Luke Perry Had a Stroke and Died. I Had One and Lived.

I had both the privilege of more days and the awareness that those days would be limited.

Comments: 176

  1. Thank you so much for writing this.

  2. If a close relative had a brain aneurysm, you may be at increased risk for one. Ask your doctor if you should have an MRA (magnetic resonance angiogram). Procedures to treat brain aneurysms before they rupture have improved greatly.

  3. @Richard Waugaman this is too true. My mum had been diagnosed and fixed 16 years ago. My great-grandmother died from it. My mum always encouraged me to get an MRI, but I put it off for years. At 49 I was bulletproof. During an unrelated matter, I had given my GP this medical history and he referred me for an MRI 'just in case'. I was diagnosed with 2, which I have since had fixed. This prompted my sister to do the same - they found 6.......

  4. @Survived Thanks so much for sharing your story. It will encourage others who are at risk to get evaluated and treated.

  5. @Richard Waugaman And it's a slightly different issue, but abdominal aneurysms can also run in families, and are deadly.

  6. i had what i've come to refer to as a temporary alteration of awareness one day at work. it was so profound some part of my brain was wondering how i was going to drive home. the strangeness passed and when i got home i called my sister the nurse. my family is crowded with stories of tia's and outright devastating cva's. she recommended the emergency room where i was first worked up for a stroke, and when that turned up nothing they started in on my heart and turned up aortic stenosis, which in the course of two and a half years got me to the point of a new heart valve. this whole thing turned up spots on my lungs and i'm due for a followup cat scan this month. i had no idea there was something going on with my heart, and i'm lucky i have family members who don't fool around when they think something needs to be looked at.

  7. Wow, a great article by Ms. Swisher, who I do not often enjoy reading. If only she could resist shoehorning grok in there. But no matter, it was the best work I have read from her in a long time. There's a human under all of that snark.

  8. Thank you Ms. Swisher. You have a large platform for which to share this very relevant information.

  9. So part of this essay is a justification for being so hard on people--ie, treating them badly? You need to get over yourself, there's no justification for treating people badly, certainly not because we all have limited lifespans.

  10. @ZHR Yes, I agree. Rationalizing bad behavior by our limited lifespans seems to be just the opposite of what we need to be doing. Life is short. Don't make it miserable for others, even if yours is.

  11. @ZHR I simply didn't get that part of the lesson. Being tough on other people ( she says people that she covers, so I assume writes about) - well, if she means she is rigorous in her own work, that's one thing, but the way it reads - referring to those people who "inevitably mess up " - that's the human condition. If your new awareness of the preciousness of life motivates you to go all out for your dreams that's fine, but if the awareness of impending death makes you race, impatient with other mere humans, to the point where you are willing to push them around for your own purposes - well, that was part of the ugly side of Jobs, too, was it not?

  12. IMHO, the sad irony in this is that Kara did not mention that Mr. Jobs (R.I.P.) himself *delayed* (by nine months) treatment on his cancer. There have been reports that he was seeking his own treatment path, delaying more conventional treatment .. which very well might have greatly accelerated his death. I had an experience like Kara. Should have slowed down and gone to E.R., STAT. Really, really dumb that I did not. And for God's sake, it is obvious -- stop smoking, heavy drinking, doing dangerous drugs, eating too much, and not exercising daily. Be an adult. Thanks.

  13. Ms.Swisher Thank God for your intuition and for your brother, the physician,,that got you to get immediate care. Enjoy your life.

  14. This article makes no sense. Some people get a disease (I guess a stroke qualifies) and live and some die. I had cancer (prostate, one of my favorite organs) and lived (sort of). Others die from it. PS Most men die with it, not from it. Women have their own problems (not including men).

  15. @Mark Shyres Well, among other kinds of "sense" the article makes is that some people get a disease and *whether they live or die* can depend on how they react to the earliest symptoms. I'd wager that, given how many people read the NYT, this one article is likely to make that difference for some number of people (more than 1 but less than ??).

  16. @Mark Shyres I should mention that when I got prostate cancer my wife prayed and prayed. It did not work. I lived.

  17. @Mark Shyres. Your humor is appreciated.

  18. In the 1980s I was listening to a Washington classical music station - WGMS, I think - as the man reading the news started talking gibberish. After too long the broadcast went soundless for many minutes. I learned after a day or two from the Washington Post that he had had a stroke and died. A great, shocking loss. How suddenly life can end.

  19. I remember that. I was listening to that broadcast. The DJ's name was Bill Cerri, and he was only 60 years old when he died.

  20. Excellent piece, Ms. Swisher. Thank you for sharing your experience.

  21. Important article at a time when the medical community is trying to get people to recognize the symptoms of stroke ('brain attack") so they go quickly to the ER and dont go home and try to sleep it off. Ms. Swisher played it perfectly, a testament to her cleverness and her convincing brother. Getting the rest of us to do as well is certainly an uphill battle.

  22. I survived a ruptured AVM (arteriovenous malformation) 2 weeks after my 30th birthday. I always say it was "The best of a worst case scenario". The thing took out the movement in my left arm and leg but left me with the ability to; drive, communicate,think, travel, work. I was working out at a gym when I had my stroke and was lucky to get to the hospital early. I agree with survivorman, even when you get to the other side of a stroke you really miss what it took from you (even if it didn't take everything). I appreciate this thoughtful article by Kara Swisher. Strokes happen to everyone! young and old!

  23. Thank you to the author for her excellent essay and for sharing such important information--and her insights.

  24. From a food standpoint, I was lucky. I was raised at a time when junk-food and highly processed food wasn’t so common. Now, many people have lived their whole lives eating salty high fat, highly refined, processed food. They’ve been raised on a junk-food diet. I would say to this younger generation, beware, for what happened to Luke Perry and Mara Swisher may not be anomalies; in fact, because of a lifelong junk-food habit, your arteries may be more prone to clogging, with the resulting strokes and heart attacks, than previous generations.

  25. one thing i did not read in the coverage of his death was what type of stroke he had.

  26. @allen Yes, the details have not come out yet. What's struck me is all the coverage about how stroke can happen at any age. Obviously it can, but it usually doesn't just "happen." It's not a random event without a cause. His face to me indicated something was going on, not sure what - it looked like emphysema, there was just something about his skin. But it could have been anything else, a whole range of things. We may never know in the end. RIP. Mr Perry seemed like a universally beloved fellow.

  27. Two weeks ago, a friend got up in the middle of the night, and fell suddenly. He thought it was his sciatic nerve acting up. He went back to bed and only realized in the morning that it was something strange. He had a stroke and will go back home from rehab next week, but he still can't move his right arm, and he's right-handed. He is 54 years old.

  28. @Marilyn Sue Michel Coincidentally, I had PT today, and my therapist happened to mention that the people he sees with stroke on the dominant-handed side of the body adapt surprisingly quickly to the change of handedness. I hope that is true for your friend.

  29. How fortunate are you? Thank you for sharing your story.

  30. A nice piece. Still, I hope it won't seem pedantic to quietly note that Steve Jobs––a talented but very flawed man––may not be a fount of wisdom when it comes to letting your awareness of death color the values of your life. Jobs's peculiar and finally irrational reaction to his understandable fear of death did not serve him well. And his definition of the good life is highly questionable as well: in his case, worldly success came at the cost of the wreckage of many lives of those in his orbit. It's one thing when pundits hold Steve Jobs up as a demi-god of wealth and success. But it doesn't seem that had even average moral grounding or ethical insight. There are better people to read and cite for that.

  31. I had a stroke sitting at my desk at work when I was 38 years old. in 1988. My boss called an ambulance after I tried to drink some tea, it dribbled out of my mouth, and couldn't speak. At the hospital emergency room, my drooped left side of my face righted itself, and the emergency room doctor gave me the "hysterical woman" diagnosis. "You probably just had an anxiety attack that mimicked the symptoms of a stroke," he said. I drove the 25 mile commute home. I felt basically okay, but what was weird was that I had been a half-pack a day smoker and had had trouble quitting. But after I drove home, I lit up a cigarette and when I dragged on it, it tasted really lousy. "This tastes like ashes, I don't want this," I said to myself, throwing it away. That made me go to my regular doctor, an internist. He agreed the stopping smoking immediately was good, but it was strange and he had me go to a neurologist, who ordered an MRI. Turns out a part of my brain that was essentially uncharted territory (not affecting memory or motor skills or speech, just "emotions" and also, apparently, addictions) was affected. After every possible test was performed on me, the doctors said they didn't know why a blood clot lodged in my brain, but that basically I was fine. They told me to take an 81mg aspirin for the rest of my life and to have a good life. My doctor said, with physicians' wit, "Well, that was a stroke of luck, wasn't it? You stopped smoking."

