When a Scientist Survives a Stroke
At approximately 9:00 PM on Tuesday May 14th, 2019, my 28-year-old marathon-running, scuba diving, Ph.D.-earning wife collapsed in our bedroom after getting up to go to the bathroom. It’s pretty rare for a young, healthy person to experience a stroke. It’s even rarer for that person to be a scientist. With that being the case, Katherine and I decided to turn this extremely unlucky event into an educational opportunity. The human brain is a remarkable biological machine, and a stroke and the recovery process really highlight that fact. In this blog post, we’ll provide a firsthand account of what it’s like to have a stroke and go through the recovery process — all from the perspectives of two inherently curious and inquisitive individuals.
But before we get this party started, Katherine and I want to express our sincerest gratitude to our family, friends, and acquaintances — and even some strangers — for all of the love and support we received. We would also like to thank all the medical and health professionals who literally helped Katherine get back on her feet. In particular, we want to acknowledge the ICU and TCU nurses, each of whom was exceptionally competent and kind (a rare blend!).
The following is an annotated timeline of Katherine’s stroke and the first 17 days of her recovery and rehabilitation. It will feature my personal recollections, some commentary from Katherine, and occasional asides discussing the relevant science.
2019/05/14 09:00 PM
Katherine and I were reading in bed at our summer Airbnb in San José. I remember us holding hands and exchanging loving smiles. Katherine stood up, put her shorts on, and began walking to the bedroom door. I was looking at my phone when I heard her say “whoa”, and then I heard a thud… Katherine had collapsed. When I went to check on her, her eyes were open, but she was catatonic and her right side was completely paralyzed. I told our Airbnb hosts to call 9-1-1 and waited in horror for the EMTs to arrive.
Science aside: How common are strokes in young women?
It was pretty hard for me to pin down exactly how rare strokes are for young women because the age bins are often quite coarse, or don’t go low enough. For example, this document from the American Heart Association shows women aged 20–39, a twenty year window, represent 0.7% of all strokes. Since age is one of the major risk factors for stroke, it seems likely that most of that 0.7% is concentrated towards the older end of that bin, and so doesn’t represent the true proportion of stroke victims who are 28-year-old women. Regardless, 795,000 people suffer a stroke in the U.S. every year, and 0.7% of that number is 5,565. According to the 2010 census, there were around 41,141,300 women in the 20–39 age group. The U.S.’s population has grown ~5.9% since the 2010 census, which gives us approximately 43,606,845 women in that age bin today. 5,565 is 0.013% of 43,606,845, or approximately a 1 in 8,000 chance of a stroke when conditioning on Katherine’s coarse age bin and sex but ignoring other lifestyle factors.
As an academic digression, I’ve made a conscious effort in my life to avoid using “random” when I actually mean “difficult to predict” (see this Wikipedia article on predictability for some additional discussion of the difference). While it might feel random that Katherine had a stroke, it actually wasn’t. There was some causal sequence of events that led to a blood clot trapping itself in the blood vessels of her brain. Describing such an event as “random” feels defeatist to me in that it suggests her stroke couldn’t have been predicted and therefore prevented.
2019/05/14 09:15 PM
The EMTs came to us quickly. They took Katherine’s vitals and asked me a series of questions I do not recall. They eventually moved Katherine to a stretcher and then took her to the ambulance. The EMTs continued working on her, and then they left for the emergency room at around 9:30 PM. During this entire sequence, Katherine was “awake” but unresponsive and her right side was paralyzed. I had no idea what was going on. At this point, I thought she had fainted and damaged her brain in the fall. Medical professionals wondering why this young, healthy woman was experiencing a stroke would be a recurring theme.
MAA: Do you remember anything from right when the stroke happened?
KES: I feel like I remember most of the stroke event and the trip to the ER. Some highlights: I remember feeling lightheaded and like I was going to faint, lying on the bed while Michael said my name over and over, vomiting in the stretcher on the way to the ambulance (unclear if it was morning sickness or due to the stroke), staring out the ambulance window, and feeling like the EMTs were mad at me because I wasn’t responding to them. I don’t remember ever feeling scared, it was more like I felt it was all a big misunderstanding.
Science aside: What is an ischemic stroke?
To understand how an ischemic (ih-skee-mik) stroke works, you have to first understand why the brain needs blood and how it gets that blood. The human brain contains around 86 billion specialized cells known as “neurons”. Neurons communicate with each other via connections called “synapses”. There are on the order of 100 trillion synapses (a trillion is a one followed by 12 zeros!) in the human brain, and this vast neural circuitry gives rise to the most powerful computational apparatus we know of in the universe. Unsurprisingly, this powerful biological computer requires an extraordinary amount of energy to function (specifically, around 20% of the body’s total energy and 60% of the body’s glucose supply!), and that energy is provided by a lot of blood:
Glucose (the brain’s energy source) in the blood is passed to neurons via specialized transporter molecules that line the capillaries of the brain (see this Quora answer for a nice explanation of the mechanism and this figure from Wikipedia summarizing all of the metabolic processes taking place in neurons). The circulatory system is often compared to a road system because there are “major highways” that transport large amounts of blood quickly between main hubs, smaller highways that branch from the major highways and feed into smaller hubs, and then smaller roads (i.e., capillaries) that allow the blood to reach its final location (this website has some nice figures showing the brain’s “road system”). This road analogy also adeptly translates to ischemic strokes (i.e., strokes caused by blood clots). An accident on a major highway is extremely disruptive and prevents a large number of people from reaching their final destinations. Similarly, blood clots in blood vessels that supply blood to many parts of the brain are more debilitating than strokes in the smallest capillaries.
