by Melissa Gramaglia – Recipient of the 2015 NPAA Transformation Award
This is the story of my stroke & recovery.
When I was 34 years old, life was finally coming together. My husband and I were married for 2 years, we had just bought a beautiful new home, I had a job that I loved, and we were expecting twins! Life was so promising! I had prepared for the pregnancy by taking prenatal vitamins, eating healthy and training lightly at the gym every day at lunch. But as the pregnancy progressed, the doctors had begun to monitor my health (and the health of the babies) very carefully. My cervix started funnelling at 27 weeks, which had put me at a very high risk for an early delivery. Immediately, they had suggested bed rest and steroid injections in case our twins made their debut early. I had my first round of injections at 28 weeks, and then a second round of injections at 32 weeks. If Isaac and Alexis were to come early… we were prepared.
Every week that went by was a total blessing. We were grateful to keep the babies developing for as long as we could. We had nurses call every day to check up on me, and once a week they came to the house to check on the general health of me and the babies. But on Thanksgiving weekend 2013, as I lay in bed with my husband, I suddenly didn’t feel quite right. I tried to get up and out of bed, but collapsed against the wall. My speech was slurred and I couldn’t see anything out of the left side of my face; he immediately knew there was something terribly wrong. My husband called for my dad (who was staying with us at the time) – to call for an ambulance. The problem was that my dad thought I was in labour, when in fact… I was having a major stroke. At that moment, our lives changed in an instant.
All I remember is thinking, “Why is this paramedic talking so loud and why he is so mean?”… And I kept telling him that I was fine! All I could do is focus on my husband because I couldn’t see anything out of that eye. Once at the Foothills Hospital, there was a flurry of activity. Again, they were asking me all sorts of questions. I had no idea what was happening. I just wanted my husband. I remember getting the CAT scan. My husband met with the neurologist, Dr. Menon, and he said to Giulio – “my first priority is to save your wife’s brain, the second priority will be to save the kids.” They issued the TPA (the clot busting drug that we can attribute to minimizing the brain amount of brain damage) and prayed that the kids would be ok. I had suffered a major left MCA (middle cerebral artery) stroke.
Once they had moved me up to the neurosciences ward, they kept monitoring the babies. I was having contractions, so they thought they may have to deliver the kids early. I was not allowed to eat anything for 24 hours, and I literally was starving (I remember thinking how mean the nurses were!). Finally, they gave me some peanut butter toast once the contractions stabilized. I swear it was the best thing I’ve ever eaten. I had completely lost the ability to communicate and they had inserted a catheter amongst the emergency room mayhem – so my only words were “pee”. That was the extent of my language skills going forward. The next day, I remember my husband leaving me for just a short minute to grab something from the cafeteria. He had given me the iPad since I had been playing solitaire to pass the time on bed rest. I remember looking at it and being so confused?? That was the game changer. I had no idea what to do with the cards laid out in front me.
I spent nearly a month in the new South Calgary Campus hospital (they had moved me from the Foothills). I spent time doing speech therapy and occupational therapy for 2 weeks before the babies arrived. I had to learn how to do everything from square one. I didn’t know the alphabet, my name, my date of birth (which is kind of funny because they had to take my blood every 3 hours and they would ask it every time!). We practiced looking at objects and learning what they were (house, cake, etc.). It took me a week to learn my address. Counting money always had me in tears with frustration. I didn’t know how to apply makeup anymore. At one point I tried to shave my legs in secret because I hadn’t done so in a month. Note to self: do not try to shave your legs while on blood thinners! Finally, on October 30th, my water broke. Isaac (Baby A) couldn’t wait to come into this world anymore. Because I was on blood thinners, the team of doctors advised that the delivery would be safest if I was given a general anesthetic. In theory, this was great! Everyone should be knocked out and wake up with 2 babies! Isaac Jack was born on October 30, 2013 at 10:52pm at 5.8 oz and Alexis Kate was born 30 seconds later at 3.12oz. We were so in love! Daddy got to meet the kids in the NICU while I recovered in surgery.
