34:26
Okay, what are you are comfortable with that affect?

Bill Gasiamis 34:31
Yeah, I’m comfortable with it now, and now I’m I’m comfortable with the fact that I cry actually, and I pretend it’s not happening, and then the kids all know what it’s about, and I’m just like, yeah, just crying again, guys, it’s all good. It doesn’t mean anything.

Bill Gasiamis 34:47
But it’s also good to have a cry and get it off my chest, or whatever it is, yeah, it feels like there’s kind of like a unspent amount of emotion that needs to be expressed and spent.

Norman Vandal 35:01
Obligation, a release, right? Well, you know, I tend to, one of the things that sets me off now is that I’ll be doing something and then I’ll think, you know, about where I was, and that brings me to tears, because I I just, I go right back there, you know, and I see, like, one of the things that I need to do.

Norman Vandal 35:25
And part of it I believe is because of this affect, and the way that it sort of makes me feel psychologically is, I’m very big on, like I said, on on imaging and on, on, you know, being able to think that way and one of the things that I need to do is I need to go back to Fannie Allen, the rehab center.

Norman Vandal 35:49
I need to walk in there, and I need to see that place again, and I need to feel whole. Do you know what I’m saying? I just need have that feeling, and I’m trying to build up the courage to do it, because it’s going to take some courage for me, and I know when I do, it’ll bring the tears, but that’s okay with me, and they’ll understand, but I have to go back there.

Norman Vandal 36:12
I have to close that circle, because it’s to it’s almost the only thing that will tell me where I was and where I am now, and to make that sort of memory connection. Now you asked about weight. Well, one of the things drugs that I was put on, aside from statins, and was Plavics, which is a blood thinner, and I was taking a fairly hefty dose, dose of Plavix.

Norman Vandal 36:43
I’m not I can’t remember exactly what the milligrams were, but within a short time, I started to have taste issues in my mouth, and it got worse, and it got to where I basically I couldn’t eat because everything tasted so terrible that food was completely unpalatable to me, and it was worrisome, and I would force myself to eat.

Norman Vandal 37:11
My son would tell me just how many calories I had to consume based on my height and and I kept trying, and I started reading labels and trying to do and I could not do it. And so I tried contacting the neurologist that I had up at UVM, and I went for two and a half weeks, and she never got back to me.

Norman Vandal 37:31
So I decided on my own that I had taken all of the medications before, with the exception of Plavix, and I made the decision on my own that Plavix was doing this. So I quit the Plavix. I was taking 81 milligrams of aspirin, two as a blood thinner.

Norman Vandal 37:51
But a short while after dropping Plavix, I was sitting on the sofa one day, and I started feeling very lightheaded and very weak, woozy, kind of, and thought something’s wrong. So right away, I called my son, and he was skiing over in the top of a mountain with his two girls, and he said ‘Dad, I’m I can’t get there for like, an hour and a half. So why don’t you call your neighbor, Bob?

Driving and Independence Challenges

Norman Vandal 38:21
I did, and Bob said ‘Yeah, I’ll take you right down. So I went to the ER room in a little hospital south of here in the town Randolph. It’s a very rural, you know, hospital, but it’s excellent. And they checked me in right away from the ER, put me in and ran tests and so on.

Norman Vandal 38:37
And I got a hospitalist doctor there who was just amazing, he was a kindred spirit, and his his attitude and his approach, and it was just reassuring, and he said ‘You know, your Magnesia did blood tests, and my magnesium count had tanked, and he said, you know, explain to me just how important magnesium was for all these functions, and I was deficient in other areas too.

Norman Vandal 39:07
And his explanation to me was, well, first of all, we’re going to put you on magnesium, and I had three IV units, big, units of magnesium, and I was so low. And then he said, at the same time your your symptoms are really like anorexia, because you’re not eating and you’re no longer hungry, you no longer want to eat.

Norman Vandal 39:30
And I said that ‘That’s true, and all the while the taste was getting better because I had stopped the Plavix, and I was in there for three days, and after three days, food was tasting better, and I was getting more, I was feeling a lot better physically.

Norman Vandal 39:53
I wasn’t getting that wooziness or anything. But I think that may have been primarily the magnesium, another thing.

Bill Gasiamis 40:00
And what happened with the with the blood thinner, though, did they put you on a different blood thinner?

Norman Vandal 40:07
No, I was supposed to take the Plavix, part of the protocol was for 60 days, and I quit taking it, like it probably 50 days, or and I stopped, and I didn’t go back. And by that point, I was seeing my cardiologist, and I had pretty much dismissed going back to that neurologist, but I did have a zoom interview with her zoom appointment, which is the the other time that I’ve done this.

Norman Vandal 40:37
Other than now. And it was a scheduled appointment, and we talked, and I told her how I was doing, and she said ‘Great. And then I said ‘You know, I have to tell you, you put me in the hospital. And she said ‘What do you what do you mean? And I said, Well, you never got back to me for two and a half weeks. Well, did you speak to my nurses? I said, several times.

Norman Vandal 40:59
I said, in fact, one got tired of me calling and was very rude to me. Which one was it? I said, Well, why don’t you go, go look at the portal, which is what I’ve been doing, and you’ll see, I said, I’m not going to, you know, sort of rat on somebody this way, you know, I mean, really. So she apologized and so on.

