Guess Who is Back

Ok, Ok. I have been a horrible blogger as of late. I will try to quickly sum up my reasons for not posting anything for a while and attempt to not whine in the process. If at any point this post begins to take on a whining, complaining tone, please reach thru your screen and slap me. Not to hard though please I have a meeting this morning.

So, my blog has undergone quite a metamorphosis. I have covered a wide range of topics. The blog started out as a training log and a place for me to vent my frustrations with the things that keep me from training, namely work. Then earlier this year when I had stroke number 5, it became a log of my journey to get healed. I documented my hospitalization wherein I learned that I had a PFO (hole in my heart). I chronicled my search for the right doctor to fix the issue, taking me from UCLA and finally to Cedars Sinai where I had my surgery on April 24th. I wrote about my procedure and recovery, my frustrations in being out of action for about six months of this year and finally I told the tale of my return to the mats. Very long story short, it’s been quite a year.

Last week my blog turned one year old. The one thing that strikes me as particularly funny is the fact that it has in many ways come full circle. Now it’s not my heart or a stroke keeping me off the mats but the same things I wrote about in my blogs inception. And frankly, isn’t that better? I think so. I am healthy. For the first time I am now living without the constant fear of migraines or of suffering another stroke. I had felt like a ticking time bomb over the past three years and now I feel as though I have permission to be optimistic, to live without limits. That is a pretty cool thing and I don’t take it for granted.

So here we are. I mentioned full circle, well here it is. Over the past month and change I have been working odd and inconvenient shifts in support of a special project at work. This has meant sometimes working from 10pm to 7 am or from 6pm to 4am or even 3 pm to 1am. You get the point; I’ve been all over the place.

I have not been totally inactive during this time. I have been taking a number of the conditioning kickboxing classes when possible and I have been at open mat on a few Saturdays, so not a total slouch. I did have a little scare though. Over the past few weeks I would occasionally get a slight chest pain during some of the more exertive moments of the conditioning classes when sudden bursts of strength and speed were required. Those pains would last throughout the remainder of the class and sometimes persist thereafter for a while. You can see why I had been hesitant to re-join BJJ lately as it is entirely moments of exertion of strength and speed.

So I contacted my wonderful Doctors and they assured me that all is well. I have my 6 month post-surgery checkup at the end of November so if anything is wrong we will find out for sure. Until then I will continue to try and get / stay in shape and listen to my body while doing so. Basically I am back, I plan to post like a madman and keep everyone updated.

Thanks to everyone who dropped me a line to make sure I was doing well because of my conspicuous absence in posting. I really do appreciate everyone’s concern. So now, you can get sick of me because I will be back to posting all the time.

One Month

Healing Milestone:
Well here we are. It has been one month (30 days) since my PFO closure operation. In many ways it feels like just a few days have passed and in others it feels like it has been so long. This is the first significant milestone in my recovery. This coming Wednesday (27 May) I have my follow-up where the doctors will take a look with an echocardiogram to make sure things are healing as they should. I will make sure to post my results as soon as I hear them.

PFO Migraine Stroke Group:
While I am on the subject of my PFO. Someone who read my blog pointed me in the direction of a new PFO Migraine Stroke group on Facebook http://www.facebook.com/home.php?#/group.php?gid=106434738635 . The group is still small but hopefully it will grow to help people like me who are struggling with the same problem.

Random News:
I am hoping to start a separate blog for just my medical adventures so that when I return to the mats I can return this one back to its Jiu Jitsu focus while still continuing to write about PFO, Stroke and Migraine. I feel that these are issues that are just not discussed enough and It is my mission to help educate, inspire and guide people struggling with the problems that inhibited me for so long. Keep your eyes open for that new blog as my return to the mats draws near. Also, keep your fingers crossed for me as I go into my appointment on Wednesday, optimism is high.

Happy Birthday to Me!!!

Today is my Birthday. Well, not exactly. You won't find any note of it on my driver's license. Its not on my passport; nor is it on my birth certificate. So, as far as any "official" body is concerned technically today is just any other day, but symbolically.....today I am one week old.

The card I carry in my pocket provided by NMT (the company that manufactured the device used to plug the hole in my heart) lists the model number, serial number, lot number and the date....April 24th 2009. One week ago today. So the way I see it today deserves a bit of celebration.

Anyone who has followed my blog for a while, especially those of you who have read this since before I KNEW I HAD A HOLE IN MY HEART (that still freaks me out sometimes) will know that nostalgia is not my strong suit. I wrote about how new years resolutions tend to go by the wayside (http://grappling-with-life.blogspot.com/2009/01/goals-for-2009.html) and that I would rather make goals. So needless to say, I am finding myself struggling to find the proper perspective on this second chance at a normal life.

I don't want to be one of those whacked out people who suddenly sells off all their possessions, moves to a cave and contemplates their navel for the rest of eternity. On the other hand I don't want to be unappreciative either. This is a rather profound event in my life that very likely has saved my life. I feel a great responsibility to get things right, I feel like I need to be a voice for these issues. I feel like I need to be the best me I can be.