  32. Kara, your essay has hit home, and I am grateful for that. I have not sustained a stroke myself; however, one of my most rewarding jobs was working as an RN in Acute Rehab where our most frequent patients were victims of strokes. Also, my once vibrant husband of 52 years sustained a major stroke in 2015, that on top of having Parkinson's Disease. He lives on miraculously...loving and embracing life as he always has. What Ms Swisher has pointed out resonates, I am sure, with thousands of people. First, is that often we just do not know when diseases of the brain and body as a whole will call upon us. We are humans after all. And as perfectly constructed as our bodies are, they are machines with a soul, ironically fragile and vulnerable. Importantly, we know our own bodies better than anyone. If something is amiss, we should not take it for granted. Finally, I had the privilege of hearing Frank Ostaseski speak just several weeks ago here in my city. He, of course, was wonderful. If readers do not already have it, I highly recommend purchasing his THE FIVE INVITATIONS - Discovering What Death Can Teach Us About Living Fully.

  33. I had the exact same kind of stroke just 13 days ago and so reading this really resonated and comforted me. I've not told my two teen daughter's yet...but plan to do so after this school year ends for them. Thanks for sharing and good luck with your recovery.

  34. I wish I was important enough, or thought I was important enough, to write a really long essay, and have it published, to say what the first year nursing student would advise. FAST. Face... smile and does one side droop? Arms... raise both arms and does one arm drop? Speech... words slurred or strange? Time... if the answer is yes don't be calling your brother... call 911.

  35. @Joseph. When my father had his big stroke that almost killed him, he was only 53. Not knowing what it is -he felt unwell, had trouble moving one arm, but didn't experience any pain- he called me around 11 PM, I was out-of-state in a different time zone. I had to argue with him and practically yell at him to hang up now and immediately call an ambulance and tell them that he is having a stroke; since it didn't hurt, he wanted to wait until the morning. That's a key difference between many strokes and heart attacks - strokes are often not that painful, whereas heart attacks typically hurt, often a lot. That being said, loss of neurological function plus major headache is also a stroke, and the massive headache is important for the correct diagnosis - that might be a bleeding stroke, which often requires neurological surgery to stop it.

  36. @Joseph AND sudden severe headache with no known cause. I have been bugging American Stroke Association to come up with an acronym to include headache.

  37. As moving and insightful as this essay is, I did not cotton to the following: "I imagine this is what the actor Luke Perry thought when the paramedics first reached him. A stroke? No way. Only old people get those." How in the world can this author possibly make such an assumption even imaginatively about Mr. Perry just to score some points for herself and her own response? We'll likely never know if Mr. Perry even had time to think such a thought, since quite often a stroke comes with zero warning -- as I know all too well.

  38. In September of 2017 my cardiologist ordered a heart cath because I told him I was having trouble catching my breath.The procedure caused the stroke I had while in the hospital. Oh, said everyone, you had a mini stroke or a mild stroke. It could have been worse. You could walk, talk, reason, etc., and that I should be grateful. The stroke wasn't due to high blood pressure or the usual things that cause strokes. I suffered a "procedure" stroke. I still think that the physician who did the cath was careless. But how can this be proven? My left hand is weak, I walk with a limp on the left side, and I get tired very often. I was 78 when this happened. I am now 80 and mad as hell -- with my cardiologist and with the "cath" guy.

  39. Having now binged on a seemingly limitless supply of testimonials to the selflessness of Luke Perry and how he took every opportunity to make something good happen, I can only think that there is no possible way that the world would not have been better off if he had lived at least another 10 or 20 years. I should have died from stage IV cancer 2 years ago, but here I am--only a part-time good person on the order of Luke Perry, who will hold open a few doors and paint a few portraits in my numbered days ahead. A death like Luke Perry's does at least teach us to "number our days" (Psalm 90:12).

  40. Acute stroke: Welcome to my world. Age 50 and doing all the job stuff every workplace constantly demands. Mercifully family, intensive care, PT rehab refocus what's important. Endure. survive and thrive: it's your life.

  41. Most of the male members of my family have died of strokes. My brother, whom I was closest to had several heat strokes in his teen years. He died at 77 YO and IMHO and both he and my mother did not sweat very much when working outside in the summer heat. So again IMHO heat strokes are dangerous. I am 77 YO and in perfect health. Recently in a procedure to remove a tooth root, my blood pressure skyrocketed to 220 MM and the dentist and his assistants immediately put me under nitrous oxide and the BP went back to normal. That made me very happy because I have been waiting for a stroke and the side effects are horrid. My brother battled for years and had a miserable life for almost 20 years.

  42. @Butch Burton "Heat strokes" have nothing to do with strokes.

  43. The author says she did not have high blood pressure before she had a stroke. However, half of American adults have high blood pressure according to new guidelines published in 2017. The figure among post-menopausal women (average age of onset is 51) is closer to 75% according to an article published by the American College of Cardiology in 2018. The American Heart Association reported in 2017 that, "High blood pressure is the single most important risk factor for stroke because it’s the leading cause of stroke.HBP adds to your heart’s workload and damages your arteries and organs over time. Compared to people whose blood pressure is normal, people with HBP are more likely to have a stroke. About 87 percent of strokes are caused by narrowed or clogged blood vessels in the brain that cut off the blood flow to brain cells. This is an ischemic stroke. High blood pressure causes damage to the inner lining of the blood vessels." In 2016, the CDC reported that 1 in 5 Americans with high blood pressure do not know they have it. Today, under the new guidelines, even more Americans are likely to be unaware that they have high blood pressure. CDC also reports, "About 8 of every 10 people having their first stroke have high blood pressure." A plant-based diet and plenty of exercise are great ways to avoid high blood pressure and stroke. In his recent best-selling book, "How Not to Die," Dr. Michael Greger devotes a chapter to high blood pressure and another to heart disease.

  44. @Dan Frazier I second Dr. Greger's book. I talk about a plant based diet with my patients all day long. Less meds, more lifestyle changes!

  45. What an absolutely superb article. About Luke Perry. Aboutmedicine. About life. About death. And about it’s authoress. Every time I read articles like this, it makes me proud to be what will inevitably be a lifelong subscriber to the NYT

  46. A good outcome. Of course in this case the 90210 character's trust advice could have sufficed to counter the benighted fatalism of a parent (!) with 'no time at all'.

  47. Thanks for sharing your experience and the reminder that "tomorrow is promised no one." Or as Marcus Aurelius wrote in Meditations: "You could leave life right now. Let that determine what you do and say and think." (2:11) Or as my play-writing teacher once advised: "write like you're dead." Momento Mori.

  48. More people need to learn to recognize the symptoms of a stroke -- and more importantly, to realize the importance of time. We need to think of it with the same urgency as having a heart attack: get to an emergency room immediately and the doctors may be able to save your life and hopefully your quality of life. With ischemic strokes in particular, if you get to a (properly outfitted) ER within a few hours, there are drugs that can prevent the stroke for wreaking widespread destruction of your brain. But if you wait, those drugs cannot do you any good and a portion of your brain will be permanently destroyed. That happened to my father. He recognized that he was probably having a stroke and went to an ER. They did an MRI and diagnosed his stroke -- but they weren't trained in the use of the drugs so they didn't administer them to him and he lost the use of the right side of his body and most of his speech ability for the rest of his life.

  49. Ms Swisher mentions that she has 'a type of blood that is more prone to clotting'. I wonder if it is the same type as mine - my stem cells make too many platelets (essential thrombocytosis). At 48 my blood test results were normal; two year later though, I had a dangerously high platelet count. If I had not been warned through a routine blood test it is likely that I too would have had a stroke. Luckily there are drug treatments (with low side effects) that can bring one's platelets back down to safer levels. Anyone in their late 40s would be well advised to get annual blood tests.