Since the kids were a month early, Isaac and Lexi had to be tube fed. They were too small to learn how to suck. I was trying to learn all the basics of motherhood: breastfeeding, pump assembly, bathing, diapering, etc. Lucky for me, my husband stepped up to the plate and assumed the role of caregiver/Mr. Mom. What on earth would I have done without him beyond me. I remember trying to learn how to breastfeed in the hospital and the lactation consultant was trying to show me where to put my baby. I was on the verge of tears with frustration. I didn’t know the difference between a knee and an elbow, let alone putting a baby in the mix! It was so hard… even trying to figure out how all of the pump pieces fit together. I desperately wanted to breastfeed my kids since I knew how good it was for them, so I persevered and became an “exclusive pumper” for 7 months! It was one of the successes that I am extremely proud of. I felt like that was the least I could give my kids. I can’t begin to tell you how difficult it is when you feel like a failure as a new parent. I desperately wanted to easily diaper my new babies, but I would get things confused and put the diaper in the sink and the wipes on the baby. My husband became our everything! He would do the ungodly 3 hour feeds every night by himself so I could get at least 6 hours of sleep (which is paramount when you are recovering from a stroke). He did it every night, without question, and still went to work every morning. I am the luckiest woman in the world for 3 very important reasons – my wonderful husband and our 2 beautiful kids.
Before we left the hospital, the entire team of staff at South Calgary Hospital met with us to discuss the next steps in my recovery. They wanted to make sure that we would have the very best care available, including family support. We were referred to a team called Early Supportive Discharge (ESD), who provided us with 5 months of steady home care. All I have to say is that we are extremely fortunate to be Canadian citizens and have free access to some of the best health care in the world. When the resources are needed, they are provided without question (my neurologist gave us 3 extensions in this program which is unheard of!). I am eternally grateful. The amount of caring individuals that we had come to know and love throughout my recovery is amazing! My parents came to live with us for the first 5 months. What we would have done without their help is beyond me. They helped with the therapy schedule, baby care, pumping milk, walking dogs, making dinner, folding laundry, etc, etc… the list goes on. They were a god-send in those first few months. They gave us the best gift a parent could ever give; which is love, patience and time to put my brain back together.
At home, I did therapy 5 days a week – at least 2 hours a day. I had developed aphasia and apraxia from the stroke, which are language disorders. I didn’t know how to speak, read or write. In my first therapy session at home, they asked me to make a grilled cheese sandwich. I forgot the cheese! They basically had to teach me life skills all over again. We practiced following a recipe, going grocery shopping, ordering lunch in a restaurant, taking the bus – as well as baby care and home care. I was super self conscience about my speech in public. It was so challenging to try and carry a conversation with anyone. However, my therapists became like family and I started feeling more like ME again. But, the same time that ESD was coming to an end, so was my time with my parents. I was completely petrified to be left alone with 2 little babies and the dogs while my husband was at work. What if they both cried at the same time? Then what? How would I manage? And beyond that, what about the silence? I was so used to having a busy house with my parents and therapists coming and going. I was worried about being alone. My husband was certain that I could do it on my own… I just needed to be confident. But the day that they drove away, I just sat on the stairs and cried.
Well, doing it on my own. I guess that if you put a challenge in front of me, I am going to make it work – no matter what. That’s just the type of person I am. I settled into a pretty awesome little schedule. I pumped milk first thing in the morning before the babies woke up. Fed babies, went for a walk with babies and dogs in tow (which, by the way… I didn’t know how that would work because they are 130lbs each!), fed babies, pumped milk, cooked dinner, did laundry, cleaned house, etc, etc! We were totally self sufficient! My amazing husband was a huge part of that. I am extremely proud to say that we did it on our own. It helped immensely that one of my therapists recommended a sleep training book which was crucial. I allowed me to have the kids in a rock solid schedule so I could get things done. I still did not drive, so my husband would do all of the grocery shopping for us. We pulled together as a family and made things happen.
