A Stroke of Luck After experiencing a migraine that mimicked a stroke, an SLP gains deeper patient insight. First Person/Last Page
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First Person/Last Page  |   April 01, 2015
Kim Karnell and her husband, Phil, enjoy the French Quarter dog parade “Barkus” with pets Toby and Tillie.
A Stroke of Luck
Author Notes
  • Kim Karnell, MA, MCD, CCC-SLP, is the owner of Bayou Speech Services, LLC, in Jefferson, Louisiana. She has worked with children and adults in hospitals, clinics and Louisiana public schools. kimkarnell@gmail.com
    Kim Karnell, MA, MCD, CCC-SLP, is the owner of Bayou Speech Services, LLC, in Jefferson, Louisiana. She has worked with children and adults in hospitals, clinics and Louisiana public schools. kimkarnell@gmail.com×
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Special Populations / First Person/Last Page
First Person/Last Page   |   April 01, 2015
A Stroke of Luck
The ASHA Leader, April 2015, Vol. 20, 72. doi:10.1044/leader.FPLP.20042015.72
The ASHA Leader, April 2015, Vol. 20, 72. doi:10.1044/leader.FPLP.20042015.72
“M-o-o-o-m!!! Kim can’t see!” So screamed my older brother when I lay down heavy-headed, waving my hand in front of my face as everything grew blurry. Fragmented really, like looking through intricately cut crystal. This is my first memory of a migraine with visual aura. I was 12 years old. “Probably need more Vitamin B,” my family diagnosed. I bought it.
My migraines were not properly diagnosed until well into my 30s—an episode while driving my mother-in-law cross-country took me to an emergency room just outside Las Cruces, New Mexico. I learned how to avoid triggers like poor sleep, eye strain, caffeine and sugar. No more tall lattes for me.
When I reached my 40s, the migraines’ frequency and intensity grew. Vertigo became a new warning aura. When it occurred at my previous job, the school nurse would lovingly check my unremarkable vitals. I typically went home dismissing these dizzy bouts to old New Orleans buildings’ mold issues, collapsing in bed with the onset of migraine.
In 2013, I got slammed. On Dec. 1, I experienced the most intense and painful migraine of my life. In the car with my husband barely five minutes from home, I begged him to pull over as I suffered through this skull-splitting event. Agitated and nauseated, screaming in pain, I eventually cried as the pain became bearable. Once home, I collapsed in the bedroom, lights out, near motionless until the next day, when I made an appointment with a neurologist.
Three days later, I suffered what has aptly earned the nickname “the scariest of migraines.” Nauseated and flush at the onset, I had throbbing pain at my forehead and base of my skull, tremors, deafening tinnitus, and numbness on the right side of my face and jaw. Slowly, my speech became dysarthric, and my gait, shuffling and ataxic. With some rehab experience as a speech-language pathologist, I was convinced it was a stroke. Over nine hours in the emergency room, I was tested and monitored, and eventually the worst of symptoms resolved. Diagnosis: migraine with vertigo. Relieved but stunned, I went home beat up and utterly exhausted.
My crackerjack neurologist diagnosed this mini-stroke imposter as a vertebral basilar migraine (migraine with brainstem aura), which mimics a transient ischemic attack. Unlike a stroke, blood vessels during a migraine are merely constricted for a period, allowing for fuller recovery. As with a TIA, the dramatic symptoms of my migraine resolved within 24 hours; and, also as with a TIA, there were residual impairments that required rehabilitation.
All cerebral events are scary, stressful and life-changing. How fortunate I feel, not only for recovery and to resume work as an SLP, but also to experience the patient perspective. To be closer to understanding their predicament and struggle for healing, to feel true empathy, is a gift that I treasure. I am not grateful for my variegated migraines, because they are so painful and debilitating. But I would not trade my basilar migraine experience, given the deeper patient insight I have acquired. It has truly been an unusual stroke of luck.
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April 2015
Volume 20, Issue 4