Surviving a Stroke: Returning to Life

On April 17, 2022April 17, 2022 By rmascardoIn health, Renato Mascardo2 Comments

Hello Friends & Family,

I actually started writing this blog post a couple months back but didn’t enjoy how it was coming together so I started from scratch. Not sure why but maybe because there was still tremendous uncertainty in the entire thing. Well, there is surely less uncertainty now but I’ll save that for the end. For those of you not following along at home, I had a stroke in November 2021. It opened my eyes to the value of life we too often take for granted and how awesome the web of people around us are. I’ve been journaling my experience on my blog (Surviving a Stroke, Surviving a Stroke: Recovery) primarily to help raise awareness of the risks of strokes, create empathy for the those working their way through recovery and the hope of maybe making folks aware enough to save a life.

In 2018, 1 in every 6 deaths from cardiovascular disease was due to stroke.
Someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.
Stroke-related costs in the United States came to nearly $46 billion between 2014 and 2015.This total includes the cost of health care services, medicines to treat stroke, and missed days of work.
Stroke is a leading cause of serious long-term disability. Stroke reduces mobility in more than half of stroke survivors age 65 and over.

[Reference: https://www.cdc.gov/stroke/facts.htm]

It has now been roughly 6 months since I was flying over my favorite Utah ski resorts in an Intermountain Life Flight to the Neuro ICO in Murray, Utah. What’s the update?

Finding My Joy

Memento Mori is latin for “remember that you [have to] die’ and a saying that is supposed to remind us of the inevitability of death. It is also a name of a gift shop outside of Disney World’s Haunted Mansion selling death oriented souvenirs. I kid you not. I know what this phrase meant before but I didn’t digest it until recently. There is a fragility to life that feels random. The doctors have told me there was no good reason why I had a stroke and I’m super lucky to have come out basically unscathed. It feels like it just happened.

So, how have I internalized this? I just need to live the best life I can live while I’m here. We all need to find our joy. That surely sounds weird but life is really awesome, we need to enjoy it while we can. The little things that bother us are truly are just little things surrounded by awesome moments we’re too busy to enjoy. Why are we so busy? Who knows. Because we all have attention deficit disorder (ADD) and FOMO. Enjoying the moment has never meant more to me.

A ~~good~~ great friend of mine sent me a text that had me thinking. He texted me about the Socioemotional Selectivity Theory and how I should read the book “Being Mortal” by Atul Gawande.

“Being Mortal” is an amazing book. I highly recommend it. It is a doctors journey working through the reality of death with his patients and ultimately with his father. Gawande offers a balanced and thoughtful perspective. In one chapter, he discusses the Socioemotional Selectivity Theory which is a life-span theory of motivation. The theory states that our perception of our own mortality impacts what we are motivated to do. When we are young, we are invincible and invest in long term experiences and relationships. But, as we grow old, we maximize positive emotional experiences and hone in on our friends that make us happy. We become increasingly selective, investing greater resources in emotionally meaningful goals and activities. Those that have life changing health issues early can experience an acceleration of this phenomenon. I can absolutely relate —

I now value my life, my family and my friends with a deeper sense of appreciation
I now value each life experience more deeply
I am more present in the moment
I now carry less stress for the little things that used to really bother me
I now have less patience for bullshit and things that waste my time
I now smile and laugh more
I now give bigger hugs
I now have a desire to make a broader impact beyond just me

That all sounds like metaphysical transformation crap but its all true.

I’ll note that my path through my stroke pales in comparison to others. I joined several stroke support groups on Facebook and I was humbled. Humbled by the journey of recovery people were going through. I am grateful for my recovery and support I had throughout. Folks would post things like “Strokes are worse than death. Wish it had taken me.” and “My life died when I had my stroke”. Absolutely no joke. These are real people with real challenges. I really want to help them all in some way.

Work

I went back to work in January 2022 after the holidays. I needed every minute of the time off but felt ready enough to get back into the flow. It definitely felt a little weird getting back in my routine but I was back in the groove in no time. It was great to get back to my team and help them however I could. But, there were many moments of reflection on the true meaning of work in the bigger picture. My wife diagnosed me as a workaholic a long time ago. I really enjoy work. I care deeply about my team but realize there is so much more to life. 20+ years in Silicon Valley will skew you to think that work is everything. It’s something for sure. But its not everything.