  50. Thank you, Kara. As someone who was downsized out of a start-up purchased by another start-up in December and trying to weed out another poorly-managed get-rich-quick scheme out of the expense of my health in Silicon Valley, I’m grateful for this article and for your podcast guest interviews. My mother passed away from breast cancer when she was six years older than I am now, and this article reminded me of the important things in my life path, both in work and in passion. Bless you, and good health.

  51. Best wishes for your continued good health and cogency... But you touch on something about US health care that drives me bat-crazy... The data gridlock that the US IT industry – no names named – has aided and abetted in the US health care industry is beyond the pale... They’d have you believe that how well you centered your car in the parking space at the oncology center correlates with the stage of your cancer... It may – but there’re often far more fundamentally causal connections and correlations... As I understand things, incompletely-closed congenital holes-in-hearts aren’t that uncommon... Since blood not been cleansed of small clots by filtering through the lungs can get to the brain, the chances of a stroke – and that it’s a block rather than a bleed – have got to be higher for this cohort... Holes-in-hearts probably could be diagnosed by an AI-aided stethoscope – even though I’d prefer annual full-body 3T MRIs... https://spectrum.ieee.org/biomedical/devices/a-smart-stethoscope-puts-ai-in-medics-ears But having watched askance as the industry blocked ingestible cameras and continuous glucose monitors for decades... I’d often think: “What Would Steve Jobs Do” Well, battling (an islet cell variant of) pancreatic cancer for several years while making a final trillion-dollar dent in the universe likely took up most of his time... Today, often think: “What is Jonathan Rothberg doing” Every so often, I watch one of Steve’s elevator speeches on YouTube again...

  52. Whenever I see someone this young die from a stroke or heart attack I want to know: what was their diet? What did they eat? What did they do for exercise/movement? What did the inside of their arteries look like? If it is even possible to get these details and include them in the story, I believe it can help save lives by illustrating the effects of diet and exercise.

  53. @Scott: It is not possible to avoid death by attaining perfection in diet and exercise. It is not even possible to push it back by an hour by that method, if one's body has the right (wrong) kind of built-in flaw. The Personal Responsibility meme assumes that every illness illustrates the sufferer's exercise and dietary sins. That causes much unnecessary stress and guilt. Treating oneself well is good, of course. But requiring exercise and dietary perfection of oneself and others is, in truth, an example of treating oneself (and them) poorly.

  54. @Scott: At the age of 48 I suffered a massive hemorrhagic stroke. I was (and remain) a runner who paid exceptional attention to my diet and health. I’m now 55 and, by the grace of God, suffered no lasting ill effects from the stroke. Sometimes it’s got nothing to do w/ how well (or not) one takes care of oneself.

  55. @Scott At age 59, after a lifetime of robust health, I had a heart attack on the Brooklyn Bridge while in the middle of a 4 mile run. I had been experiencing shortness of breath and an irritation I had been feeling in my chest when I made the slightest exertion. I ignored this and continued going to the gym daily and running my 30 miles a week. I was in excellent shape, total cholesterol <150, Low BP, a 32" waist. My diet was mostly organic, no processed foods, yada, yada, yada. I felt like I had a volcano that was erupting in my chest. I never called 911; I walked to the hospital, one mile, in the dark - and it was raining! Several days later I had a sextuple bypass. And a year later, new blockage and angioplasty. And pneumonia twice since. But I was seriously remiss in ignoring the warning signs and wanting to be some sort of hero by walking all the way to the hospital. I could have been a dead one. All this to say: 1 - Say yes to the best diet and exercise routines you can. Every doctor said that I survived because of the shape I was in. Today I am a very healthy and youthful-looking 65. 2 - Listen to your body. Don't try to rationalize symptoms, especially neurological ones. 3 - Don't let your ego get in the way. I did. I really skirted the edge. I made some less-then-intelligent choices back then. At least today I know better. I hope.

  56. Thank you Ms Swisher for your essay. As a stroke neurologist I can add that the best way to reduce one's risk of stroke is to deal with the modifiable risk factors: reduce your blood pressure starting with increasing your activity with a focused exercise program. Stop smoking. Reduce the amount of carbohydrates and red meat in your diet, lose weight (see above), treat your diabetes if you have it. If you experience the symptoms of a stroke call 911. There are effective treatments that can "cure" a stroke but they must be employed as soon as possible; within hours of onset of symptoms.

  57. My father almost died from a stroke when he was in his mid-fifties. I had to almost yell at him to call an ambulance and not wait until the morning. The author is absolutely spot on: just because you don't fit the profile doesn't mean you won't have a stroke. It's in the name: Strokes strike (!) suddenly, and often without any prior signs or warnings. But, regardless of all that, time is of the essence; firstly to safe the patient's life, but also to minimize the extent of the damage and prevent follow-on strokes. Last, but not least, especially younger and otherwise healthy patients are often excellent candidates for treatment with clot busters (enzymes that dissolve blot clots), but that treatment can only minimize the damage if it's used shortly after a stroke, and requires exclusion of a wet stroke (bleed) which also takes 15-20 minutes. So, whether you have a strong headache or not, if you suddenly develop so-called neurological deficits, such as you can't move a hand or a limb, loss of touch and feeling, sudden changes in speech or vision - call or have someone call 911. Right away. Time is not on your side.

  58. The author is very lucky that the hospital she went to in Hong Kong gave her an MRI. When I was out of the country in London, I had a TIA with similar symptoms to that of the author, but because they subsided in a few minutes, the emergency dispatcher wouldn't send an ambulance so I had to take an Uber to the hospital, and the ER wouldn't do an MRI. They prescribed aspirin, but nothing else. Luckily, I survived and made it back to the US, where I got a full workup a few days after the incident. Of course, one never should fly within a few days of a TIA, but it was a calculated risk since I was getting no care in Britain.

  59. Here in the USA, you would not have necessarily gotten an MRI either. In the ER at hospitals that are not specialized on stroke care, they usually do a cat scan first, which does not show symptoms of a stroke until much later.

  60. Actually - most ers do CTAs now that show us clot in the cerebral vessels. (I’m an ER doc in the states). Some of the smaller/older hospitals may not have the ability, but most do.

  61. @Leonardo At a top Bay Area hospital my hemorrhagic stroke was misdiagnosed as a migraine, and I was sent home with anti-nausea medication. My husband brought me back a second time and had to demand that I be given a spinal tap. When the doctor saw the blood in my spinal fluid her first words were "Oh, my God." Mistakes happen everywhere.

  62. Kara, An opinion piece I found worth reading; twice.

  63. Not often I tear up from a column. Glad you made it, Kara.

  64. Rest in peace, Luke Perry I always shamelessly stole his iconic answering message, "You know the drill." Strangely enough, after his death from a tragic stroke it seems somewhat prescient.

  65. A month ago, I conversed with a Gen-X'er who said to me: "It's a curious thing about Baby Boomers. Whenever you tell them someone died, they always switch the topic to their own past health issues. If you tell them Steve Jobs died, they will hijack the conversation and talk about a near fatal aneurysm they had while, say, snorting coke in the 1980s." Today, I shared Kara Swisher's column with my Gen-X friend. We both enjoyed it immensely. Great stuff.

  66. @Sándor all older people (Boomers and Silent Generation) do that. And my husbands Gen X kids do that too. The younger people have not experienced it yet - but as soon as they do they will engage in the behavior you described. It is not a boomer thing, it is an age thing.

  67. @Sándor Ah, one day they too will be old and swapping stories of their medical mishaps and maladies. Enjoy the giggles while you can, kids.

  68. What makes you think this is peculiar to baby boomers? I’ve heard such stories from people of every generation. It is simply a human trait to make sense of events by citing one’s own experiences.

  69. Excellent piece. I didn't realize that even if everything looks ok, it's possible that a stroke is occurring or has occurred. The thing is, as with heart attacks, it's embarrassing to show up in the ER and made to feel like a hypochondriac because everything checks out as A-OK. Reading this reminds us all that it really is better to call 911 and deal with the the nghtmare of ERs -- because that's where early intervention can prevent or mitigate stroke.

  70. @Valerie Brys I was once sent to the ER by my employee health because they thought i might be having a heart attack. I was so reluctant to go and waste people's time as I was sure I was fine. I received excellent, immediate and thorough care and though everything checked out fine nobody once made me feel bad for being there. It made me look at things differently and as someone who works in an ICU and sees the difference moments can make, I don't think I'll hesitate on going in if in any doubt again.