Norman Vandal 41:19
Which was, you know, okay, but still, this had done me some damage. So this was on a Thursday afternoon, on a Friday night, at 7:30 she called me and she said, this is Dr so and so. I won’t, I won’t use names, but, and I said ‘Oh, hello. And she said ‘Well, I need to inform you of something. And I said, What’s that?

Norman Vandal 41:42
She said, Well, you have a brain aneurysm. And I said, what really? And she said, Yes, you have a brain aneurysm, and I need to tell you about it, because it needs to be watched. She said, It’s very small. It’s one millimeter, but it should be should keep an eye on. And I said ‘Well, okay, thank you, I’m going to, going to see a neurologist down at Dartmouth.

Norman Vandal 42:07
I don’t know if you’ve ever heard of Dartmouth in New Hampshire Dartmouth College.

Bill Gasiamis 42:12
I have heard of Dartmouth, yeah.

Norman Vandal 42:14
It’s an excellent place, probably the best around, unless you want to go to Boston. So anyhow, that was the story there.

Norman Vandal 42:23
But I also, one of the things that I wanted to relate to you that was really devastating for me is I live in a very rural location, I lost my wife 11 years ago, and I live alone, and I’m outside all the time. I garden, I hunt, I fish, I’m just really active. But I’m active here, and what I, you probably would think, is a wilderness. So driving, having the ability to drive, is very important to me.

Norman Vandal 42:54
I had to ask friends and relatives, you know, son and daughter and to drive me everywhere and so everything became this conundrum of people are willing to help me, and that’s wonderful, but at the same time, it was hard to be in that position where I had to ask people for help continuously, and it was really just eroding. I mean, it was a worse feeling.

Norman Vandal 43:24
And so part of what I was doing in my physical therapy was trying to enable myself to have enough movement and control cognitively, I was okay, but to be able to drive a vehicle. And so I was going to an outpatient PT nearby, and the therapist said ‘Well, I was doing these things where I couldn’t, if I put my heel on the floor and my foot flat on the floor, I couldn’t pick up the front of my foot.

Norman Vandal 43:57
Couldn’t pick it up at all, you know, it was like paralyzed, and I gradually worked and worked and worked, and she told me something interesting, she said, I don’t know if there’s really clinical data to support this, but if you’re going to do that with your foot, you should do it with your left foot and your right foot, because she said, I believe that this coordination between the two, she’s just like walking.

Norman Vandal 44:21
You’re not going to walk with one leg, and I started doing that. So I would tap with, you know, with both feet, and I got and I could watch myself, I was very, very driven to be back now, to get my license again, I had to take two tests.

Norman Vandal 44:38
One was a cognitive test, and the other was a driving test, and it was very difficult to get these scheduled, but there’s only two people in the entire entire State of Vermont who do it. The first was up at Fanny Allen, and they were booked, and it would have been three months, and so I got one in in Rutland, Vermont, and but first I took the cognitive test.

Norman Vandal 45:03
And when I did, the therapist who who graded or scored me said ‘You’re testing as high as anyone with with complete normal cognition. Your cognition is perfect, and so then it meant the driving test. Well, I went to the driving test with my son who drove me there, and I drove with this young man. He was a therapist, and he was also a driving instructor.

Norman Vandal 45:29
And when I drove, he was more of an instructor than an observer, and he was very didactic, you know, like, well, you made that turn too slowly, you didn’t get off the highway fast enough, you slowed down too much. And of course, I’m trying, I hadn’t taken a driving test since I was 16 years old, you know, so.

Norman Vandal 45:54
But I thought that I did pretty well, aI had, in my own mind, I felt like I had achieved what I needed to achieve, and I was there. Well, when we met afterwards and went to his office, he said to me, he said ‘Well, I see nothing, no damage from the stroke that impairs your driving ability, however, you need more practice, and we need to meet again.

Norman Vandal 46:24
And I did the other part of that syndrome that you we talked about with laughing, I got angry. I got very angry, and I lost it, and I screamed at him and said ‘You’re victimizing me man, you know, you just, you’re hitting me with all of these little inconsequential things. And my son, who was in the room, just, was just horrified by my behavior.

Bill Gasiamis 46:54
You seem, right now, you seem like, you know that was ridiculous, what you were doing and how you were behaving, but right at the moment ‘Oh, you thought it was justified.

Norman Vandal 47:05
Well, my son said ‘Why did you do that, dad? And I said ‘Listen, sometimes a person has to do that. I said ‘Sometimes you have to stand up for yourself, and you have to do that. So I thought about it, and I gave it some thought, and my son was pretty angry with me for doing it and thought and I wish I’d known more about the condition.

Norman Vandal 47:25
Because I might have been able to explain to him that this is some of this is the stroke and some of it. I was genuinely disappointed and angry, so I wrote this young man, a letter afterwards, and I apologized. I said ‘You know, I’m really sorry for having done this, but I’d like you to understand how much driving means to me in my life and where I live and how I live.

Norman Vandal 47:47
So he told me to practice driving with my son, which I did, and I did some with my daughter and then I went back for the next appointment, which was about a month later, and we went out, and he was having the same thing, little tidbits of you didn’t do this bride, you didn’t look in that mirror long enough, and they were, none of them had anything to do with legality.

Norman Vandal 48:16
They were all the idiosyncrasies that he would like to see in his students, you know. And I’m taking what is going on here. So we get back, and he starts with this litany of what I did wrong, and I’m thinking he’s not going to pass me again. And I can’t lose it again, you know. So he then said ‘I’m going to pass you. And I said ‘Great, thank you.