Here are some other observations I had about work —

Everything keeps going without you. You might think you are the most important thing at work but folks figure things out.
I needed to create a new leadership framework and style. I wanted to take he opportunity to develop a new gear in my leadership style that would be good for me and my teams. The same level of drive and motivation with less wear on me and more empowerment to my leaders. This is still a work in progress but I’m getting there.
Snoozing alerts is heaven. You actually don’t need to listen to every alert that comes at you and to be honest, its bad for your brain.

Working Out

I usually start my week Monday morning by going to 5:15am CrossFit at Park City Fit. I try to go 3-4 times a week when its not ski season. It was just something that I built into my routine many years ago and helps me start my week with structure and discipline. I feel lethargic when I don’t go. My doctors cleared me to get back into the box but asked me to modify my workouts so that not to put pressure on my brain. Well, I was modifying my workouts well before my stroke so there wasn’t anything to worry about there. Haha.

That first Monday back to work, I got up at 4:30am like I usually do. Got dressed. Made a cup of coffee. Jumped into the car and I was off. I turned on the music and the most perfect song came on, So Damn Lucky by the Dave Matthews Band. Dave Matthews said at a show at Radio City Music Hall —

“This is a song about where you’re about to trip and fall and smash your face but everything slows down to the point where you comprehend you’re gonna get hurt but it’s not enough time to do anything about it. And this song is about how not to forget about counting your blessings.”

Consider this my soundtrack for this blog post.

CrossFit has always been about community to me. Great people. Suffering together. It was so great seeing familiar faces again. I modified all the workouts that week significantly and it didn’t matter. It felt so great to be getting back into my routine.

Monday	Wednesday	Friday
Intervals For Time: 40 Dumbbell Snatch (50/35) 30 Box Jump (24/20) 150 Double Under -8 min Cap -Rest 2 min- 30 Box Jump (24/20) 40 Dumbbell Snatch (50/35) 150 Double Under -8 min Cap -Rest 2 min 150 Double Under 30 Box Jump (24/20) 40 Dumbbell Snatch (50/35) -8 min Cap	For Time: 50 Clean & Jerk (185/125) 75 Toes to Bar -Complete in any order you like to accomplish the work Goal: Sub 20 min	CrossFit Open 13.4 AMRAP 7 min 3 Clean & Jerk (135/95) 3 Toes-to-bar 6 Clean & Jerk 6 Toes-to-bar 9 Clean & Jerk 9 Toes-to-bar 12 Clean & Jerk 12 Toes-to-bar 15 Clean & Jerk 15 Toes-to-bar 18 Clean & Jerk 18 Toes-to-bar…

Sport

Am I still skiing? Hell yes. The doctors cleared me for light skiing in January but asked that I keep it tame. I’ve not been a high adrenaline, high risk skier anyway so that wasn’t going to be that hard. I didn’t start skiing until I was 15 so a beginner compared to the winter sport talent in Park City, Utah. I spend most of the winter at Park City Mountain, Deer Valley, Snowbird and Alta getting better at my turns, working the moguls and just getting better at the sport overall. I still love the steeps but I take them more carefully these days. Next year, I’ll take on the challenge of backcountry skiing. There is nothing better than being outside and listening to the quiet of the snow.

As I write this, the ski season is coming to an end, the tourists have left and we are entering the mud season. I’m looking forward to getting the mountain bikes out as soon as the ground dries up a bit.

Looking ahead, my goal is finally start something that I’ve been wanting to do for years — Brazilian Jiu-Jitsu. I’m not going to let this “health setback” keep me down.

What is the final prognosis?

My neurologist ran me through a bunch of test this past month to help answer why this happened to me. She ordered a battery of blood tests along with full torso, chest and brain scans. They required me to drink a bunch of this super tasty medical berry smoothie. This was a bit of nerve racking experience for me — what if they found something like cancer in one of these scans? That is actually one of potential causes for a stroke. Not sure I was mentally ready to hear that. These test took me hours. I spent a full hour in a MRI tube listening to the Grateful Dead — alone with my thoughts and just looking into a mirror at my feet.