  71. I wonder about other possible links to and causes of strokes such as atrial fibrillation (AF), especially the more recently recognized silent AF which is largely asymptomatic. And also the possible connection of AF (and of stroke) to obstructive sleep apnea (OSA). One in five adults have mild OSA and nearly one in fifteen have moderate to severe OSA - and many of these folks are undiagnosed and untreated. And, although less common, you do not have to be overweight to have severe OSA. Wish more resources can be directed here.

  72. @scpa I went to my cardiologist a week ago due to having skipped heat beat sensations in my chest and he ordered a Holter monitor which I have to pick up this week to test for Atrial Fibrillation. The EKG he did last week didn't pick up AFib but he decided to monitor me for about 5 days to be sure. I then have to have an stress test in about 2 weeks to further check things out. I have a family history of early heart attack, lost my dad to one 37 years ago.

  73. I too had a stroke under similar circumstances, and was ultimately diagnosed with a hole in the heart in 2003. A PFO closure was done and I experienced no problems until about five years ago, when I again had a second event. While laying in the hospital bed googling strokes on my phone I discovered a study of PFO closures that basically concluded no improvement in stroke prevention for those patients who had the hole in the heart closed. My cardiologist informed that the PFO closures have been found to produce little or no improvement in outcome versus controls. My Doc did detect atrial fibrillation on an infrequent basis, and I now take blood thinners religiously to prevent throwing a clot from my heart during these events. I will soon be 71 and I am in good shape having survived two stroke events in 16 years. Be cautious of the efficacy of the PFO closure procedure. Remember that the medical profession "practices" medicine, and treatment protocols change with new information.

  74. @kevin cummins I'm sorry about your second event, after the closure of the PFO. My husband had a stroke at age 42. They discovered a PFO and he became a subject in a study to close the hole with a new type of device. As we understand it, the device was highly successful in preventing additional strokes in the group. Although I seem to recall that once you have a stroke you are at risk for having another and the PFO closure just reduces the risk. It's been 7 years with no incident. My husband was incredibly lucky. He had a severe stroke that, as the doctors told us, would have incapacitated an older or unhealthier man.

  75. @Kristin Like i said in my comment, I went approximately, 10 years after my PFO closure without a re-occurence, so I was shocked that I had a repeat minor stroke thinking that the PFO closure had solved my problem. After wearing a heart monitor for a month, my MD spotted a single event of atrial fibrillation measured while I was sleeping. Since then I have been on blood thinners and I have had no problems. I will be 71 this month and I am in good physical condition for my age.

  76. Thanks Kara - after being diagnosed with melanoma and then being free of it I can’t tell you how many parallels we share in our thinking (my kids 5 and 7 at the time). This was wonderful and wise and certainly a reminder of what’s important.

  77. The moral of this story: Choose your Parents well. And for those denigrating her story, I appreciated it. Anything that brings awareness to the general public, and perhaps saves lives, is useful. Lighten up. Thank you, Ms. Swisher.

  78. Though I’m glad you got help—I’m almost certain Luke Perry died of a subarachnoid hemorrhage—not an ischemic strike which often leads to disability and not death. Your article has nothing to do with Luke’s death. Although not inevitable, a hemorrhagic stroke occurs at a certain level of intensity and from my understanding the best neurosurgeons and emergency medicine personnel can provide the best care—but if the intensity level is too great then getting help immediately doesn’t necessarily change the outcome. You are comparing apples and oranges.

  79. Hemorrhagic stroke took my fiancé from me. He was 51.

  80. Time is Brain. Aged 48 I had a Grade 5 SAH ruptured brain aneurysm survivor that left me permanently disability. I have met teens; toddlers who have survived strokes. Literally in a heartbeat I had a 200 ml bleed on my brain Please if you have even the slightest stroke symptoms go to the ER.

  81. Brushes with mortality affect different people differently. I hardly ever feel that being hard on people is worth the suffering, theirs or mine. There are usually (but not always) other ways to get the job done. That being said, I do appreciate Ms Swisher's work and increasingly, I look out for it.

  82. I was treated for a brain injury after a hit and run by a careless driver. If the lesson of this article is the value of life and living it, we cannot be grateful only for our own, but for others', from those who don't have the same access to health care to those unjust victims of our judicial system that waste years incarcerated.

  83. Other lessons to take away are: 1. Stay hydrated! Especially on long haul trans oceanic flights and, 2. Move your body! Walk often up and down the aisles on long flights, 3. Aspirin therapy will help to keep the blood thin.

  84. @Kathryn Boussemart Not a fan of medical advice in the comments section: While Aspirin is great to prevent thrombosis, it exacerbates hemorrhagic stroke.

  85. Thank you for reminding us that life is precious. Events like this are great teachers if, given a second chance, we listen.

  86. I suffered a brain bleed stroke four years ago. I was relatively young (54), fit, and healthy. I appreciate your nod to the somewhat unlikable Steve Jobs, and the critics that bray at your no nonsense questions. I recovered (fully) but my encounter with the grim reaper did not make me a nicer person, if niceness is to be measured in gentle manners and cordiality. Death did grant me permission to take possession of my days, and pencil out, without regret, any thing and anyone who didn't bring deep resonance and joy to my life. This included members of my family whom I had struggled with all my life, hoping for some deus ex machina arrival of good spirits. Because of death I chose to make my world much smaller, a tiny ring of meaningful things. In her recent book Akiko Bush writes about "How To Disappear." Amidst a world of apparently infinite intrusion, Death brought me the daring gift of becoming more invisible.

  87. The many stories from survivors are, when added to the writer's own story, pretty convincing : if you (or someone you are with) have the symptoms (FAST) call an ambulance, make sure your door is unlocked, and get to the hospital.

  88. Kara, Thank you for this important message. May I recommend a wonderful one-woman play created by a wise friend in SF, Diane Barnes MD. She wrote and performs in "My Stroke of Luck," based on her experiences working through her own stroke in mid-adulthood, managing both teenage sons and the healthcare system, which, being a practicing physician, she assumed she knew how to navigate. She was lucky to enough to find her way to a new life. May others be so lucky.

  89. I loved Luke Perry on 90210 and was so sad to hear that he died. If news stories about the details of his death helps other people by raising awareness of stroke symptoms or by stopping for a moment to appreciate what they have, that is arguably beneficial although a little untoward in the "Thank God not me" sense. There is no suggestion in any story I have read that he could have been saved by a better medical response or by being a better person. The inevitable push to discover/analyze whatever his risk factors might have been like smoking or diet may have been gives people the false sense of reassurance that if they don't have the same behaviors, they have more control over their own death, and can use that information as a way to mitigate the sadness of someone else's death by blaming them. In the end, when it's your time to go, you go. If you get a second chance, you value it. When someone you love goes, continue to appreciate them and love them.

  90. @LinVA Even medical professionals assumed I smoked, had hypertension, or as time went on, had been obese. Upon being told none of the above applied to me, the go-to gotcha response was “family history”. As an adoptee, I have no family history. I reached the conclusion that no one wants to believe it can happen to them, so they blame the victim.

  91. Realizing you had "the privilege of more days and the awareness that those days would be limited" makes you pretty smart; listening to your brother the doctor makes you even smarter, and very lucky. I can't understand how some fail to get the gist of your column, and feel a need to criticize. I appreciate your honesty and wisdom. I sure hope you call your brother on his birthday, just because he's your brother. And obviously a fine doctor.

  92. First, please understand there are many types of strokes. It has not been reported what type of stroke Mr. Perry suffered and died from. Therefore Ms. Swisher is likely comparing apples and oranges. The symptoms of a stroke are the same but the cause can be vastly different. One type, an arterial is blocked suddenly, either from a local event in the artery or from material traveling in the blood stream from a remote site like the heart. The other type is a ruptured blood vessel and sudden bleeding in the brain. But most importantly if you have these symptoms call 911 or go to the ED immediately, let them diagnose and treat as it's not a simple disease, Stroke is a symptom and not an etiology.

  93. @Dr. While you are technically correct, I think the main thrust of the essay was to say that she also could have died had she not heeded to he brother's advice.