Norman Vandal 48:41
And he said ‘But I need to say something else to you. And I said ‘Well, okay, go ahead. He said ‘You need to sell your house and move. And I just was, I had so such a difficult time not to lose it. The only thing I said to him was I said ‘Listen, if you knew where I lived and what I do and how I lived, and you knew how much that meant to me, you would not say this.

Norman Vandal 49:10
You know, I said I’m I’m aware of where I am life, but I do not appreciate you saying this to me. It , just disheartening.

Bill Gasiamis 49:20
That’s interesting, it’s a perception, it’s a conclusion that he jumps to based on other things that are probably not applicable to you. And then, most importantly, what he should have said was ‘Why don’t you get your license back, and at the same time, why don’t we book in another 10 booking another 10 driving lessons, just so I can get you up to speed a little further.

Bill Gasiamis 49:47
And then that way, you can both achieve the same outcome, you’ve got your license, he’s getting your skills back up to a standard that he thinks is more reasonable or acceptable. And then you both win, and that’s, I think that’s better, it’s better to teach a person to fish than to take them.

Norman Vandal 50:07
Exactly, well, he told me that he had looked up where I lived on Google Earth, and he said, I can see, you know, I looked up where you live, and my feeling was, who gave you the right to do that, you know, but I didn’t say anything because I’d learned my my lesson with the previous outburst, you know, yeah, but what I found is I was fully capable of driving, no problems.

Norman Vandal 50:33
The only issue that I had with driving is the tiredness, and I’m sure of a lot of other people were in my situation, so I had to be careful that I didn’t bite off a trip that was too long, you know, and at a time when I was too tired, and I did that, yeah, and now I would say in terms of the exhaustion and tiredness, I’m doing quite well.

Learning and Adapting Post-Basilar Artery Stroke

Norman Vandal 50:58
I used to have to just stop in the afternoon and nap, or I don’t need to do that anymore. I’m feeling, you know, sort of revitalized and and overall, I feel really good. I have still have sciatic back pain, which I had beforehand, and it might be exacerbated a little bit more by the stroke.

Norman Vandal 51:22
And I think it’s because of the muscles that are being, you know, firing again, you know, because that’s a term they used all the time. Well, your arm is not firing, firing, and that was a visualization I could see too, you know.

Bill Gasiamis 51:38
So tell me about your your health and your life before stroke. So your stroke happened when you were 75. What was your, the years leading up to that stroke? Because at 75 I imagine most people have had a condition of some sort or another. What was your?

Norman Vandal 51:59
Well, I’d always had issues with high blood pressure, it’s a congenital, almost, I think genetic thing, always. I mean, even when I was young and alive and rugged and active and athletic and everything, I still had trouble with high blood pressure. Yeah, always that I was very active for a long time.

Norman Vandal 52:22
Did a lot of skiing and skiing in the woods and hunting and gardening and, you know, fly fishing and stuff. And I think that the trauma of losing my wife had an effect on me Negative effect, I like food, I love to eat, I like to cook, and I was overweight, and I knew I was overweight, and I would try a little bit to try to lose some weight, but I never, I sort of didn’t take it, what’s the word?

Norman Vandal 52:57
I wasn’t I didn’t see it as a serious issue, when really it was, I had had a heart catheterization once because of a snafu and a stress test, and the hospitalist doctor told me I was going to have a coronary, and I had to have a quadruple bypass, and he was sending me to Dartmouth for catheterization.

Norman Vandal 53:24
When I went to Dartmouth, the cardiologist said ‘Well, you know, if you had done this press test here, you wouldn’t be doing this. It’s because they flagged you that we have to they did do catheterization, and I had some blockage, but nothing serious, and I didn’t need any kind of a stent or or anything like that. So I guess I took that as a good sign, that I was doing okay.

Norman Vandal 53:50
I fully expected to maybe have a stent, but maybe not quadruple bypass. So I sort of some people I wasn’t I had a pretty good gut on me, I wasn’t obese, but I was 30-35, pounds overweight. I carried it pretty well, I was still active.,I felt well enough.

Bill Gasiamis 54:18
Other than your extracurricular activities, yeah, did you do as an occupation?

Norman Vandal 54:24
Well, I did a number of different things, and early on, I built houses, and then I became a cabinet maker, and then a writer. I wrote about period technologies and woodworking furniture. And then I decided that part of my life was not as interesting as what I might go to when I started teaching high school English.

Norman Vandal 54:49
I had a degree in English and literature and a minor in education, and my daughter went to a very liberal, very progressive school here, and I thought ‘Well, that’s a school I could teach in without getting fired. And so I applied for a job there and did some subbing, and I got that so then I taught for 20 years, but during that time, I still was pretty active.

Bill Gasiamis 55:18
So you’re 75 at the time of your stroke that was about a year ago, almost, and you’re six months. Yeah, you’re a similar age to my parents, my mom would be 78 my dad is 82 you you’re of that generation. When my generation speaks about your generation, we talk about how tough your generation is and that they don’t make generations like you guys anymore.

Bill Gasiamis 55:47
Also the generation before you was seriously tough, your parents would have been extremely tough because they would have lived through World War One and World War Two, amongst other things.

Norman Vandal 56:01
Not one, but two.

Bill Gasiamis 56:03
Okay, yep, not one, and then there would have been a discussion about, then there would have been a discussion about the fact that your generation doesn’t seek out psychological counseling and talk therapies and that kind of stuff.

