Category Archives: Moonlight Blog

Please Don’t Stroke This Blog Post…

I'll tell you what to do with a problem--turn it into problem-ade (or a blog post).
I’ll tell you what to do with a problem–turn it into problem-ade (or a blog post).

True to the secret of the Grail (as revealed in John Boorman’s Excalibur), my blog and I are one. When I thrive, my blog thrives. But when I’m yanked from the busyness of blogging by an unexpected life event, my blog staggers in bewilderment off the digital playing field.

On June 7, 2016, my father suffered a substantial stroke in his brain stem. Since then, my ever-expanding vocabulary includes related medical terms and phrases, some of which I’d like to share with you in the form of a blog post. I hope never to hear or utter most of these words ever again in a hospital setting.

This is not the typical By All Writes blog post. It is my way of proclaiming I’m “crawling from the wreckage.” But first, I have the urge to purge.

No permission slip is necessary to continue reading–visiting hours are “all day and all of the night.” Here’s the lexicon-like story of a sudden stroke:

Bilateral Frontal Subdural Hematoma Sounds Kind Of Scary, Doesn’t It?: Prior to his stroke, my father fell down earlier this year twice.

The first incident was a bad tumble involving black ice and the joining of his head with pavement. The second fall was a doorway-step “oopsy daisy.”

We’ll never know for sure if either fall produced the blood that pooled on the outside of his brain, but the possibility remains. The key lesson here: Falling is bad. It’s bad!

Multiple Intubation and Extubation Usually Leads to a Life-or-Death Decision: With impaired swallowing (post-stroke) comes the inability to keep “secretions” (mucus/phlegm, saliva, and blood) from entering your lungs.

Aspirating such gunky stuff into your lungs can cause an upper respiratory infection like pneumonia. And sure enough, my dad developed pneumonia in one lung.

The other problem: Upon a first trial to remove (extubate) my dad’s endotracheal breathing tube, he edged toward respiratory failure. Alas, he was intubated once again. And then…

Near-Death Experience One = Tracheostomy (Followed by a Trach-Collar Chaser): After my father had been twice intubated and unsuccessfully extubated that same number of attempts, my family had its moment of medical truth.

The yo-yo-ing process of seeing whether my father could keep his airway secretion-free on his own had to come to an end before the ultimate ending occurred.

On June 17th, my mother signed the consent form for an incision in my father’s windpipe. To prevent him from aspirating his secretions, there was no other choice but a tracheotomy.

Almost immediately, my father weaned off the ventilator like a champion breather. Fortunately, he transitioned quite well to a trach collar, which hovers over a tracheostomy to blow humidified oxygen into the airway.

Alas, I doubt trach collars will ever catch fire as a fashion statement. But wearing one does make you feel like you’re having permanent hot flashes–no peri-menopause or menopause required…

Conversing with a Stroke Patient Jazzed Up on Both Fentanyl and Propofol is Useless: My dad had multiple ongoing issues beyond the stroke. Thus, a hodgepodge of intravenous medications created the perfect bizarre-behavior storm.

I’m hazy regarding the actual order of dispensed drugs. The fentanyl was for the unimaginable discomfort of having an endotracheal breathing tube lodged in my father’s throat. The propofol was a complementary layer of sedation.

And wouldn’t you know it: Hopped up on the meds, and surrounded by many machines beeping and burping their alarming language, my dad developed ICU delirium. Which meant…

Seroquel Doesn’t Necessarily Keep a Stroked Man Down and Agitation-Free: I was initially told that Seroquel is an anti-agitation medication, and one quite necessary to give my father. Why? Well, he made multiple attempts (all successful) to pull out his nasal oxygen tube, IV lines (from both arms), and tracheostomy.

But upon further questioning, I found out it’s an anti-psychotic used to treat schizophrenia (in adults and children 13 years old and up), bipolar disorder, and major depressive disorder. Internally, I shrieked: Whoa!

Despite the Seroquel, my dad remained a mostly agitated patient during his stay at the Hospital of the University of Pennsylvania’s Neuro ICU (aka Rhoads 2).

The delirium was perversely entertaining. It ranged from braggadocio Brooklyn stories never shared (until this summer) to imaginary cruise ships and loose hips. Or was it lips?

I Forgot About the PEG Feeding Tube–My Bad: After you suffer a stroke affecting the brain stem, there’s high probability your swallowing and gag reflexes will range from inefficient to non-existent.

And once you’re hospitalized, the nurses must pump life-sustaining nutrition into you somehow. Thus, you become a likely candidate for a percutaneous endoscopic gastrostomy (aka PEG feeding tube). Because: The only way to go is NPO (nil per os)!

My recollection gets a bit hazy here; the PEG tube must have been inserted prior to the tracheostomy. If you can’t swallow food or drink, you bypass your mouth and esophagus, going directly to the stomach.

(My father tells me PEG nutrition isn’t a particularly satisfying experience. I believe him, but it’s either this or an unintentional hunger strike.)

To Avoid a Urinary Tract Infection, Steer Clear of Foley Catheters (When Possible): It’s never considered a serious hospital stay unless you develop some sort of bacterial infection, right? My apologies for the tinge of sarcasm…

As the recipient of a kidney transplant (since July 2012), my father seemed likely to develop a urinary tract infection (UTI). What I didn’t know pre-stroke was that there are different types of catheters used for non-ambulatory hospital patients.

For some reason, the Foley catheter involved in an intimate relationship with my father’s bladder refused to remain clean. Suspected bacteria in his urine was finally acknowledged as a UTI, and eviscerated appropriately with a broad-spectrum antibiotic.

Would my dad have done better with a straight catheter? Too late now…

Near-Death Experience Two = Cardiac Ablation (For Tachycardia): Early during my father’s hospital stay, an unexpected rapid/elevated heart rate (aka supraventricular tachycardia–SVT) revealed itself. Initially, an attending doctor deemed the SVT an intermittent, benign nuisance.

However, the medication used to treat my father’s tachycardia episodes began lowering his heart rate too…low. Thus, the (Silverstein 9) step-down unit’s staff transferred him back to the ICU. What to do?

During the summer-steamy weekend before July 4th, a cardiologist specializing in radiofrequency ablation greeted my mother and me with a multi-page consent form and an explanation of the ablation process:

“Cardiac ablation works by scarring or destroying tissue in your heart that triggers an abnormal heart rhythm.” (

Despite some frustration the day of the procedure–my dad’s scheduled 7 a.m. “ablation-up” call segued into an early-afternoon pick-up to prep him–the cardio surgeon was kind enough to meet with us before and after the “shocking” event.

Result: The ablation worked like an industrial stun gun with a lifetime warranty!


And that’s how I expanded my medical vocabulary from June 7 through July 8, summer of 2016. My father then transitioned to an acute rehabilitation hospital for three weeks.

He’s now continuing his glacial-speed recovery via subacute rehab (aka a skilled nursing facility), which means I’m breathing (and driving) somewhat more easily. There’s plenty of work yet to be done. My dad’s tracheostomy is out, but he’s still NPO.

My blog should return to its normal brew of entertainingly helpful (?) business-oriented snarkiness soon. Sometimes, you have to cut loose a few petrified thoughts…

Lori Shapiro is the owner of By All Writes LLC, a business-to-business (B2B) company in Marlton, New Jersey, that plies its trade via copywriting, editing, and other content-marketing services. She revels in shielding her clients from the time-consuming pain of writing their own print or web marketing and promotional copy.

Please call Lori Shapiro of By All Writes LLC at 856-810-9764 (or e-mail her via to schedule the gratis 20-minute consultation that will resolve your current copywriting or editing dilemma…

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