The test results started to come in. The good news is that almost all of the test came back clear and then there was this magical prognosis that came from my MRI —

IMPRESSION:
1.Patent dural venous sinuses without residual thrombus.
2.No acute intracranial hemorrhage.

The blood clot had fully healed and my brain was 100%. Woo-hoo!

The bad news, I’m pretty sure I’m never going to know why this happened to me. This would normally really bother me but whatever, time to live life.

How am I feeling?

I’m feeling 100%. I need to lose the “stroke 10 pounds’ as I like to call them. I sort of started eating like crap because I said to myself, hell ya I’m going to eat some cake and ice cream tonight. I almost died!

The best news, I can blame my stroke for just about anything.

“Sorry, doctor said I can’t do the laundry. I had a stroke.”
“How could I possibly miss going to see my Yankees in the Bronx with my friends? I had a stroke!”
“Is it really our anniversary? The stroke must have made me forget.”

(Kidding)

What is ahead?

First and foremost, save the date October 29, 2022 is National Stroke Awareness Day. I’ll be running a fundraiser on that day to benefit other stroke victims and remind folks strokes are real and every second counts.

Everything else — I’m not sure yet. I’m still digesting it all. Stay tuned.

As always, thank you for reading and please let me know what you think. And don’t forget to find your joy.

Surviving a Stroke: Recovery

On December 15, 2021December 15, 2021 By rmascardoIn health6 Comments

Hello, Friends and Family,

Life can feel full of setbacks. All very random and of varying degrees. Not sure I would have predicted having a stroke in 2021 but it happened. Setbacks can also be opportunities given the proper perspective. Back when I was looking for my first job out of college, I was denied a job with a technology consulting company in the Washington D.C. area mostly because of a technicality in my application. At the time, I was crushed mostly because I was still learning that “setbacks” were ok. But soon after I got that rejection letter, I got invited to join a weekend of interviewing at a technology firm in San Francisco to which I accepted a job, found a group of amazingly smart technology friends that I am still friends today and of course, met my wife and mother of the my two beautiful girls. That rejection changed my life trajectory forever. Opportunity.

Setbacks are opportunities. Opportunity for an alternate path. Opportunity for growth. Opportunity for learning. Opportunity for motivation. Opportunity for drive. Opportunity for focus. Opportunity for humility. Opportunity for empathy.

And what gets you through the setbacks? Perspective and hard work.

My goal is to come back 125% from this stroke and use this moment as an opportunity for positive change. My recovery has been going very well. Recovering from anything brain related is a new experience for me. I have never had an head injury before. The brain seems to recover differently than other area of the body. It needs rest, sleep, hydration, proper stimulation and all with the proper amount of time. Through this process I’ve really wanted to test aspects of my brain like a program running self diagnostics on itself to see how things are “coming back online”. How are my gross motor skills? How are my fine motor skills? How is my long term memory? How is my short terms memory? How is my cognitive thinking? How are my emotions? How are my behaviors? Has anything changed?

In the hospital, I took the NIH Stroke Scale Assessment and a variation of the Montreal Cognitive Assessment test numerous times. One of the questions on the cognitive assessment test is being given 5 random words, committing them to memory and recalling them 5-10 minutes later. This test was popularized when President Donald Trump said he “passed this test with flying colors” — his five words were “Person, Woman, Man, Camera, TV” and they ended up being an internet sensation.

My words were “Apple, Pen, Tie, Car, House”. I’ll never forget those words now. As Sarah will tell you, I sometimes have a problem being “present in the moment” because we’re all self diagnosed with some form of attention deficit disorder (ADD) and then blame social media. Well, at the time I was so paranoid about the test that I literally burned those words into my brain. Now, I will remember them forever. At home, I find myself easing into physical and mental acuity drills just to see how sharp I am. Secretly, I wonder if the new found brain blood circulation will unlock new comic book like brain super powers! Nope. That has not happened. (yet)

While at the hospital I was provided these cool orange socks with “grippy” material at the bottom of them — clearly to prevent recreation of Tom Cruise’s scene from Risky Business. Random unverified fact from the internet is that the sock colors you are given mean something. Feels super logical but I’m not sure if its true.