Bill Gasiamis 56:21
So it was interesting when the psychologist came to you, and the first thing that you thought was, I don’t need to see a shrink right now, which is exactly what I would have expected you to say.

Losing A Loved One While Recovering From A Stroke

Bill Gasiamis 56:33
But how did you go about dealing with your the loss of your wife, and then finding yourself kind of alone in the world. And when I say alone in the world, clearly, you’re not alone, you have amazing family around you, but alone as in, you know, the significant other aspect of your life. How did you find yourself dealing with that?

Norman Vandal 56:57
Well, it was difficult. There’s no, question, and it was a hell of a loss, and she had esophageal cancer, and it was, you know, series of surgeries and so on, and she died at home in hospice, and which was a good thing, but I was home alone with her through most of the bout, my children, actually one.

Norman Vandal 57:22
My son was living in Seattle, working in the wind industry, and my daughter was in Boulder, and her husband was getting a master’s in psychology and and they came home, but still, the entire process, the entire time I was dealing with her suffering and alone, and it was consuming, It just completely consuming, and really, what’s the word? Just profound. You know, very profound.

Norman Vandal 57:59
And and when it, when she did die, I basically went to bed and slept for hours because I was so completely exhausted, and then after, then it’s been hard, but it’s, you know, it’s, I wish I could remember the phrase that Joe Biden uses all the time when he talks about grief, because he’s quite an expert in it. He’s had enough tragedy in his life, you know, right? But, what he says is true.

Norman Vandal 58:30
You know that what used to, you know, put a tear in my eye, and I now can put a smile on my face, but it was hard because I did a lot with my wife, and it was a loss. I’m pretty used to living alone, I live very remotely, my nearest neighbor is over a mile away, I’m up 18 hundred and 50 feet in the mountain.

Norman Vandal 58:53
So my life is, even though it’s sort of immersed in nature, it’s still relatively intense, and just just being involved in that was kind of a support that I needed.

Bill Gasiamis 59:04
Yeah, your description was that you went to bed and you slept for a very long time, yeah, and you were completely exhausted. You know, some people would say that depression has that symptom, that particular behavioral pattern, did you feel like now reflecting on that, that perhaps that you were a little depressed?

Norman Vandal 59:30
No, I don’t. I don’t believe I was, and I’ve dealt with enough with students over the years to have a pretty decent handle on, being able to observe or pick out depression and no, I don’t.

Norman Vandal 59:45
I was more just completely exhausted, both physically and emotionally, I just didn’t, I’d given so much I didn’t. I just needed to get away from it, you know, with a just rest

Bill Gasiamis 1:00:00
The tapping, the tapping.

Norman Vandal 1:00:02
Oh, I’m doing that again now. Yeah, okay.

Bill Gasiamis 1:00:06
So, yeah. So what you’re saying is your response was appropriate to the particular situation that you had yourself in.

Norman Vandal 1:00:15
I think. So, yeah, and, you know, it was an interesting process because, and it still is, because I could, I could see how everyone deals with grief differently. I can see that my son and my daughter deal with the grief and the loss differently, I think that in a lot of ways, it’s had an effect on me, there’s no question, a cumulative effect.

Norman Vandal 1:00:47
I believe, I’m relatively happy, I mean, I like my life and, I haven’t really put any effort into finding a mate. I do have female friends who are good friends, but I haven’t really felt the need for that. I’m quite adjusted to being alone and to into being quiet.

Reaching Out To People In Times of Loneliness

Bill Gasiamis 1:01:14
And you spend time in the community, though, it sounds like you’re not doing it completely alone, you’re not a hermit. There must be times where you involve yourself with the community. Tell me a little bit about those other things that you do, other than your home life.

Norman Vandal 1:01:34
Well, I don’t do a whole lot, and I’ll tell you, because this is a very rural place, I mean, this town only has about 500 people, it’s very, very small, I have friends that I see and do things with, go out to dinner and, work on projects together, help each other to do things and so on.

Norman Vandal 1:01:59
I have involvement with other people, and I have plenty of friends that if I felt lonely, or I would say, I say sometimes I feel lonesome, but I don’t feel lonely, I don’t. I’m not a lonely person, but I can feel lonesome, and when I do, I try to reach out to people, and the people who’ve helped me during the stroke, it just astonishes me, It’s humbling. I mean, I can’t, people offering me, and it’s gets overwhelming, really.

Bill Gasiamis 1:02:37
One of the best things, isn’t it? It’s such a thing, a very common thing that gets reported by stroke survivors is the people that come out of nowhere and offer their support in any way that they can, and it makes it such a big difference to somebody’s recovery and how they go about navigating the months after stroke. You know, it’s really interesting.

Norman Vandal 1:02:59
Prior to to coming home, I spent after Fanny Allen rehab, I spent two and a half weeks living with my son, and he has three girls, three daughters, and Georgia is 9, and Willa is 7, and Elsie was not quite 2 at the time. And it was, it’s just another situation where, if I think back about the disabilities that I had at the time, it’s just, it’s just really overwhelming.

Norman Vandal 1:03:31
I could watch my granddaughter, Elsie, who was not quite two. I could watch her learn, learn things, to do physical things in their body, and learn, sort of intellectually, and it was so parallel to me. It was just such a such an incredible observation of feeling that I had, I could see and I would think of myself as being in that position again, childlike.

Bill Gasiamis 1:04:04
Childlike.

Norman Vandal 1:04:05
Yeah, childlike in both the eagerness to learn, but also in the inability to do what I wanted to do, and I could see her frustration in her learning, and the other thing I could see is her learning by repetition, which is exactly what I had to do. I remember one day I watched her get up from the floor.

