Thread by @annabonkhoff

Exactly 7 years ago, I spent #StrokeAwarenessDay undergoing emergency #thrombectomy for #basilar artery occlusion. #BAO

Today, I'm still in awe and celebrating how #modern #medicine saved me from locked-in syndrome and enabled me to live a normal life, against all odds.

1/ 🧵

2/ So far, I have avoided sharing this information as part of my professional life, fearing it would somehow disqualify me as a credible clinician-scientist. Finally, I realize that the experience only strengthened my resolve to give future patients the second chance I was given.

3/ What happened in brief:

I was a healthy, 25yo medical student, all excited to have finished the first 10K run of my life not even 5 hours before my family reacted #FAST and called 911.

4/ Neuroanatomy in real life:

I suddenly felt intense #vertigo a few hours after the run. Some external force seemed to press me downwards and to the side when I sat down in my family's garden chair. At first, I simply thought I was a bit dehydrated…

5/ Locked-In:

Then, in the time it took me to say "I can’t breathe", my arms and legs had stiffened, and I lost any ability to move, speak, or swallow.

6/ 911:

I was desperately trying to say "CT scan", when I heard my father and the paramedic discuss potential cardiac conditions. #TimeIsBrain However, I was unable to say it and my head hurt, as I tried.

7/ In the ED:

As often observed in #BAO, my symptoms fluctuated. I was briefly better, before another round of symptoms set in, this time featuring waves of the most severe facial pain (left #trigeminal #neuralgia), drastic hypotension and upbeat #nystagmus.

8/ The eye movement freaked out the #neurologist on-call and I was rushed to the #EVT suite: I heard people prepare the procedure hectically, while I not only couldn't move anymore, but was now also losing my sight. Everything was happening so quickly

9/ I didn't quite understand the implications of vertebral artery dissections that I was told I was having. I was mainly consumed by reminding myself to breathe, but in some abstract way, I knew that I was reaching a turning point. My life was at stake and it wasn't in my hands.

10/ My attention was finally caught by my anesthesiologist. She was speaking so calmly, explaining what was going to happen and that I should just think of a fond memory.

If it had been my very last moment, it would have been one with a happy thought. I'm so grateful to her.

11/ Luckily, I did wake up again. Amazingly enough without any obvious symptoms. It's difficult to describe the pure gratitude, humbleness and joy elicited by first loosing and then regaining pretty much everything.

12/ I'm pretty sure it's possible to be a very good stroke doctor without having experienced stroke symptoms and being rescued by modern therapeutic approaches. However, since I'm here, I'd like to finish with three insights, one as doctor, one as patient and one as human.

13/ As a #doctor: When working clinically, I treated many patients every day and might have judged my performance by averaging across all. Having been "on the other side", created a constant awareness that all of my patient's lives were unique and essentially everything they had.

14/ No extra effort, no extra minute spent, no small deed of kindness will ever be wasted, if it aims to maximize a single patient's outcome. Many patients will remember it ever so vividly given the salience of these moments in their lives (like I do my anesthesiologist's words).

15/ As a #patient: I soon realized that surviving the acute phase was only part of the challenge, as #recovery is extremely time-consuming and strenuous, especially since nobody can guarantee a good outcome. I experienced leaden tiredness, vertigo and also anxiety for months.

16/ I kept my spirits and motivation up by: 1) seeing healthy life around me that I SO much wanted to be part of again, 2) appreciating the possibility (i.e. human strength) of adapting to new circumstances and 3) accepting that tomorrow was another day full of new opportunities.

17/ As a #human: The best, immediate measure that I discovered to ensure my sanity, despite being fully aware of my own #mortality, was to practice kindness and optimize moments. Kindness to myself and others, every single moment, so no moment is lost.

18/ I wouldn't be here if it wasn't for the people in my life.

My family that immediately called 911. All the healthcare professionals offering #FAST and effective treatment. My friends and everyone along the way, who cheered me up and continue to make life so wonderful & fun.

19/ I feel ultimately grateful to all of them.

20/20.

Life is good.