  94. @RaVi Kiran K My comment was meant to explain that the author of the essay was not in a life threatening situation as the cause of her TIA, which technically is not a stroke, was different then the unfortunate MR Perry. The treatment and prognosis is different for the different etiologies of a stroke.

  95. Had virtually the same event 10 years ago after a flight to LA. At the risk of reading Ms. Swisher’s story as my own, my take on her story is that the clot that went through her PFO broke off from a larger clot that was deep vein thrombosis (which occurs in your leg). The “type” of blood that makes one susceptible to a DVT is a protein S deficiency, at least that was the case for me. She appears to have been lucky that she did not have a pulmonary embolism since clots would nearly automatically go to the lungs. I had one in each lung in addition to the stroke. That said, I was extremely lucky; my only long term effect is epilepsy, which can be controlled by medication. So thanks for listening. A few precautions: for any long distance flight, get up at least once every two hours (more frequently if you can) — deep knee bends and stretching. Drink a fair amount of water, no alcohol and try to avoid caffeine. If you’re really worried, ask your doctor to check your protein s at your next visit and if deficient ask for a prescription blood thinner for long flights. (Lovenox; heparin). BTW, my cardiologist said not to worry about the PFO; 25 percent of the population has one (extrapolating from studies).

  96. This is a beautiful essay. Kara, you took away exactly the right lessons from your walk to the edge. Twenty-four years ago, my esophagus spontaneously ruptured and I got very sick very fast. This is an event so rare most doctors will never see it in their lifetimes. Unless it is treated quickly, the chances of death increase exponentially. I won’t go into the details here, but after three operations and five weeks in the hospital, I made it. Life has been good after that, fantastic, in fact. But it is different than it otherwise would have been. Since then I’ve tried to remain radically focused on the present, but also know that it can all vaporize in an instant. Death is now a constant companion but not an especially scary one. He’s always there now, gently reminding me to live in the now.

  97. Thank you my fellow warrior/survivor sister — I survived an ischemic stroke in October, 2012. I felt every word, every thought put into this beautiful essay. And thank you for reminding us to LIVE FULLY. I have minimal visible outward signs of having had a stroke, so people tend to think it’s not so “serious”. In addition to sharing stroke resources and supporting other survivors, like you I find myself checking people hard when they squander time or resources. Every day is a new gift to open, folks! Sidebar: To everyone reading this, please remember the sign for stroke: F. A. S. T. (Face/Arms/Speech/Time).

  98. @Alish AND sudden severe headache with no known cause. That was my only symptom, and my hemorrhagic stroke nearly killed me.

  99. @Lawyermom yes, that’s an important symptom to add, that many are unaware of. So glad you’re still here too my fellow warrior/survivor sister. Bless you.

  100. Me too. It’s two years since a SVH stroke. I was 71.I’m never going to be the same but my cognitive skills are still ok.

  101. Kara Thank you for your article and for sharing your thoughts. Your story resonated deeply with me. The day before my 60th birthday I was told that I had multiple serious heart issues. One of those relatively minor issues was A Fib, which can cause stroke. I am a non-smoker, 11 times marathoner (Boston, New York, Chicago, Portland etc etc) and did not fit the profile of someone with heart problems. Part of the treatment for A Fib is to do a cardioversion. There, under sedation, they use electrical paddles to try to jolt your heart back into a regular rhythm. You probably have seen the scene on TV. The second cardioversion induced a stroke that night despite being on anti-coagulation meds. Walking in the middle of the night to the sensation that your arm, your voice and your body is no longer under your control is frightening. I am fortunate. I was minutes from an ER. I recovered. I am still trying to fully learn the lesson that this experience is still teaching me. Life has changed. I value the time with those I love deeply. But most of all I am every aware of the fact that I came very close to dying or living with some physical and mental capabilities forever gone. Life is a gift. Make the most of it.

  102. @David J Bilinsky Amen!

  103. It is quite disturbing that while a crucial area of medicine very few medical students choose to go into neurology. It take many years of training and every case is complex. The amount of time performing detailed examinations, review of imaging and treatment options for stroke and dementia patients can be hours and there is simply no reimbursement for this time so neurologists are some of the lowest paid physicians in our hospital. There are severe shortages of this field in our region. Our hospital even tried to recruit a full time neurologist from the university but cannot afford to pay even one because they complain they take too long with patients and don't "see volume." Perhaps insurance companies will change the way physicians are paid and place much more value on complex diagnosis and time with patients than on procedures and surgeries and you will have the best and brightest students going into the neurology field.

  104. @Michael Going to medical school is so expensive. There should be ways the best and brightest can get their education and become doctors. Who deserves it more than a doctor who perhaps can save lives.

  105. My father died when he was 45 & I was 21. I too, have made decisions as though my time were limited, and despite now being 58, I know more than ever, it is.

  106. Same here, except after an on and off ungodly headache, I collapsed in a hotel lobby. A few minutes earlier and I would have collapsed alone in my hotel room, where housekeeping would have found me lifeless hours later when I failed to check out. Please— if you ever get a horrendous headache or any other symptoms, call an ambulance. If I could do over one thing in my life, I would go to a hospital immediately due to the severity of the headache. That might have saved me from a ruptured aneurysm, my near death, and all that followed.

  107. Excellent PSA for the watchful waiters among us who are generally disinclined to seek help. Thank you for sharing your story, and making near-death entertaining no less.

  108. Perhaps more lives could be saved if we were better informed by the medical corps of the precipitating causes (in Ms Swisher's case, a recent long flight) and the symptoms of a potential stroke or thrombosis. I had written off the sparks and flashing lights in my field of vision as a sign of fatigue, or at worst, a possible detached retina as I am quite myopic. The eye doctor in France noted my optic nerve was under pressure, ordered a rush MRI in Paris. Upon receiving the analysis, he sent me back to Paris for emergency treatment without a minute to lose. Ended up on an IV drip for two weeks to dissolve a thrombosis of the vein of aligning the optic nerve of one eye. Conclusion : if I had simply written off my painless visual anomalies as a sign of fatigue, I would have lost my eyesight or possibly my life had the clot migrated elsewhere in my body.

  109. Thank you Kara (and her brother Jeff) for this eloquent reminder that bad things can happen to good people at anytime, anywhere. This is not to say we should live in fear, but we should live aware of different possibilities. Years ago, when I was a first year medical student, I got a call from my favorite aunt. She told me that she was going to see her “eye doctor” because of some unusual visual symptoms she was having. I listened carefully and then told her she needed to go to the ER STAT. It turned out that she had advanced atherosclerosis of her carotid artery and was having what Kara had...a transient ischemic attack. Thanks to a quick surgical intervention, she had a good outcome. Got weird symptoms? Pay attention. Don’t wait. Tell someone...preferably a doctor, a nurse, or even a med student.

  110. I knew a man who was 59, seemed physically fit. He had a stroke while in his car. His wife drove to a hospital with a sign that said "neurologist on staff." Even though it was in the middle of the day in the middle of the week, their neurologist wasn't there. She could have taken him to another hospital a little farther away or the hospital she took him to could have transferred him. He wasn't treated in time and ended up severely disabled.

  111. Well put and very kind of you to share. I noticed the news cycle was seemingly starting to move towards questioning whether there were substance abuse issues with out saying it outright. People can, and do have strokes. The loss of Luke is sad enough, no need for us to pry or make implications. Thank you for reminding us that this can happen to any of us, and for the important life (and health) lesson.

  112. So an MRI discovered I had had an ischemic stroke, sometime. No symptoms, doctor had no idea when (who knows, perhaps in utero). Never smoked, did drugs, no high blood pressure, no family history, no heart problems, not overweight, exercise lifelong, vegetarian, nada. This does set me up subsequent strokes which is not mentioned in this article. Baby aspirin recommendation. Doctor added a statin which made me ache so much I stopped exercising so I quit and went back to exercise. An article on ischemic strokes as a class would be useful. The range of symptoms or lack of. I keep wondering if I missed one tho if in utero not very useful. For once it was all my head tho.

  113. @poslug Smart move to stop the statin, poslug. I didn't pay attention or connect the statin with the pain, and now I can't walk a quarter mile before my legs cramp up and ache. Looks like I'm stuck with it for life.

  114. Kara, Persuading you to bail on your important conference to go to the emergency room must have seemed harder to your brother than learning everything in medical school that predicted the consequences of your symptoms. The future is different from the past when humans are convinced to choose the unexpected. That’s what made Jobs exceptional.