After ESD was over, I was sent to Community Accessible Rehab (CAR). This time, it was my responsibility to get myself to the South Calgary Health Centre 3 days a week. Luckily, my husband works for a pretty amazing company who understood our situation and allowed him to work from home on our therapy days. My husband would come home at noon, we’d feed the kids, and he could work while they napped. Again, I met with a remarkable new team of therapists who supported my recovery. The crazy thing about having a stroke is that you don’t realize your challenges until you meet them head on. You think that you can still do everything the same way you used to, until you realize you can’t! I remember meeting with my neurologist about 3 months into my recovery and he asked me how recovered (percentage wise) I thought I was. I said 75%! Which is ridiculous! Little did I know how long and hard the road ahead of me was going to be. I still have a very difficult time with pronouns in simple conversations, I get things backwards all the time, I have no sense of time, and directions are a challenge. I don’t think my problem areas will ever fully resolve themselves – but every day seems to get better and better. I still celebrate every success because those are the little things that keep me pushing on. I want to be the best possible wife and mother that I can. At the end of the day, that’s what matters most.
During my time at CAR, I worked with a recreational therapist whose main goal was to get me back doing some of the things that I love. At first, I joined the YMCA on my own. It was not a positive experience… I felt lost and overwhelmed, so cancelled my membership after 3 short months. However, my Rec Therapist facilitated a meeting with the strength and conditioning manager who became my personal trainer. I needed someone who (somewhat) understood my disability and could build that confidence back into the gym. I needed the extra help to remember the movements, to process the information about where each body part was located, and at the end of the day, to get back to doing something that I loved! I looked forward to Wednesday afternoons where I would walk over to the YMCA (after 2 hours of therapy) and finish off with a great workout.
I wish it was that easy going forward, but unfortunately, I couldn’t get my kids into childcare at the YMCA. With the twins, there were only a certain amount of time slots available (especially with 2), so I had to find something with more availability. I was still not driving, so the closest gym to me was the World Health Midnapore. It was a 45 minute walk there and back, but I was game to do anything possible to get me out of the house and provide my kids with some socialization. It was tough! They were 15 months old at the time and had never been away from mom. I would load up my kids and dogs (because they needed exercise too!) – kids would play, mom would work out, and dogs got their daily walk in. In my opinion, it was a win-win-win situation all around! That’s another proud accomplishment for us. I truly believe it is our responsibility as pet owners to ensure our dogs also got their exercise in every single day. We rarely miss a day.
It was around my last therapy session that I had seriously contemplated entering a figure competition again. I had competed back in 2012 as a bucket list item before I got pregnant. I wasn’t sure if I could do it because it is such a serious commitment; however I wanted to give myself the opportunity to set this goal and achieve it. I’ve come SO far… and I thought this would be the icing on the cake (or the coconut oil on my egg white omelet!). I wanted to do it for me… to show my husband, my family, my friends, my kids, my doctors, nurses, therapists, coaches, and everyone who has helped make my journey a success, THIS is the result of you! I am successful because of everything you’ve given me. THANK YOU. I am truly fortunate for the opportunity to come back stronger than ever.
I finished my last therapy session on December 11, 2015. In that window of time, I got my license back after almost 2 years, I started playing soccer again, I went back to the gym, my speech and spelling improved dramatically, and I’ve been working on building some self confidence. My journey is not over and there are still some question marks about what the future holds, but I am confident that WE (as a family) can overcome anything. I started training to compete with the NPAA in the spring 2016 show. I want to show the world what dedication, perseverance, and commitment really mean. On the days that were a struggle and I wanted to give up… it would just make me work harder. My dad always tried to instill a good work ethic in me, and I’m proud to say that paid off. A positive attitude goes a heck of a long way! I can’t change what happened to me, but I can do everything to make our future bright. Besides, we have 2 amazing kids to raise.