Norman Vandal 1:04:27
Then a physical therapist came, and I said to her, I said ‘Do you think I could get up from the floor? She said ‘We’ll do it. So I laid down on on the floor, got down as best I could, and I tried getting up, and I put a hand on the table and put and I was able to pull myself up, and it was just mind bending for me, it was like I could have it was a gold medal, you know.

Norman Vandal 1:04:52
I mean, I was just blown away by the fact that I could do this and I got to where as much I have to say that this stroke has taught me so much about myself, about other people. Now I do things like I’m doing I do 99% of what I’ve ever done. But it isn’t easy, and there are times like I’ve been working on a tractor recently, and I have to reach in and turn, put a nut on a bolt.

Norman Vandal 1:05:27
And my hand has not been taught to do that yet, and so I reach in and I grab this nut I can, I’m fumbling, and I’m trying to hold him and it drops, and try to pick it up. And I do and and I try again, and the weird thing is, I can feel the connection between my brain and my hand. I can just do, you know, did you get that feeling?

Bill Gasiamis 1:05:51
I do know exactly what you mean. So I have a unreal I have a very deep understanding of either the lack of connection or the connection, because depending on the day, sometimes the connection operates better and sometimes it operates less.

Bill Gasiamis 1:06:08
Especially for me, it’s in walking more than anything. So I noticed that on a day where things are not going as well, it’s like the connection’s not there, and the and the way to restore the connection, in a way, is to stamp my foot on the ground and just to let the brain know this is what you are looking for, get onto it.

Norman Vandal 1:06:29
Did you find that anger helped? Like sometimes I say, damn it, I’m gonna do this. You were done, you know what I get?

Bill Gasiamis 1:06:38
That’s most of more determination, right? Writ and determination.

Norman Vandal 1:06:47
I was working with a PT one day, and she was making me take a ball in my right hand and throw it at this trampoline that had was on a slope, and so the ball would bounce, bounce back to me. And she said ‘Well, throw it with your right and catch it with your left. And I just could barely do it.

Norman Vandal 1:07:06
I mean, I was throwing just so ungain, you know, awful. And I said to her, I said ‘Do you mind if I get angry? And she said ‘No, go ahead. And I went, you son of a bee, and I really started cussing and getting right, and I threw that ball perfectly, and you know what I did? I caught it with my right hand.

Norman Vandal 1:07:27
I was blown away, and I thought, why this is contributing, like you say, it’s determination, but it’s also that when I would do that, I would feel that brain connection more, and I have to say that’s a wonderful thing. It really is a wonderful thing, despite the stroke and all that.

Bill Gasiamis 1:07:47
It’s a correctly channeled aggression, perhaps, right? It’s kind of channeled, yeah, and it’s a rather see, I’ve seen people who have done what you’re saying, but in a negative way, in that right? They are being negative and aggressive to themselves and beating themselves up about the fact that their arm is not working, etc.

Bill Gasiamis 1:08:09
So I’ve seen that part of it, but the part that you’re talking about is more appropriately channeled, and then, therefore you use it to help you and support you in you get a result out of it, and that’s good.

Norman Vandal 1:08:23
I do.

The Hardest Thing About The Basilar Artery Stroke

Bill Gasiamis 1:08:24
And observe that, I was going to ask a little earlier, what’s the hardest thing about stroke?

Norman Vandal 1:08:32
I think the heart the hardest thing for me has been and maybe it’s because I do live alone, but it’s been my loss of independence, from from the beginning. Now I’m almost completely, independent. Now that was really difficult for me, because I was always a really independent person, but both, sort of in my habits and in the way that I live.

Norman Vandal 1:09:05
But even in the way that I think, and I’ve always been very focused on accomplishments, but not, not I’m not talking about being any sort of a hero or but it matters to me that I’m able to do things and get them done, you know. And there are things that I enjoy. I enjoy working, I always think about the shakers who say, was it mind to hands and heart to God, like feeling that.

Norman Vandal 1:09:37
And that was really hard for me to lose that independence and to get it back now. And the only thing now that that I have, like I said before, is this monkey on my back and the possibility of a recurrence. I’m doing everything that I possibly can to avoid that, and still, I know there’s a chance. So now, when I went to visit the neurologist, my new neurologist at Dartmouth.

Norman Vandal 1:10:05
I met with him, and he asked me, you know, how I was doing and what my tests were, and so what my numbers were. And it was the first time I’d met with him, and he said ‘Well, tell me about your stroke. And I said ‘Well, I had blockage in my basilar artery, and it contributed in Orange County.

Norman Vandal 1:10:24
He said ‘No, no. He almost laughed. He said ‘The basal artery doesn’t feed that part of the brain. So now I’m thinking ‘What is going on here? You know? He said ‘It doesn’t feed that part of the brain. And he said the basilar artery was not involved in your stroke, at the time, I understood that, he told me I’d had a bleed, which was hemorrhagic, which was completely different.

Norman Vandal 1:10:56
And so I contacted him recently, and I said ‘Listen, I’m really unclear about this. It was so shocking to me that I wasn’t asking the right questions. I was just it would just hit me like what went on. So he wrote back and said, well, first thing he told me, he said ‘I can’t tell you to do more than you’re doing, because your progress and your numbers and, your weight loss.

