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Princeton Times Editor Tammie Toler: Journey to recovery starts with one step

PRINCETON, W.Va. — A Chinese philosopher once prophetically declared, “A journey of a thousand miles begins with a single step.”

Tammie Toler
Tammie Toler

While most of my journeys don’t amount to a thousand miles, I know for sure that the journey of my lifetime began with a single step last April. It was the first step I had taken in weeks — since March 28, 2014.

March 28 was the day my whole world turned upside down. It’s still not completely right, but it’s getting closer every day.

•••

It wasn’t a terribly momentous day. I had just wrapped up a hugely difficult and always strenuous project at work. For weeks prior, the Times staff and I had lived to finish our annual Progress edition and to get all of our entries submitted to the West Virginia Press Association’s yearly Better Newspapers Contest. I was halfway to the goal of completion when I lost consciousness.

The Progress edition went out that morning in our paper, and having secured an extension in the WVPA deadline, I was expecting to have a little time to recuperate before engaging in a frenzy of compressed- file contest entries ranging from editorials and opinion columns, to newswriting, legal coverage and layout.

That Friday, I got up, got dressed, kissed my love goodbye as he left for a few days out of town. As I embarked on the day ahead at work, I knew I was exhausted, but that’s a feeling to which I’ve become accustomed at the end of each March.

At work, I remember halfheartedly reviewing the annual super-edition of our weekly newspaper and being relieved that it was complete. As the day slogged on, I became more and more tired. I attended my weekly Rotary meeting, where friends later advised I seemed quiet but OK otherwise.

When I returned to my empty office that afternoon, it was all I could do to keep my eyes open. The office was eerily quiet, as Reporter Matt Christian had taken off early to make up for hours previously logged finishing Progress stories and Ginger Boyles, the office coordinator, was done for the day.

I made the executive decision to follow Matt’s lead and call it an early day. I gathered my purse, keys and other essentials and departed for home, roughly a 20-minute drive away.

•••

I don’t remember anything else that happened that night or the next 10 days.

I’d planned for a quiet night at home, watching the Netflix movie that had just arrived in the mail, with my loyal puppy by my side on the couch. I talked with Mom and let her know that I was going home to rest. She vowed not to call me, in hopes that I could sleep without the interruption of a phone.

At some point that night or early the next morning — apparently while preparing to take a shower — I passed out. Dad discovered me the next morning, unconscious and lying on the bathroom floor, with the shower running. The aforementioned canine friend was by my side, refusing to leave me, even when emergency responders with Princeton Rescue Squad inadvertently stepped on him amid the chaos.

The PRS ambulance rushed me to Princeton Community Hospital, where doctors found it difficult to keep me breathing. I was placed on a ventilator, and the prognosis was not good.

When a CT scan revealed a brain hemorrhage, plans began to transport me to a trauma center, meaning I would face treatment at either Charleston Area Medical Center or Carilion Roanoke Memorial Hospital.

Initially, my family leaned toward Charleston, because we were familiar with the area and had close loved ones who lived there.

But, much like my relaxing, restorative weekend, that plan was not meant to be. The weather was bad, there was no trauma neurosurgeon ready to meet me at CAMC, and there were no helicopters available to fly me to Charleston. Word soon arrived that a Roanoke neurosurgeon was ready and waiting on the MedTrans helicopter that would take me to Roanoke. The trip cost my insurance company and me a combined $76,000; it’s a shame I didn’t see a second of it.

Upon landing, a team of neurologists, neurosurgeons and even hematologists (blood specialists) ran a battery of tests on my unconscious self and determined I had suffered a cerebral venous sinus thrombosis — a stroke that affected both hemispheres of my brain but was focused primarily on the right side, which meant that it left most of its deficiencies on my left side. Exhaustive testing also revealed that I had a blood-clotting disorder that makes me predisposed to developing blood clots that can cause catastrophic consequences if they reach the brain, heart or lungs. Mine found its way to my brain.

I was unconscious for nine days, during which time, I underwent surgery to remove a portion of my skull to relieve the swelling and pressure the bleed caused on my brain. Before waking, I also underwent surgeries to treat a collapsed lung, install a tracheotomy tube to help me breathe and insert a feeding tube to nourish me while I couldn’t eat.

My memory, though largely intact, was a bit like Swiss cheese once I awoke; there were random holes that could have once contained memories, skills, lifestyle tidbits and all sorts of attributes that made me the me that I used to be.

I was somewhat aware of what went on around me, but every experience seemed surrounded by a strange fog that clouded everything.

Steve — an amazing man typically referred to in this column as my favorite fellow — explained what had happened to me — the stroke, the surgery, the hospital stay, but the reality of what I had yet to face was a mystery to me, even as I was released from Carilion Roanoke Memorial Hospital and sent to the Carilion Roanoke Community Hospital, where I was slated for multiple daily sessions of speech, occupational and physical therapy for up to a year, if not more.

I knew I was weak and had difficulty thinking straight at times, but it wasn’t until I came face to face with a mirror that I truly understood just how little I resembled the person I had known. My hair had been shaved to make way for the first round of brain surgery. My face was swollen from surgery and the weeks spent unmoving in a hospital bed. There were ugly, mean scars left behind by each of the procedures I had endured in a bid to save the life that seemed so unattainable at the time. As bitterness at my new reality threatened, I cynically declared I had more scars than Frankenstein.

And, to add insult to injuries, anytime I was upright and out of bed, I was required to wear a ridiculous- looking foam-and-rubber helmet to protect my brain from further injuries, in the event of a fall or accident. The skull usually does that, but by that time, I was missing a portion of mine. My helmet was thick and pink, and I hated it with every single fiber of my being.

