Remembrance Day

Tomorrow is Remembrance Day – the eleventh hour of the eleventh day of the eleventh month…but today is MY remembrance day. It was today, 5 years ago that I suffered a subarachnoid hemorrhage*, or a stroke – a bleed. I am one of the lucky ones to have walked away from it the same person I was. I didn’t die like a third of people do, nor have serious disabilities like another third of people do. No. I am relatively unscathed, apart from perhaps being a bit more tired than I used to be.

So today I am grateful. Grateful to be alive. Grateful to be alive and to have been able to have two children. Grateful to have had a natural birth for both of them. Grateful that I am alive to still be with my husband, and friend, Ben – who is much more than that, of course. Grateful for both my parents who are alive and well, as well as my two grandmothers who are in their 90’s. Grateful to be able to laugh and chat with my friends all over the world, Grateful for the internet and email and text messaging and telephones. I am sobered on this day, every year, to what could have been- what might have been. I’m extremely grateful and humbled by modern medicine – to my neurosurgeon at King’s College Hospital in London. Considering all the places I have traveled to, and all the remote places I have been, I am eternally grateful for having been in London on this day, 5 years ago, and to have had Ben with me to take charge, call an ambulance…call a taxi…and be there by my side when I needed him. Today I remember that I am lucky to be alive and I am happy to still be here. I am thrilled to witness how my children are exploring and experiencing the world. Today I am reminded that even if I’m feeling low, at least I am feeling something .It makes me happy to be alive.

Actually, for the first time, I have not been reliving the whole thing. I think it’s perhaps because I am not living in London anymore, where things could trigger the memories. So for me it’s refreshing to have arrived at today without angst and dread.

I’m grateful to be here. And loved.




*Background:
Subarachnoid hemorrhage (SAH) implies the presence of blood within the subarachnoid space from some pathologic process. The common medical use of the term SAH refers to the nontraumatic types of hemorrhages, usually from rupture of a berry aneurysm or arteriovenous malformation (AVM). The scope of this article is limited to these nontraumatic hemorrhages.


Frequency:
In the US: Annual incidence of nontraumatic aneurysmal SAH is 6-25 per 100,000. More than 27,000 Americans suffer ruptured intracranial aneurysms each year. Annual incidence increases with age and probably is underestimated, because death is attributed to other reasons that are not confirmed by autopsies.
Internationally: Varying incidences have been reported in other areas of the world (2-49 per 100,000).
Mortality/Morbidity:

An estimated 10-15% of patients die before reaching the hospital. Mortality rate reaches as high as 40% within the first week. About half die in the first 6 months.
Mortality and morbidity rates increase with age and poorer overall health of the patient.
Advances in the management of SAH have resulted in a relative reduction in mortality rate that exceeds 25%. However, more than one third of survivors have major neurologic deficits.
Race: Blacks have a higher risk for SAH than whites (2.1:1) (Broderick, 1992).

Sex:
Incidence of aneurysmal SAH is higher in women than in men.

Age:
Mean age of SAH is 50 years.