Norman Vandal 1:11:21
Everything is exactly what you should do. It’s what I would tell you to do when you’re doing it already, and then I said ‘Well, what about this brain aneurysm? And he laughed. He said ‘A one millimeter brain aneurysm and a 75 year old man. He said ‘that’s so small, it’s well within the realm of misdiagnosis.

Norman Vandal 1:11:46
He said ‘In your lifetime that one millimeter brain aneurysm is not going to grow and rupture. He said, If you were a 45 year old man, I would treat it differently, but he said ‘I can’t even tell you that it exists. He said ‘So do not worry about it. It’s not there. He said, just don’t, it’s not going to happen, which was good.

Norman Vandal 1:12:10
So recently, I was thinking about ‘Well, okay, well, if this was ischemic, ischemic, then I’m, I’m dealing with plaque, you know, I’m dealing with that blockage, but if it’s hemorrhagic, I’m dealing with a separate set of circumstances, but I thought, well, but the protocol, I think, is the same, right?

Bill Gasiamis 1:12:32
Yeah, blood pressure needs to come down and under control. Blood Vessels need to be clear and operating and allowing blood to flow without any plaques, so that you’re you’re on all the right protocols. There’s no other thing that you might be doing, however, it might be good to see if you can get some clarity on what type of stroke it was.

Bill Gasiamis 1:12:56
Perhaps your neurologist can read the reports from back in the day and find out what exactly happened, because that first neurologist seems to have given you maybe only half the story, or not the full story. There seems to be, certainly some communication breakdown with that first neurologist. Something’s not right there.

Norman Vandal 1:13:19
Yeah, yeah. It makes me feel like, do I need a third opinion?

Bill Gasiamis 1:13:23
I would say, yes, you know, why not? I mean, I did that. I did that a number of times. I went to see a lot of doctors, my scans were viewed by a neurologist in Greece who happens to be my cousin, who was never going to treat me. Then there was another doctor who I saw in one particular hospital for the first incident, and then I left that hospital and took myself to another hospital where I had another opinion.

Bill Gasiamis 1:13:50
So sure absolutely, the more information you have, the better you are, and if you can reduce the anxiety in your mind, in the back of your mind, about what actually went wrong, and how am I tackling this? Then I think it’s very valuable to get another opinion. And doctors all are used to patients getting second opinions, and I don’t think anyone’s going to be offended by that.

Norman Vandal 1:14:14
No, and I don’t worry about doing that. I’m not concerned about it. I’m a pretty good advocate for my own health. He wrote me when I said tell me, I’m really unclear. You know, I remember you saying it was a bleed. So he wrote to me, and he said ‘I never said it was a bleed. And I thought, Well, gee, I think I heard that.

Norman Vandal 1:14:39
But here again, maybe it’s the stroke, and I don’t know, but he said to me ‘I had a left putamental and corona radiata in fraction due to penetrating artery disease.

Bill Gasiamis 1:14:56
Okay.

Norman Vandal 1:14:58
Okay, chew on that one.

Bill Gasiamis 1:15:02
Penetrating artery, disease.

Norman Vandal 1:15:10
Putamental and corona radiata infarction and then he said, You have asymptomatic stenosis of cervical right ICA and basilar artery.

Bill Gasiamis 1:15:26
Okay.

Norman Vandal 1:15:27
I think is telling me that I do have some blockage in the facial art.

Bill Gasiamis 1:15:31
Yes, okay, so it sounds like they’re all. Sounds like you’re on the right track as far as your protocols, everything that you’re doing, exactly what they’re saying. It sounds like somebody is aware of exactly what’s going on, and that thing that you said about yourself is perhaps the stroke is causing you to misunderstand or hear things or imagine things that weren’t said.

Bill Gasiamis 1:15:52
Yeah, that’s a very interesting observation as well, to keep in mind and to be aware of, and it’s great that that you tested him on the fact that you thought that he said you had a hemorrhagic stroke, and he corrected you and said ‘No, you didn’t. And I never said that. That’s good too. I mean, those are conversations you need to have, that’s how things get cleared up.

Norman Vandal 1:16:16
Yeah, and that third opinion you’re you would advocate for.

Bill Gasiamis 1:16:20
Absolutely yeah.

The Good And Bad Days In Recovery

Norman Vandal 1:16:23
I think, I’m gonna pursue that. So now you were saying about how sometimes your progress seems to the good days and bad days, I guess is a way of saying it, and, you know, I find that when I’m tired and this is one thing, if I could ask your audience a question, this would be one of them ‘When you’re tired, when I’m tired, it seems to go south.

Bill Gasiamis 1:16:52
Yes.

Norman Vandal 1:16:52
It just seems to be, it moves backwards, you know, and, and I’ll find that I have a little bit of wiggle in my foot, my leg doesn’t feel quite as strong, my arm is a little bit more shaky and and is that something that you have felt? And how long does that last?

Bill Gasiamis 1:17:14
Yeah, so for me, if I have a bad night’s sleep, or if I had a couple of big days where I didn’t rest enough or did too much, then what happens is the deficits increase and get worse, and I notice them more, and then it settles down when I want to go back into a proper sleeping routine, for example.

Bill Gasiamis 1:17:35
And then things settle down, and I notice it less, so it may not be a deterioration, or that you’re going backwards. Well, in your case, you’re not going backwards, or what it is is perhaps the inflammation that occurred that impacted your brain in a negative way is just kind of rearing its ugly head and letting you know that you’re you’re still not 100% and you need to pay attention to your symptoms.