It fills my heart to know that this little blog has begun to help already. Some of you may have noticed the "For more information" contact bar that I added off to the right hand side. Shortly after my post about finding my PFO and adding that contact link, two people with conditions mirroring mine contacted me. Both of them had suffered strokes (one of them multiple times like myself), both of them had PFO's recently found and like me both of them were looking for answers. Because of this little blog, I was able to help. One of the two had their PFO closed TODAY by the very same doctor who did mine one week ago!!! I cannot express how good it makes me feel to know that I was able to help someone while on my own path to wellness.

This person never did BJJ, had never read my blog before. I was stumbled upon simply because they were googling the things I had written about. I know they will read this so when they do, I want them to know that I am so happy that they are also on the road to recovery and they better enjoy the journey....Happy Birthday!!!

All Tested for Now

Getting Testy:

The MRI is done, and it shows what we had feared. Damage. Permanent damage. Enough for the Neurologist to definitely classify at least one of the attacks I've had as a stroke rather than a simpler TIA. The Cat Scan I had pretty much said the same thing but the MRI shows the newly empty sections in glorious, cavernous detail. The good news is that the scan showed no signs of a clot, tumor or other unwanted bit of nastiness. In fact, my "right cerebellum is unremarkable", so there's that.

So, what this means. My neurologist is obviously concerned that I am not just suffering from Migraine Induced TIA as has been the assumption we have been running under since September 2006. His reasons for doubting that diagnosis now is because with Migraine TIA's, it happens predominantly in Women and there is no damage. Well, I am not a woman, and there is definitely some damage.

That is why he is having me see a Cardiologist. It will be up to the Cardio Doc, to rule out any circulatory issues (clots and such) as well as to look at the possibility of a Ventricular Septal Defect (VSD). A VSD is basically a problem with the tissue that divides the ventricles of the heart and because of the complications, can cause stroke.

The Cardio Doc, took about another gallon of blood to test for another billion conditions that can cause stroke. Then he performed an Echocardiogram and some ultrasounds of my Carotids and various other spots. Hopefully they find nothing, but at the same time I kind of hope someone finds something. I desperately want some answers.

I will see the Cardiologist again in about a week for all of his results and then the Neurologist again the following week. So, until then I'm supposed to be the patient patient, plod along and wait. One bit of good news I received from my neurologist the last time I saw him was regarding my arm. I asked him what the prognosis of getting normal function back and he said "your young enough, it should come back eventually". No time frame, no promise. But some hope.

I'll give them another couple of weeks before I hound them again with questions of beginning BJJ again. But I will not wait to begin trying to rebuild function in my arm. I saw my 8 year old niece last night and I had not realized how much strength I had lost until she asked me to pick her up when we were playing. It was terrible feeling like I was limited. I have to believe that working on this arm will help rebuild those damaged pathways.

UFC Fight Night:

So Dr. Evil and his son came over to watch the fights last night. It was good to see him. We have not spoken much since I've been out of the gym. We watched the fights, traded stories about the gym and even had a spontaneous light roll on the living room floor afterword. I suspect its always kind of like that isn't it. You get BJJ guys together and inevitably, somehow, a roll will begin for no good reason.

It was funny. And again, painfully obvious that my arm is junk in its current state. A big thanks to Dr. Evil (enough Doctors already) for giving me a couple minutes of BJJ during this ordeal. Thanks to everyone for their support.

Back to Real Life

At Work (1/5/09)

Well, its Monday. Like many people I'm back at work after a bit of a break. This marks the official end of "Gauntlet Week" as Neil and I were calling it. We had intended to hit it hard and attend class each morning that the gym was open leading up to new years day and to do open mat the following Saturday. We both had issues that kept us from action during that week...his sausage toe for a day and my Migraine for one, but we made a good run at it.

I did realize one thing during this time when I wasn't working and was able to attend BJJ without putting in a full work day first. I wasn't nearly as stressed or feeling the same mat anxiety as normal. Could there be a pattern here? I'll try to be cognizant of this for a while and see if there is in fact a correlation.

I know that BJJ is an excellent method for relieving my stress from work, but on the other hand is all that stress from work inhibiting my BJJ? I never thought of that pickle before. That feeds right into my underlying theory....STRESS IS BAD.

Perhaps instead of getting an MBA, I should have studied psychology. It seems I have the knack (on vinyl none the less). Well, like I espoused in my post about goals for 2009; Relax. Easier said than done I know. So, I'll take it one day at a time and see how it goes. I'll start with tonight. I'll hit the mats at 6:00 and consciously try not to be conscious about anything. I will just be. Man, I'm sounding like some kinda granola eating, Birkenstock wearing, patchouli stinkin hippie. Hey, if it helps my Jiu Jitsu, pass the beads.