I was advised to bedazzle it, write inspirational messages on it or do something else that could be construed as therapeutic. I quickly rebuffed the well-meaning suggestions, quite honestly replying that the only therapy I planned to get out of the hideous garment would come when I was through with it and could add it to a raging bonfire.

As striking as they were, the losses weren’t just in appearance or a physical nature.

All semblance of my independence and privacy went the way of the handful of memories that fell through the Swiss cheese holes left in my consciousness.

Because the rehab facility mandated that someone be able to make decisions if I became incapacitated again, legal action was taken to declare me incompetent and give my parents the right to make all my financial and healthcare decisions. Thankfully, that petition proved to be unnecessary and was dismissed as I healed, but everyday issues presented big challenges too.

Getting out of bed required the use of a wheelchair, a sliding board and at least one other person. Going to the bathroom required the permission and supervision of a nurse or nurse’s aide. In order to be released from the rehab program, I had to shower twice in the presence of my occupational therapist, to prove that I could handle my most basic needs.

•••

That first step toward recovering the parts of me that I knew occurred on April 24, my second day in therapy. After completing the grueling process of getting me — including my weakened left arm and leg — out of bed and down the hallway to the therapy facility, I was fitted for a walker and assisted to stand.

With someone following behind me with wheelchair in the event I became too tired to continue, I took a handful of steps, and people cheered.

A perfectionist even then, the tiny accomplishment seemed insignificant to me.

Over the days that followed, the number of steps increased; the speech therapist’s reviews improved and the occupational therapist allowed me to cook in the kitchen built into the hospital for clients.

After one week in the rehab hospital, my “team” reviewed my case and turned that potential year-long stay into one estimated for three weeks. I cried when they delivered the news, because it seemed so long. My mom cried because it was so short.

Two weeks after that announcement, I was wheeled out to the vehicle waiting to bring me home. I could have walked, but the hospital wouldn’t let me.

•••

I wish I could say recovery was smooth sailing from that point on, but it wasn’t. I progressed quickly through outpatient physical and occupational therapy at Princeton Community Hospital and was released from those programs.

On Aug. 7, 2014, I underwent cranioplasty surgery to replace the skull bones that were removed in April. The surgery made the hated pink helmet unnecessary, but the hospital stay that was supposed to have spanned up to four days stretched to three weeks when regulating the thickness of my blood and preventing another clot proved difficult.

On Sept. 19, when I was just days away from my planned return to work (Oct. 1) and a driving test that would have put me back on the road, I suffered a seizure while ordering jeans at a store in South Carolina. When I fell onto the concrete outlet floor, my right arm sustained much of the blow, breaking the upper bone in the arm and damaging the radial nerve, which controls extension of my fingers and the flex in my wrist.

Seizures are common in people who have suffered strokes, as my local neurologist — Dr. David Grouse — explained recently, because the blood left behind from a brain bleed is likely to oxidize and irritate surrounding tissue, altering electric signals routinely at work in the brain.

The seizure and broken arm immediately turned my plans to get back to living my life into another six- month span of being babysat and watched constantly for some signs that things weren’t right with me. They also stole the use of my right arm for four months, while the bone and nerve healed.

I had to keep my arm immobilized in a brace for most of that time, so driving and typing were ruled out. •••
Finally, in December, my orthopedic surgeon declared the bone healed to the point that I could remove

the immobilizer and start using my arm and hand gradually.

Still, I had a few months to go before I reached six months without another seizure or brain-related incident.

I met that milestone March 19, and I’m still almost afraid to recognize the goal, for fear something else will happen and I’ll have to start back at that first step again.

Like the friends who participated in my prayer vigil last year, I pray that is not part of the journey God has planned for my life.

But, if it is, there’s little doubt what I’ll do — the only thing I can do really. I’ll start the journey with a single step and just keep walking through the challenges.

•••

It would be impossible to thank everyone whose friendship and support sustained me when it would have been so easy to give in to the feelings of helplessness and anger I fought over the last year, but there are some people who are so special they deserve a shout out and my eternal gratitude.

I must start with my family. No matter how difficult I got — and believe me, I was beyond difficult at times — they stood by me, cheering me on and reminding me that I could find myself again behind the reflection I still have trouble seeing as me.

My work family at the Princeton Times and Bluefield Daily Telegraph also stood by me throughout the ordeal. Despite the red tape and road blocks that kept me from getting back on staff as quickly as many of us would have liked, they rolled with each punch and kept both newspapers rolling on the press and out the doors. My friend and colleague Bill Archer even called and offered to give me driving lessons, if I needed them.

Steve reminded me I was beautiful to him, even when I felt like the ugliest girl in the world. He and at least one other dear friend offered to shave their heads if it would make me forget about my hairless state last summer.

My nephew, who sweetly believes me indispensable at work and elsewhere, made it a point to routinely assert how much my community and my newspaper needed me.

I think I must have made a prayer list at every church listed in the phone book and even a few in other counties and far-away places. From the bottom of my heart, I thank each and every one who asked God to touch and heal me.

Though I wasn’t always a willing participant, I am a testament to the fact that prayers are answered, no matter how dark the situation seems. And, as my mom has encouraged me, I have to remember to say thank you when He answers, no matter what the answer.

If God reads the Princeton Times, I hope He understands that this is part of my thank you. And, for those of you I know read it, I hope you can feel my gratitude.
— Tammie Toler is editor of the Princeton Times. Contact her at [email protected]

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