Bill Gasiamis 1:18:02
And then you need to rest more, perhaps, or you need to alter your diet, or you need to do a little less physical activity. You’ll know what it is that kind of sets you off down that path of not feeling so great, and then you can just ease back on that.

Norman Vandal 1:18:08
You know, I’m trying to, I’m very big on letting my body speak to me, trying to read that. There are days when I feel a little bit woozy, it looks slightly dizzy. A weird thing that happens too, is that I wear reading glasses, I’m wearing them now, and they’re basically what I call drugstore glasses.

Norman Vandal 1:18:40
They’re magnifiers, you know, and if I happen to be working with the glasses on, and then I start to, I stand up or whatever, and I walk a few paces, I get so dizzy, so quickly, it has that effect. And that’s all, it’s a standard reaction anyhow, but it’s so much hyper, so much greater now than it ever has been.

Bill Gasiamis 1:19:07
I had a very long time where my brain was playing games, you know, in tricks on me, where I felt like I was in another plane, in another dimension. I was having these weird kind of out of body experiences, and I would take a little bit of time to kind of reset and go back to baseline, and it was happening just on a normal day. I wouldn’t think that anything had changed or anything was different.

Bill Gasiamis 1:19:36
Then all of a sudden, I’d be feeling spaced out or lightheaded, and I need to rest and sit down. It’s not uncommon that there’s still stuff settling down in there, and this stuff moving and changing. So it’s not uncommon, the important thing is, to for you to be certain that your lightheadedness or the conditions that you notice.

Bill Gasiamis 1:19:59
Not say, a sudden drop in blood pressure too low or a high or a response to something else, that’s kind of the only thing you need to be aware of, and I would make this type of information known to your medical professionals that look after you and let them know.

Norman Vandal 1:20:06
I told him about this feeling of dizziness and lightheadedness sometimes, and he said his explanation was. He said ‘Well, you know you’ve dropped 30 to 35 pounds. You’ve lowered your blood pressure substantially. Your A1C is lower, you’re getting used to functioning with less highs and lows of glucose, and he said ‘You’ve had a stroke.

Norman Vandal 1:20:48
And I also have stenosis in my aortic valve, which has not changed in years. It’s not symptomatic at all, and there’s no it’s very moderate, and he said ‘But you know, it could be that stenosis, under the circumstances, is causing you to feel lightheaded. So, I am trying to observe like I said ‘Let my Body Talk to me, to so that I can sort of feel it out, you know.

Norman Vandal 1:21:19
I can figure out the scenario or the triggers or what it is that causes it, and just having to do those things is both, it’s a blessing in a way, honestly, I really feel like it’s teaching me about my body and my brain and the way it functions.

The Lessons From The Basilar Artery Stroke

Bill Gasiamis 1:21:43
Yeah, you touched on all the things that you learned from stroke earlier that you’re learning so much, and what’s the, what’s something that you’ve learned about stroke that’s really had a profound impact? What’s something that, okay, let me rephrase it. What’s something that stroke has taught you?

Norman Vandal 1:22:02
Something that what?

Bill Gasiamis 1:22:03
Stroke has taught you?

Norman Vandal 1:22:07
Well, in sort of, you know.

Bill Gasiamis 1:22:13
Philosophical kind of way.

Norman Vandal 1:22:15
Philosophical sense, it’s taught me a lot about fragility, I mean, I’m 75 years old and and I do not feel like an old man, I don’t. And I always my entire life, I’ve said I’m never going to walk like an old man. I’m not going to let myself walk like an old man. And I see friends of mine who are my age, and they’re walking like old men.

Norman Vandal 1:22:45
I don’t even with the stroke suffering, I don’t, and I’m proud of that. But at the same time, what it’s done is it’s taught me about this fragility and of life, and I’m sure it would have learned some of that also from just my age, but I’m aware and the monkeys on my back, and I know something’s going to get me.

Norman Vandal 1:23:12
I’d rather it not be a stroke and have to put my family under a lot of stress, and being capacitated that way. So I guess most of what it’s taught me is, but I don’t want to make it sound like it’s entirely negative. These are negative things that I’ve learned, but the positive things that I’ve learned too, I’ve learned about what inner strength I have to be able to do this.

Norman Vandal 1:23:43
I’ve learned about fear. I’ve learned about sorrow, I’ve been able to experience my body in ways I’ve never been able to do before, and I think it’s wonderful. I think a lot about the brain, and I never have before how the brain is wonderful and how it functions, and you know what, what it needs, and so on.

Norman Vandal 1:24:13
So, it’s been a learning experience for me in many regards, and I just hope that that’s true for a lot of people. That’s a common feeling, because I and, like I said ‘You know, I’ve recovered to the point of where most people watch me and they say, I can’t tell you how to stroke, and they say to myself, you can’t, but I can.

Bill Gasiamis 1:24:42
Yeah, compliment to you, but they’ll never what it’s like to be you, because they’ve never so we don’t want them to know anyway.

Norman Vandal 1:24:50
I’m not insulted by it or anything.

Bill Gasiamis 1:24:52
No, yeah.

Norman Vandal 1:24:53
yeah.

Bill Gasiamis 1:24:54
It’s better that they don’t know. As we wrap up, I’d like to ask you, to see if you can impart some wisdom on our listeners. There’s people that are listening that are your age, my age younger, going through something similar. What would you like to say to them?

