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My Brother Neel

My brother Neels : He had a Ischemic stroke. 30th July

No body could have predicted that things will change in our world so much , so sudden. 30th July 2010, I was gardening in my Reading, UK house, that my wife called me from the upstairs and shouted that something really bad has happened. I queried her, and the reply was just shocking: My only brother who lived in Dallas, US had a stroke. I could not believe, he is only 39 years old healthy , strong guy : How come he can ever have any health issues, that to Stroke. I was only there in Dallas, during June to see my brothers new born daughter. I always made a point to visit him whenever I visited US. Though I complained him all the time to come to London, he was just too much into his stressful job. He never had a break for last 5 years, and not sure if that contributed to his stroke.

 

I always loved my brother, Neel: my only brother. We shared so much… throughout our childhood, that he is almost part of mind, body and soul. But until now, I did not realize that I loved my brother so much. This day changed everything around my life. I took the next inbound flight to Dallas. My family lived in 3 timezone, Neel lived in US, I lived in UK and my parents are in India.

 

Arrived and straight went to ICU. He could able to recognize me and had tears in his eyes, but was very slow talking to me. I wanted to show him: I am  there and things will be fine , but could not resist myself showing him a tearful eye. He could not able to swallow, move his left hand and leg. Wanted to speak to his doctor, nurse whosever were there around. They all explained, that don’t think of days to come, lets stabilize him 1st. His friends and wife were gave me 1st hand information , that what had happened and how he was moved to ICU. Days before , he lost his balance and that’s when they took him to emergency. After MRI scan, doctors confirmed that he had a stroke in his right side and front (both side ) of the brain. After 3 days of continuous monitoring, many blood samples , respiration test, swallow test he was finally moved to acute ward. I stayed with him 24/7, while working from the hospital. Thanks to my company and my global work environment that I could able to execute my daily work from the hospital running a global operation. I watched him desperately that if he can swallow his food, if he can move his tongue so that he can be relieved from the nose feeding. It was painful for him, while he was coughing continuously.

 

Cause of the Stroke :Doctors told me that he had acute stroke due to ‘Carotid artery dissection’ . The artery got some dissection and forced the blood to move side ways, and that distracted blood flow to the brain and loss of oxygen. The clots moved up in the artery, hence permanently damaging the brain cells, which is termed as  ‘Ischemic Stroke’.  They could not able to pin point the exact cause , but gave multiple different parameters that might have contributed to the stroke. As he had fever and cough for many days, and he might have coughed heavily to create a sudden trauma and might have dissected the artery. The other causes could have been , that he had cholesterol, high blood pressure, stress and diabetics. But nothing was that high, which could have triggered a stroke: Having said that, the actual cause will always be a mystery.

 

There were 2 clots in his right side of brain where the mortar function of brain stored. Due to these clots he lost left hand and leg control and some swallowing ability . There were further 4 to 5 small and big clots in and around front of the brain. That impacted his initiation and motivation side of the brain.

 

The sever impact could have been avoided, in case if people around could have seen his stroke symptoms and admitted him to emergency ward. He then described me the story later on 5th of August. He described that he experienced early loss of control, almost 4 days before he was brought to hospital. He had  left side weakness, loss of control , one side face dripping :  started almost on Tuesday when he woke up. He continued his life almost thinking nothing has happened, though he did realize something was going wrong, he never called the doctor. Perhaps his cognitive side was impacted, so he did not realize what was happening to him.  But other family members did not realize that these are strong stroke symptoms. He might have multiple transient ischemic attack (TIA), as he did complain some pain and numbness in his left hand earlier; He spoke to me that week while he had the stroke, but never told me the symptoms, though I advised him to visit doctor as he was complaining pain in his left hand.

 

 

Stroke, have brought devastating impact on him and whole of our family.  We  experienced the seven stages of grief: shock, denial, anger, bargaining, depression, testing and finally acceptance. The frustrations and concerns are equally felt by him and those around him. Suddenly the life has changed in a foreign country where he flourished as a principal IT consultant, his new born baby girl, his grown up 7 year old boy, his wife,  my parents, my wife and his friends…. All have to come to term with the changing reality. I am yet to come to term that my brother is no more the same , who was my  emotional cushion,  my childhood guide, my adulthood best friend who would always give his 100% to me.  Every second person tells me in the hospital, hai you are the best brother we have seen…. Common they don’t know my brother he is ‘the best brother’ just that he is not well right now.

 

Recovery stage 10th August.

 

Neel failed multiple swallow test, so doctors have decided to put a pet tube, so that he can be fed through a pipe directly through stomach. But he did chew 4 ice cubes , and I kept him moving his tongue , and chew so that he can eat again. I wrote in the board, where he can see this constantly, but I guess he had to heal automatically. And just after the operation on 11th August, he started swallowing on 12th. And the same day they moved him out of the acute ward to the therapy ward.

 

Satyakam, Sachi, Venkat, Sukant, Amit and many more friends would visit, help me getting his finance, admin work shorted. They were so good support to me and family during this bad times. My wife and son flew to give us company. Again Neel is great fan of my son Dev, He stayed most of his time in the hospital playing with his ‘Dadu’ so as my wife helping Neel and myself. During all these times, Neels wife have been shuttling between him and her 3 month old daughter.

 

Hope and Challenge. 24th August

 

It has been almost 12 days now in the UT Southwestern therapy center, Neel has been doing well. According to Doctor, he has been recovering very well. He is now eating solid, no more water thickeners and really boiled food. He is getting his strength back, he can sit-down and move using his right hand side of the body. And he is now also putting his left leg forward. What a change in 3 weeks time. I thought he will never able to walk, now he is able to walk a little with support, he can sit-down straight and eat on his own without supervision. His speech are coming well, so as his cognitive and short term memory loss. He had some left side neglect, which is also getting better, as he remembers to shave his left side of face and able to finish his left side of the food plate.

 

Neel is rediscovering the joy of living with the changes. I have been advocating him, to really lead a life with his ‘Terms’, and do what he always wanted to do. He has got a new life, and he needs to appreciate and enjoy it. We have been working hard in the therapy , while watching movies , talking about our childhood and many more stories we spent together. Since July 30th, every day I have been desperate for Neels complete recovery. The most difficult challenge is making a commitment to recovery. It is very hard work, requiring fortitude and discipline. The hardest part is to work consistently at those things that you can do, such as moving an arm or a limb. Physical therapist, Occupation Therapist, Speech therapist are  often referred to as “Pain and Torture” for a reason—it hurts. The simple act of stretching an arm, as with many of the things that one could do without thinking in one’s pre-stroke life, requires the innate ability to lean into a left hook. Instinctively we shy away from pain, with good reason. But for a stroke survivor, you have to learn to work through the pain, and that is the most difficult challenge that Neel is facing. He is complaining constant pain in his stomach due to feeding tube. And pain in his left hand , shoulder and  his left leg.

I have taken up the nurse, the ‘Tech’ those who help washing and cleaning the patients, physical, occupational and speech therapist almost repeating after all the acts what he learns during his therapy session. Sometime he gets bit angry with me , as I am trying desperately for his recovery, and I am bit impatient. I am learning through my acceptance that something like stroke has happened to him, and he will recover eventually. Dr. Lee ( his initial neurologist) once told us, look a bone injury may take 4 to 6 months to heal, it is brain injury… give some time he will be better. I am hoping for that day , and I am quite certain that he will be the same old big brother ‘Bhaina Neel’ again……. I love him and he needs all the love of this world.

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