  115. This article is beautifully written and infused with love. Certainly the best thing I've gotten from my morning read of the Times for a while. Not the Time's fault that there is so little love or even tolerance in our political world today.

  116. Glad you are okay for now, Kara!

  117. Your last sentence made me tear up: “Well, I guess, but not if you are lucky enough to have a brother who saved your life.” Those few encapsulates the true love siblings have. I have it for my own sisters, even though there is strain between us. And don’t forget, you abided by his long-distance prescription at a time when you were busy with Very Important Things. You survived to write about it years later in a powerful medium; hopefully, others will read and take your experience to heart, even if, like most of us, there is no competent physician’s phone number in our Contacts list.

  118. Glad you are still here and able to write this. The next step in the prevention of such things is a proper helathcare system in these United States that not only promotes wellness and treats disease but takes a full inventory of family history and risk factors into account. Given your family history, for example, one should not wait until something happens to consult a physician. I was pummelled on another page of this paper when I stated that a man of his age should not die this way by replies listing the many ways people at that age could have a stroke. They all missed my point: that a true healthcare system with an emphasis on wellness system could prevent much of this. Patients should not find out about a problem only after it has done damage and that is where our very expensive system is failing. Big data can do far more than predict traffic flows. Big data, rightly applied and in a timely manner, can greatly reduce the likelihood of your TIA. We should all be able to sit down with our primary Physician and give a full medical history and get a thorough examination while we are young and healthy so that we can make timely changes and interventions- if necessary- for a healthy life. Be well.

  119. @David Gregory Agree with you about the need for a healthcare system that provides long term tracking of our health by competent, caring doctors. I had such a doctor, a General Practioner they were called back in the day, who cared for our family from my age of six until I left for college. He practiced medicine. Now, I survive the nonsense of a healthcare system which practices billing and form-filling. And five different "Primary Care Physicians" in seven years. Medicine? Not so much. Don't get sick. Die quick.

  120. @David Gregory Big data is unfortunately being used to tell people no and extract more money from them. Actuarial assumptions running riot.

  121. I appreciate that the sentiment to "seize the day" can be encouraged by the shocking experience of any significant personal health crisis, but I am disappointed that it might also motivate sufferers to become "tougher" on other people, family or others. In my own experience, the recognition of personal frailties has engendered what I hope may be a more compassionate reaction to people near and far. After being presented with unavoidable evidence that "that could never happen to me" is not a justifiable view, it's only a short step to trying to understand why we all get so many things wrong and accept that we are flawed in many ways. Different horses for different courses I suppose. And that's fine too!

  122. In my case it was not a stroke or a TIA but it was in my brain, strictly speaking. At age 6, it was polio. I was giving an ultimate wake-up call about the precariousness of life and the gift we receive of the chance to experience the joys of the world as we pass through it. I would like to think I have not wasted the opportunity. Thank you, Ms. Swisher, for the reminder.

  123. Thanks for sharing the story. Educational, and not just because I 'didn't know what "obstreperous" meant.

  124. There are strokes and then there are strokes. Some are massive; some not so much. My aunt survived a stroke with no treatment and few limitations. It was a stroke, not a TIA. My mother on the other hand had a stroke that hit her brain stem and she died almost instantly and she was in the hospital as a patient when it attacked. So please don't compare yourself to Perry or wonder what he was thinking. Having said that, it is very important to get to the hospital immediately.

  125. Thank you Kara! Last year I lost my good eyesight and thought my TV had broken ;and that was why I was seeing two of you being interviewed by two of Mika and Joe! For a year ,after being admitted to a hospital to undergo the same testing and intervention u had stat!I finally learned my TIA wasn’t a stroke !!! Indeed .... I have a 6th Cranial Nerve Meningioma!!’ The thing has apparently been there unnoticed by many Radiologist since at least 2015 when I spent weeks battling similar symptoms as u had. The strange facial and extremity sensations. The ignoring of the obvious. Worse I am a retired nurse and teacher. So I experienced the “ denial” I would counsel my clients against when they felt abnormal events. I share because everything Kara has shared is spot on! Death is the teacher and we scuttle around making big messes running from it until .....

  126. I wish I had at least the common sense to realize what was happening to my mother while I was there yet. She would be alive today and not one day goes by that I don't hold myself responsible for it.

  127. @GlennS Please do not beat yourself up over your hesitancy to stridently intervene . Symptoms are hard to define as serious sometimes ,because we have an active responsive nervous system and feel transient sensations like tingling and cramps and nerve pain all our lives that isn’t dangerous just within normal limits . My heart aches for your loss and sadness.

  128. @Glenn S. Forgive yourself!

  129. @Glenn S., Don't take on that burden. You could have done everything right and she would have still died.

  130. I live like I could die any day too, but unlike Steve Jobs I prioritize the people around me and just generally enjoying life. If today was my last day and I could reflect on it somehow, yes, I was right to sit around in pajamas and read the news while I sipped coffee, and my kids still remember me fondly and are well-adjusted because I took time to be kind and patient with them and let them know they counted. Could Jobs say that? No, he can remember the iPhone. Great.

  131. Time is truly the issue. Having survived a hemorrhagic stroke. I can attest to it. I was in the emergency room in less than an hour and consider myself extremely lucky. I still have stiffness and difficulty going down stairs but all in, things could be infinitely worse.

  132. Thank you, Kara. We are among the truly fortunate. We have a family member as our medical advisor, excellent health care, and the ability to make choices in our lives . Luxuries denied to most of the world. My 'wake up call' was 95% blockage of the coronary artery called the "Widow Maker". At 57, I narrowly missed a fatal heart attack because I had good advice and acted quickly. My life changed dramatically as a result. Death is our next door neighbor, Kara, and we can no longer deny that fact. Our lives are sweeter because we must come to terms with our mortality.

  133. @elained I am in exactly the same position as you (LAD, 95% blockage, access to superior medical care). We are blessed. I am glad you are well. Kudos to Kara for the column.

  134. I had a stroke and lived. A year or so later and 20 pounds lighter, I'm still fighting my way back but occasional speech problems surface sometimes. . Luckily my employer stuck by me, we're a small firm. It took more than two hours to get medical help, I was in rural Georgia. I was 64 when it happened.

  135. Me too. Blood mutation that causes clotting. For me lots of little strokes that lead cognitive decline and disability. Fought hard to recover. Am by no means back to health but am remarkably better due to great medical intervention.

  136. This “deja vu” article caught my eye. Twenty one years ago I was dropped to the floor while examining a patient from my PFO and neighboring ASA causing paradoxical flow coupled with a high level of anticardiolipin antibodies ( which can cause hypercoagulability ). Before that time I would have been thrown into the category of “cryptogenic” strokes ( no discernible cause), but research of women with multiple miscarriages had turned up the link between anticardiolipin antibodies and stroke. Coupled with the the relatively new procedure of an esophageal echocardiogram ( for a better look at your heart), I had a diagnosis and preventative path. There have been changes to the suggested treatments for these conditions over the last two decades . Medicine is never static- that is the caveat- and new information is always ascendent, but that should not dissuade the readers from seeking and putting to use our best present treatments. Now we need to assure that as many of our citizens as possible have access to our best medical practices by developing a universal care system for the US. A major reason for bad outcomes in stroke patients is their hesitancy to seek immediate care due to financial concerns. And, finally, we, as physicians, must persuade patients that good science is good science: Get your children immunized for measles !

  137. Noted in Kara's article that she has blood "more prone to clotting". While not sure what that may be, there is a known blood factor : Lipoprotein(a), which is a "stickier" LDL and can contribute to stroke potential/heart attacks. It is a genetic factor and does not show up in standard blood tests. Must be specifically tested for lipo(a). Celebrity Trainer "Bob Harper" shared his story. Thank-you Ms. Swisher-

  138. Years ago while walking our dogs mid-morning in Toronto’s High Park, I ran into a large and incredibly diverse group of people setting up a picnic. From children to seniors, every age group and ethnicity were present; a few appeared mildly disabled, others not a bit. While the diversity was hardly unusual for Toronto, their joy and camaraderie was. When I asked them what they did to deserve a day off, they all laughed as one replied, “We all had strokes!” I’m still laughing, and still in awe of their zest for life, and for the knowledge that it can all be taken away so quickly.