Norman Vandal 1:25:13
Yeah, I’ve thought about this a bit. I think the main thing is something I’ve already touched on. Well, to preface it, I don’t really consider that the stroke that I had is as devastating as what a lot of people have. And I’m fortunate for that, for sure, and I know that the specter of having that as a possibility is there, but it wasn’t.

Norman Vandal 1:25:42
But I would say to people that I think that people need to get, people need to find a place where they can basically see the goodness in this too. You know what I’m saying, that it has, it has so many sort of side benefits that you’re not aware of before.

Norman Vandal 1:26:11
Like, how important friends are and family and the support that you get, and how important it is to learn to focus more on your body, and to learn more about your body and to know how to manage hope and fear. And because I sat in a bed thinking I and like I say, I wasn’t as bad as a lot of people condition, but I thought many times, I don’t want to live like this, you know.

Norman Vandal 1:26:40
This isn’t how I want to end my life. We have a Death with Dignity law here in Vermont, and I thought many times about how in order to to put that in place, you have to have cognition. You have to know what you’re doing. And I would think ‘Gee, I hope I don’t lose that, because if I have to make that decision, I want to know what I’m doing.

Norman Vandal 1:27:04
I’m not there, you know for sure, and I wasn’t there, and I didn’t go there. But it is an option for us here, but I think a lot of people find themselves in a situation where they can’t make that choice, but I’m I can, I can smile about about this, you know, I’ve been able, and smiling feels pretty good.

Norman Vandal 1:27:30
I can smile about it now, I hope that it doesn’t happen to me again. I’m going to do every, everything in my power to make sure that it doesn’t.

Bill Gasiamis 1:27:43
So silver linings. There’s some silver linings there.

Norman Vandal 1:27:46
Silver linings, exactly, yeah.

Bill Gasiamis 1:27:47
It’s a good thing to be aware of and to say, seek them out so to speak and to understand. And hey, Norman, I really appreciate you reaching out and being on the podcast.

Bill Gasiamis 1:27:57
It’s really great to have you on who had a great conversation and I am sure, as you requested in your email, that you sent me, I am sure that is going to make a difference in other people’s lives, and it will be very interesting to hear your story.

Norman Vandal 1:28:16
When I listen to your podcast, for me, what it was, it just became this ability to have, in a way, have my own conversations while your podcast was going on, and to hear from other people and their experiences and find that commonality, be just to be able to feel like I’m not alone, I need this, and I suspect that’s one of the main reasons why you’ve done what you’ve done.

Norman Vandal 1:28:43
But I really, truly appreciate it. I do, it’s a great thing that you’ve done, and hope you keep, hope you keep doing it, because people aren’t going to stop having strokes, unfortunately.

Bill Gasiamis 1:29:01
Unfortunately, not. I certainly am. Thank you so much for being on the podcast.

Norman Vandal 1:29:05
Well, if you ever find yourself in Vermont in the States, you come and you’re welcome to stay here and I’ll show you some beautiful country.

Bill Gasiamis 1:29:14
I’ll look forward to it one day, you never know what happens.

Norman Vandal 1:29:17
Never know exactly, never know.

Bill Gasiamis 1:29:19
You never know. Thank you for the for the invitation. Okay, all the best. Thank you so much.

Norman Vandal 1:29:25
Yep, thank you.

Bill Gasiamis 1:29:27
Well, that brings us to the end of another episode. I hope that Norman Vandal’s journey of surviving a basilar artery stroke inspired you as much as it has inspired me his determination to overcome the physical and emotional challenges of stroke recovery, and his insights into rehabilitation and life after stroke are truly remarkable.

Bill Gasiamis 1:29:49
Thank you to everyone who has already left a review. It helps others find the show and provides much-needed encouragement to stroke survivors. If you haven’t. Already, please consider leaving a five star review and sharing your thoughts on iTunes and Spotify, and for those watching on YouTube, remember to Like comment and subscribe to stay updated on future episodes.

Bill Gasiamis 1:30:15
If you’d like to further support the podcast, you can do so by subscribing to our Patreon page at patreon.com/recoveryafterstroke, every contribution helps bring more stories like Normans to people who need hope and advice on their stroke recovery journey.

Bill Gasiamis 1:30:32
Finally, if you’re a stroke survivor with a story to share, I’d love to hear from you. My interviews are relaxed and unscripted. Just come as you are, and if you have a product or a service related to stroke recovery, consider sponsoring an episode of the show, visit recoveryafterstroke.com/contact, to get in touch. Thanks again for joining me today. I look forward to seeing you in the next episode.

Intro 1:30:56
If you’ve had a stroke and you’re in recovery, you’ll know what a scary and confusing time it can be. You’re likely to have a lot of questions going through your mind, like, how long will it take to recover? Will I actually recover? What things should I avoid in case I make matters worse? Doctors will explain things, but obviously, you’ve never had a stroke before.

Intro 1:31:17
You probably don’t know what questions to ask, if this is you, you may be missing out on doing things that could help speed up your recovery. If you’re finding yourself in that situation, stop worrying and head to recoveryafterstroke.com. Where you can download a guide that will help you, it’s called ‘Seven questions to ask your doctor about your stroke.

Intro 1:31:40
These seven questions are the ones Bill wished he’d asked when he was recovering from a stroke. They’ll not only help you better understand your condition, they’ll help you take a more active role in your recovery. Head to the website now recoveryafterstroke.com and download the guide. It’s free.

The post What is a Basilar Artery Stroke? Understanding Causes, Symptoms, and Recovery appeared first on Recovery After Stroke.