Please don't take any of that too seriously. I guess that's the point isn't it? don't take it too seriously. Relax, flow, let the learning happen. Stress only stops the progression. So stressing about stressing can only doubly inhibit performance. Stress tenses up muscles, inflames blood vessels and drains energy. All the things that lead to flat out poor grappling.
Like I said in my thesis above: STRESS IS BAD

Stupid Brain

BJJ (12/30/08 9:00am)

Didn't sleep very well last night. BJJ on the brain. But I woke up surprisingly well rested and ready to roll. I was really focused on Jiu Jitsu this morning. Today I was prepared to let it all hang out when rolling. I was going to initiate, take chances, be loose and be aggressive. Basically, I was in a good place mentally. Lets head to class!

When I arrived at the gym, I noticed that Neil wasn't there. I figured that something must be wrong, we'll get to that later on. There were four other guys in the line up this morning plus Fritz and Carl leading us. The gym was a meat locker this morning. I like it on the cold side, so that's fine with me but its fun to watch the warm weather guys struggle.

We began warm-ups. Nothing out of the ordinary. Jogging, high knees, high heels, sideways, push ups, jumping jacks, jumping jacks to the front, jumping jacks kicking to the front, to the side, clapping under the legs, rotating wrists and ankles.......and then it happened. I realized that I couldn't see anything.

There goes my brain again, getting in the way. For those who don't know, I suffer from too many neurological conditions among them are Migraine (http://en.wikipedia.org/wiki/Migraine) with Aura (http://en.wikipedia.org/wiki/Migraine_with_aura). The Aura precedes the onset of the pain phase of a migraine with delightful disturbances in vision that in my case look like geometrically formed lightening bolts across my field of view. It starts off small and gradually increases in size until it overwhelms the entire field of view. The fun part is that, you still see these lightening bolts with your eyes closed. Because its in the brain, not in the eyes.

So, I had to excuse myself from the mats, pop my rescue med (which is always in a handy container on my key chain) and sit in the cool, dark, heavy bag area with my head covered until my vision cleared up. How embarrassing. I hate it when my condition takes me away from doing things I love, but I hate it even more when it makes a spectacle of me. I don't want that kind of attention and when you tell people "I cant see" or "I'm getting a migraine" they don't understand.

When people hear the term migraine, they often think of the diluted word that is used by many to describe common headaches rather than sever clinical, neurological bombs. I am always fearful that people are lumping me into that group. That they don't understand the realities of my condition.

Anyway, there is one last training session for me in this year...I intend to make it count!!! My next post will be an account of that class. Following that post will be a recap of the year and a look at my goals for 2009!

The Diagnosis

Neurologist (11/24/08)

For those who don’t personally know me, which is pretty much everyone who reads this blog, there is another dimension to life that I have dealt with off the mats. I have suffered with migraine headaches for most of my life. They began to occur at about the age of thirteen and they continue today.

My condition is referred to as Migraine with aura, because immediately preceding the pain, I experience a disturbance in my field of vision that is still there even with my eyes closed. This aura is caused when a part of the brain shuts down because the neurotransmitter levels are so out of whack it just needs to reset. Over the course of thirty to forty-five minutes my vision returns to normal and the pain slowly fades in.

Luckily there are now medications that help to abort the migraine, provided I am able to take it immediately at the first sign of aura. When the medication works (about 80% of the time) by the time my vision clears, I am left with a really bad headache and not a full blown migraine. A vast improvement!

On September 21, 2006 however my condition took an interesting turn and my migraine presented in a wholly different way.

It was a Friday morning, I was getting ready to drive down to Anaheim for the graduation ceremony for my MBA. This was to be a great day. All my hard work was paying off. As I was getting ready, printing maps on the Internet, my wife asked me how I wanted my eggs cooked……I couldn’t answer her.

Something was terribly wrong, I could think of the words, but when I tried to speak it was gibberish. When I tried to write, it was a scribble. This was the day I was to receive my Masters Degree and I could not communicate. It was absolutely terrifying.

In short I experienced a Transient Ischemic Attack (TIA) in which blood is cut off from a section of the brain for a just a short amount of time. TIA is normally caused by a blood clot traveling thru the system and getting caught up briefly in one place where it blocks the flow momentarily. In my case, it was the spasms in the brain caused by my Migraine condition that actually pinched off the blood vessels.

Luckily, the effects of TIA are generally temporary. And in this case, I was just fine by the end of the weekend. I am now on medication to try to keep Migraine and TIA at bay but I have had a total of 5 TIA’s (none of the subsequent being as bad as the first) because the understanding behind the why and how of such neurological conditions remains largely a mystery.

When I saw my neurologist again for a follow-up on Monday afternoon, I received a piece of news from him that, while not surprising, still gave me a moment of pause. I had always had some quirky ticks. I spoke to the Doc about these things and he casually said, “Well, yeah…you have Tourette’s” like it was something that I should have already known as a fact. He explained how I have a very mild case and he also explained that there is a substantial link between Migraine and Tourette Syndrome.

As I said, I had always kind of suspected, but it still caught me off guard. When I asked him about my BJJ training specifically (something I had never done), his advice was to take things easily, not to allow myself to get overly exerted and to tap quickly on blood chokes.