  139. At the age of 68 the day after my wife's 67th birthday, I was watching tv. At about 9:30 I experienced terrific pain behind my eyes. I took two Tylenol and went to bed. When I awoke the next morning, a stroke had hit me during the night. My wife rushed me to the ER and I went though an array of tests, an MRI included and they found where the stroke had occurred. In the mean time the doctors all asked how could I possibly go to bed while a stroke was occurring. I mentioned that while I knew the symptoms for a heart attack, I knew nothing about stroke symptoms. While under the care of a neurologist, he detected what seemed to be a blockage in my Basilar artery. He sent me to Jefferson hospital in Philly. I was diagnosed with an 85% stenosis. A stent was inserted which reduced the stenosis to about 50%. I was very lucky in the entire episode including the stent procedure. That was 8 and 1/2 years ago and I know what the symptoms are for a stroke.

  140. 'Basically, you all don’t have the time to be so careless in what you do and I don’t have the time to not ask you about it.' We each have as much time as we will have, and we may make our own decisions as to our behaviors and choices. The concept of another person telling me I am doing my life wrong is merely entertaining. I may appreciate their intent, of course.

  141. @bill, Have a life-threatening event and you may change your mind.

  142. Heart health is most important! Seeing a cardiologist should be a routine part of preventive health.My afibrillation was found by accident during another procedure. There are meds and procedures that help although nothing is a panacea . None of us is getting out alive so its up to us to make our lives meaningful.

  143. This is a good story telling people don't miss any small sign of imminent danger. I installed a second stent last year after I went through a stress test showing no sign of any problem. Then not too long after, I felt tight and hard to breath when I was walking in a cold weather. Went to see my cardiologist who immediately arrange a catheter operation in the adjacent hospital. One of my main artery was 90% blocked. He told me that if I didn't see him at that time, I would be in a very big trouble.

  144. I’d like to know what type of stroke Mr. Perry had. Sadly I know from experience with my Dad that there are two major types. Those caused by a clot or a piece of plaque that’s traveled up from the carotid artery, or those that are hemorrhagic i.e. caused by a brain bleed (sometimes the result of high blood pressure). So far, every article I’ve read and heard is focusing on what to do if you have symptoms of a stroke in progress but nothing about prevention.In my father’s case, he’d had a clot that came from his carotid. He was slim, non smoker, low cholesterol so not predictable from risk stats;we later found out that he’d been experiencing tingling in both hands but had ignored these symptoms. A simple Doppler ultrasound of carotid could have discovered this. Everyone should have this test. His stroke was terribly debilitating. He lost total left side movement and developed dementia, totally disrupted his life and that of my mother my family, needed nursing home, caused significant financial drain. I also felt that his cardiologist missed hearing bruits (pronounced brewies) in his carotid.Those are sounds heard with a stethoscope that indicate obstructed blood flow. Your doctor should be listening to your carotid at every well checkup.His doctor had significant hearing loss. I feel we need to learn more about screening & prevention. In a way it is fortunate Luke did survive, because living with major stroke sequellae is so devastating.

  145. Thanks Kara. A good reminder for all of us.

  146. I am 39. Had a stroke 2 months ago with pretty much the same symptoms that Kara had plus paralysis on my right side. I also had a large PFO that was "fixed" 3 weeks ago. Absolutely the scariest thing in my life. I appreciate everyone's comments and sharing his/her story. I am wondering how many had a PFO diagnosed as well and if they got it fixed? Thanks Mark

  147. @Melissa/Mark, I found out about my PFO (patent foramen ovale) after a mild stroke last year. My only remaining symptoms are parasthesia and loss of fine motor in my left hand and numbness in left half of my face. As a 64-year old heart attack survivor with subsequent heart damage, I am not a good candidate for a PFO repair. I take an anticoagulant daily, stay hydrated, eat clean, and exercise. Hopefully, these measures will prevent future clots. I'm glad you had your PFO fixed and wish you a long, healthy, stroke-free life.

  148. I can easily relate to this story, especially her statement: "And that is why the idea of death — the absolute nearness of it — has been ever-present for me. Since my dad died, I have lived my life as if I had no time at all or very little, making the kinds of choices of someone who knew that tomorrow might indeed be her last." Kara continues to be one of my most respected reporters on technology and related business. I have survived three aortic aneurysm situations requiring endovascular stents and also had a condition requiring an angioplasty procedure (coronary stents) noticed by my son, who is an interventional cardiologist who does this procedure (but not on family members). Call me stentman. Essentially I would not be writing this post today were it not for modern medical technology - encompassing both diagnostic imaging and corrective procedures. Every day is a blessing and hope I can watch my grandchildren grow up over the next few years.

  149. My father also died from a stroke when I was young. It made me feel like I was living on borrowed time, and that I had to take care of myself - exercise and eat a healthy diet - so I could hopefully avoid the same fate. Thank you for sharing your experience and your emotions.

  150. Being of an age where reminders of the prospect of impending death have occurred several times while entering ERs and being whisked off to rooms where your body is serviced with the efficiency of a NASCAR pit crew, there's a few observations I can share: + You are very unlikely to be considering how good a person you've been at that moment, in any event you can't do anything about just then. + To the extent that you live your life well and are kind to others, you do that because you should not because there's a potential benefit if things don't work out well in the ER. Now as to strokes, it all has to do with the size of the clot and where it ends up. The extent to which blood flow is restricted then determines the damage and survival, something that is only established after drugs clear out the clot and has to do with many factors, age being one of them. But be aware that in a study of 91,000 Medicare patients between 2003 and 2006, they found that nearly two-thirds who are discharged after having a stroke will die or be readmitted to the hospital within a year. So, learn about the symptoms but as importantly do what you can to minimize the risks and, oh yes, be nice to each other.

  151. I went to medical school as part of my desire to help people in my 40s. After spending another day sitting and studying, I too was hit by a Deep Vein Thrombosis or DVT. This is the same item that started Kara Swisher's problem. A DVT forms in the veins within the leg due to lack of activity and is especially prominent with flights over 4 hours. Basically the blood starts to clot due to inactivity. Also certain people are more prone to DVTs, such as woman who are pregnant. A person experiencing a DVT may feel pain in their calf or notice swelling in their feet or leg. The DVTs will normally go from the leg to the right side of the heart and block the blood flow into part of the lungs. This is called a Pulmonary Embolism or PE. This can create a dry cough if the clot is small. If the clot is large it can trigger a heart attack or Atrial Fibrillation. Most DVTs don't cause strokes because there is normally no way for the clot to get to the brain. The exception is for those people who have a heart defect like Kara Swisher. The hole in her heart allowed the clot to go from the right side to the left side where it was pumped into the brain. Passengers on any long flights need to get up and move every 30 minutes if possible. If you are going on a long flight frequently buy compression stockings. These stockings exert pressure on the leg to maintain normal blood flow and significantly reduce the chance of a DVT forming. They can save your life.

  152. Medications can be very expensive as prevention for these and other conditions. The pharmacy department workers often ask, " Are you aware of the cost?" I am fortunate but so many are not. There has to be a way to reduce drug costs for people to help save their own lives It is unfair for a person of limited means to have to make choices when health is involved.

  153. In Plato's "Phaedo," Socrates calls philosophy "practicing dying."Ms. Swisher's op-ed provides a thoughtful contemporary restatement of this ancient wisdom. Often misinterpreted as favoring death over this fallen life, it is rather a resounding impetus to the kind of questioning that belongs to a well-lived human life.

  154. My father had a stroke last May--the day after unsuccessful surgery to remove kidney stones. A visiting nurse was checking on him at home since the surgeon released him with both internal stents and a barbaric tube still inserted and draining from his back. She realized she didn’t have all the correct paperwork but said she’d be back either later that day or the next day. Thank goodness she came back a few hours later and recognized that my father was having a stroke. My father left me voicemail that he was going to the hospital because the visiting nurse thought he was having a stroke. I asked my lunch guests, gee, can somebody call you when they are having a stroke? Nah, was the response, he isn’t having a stroke. Well, guess what, he was. And yes, you can call someone. And yes, you can dismiss those little signs (he had fallen earlier in the day when getting out of bed due to leg numbness; when he told my 90 year old mother that he thought he was having a stroke, she also said, nah, you aren’t having a stroke). Because he got to the hospital right away where they administered the miraculous tPA drug, and with many weeks of rehab, the effects of the stroke are now minimal. His fall earlier in the morning was most likely a kind of mini-stroke that led up to the more serious one a few hours later. It is important *not* to dismiss small signs, or not let others tell you to ignore small signs. If you think you are having a stroke, you need to get immediately to the ER.