Red socks indicate allergies; orange means the patient is a potential flight risk, and purple signals “do not resuscitate.” Like a neon sign, the socks are bright cues to all hospital staff. It’s the yellow socks that scream the loudest, demanding the most attention. Patients wearing yellow socks have been identified as being most at risk of falling. And falls can easily lead to broken bones, head injuries, longer stays in the hospital, increased costs and liability, and in the most severe cases, death.
[Reference]

The orange socks meant that I was a flight risk! Marked like Andy Dufresne from Shawshank Redemption. Rest assured, I wasn’t planning to break out of my stay there.

Being discharged was a glorious moment. I appreciated every moment of my time in the hospital but it was time to go home. My dad (who is an Endocrinologist) had warned me that patients can experience a “high” leaving the hospital but that will come down and may even experience a setback in their recovery when they get home. He said to take it easy and not to jump back into things quickly. Wise words. I went home that day feeling great but then I actually fell down two stairs after everyone had gone to bed. I jumped up and laughed thinking to myself, “Whoa, it’s like I had a stroke or something.” It was at that moment that realized I probably needed the time to heal and this was a very different injury that I had experienced before. I should have had my yellow socks on. They would have protected me.

Now, for some thanks. Holy smokes the support was overwhelming. Sarah was at my side all day long. We joked it was the most dedicated time we spent without the kids in a long time! Our new friends in Park City sent so much food and support. All of our friends and family filled my phone with messages of support and offers to help. My CEO and co-workers just told me to relax and heal. That part was very hard for me as a chronic workaholic but I needed all the healing time I think. My old CrossFit box sent me a box of messages! I couldn’t ask for anything more from my people. Sarah and I are so grateful.

So, what am I doing during my downtime. Finally got the time to read Frank Herber’s Dune. I’m a huge sci-fi fan and this had been in my reading list for a long time. It did not disappoint and neither did the new movie for that matter.

“The mystery of life isn’t a problem to solve, but a reality to experience.”
― Frank Herbert, Dune

Our dog is getting lots of walking. I’m easing myself into physical activity again. I was scheduled to do a half-marathon in January but that probably isn’t going to happen. I’ll be getting back at Park City Fit in January on a modified workout regimen. The days of super heavy lifting is probably limited these days but my CrossFit friends would probably say I never lifted heavy anyway. Haha.

I’ve also been spending a lot of time trying to work my way through our medical system. It seems that acute symptoms get immediate attention but those with moderate symptoms can get lost in the shuffle. It took me close to a month to get a referral from one medical organization to another accepted and a doctor appointment scheduled. It involved dozens of phone calls and offering to purchase a new fax machine that was involved in the process. Yes, there is one actual fax machine that accepts all the referrals and it was broken for days. I’m grateful for the medical system we have but there are aspects that ripe for innovation — and by innovation I mean stop using a friggin’ fax machine from 1985. However, the bills got to me like butter on a hot piece of toast.

Checking … Apple, Pen, Tie, Car, House … yup, still ok.

Few things I’m keeping an eye out on —

I’m keeping an eye out on is being hit by another stroke. I have a much higher likelihood of having another stroke within the first three months of had one.
How the heck did this happen to me? The doctors might never know.

You might be asking yourself why am I being so open about having a stroke? Well, I really do think that stroke awareness is a real thing. I really didn’t know much about strokes before this or what to do when they happened. I just got lucky. Folks need to know that strokes can happen to anyone, anytime and anywhere. Folks needs to know the symptoms and what to do when it happens.

The other thing I’m committing to is raising and donating $10,000 to stroke research and awareness in 2022. I’m not sure how yet because I want to find the right charity. It might be that I start my own non-profit in 2022 that is focused on this but that will be for a future blog post. Stay tuned.

I truly believe Sarah, my dad, my response and medical staff saved me from long term damage or even saved my life all together. Will never forget Sarah telling, “Call your dad, you might be having a stroke.”

Do I think being so open about having a stroke might impact if folks might look at me differently or my employability? Whatever, if I can help one person be more aware of strokes then its worth it. Don’t hire or invest in me. You’ll regret it. #125percent

Hope you found my post interesting! Comment or reach out!