Fuzzy Necromancer

So for strokes the signs are abbreviated BE FAST. Balance loss, Eyesight changes, Face drooping, Arm weakness, Speech difficulty, -> Time to call 911.

Had I known those MAYBE I would have figured it out but my symptoms were a little mixed. I was reading (fanfic!) in bed because it was a sunday morning and i had nothing pressing to do and suddenly got dizzy. I put my laptop aside because my eyes were blurring (Eyesight changes - symptom #1), and laid down, thinking it would pass, it didn't, it's a little vague how it progressed because I'd been having headaches and neckpain for about 3 weeks leading up to it so I was like 'idk is this a migraine?' (headaches can be a stroke symptom so symptom #2) but i got nauseous and eventually got up and to my utmost surprise I immediately fell over as if I was the drunkest of frat bros. The room literally spun before my eyes as I fell to the floor (Balance loss - symptom #3). I have had some Nights and I had never been that unsteady before. I crawled my way to the bathroom, threw up (nausea - not a common stroke symptom) , took 800mg of ibuprofen, and crawled back to bed.

if you know anything about ibuprofen you might know it's a mild blood thinner and that's a high dose. I may have inadvertently helped myself with that one. I was just feeling like shit and thinking 'idk this might help'

At this point I still thought we were still in Normal Land. Sure, it was a weird morning, but Surely There Was A Reason. (Yes There Was) Anyway, as I'm lying there willing my body to stop suffering I realize my arm is going numb (stroke symptom #4) and I switch positions, because weird, but it doesn't go away, and I gave it a good little while. I'm on a medication that can make my limbs tingle but it usually just does it to my fingers and it dissipates quickly but this wasn't dissipating, and then I realized one of my legs was also going numb. Then one side of my face is going numb.

(at the time I did not look in the mirror but I had a drooping eyelid - symptom #5)

Those all seem bad. I grab my computer and google 'when to go to the hospital for dizzyness' as that felt like the worst of my problems. and indeed the list I found highlighted that if you are also experiencing loss of balance, blurred vision, nausea, and limb numbness, you should see a doctor. That seems like far too many symptoms to be having all to be listed. I grab my phone (thankfully plugged in and by my bed), and start layering on more clothing because it's about 10 degrees out and i'm in a pajama dress. The very nice man at 911 talks with me and sends an ambulance, I tell him I don't think I can get out the front door of my building on my own and he asks if I can get to MY apartment door to which I say yes and he assures me that's fine they will have keys to my building.

(I have been since informed they love to chop down doors but no, I could get that far)

I wait by my door laying down on the ground and they arrive pretty quickly. They see to me in the hallway, which is more of a lobby in my building and the only place with room for me to lie down (I cannot stand unassisted at this point) they ask me a bunch of questions, take vitals, and ask me where I would like to be taken. Me, having never had to go to the fucking hospital in an emergency before, simply go 'wherever is close' because I again, I am having a stroke and do not have the wherewithal to think through these things.

A big firefighter helps me down the stairs (it's only a half flight and I still almost did not make it) and we get underway.

At the hospital they wheel me into triage and I mostly lie there gratefully and answer some questions and respond to some tests (grip strength, following a pen with my eyes, that sort of thing) and then I hear what is great when you've been at urgent care for two hours but what is Very Bad when you just arrived in an ambulance and that's 'She's next'. I jumped the line for a CT scan and an MRI. I was there less than ten minutes before I was actively being scanned. honestly closer to five.

"Burial or cremation?"

"Do you want an autopsy?"

"Who is to be informed of this death and invited to the funerary service?"

OR

"Will you be suspending curative efforts or switching to hospice?"

"Will you be placing [patient] into a care home or keeping them with you?"

"Do you consent to homecare services?"

"Do you accept the current diagnosis or do you wish to hear additional opinions?"

OR

"Do you want to try an organ transplant?"

"Do you want to enroll in a clinical trial?"

"Are we permitted to perform blood transfusions on this patient?"

"Are we permitted to provide this patient with psychiatric interventions?"

OR

"Are we putting this money into a trust or dividing it among family members?"

"Are we selling this house or gifting it to an heir?"

"Are we selling the deceased patient's furniture or donating it?"

"Are we burying this body or giving it to science?"

That is for Durable Powers of Attorney, both healthcare and financial.

"What's a living will, then?" is a detailed list of instructions left regarding care during your period of incapacitation, especially when Death is the expected outcome. Where as a DPOA might specify only a few short things: "No ventilator" or "Don't donate my heart, take everything else" or "No pig valves, not even to save me", a living will can be more elaborate, and doesn't necessarily name a singular decision maker. Many states in the US do not treat living wills as legally binding. But, in the absence of more concrete documents, they can be a valuable guide for family members and key members of your care team. We encourage these often in palliative and end of life care, due to those patients being at risk for extended periods of incapacitation.

If you have MS, Huntingtons, Cerebral Palsy, HiV, Schizophrenia, Bipolar Disorder or a history of psychosis, a family history of Alzheimers and/or Parkinsons and/or Vascular Dementia, I urge you to consider a living will. If you do extreme sports or otherwise frequently risk severe head trauma and/or prolonged oxygen deprivation, I strongly urge you to consider a living will. If you have a history of severe substance abuse and/or suicide attempts, I strongly urge you to consider a living will.

"Ha! No WAY man, I ain't signing away my rights to NOBODY. I'm staying in control 'til the moment I die." Unfortunately, no. You will not. If you are unconscious, you cannot make choices. If you become too psychotic to find your way outside and collapse from dehydration because you think your tap water is poison, they will not let you make your own decisions. If you begin suffering from dementia and believe your are seven years old and still in your hometown, they will not let you make your own decisions. If you are effectively brain-dead but breathing on your own, you cannot make your own decisions.

I have had many patients who thought it worked like this, and I have needed to explain to them that their logic is flawed. Your refusal to acknowledge these laws does not exempt you from them, and if you do not choose an advocate/decision-maker ahead of time and then are determined to need one, The System will simply choose for you.

"If I don't pick somebody, who gets to make decisions about my care?" Your next of kin. Who your next of kin is determined be goes like this:

Do you have a LEGALLY MARRIED SPOUSE? If yes, that is your next of kin. Marriage trumps everything else. Keep in mind, if you are living apart from a person you are not "with" but are still LEGALLY married to, that person is still next of kin. Even you no longer speak to them regularly, they can absolutely seize power over your healthcare and your finances. Even if you are currently legally married to your first choice decision maker, fill it out anyway. They are actively working to strip us of our rights, so dig your heels in.

If there is no spouse, they will seek out any adult children you may have, and assign Next of Kin to the eldest one.

If there are no adult children, they will seek out your parents. Yes, even if you are an out and proud trans lesbian, and they are aggressively cruel MAGA cultists who exclusively refer to you through the use of slurs.

If there are no parents, they will seek out your siblings and give decision making over to the either the oldest one. Or, more often at this point, whoever picks up the phone first. Yes, even if you hate your siblings, they have a much firmer claim over you than your friends or your partner in a world without marriage equality.

If there is NO biological family willing to step up and make choices for you, THEN they will turn to friends and unmarried partners, but, the bio family can sue to reclaim their rights at any time.

"Jay, that's not true!! When I was in the hospital and couldn't speak for myself, I didn't have that filled out and they still knew to call my girlfriend instead of my mom. Doctors understand that families are complicated, they wouldn't do this!"