  155. @CJ Visiting nurses are special. I have seen them in action in a hospice situation. Contributing to them is a very worthy cause.

  156. This column could save lives. Stroke awareness and the necessity of seeking IMMEDIATE medical care are likely the two most important steps that could save many lives. WedMd has a list for a quick test people can use to see if someone is having a stroke: "Use the FAST test to check for the most common symptoms of a stroke in yourself or someone else. Face: Smile and see if one side of the face droops. Arms: Raise both arms. Does one arm drop down? Speech: Say a short phrase and check for slurred or strange speech. Time: If the answer to any of these is yes, call 911 right away and write down the time when symptoms started." From what I have read, acting fast does not guarantee a good outcome but not acting quickly with clear signs of a stroke would virtually assure a bad one. I suppose, also, this is another reminder to everyone to have regular check-ups to monitor high blood pressure and other signs pointing to the potential for a stroke. When I fly, particularly for longer distances, I take a children's aspirin before and during the flight and try to walk around as much as possible, although it is more difficult these days with crowded aircraft and constant concerns "security". It would be helpful if flight attendants were more aware of the necessity of movement to prevent blood pooling in the legs.

  157. There is another outcome besides life or death. That is what happens when a CVA leaves the patient hopelessly paralyzed, unable to speak or care for themselves in any way, except to eat and breath and know where they are. This the real crises in the elderly who then need caregivers, 24/7. Find a spouse, also old and infirm, relatives who have their own lives, same for their children. Resources quickly disappear as do friends and relatives, unable physically or mentally to give the care needed. A Care Home, Long term care insurance are suboptimal options. A Caregiver a couple of hours a couple days a week is all that is offered leaving the patient in bed, incontinent, needing to be fed, never turning, bed sores, infections and finally pneumonia and death. Reminds me of End stage Renal disease before 1974 when Dialysis became covered by Medicare. What does Medicare offer for those described above? Not much. It is long past time to include this care in the M'Care program. Finance it by adding it to the Medicare tax as part of one's payroll with the same 80/20 benefit, the latter covered by a private Insurance for the 20% not covered by Medicare.Home care is the ideal, not warehousing in Care Homes. From my own experience with my wife for 5 years, it is amazing how much improvement can occur with proper care in both their physical capabilities, cognitive state and mental capabilities. The old person you previously knew is still locked in their brains waiting to come out.

  158. Looking back in my 70s some things I believe have been helpful for me. This has been my advice to myself. Be a regular at the gym. Stretch, do aerobics, and use those weight machines. Increase the number of routine visits to my primary after 50 with lab tests. Follow the best advice on diet I can. Some of life's pathology is simply the luck of the draw, but some of it is under my control. Stay at the controls as best I can. That approach can be life saving and/or slow time's steady deterioration.

  159. You had me up till mentioning Steve Jobs. He might have lived if he trusted modern medicine.

  160. @Flower: Most people don’t, until it’s too late. Then blame doctors for not digging them out of their alternative medicine enclaves & treating them as they would an orphaned child. Have weird symptoms, see doctor. Follow all instructions, even if they seem nonsense to you. Add alternative therapies if you wish, as long as they are not detrimental to your life. For many today the first treatment for a serious illness should be removal of the brain. Most people don’t use it anyway. Until that happens, many will die, for they only want treatments that 1. Don’t hurt. 2. Don’t make them change one thing in their lives. 3. Insurance will cover. Say no to any, & people stay away in droves.

  161. @ Kara Swisher. Thank you for sharing this important piece. We would like to note the following: The American Heart Association/American Stroke Association 2009 definition of a transient ischemic attack (TIA) is "a transient episode of neurological dysfunction caused by focal brain ischemia without acute infarction (see link to citation below)." Because there was evidence of acute infarction on your MRI, as described in your story, you had a stroke and not a TIA. Additionally, the term mini-stroke is a generic term that should be used to indicate a small stroke. In summary a TIA is a red flag indicating that stroke may be imminent but is not in itself a stroke. Tzvi Jonas, MD, Assistant Professor of Medicine UMass Medical School Bill Tosches, MD, Associate Professor of Neurology UMass Medical School https://www.ncbi.nlm.nih.gov/pubmed/19423857

  162. I survived 2 strokes 3 months apart. Do you have Factor IV Leiden? I'm thankful every day to be here.

  163. Wow what a vivid story...Stroke symptoms are important to 50-somethings... even in affluent countries like the US...Men & Women, Black & White... Thanks for revealing your close shave...

  164. Kara's stroke happened in 2011. My hope is that she has made a full recovery by now. She has done us all a good deed by reminding us of the risk of stroke. Her comments here about Steve Jobs are a bit puzzling. Jobs was an abusive, miserable man decades before he contracted the fatal illness that would eventually kill him. His treatment of his own daughter was unforgiveable.

  165. Nice headline. TIAs aren't strokes though, they're warning signs just like angina isn't a heart attack. Not walking on a long flight has nothing to do with TIAs, that would be blood clots in the legs (deep venous thrombosis or DVT) and pulmonary embolism. Ditto for hydration. Hole in your heart? If that's the source of the clot in the brain, which would then properly be called an embolus instead of a clot, the cardiac ultrasound should have shown one of the chambers of your heart to be full of said clots. Glad you're still around but you don't get to tweak medical facts to write your column.

  166. @drdeanster Having a hole in your heart where clots that formed can bypass the lungs and go directly to the brain is the probable cause

  167. I started this article hoping to learn something about her ministroke and its after-effects. It was totally unhelpful. The title is just a springboard to talk about other things.

  168. To put more of a point on this story, please tell us (1) how much you paid for your excellent treatment in Hong Kong, and (2) an estimate of how much you would have been out-of-pocket if it had happened in the US. Bonus points for (3) an estimate of the US cost had you been uninsured. I expect these amounts: (1) $0 (2) $6000 (3) $125,000

  169. I have practiced Oncology for 30 years, and the most important lesson I have learned from my patients is that life is short, it is precious, and we are all rushing to it's end at breakneck speed. TJL

  170. We should never forget that life is to be cherished. Tomorrow’s are not guaranteed, waking up is a gift. I am glad your brother gave you informed accurate advice and you listened. When death comes for us it doesn’t care who we are or what needs to be done that day. We need to take care of our bodies and realize that when we leave for work in the morning like the people who went to work on 9/11 we might not return home, I can only hope that Mr. Perry’s family find comfort in knowing he had a full life even if was only 52 years and he created memories that will substain them at times when the grief becomes to much to bear.

  171. I can relate to lots in this account - closely related health crisis (blood clot causing myocardial infarction vs stroke), the age part, genetic condition, children, lasting sense of mortality, noticing the notables that died of what I survived... ...not so much the 'life lesson' part, or being tougher on others, or 'realizing' the humanity/wisdom of an abusive entrepreneur seen as some kind of culture hero...

  172. Thank you for writing this.

  173. And everyone who read this article should check for what are signs of a stroke. I plagiarize freely from the National Stroke Association at: https://www.stroke.org/understand-stroke/recognizing-stroke/act-fast/ If you think someone's having a stroke, check these things. Face: Ask the person to smile. Does one side of the face droop? Arms: Ask the person to raise both arms. Does one arm drift downward? Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange? Time: If you observe any of these signs, call 9-1-1 immediately. They have additional signs, too, at the link. Any of the following things happening suddenly: - numbness or weakness of face, arm or leg, especially on one side of the body - confusion, trouble speaking, or understanding - trouble seeing in one or both eyes - trouble walking, dizziness, loss of balance or coordination - severe headache with no known cause Call 9-1-1 and note when symptoms began Stay well, Ms. Swisher.

  174. @b fagan...most informative...thank you very much

  175. I worked in a hospital doing a psychology internship years ago many patients had strokes. I recall there were left and right hemiplegia..speech and motor abilities were affected or both..Physical..occupational..speech therapists worked with all..Kudos to their care and concern.

  176. Beautiful. Thank you