2019/05/14 09:30 PM
Our Airbnb host Sal dropped me off at the emergency room waiting room. The emergency room receptionist seemed to detect the atypical nature of my situation. She took me back to a different waiting room where I could sit by myself — away from the more chaotic emergency room waiting room. I spent the next 30 minutes looking at a picture of Katherine I carry in my wallet and thinking my life was over. My only comfort at this point was knowing that she had known I loved her, and that we had never taken a moment of our relationship for granted.
MAA: Do you remember what happened when you first arrived at the hospital?
KES: My memories of the ER are a little more scattered. I remember them cutting my shirt off and feeling a little bad because it was a brand new tank top (clearly the gravity of the whole situation wasn’t getting through), getting a CT scan with them packing a lot of little Styrofoam bits around my head so I wouldn’t move as much, and sitting in a bright room with people coming in and out. I don’t remember or didn’t register half of the other tests they did like the ultrasound or chest X-ray.
2019/05/14 10:00 PM
I was summoned back to the emergency room and they took me to… an extremely old person. I told them that they had made a mistake and they brought me to Katherine’s spot. A neurologist came in and explained she thought Katherine might have had a stroke, but she was waiting on a CT scan to confirm before administering the tissue plasminogen activator (tPA) since Katherine was eight weeks pregnant. They confirmed the presence of a clot in her brain, and I had to make my first, and I hope last, medical decision on Katherine’s behalf and give the doctors permission to administer the tPA.
At some point over the next hour or so, the neurologist returned and asked Katherine if she could hear her, to which Katherine responded “yes”. I cried, and Katherine’s eyes teared up when I cried. The doctor then asked Katherine her name, to which she responded “Kelly”. The neurologist would return later and ask Katherine her name again, and this time she answered it right. I asked her what my name was and she replied “Mmmmmatherine”, and then shook her head in what looked like amused disappointment.
During this time period, Katherine was doing a couple of strange repeated behaviors like yawning and using her left hand to try to fix her hair. She said the hair fixing was probably related to some deep-seated anxieties she has about her hair.
Science aside: Different strokes for different folks.
When medical professionals talk about stroke, they often emphasize the fact that each stroke is different. The precise location of the stroke, the amount of time it takes to treat the stroke, and the individual’s characteristics (e.g., prior health and age), all interact to determine the severity of the symptoms and the recovery possibilities. Katherine’s stroke affected the left parietal lobe of her brain, which (as described in this excellent article):
helps us make sense of sensory information, like where our bodies and body parts are in space, our sense of touch, and the part of our vision that deals with the location of objects
The fancy word for sensing how your body is positioned in space is “proprioception”, and it’s fascinating. Close your eyes and touch your nose, ear, and chin with your right hand, in that order, and each time extending your arm out fully before moving to the next body part. If your left parietal lobe is healthy (one of many ways the brain is weird is that the left and right hemispheres control opposite sides of the body), you probably didn’t miss and were able to do so quite quickly.
The stroke caused Katherine to lose her sense of proprioception on the right side of her body almost entirely. When she first gained some control of her arm again, her hand would go over the top of her head when she tried to touch her nose with her eyes closed. Here’s a video of Katherine’s proprioception abilities (trying to touch her left ear) 10 days after the stroke:
Similarly, if she held her arms straight out in front of her and then closed her eyes, her right arm would drift to where it was pointing up instead of forward. Katherine’s right hand seemed to have a mind of its own (reminding me of Dr. Strangelove), so we started referring to it as “Matherine”, particularly when “she” would make a mistake.
The left parietal lobe also plays a role in language processing. Specifically:
Aphasia is defined as (from the Wikipedia article):
an inability to comprehend or formulate language because of damage to specific brain regions.
Thankfully, Katherine would nearly fully recover her ability to process language and speak within a couple days; however, she does occasionally experience paraphasia, which is (from the Wikipedia article):
characterized by the production of unintended syllables, words, or phrases during the effort to speak
In Katherine’s case, the mistakes are so innocuous that non-medical professionals who didn’t know her probably wouldn’t notice.
While it’s tempting to think Katherine’s recovery has been so successful because she is such an amazing woman (and, undoubtedly, her prior physical fitness and her determination to get better have made her recovery more successful than the counterfactual!), it’s important to recognize she was also extraordinarily lucky (well, as lucky as stroke victims can get). The fact is, a stroke kills neurons, and those neurons never come back. Had the stroke killed the neurons containing Katherine’s memories of our wedding day, no amount of determination would have ever restored them. Had Katherine suffered the stroke in less fortunate circumstances (e.g., while asleep, or far from a hospital), she would not have received the tPA as quickly as she did, and she could have easily been severely disabled for the rest of her life — or possibly even died — and it would have had nothing to do with her qualities as a person.
2019/05/14 11:30 PM
I googled:
can you recover from a stroke
2019/05/14 11:45 PM
They took Katherine to get a second CT scan, and I was taken to the Intensive Care Unit (ICU) waiting room.
MAA: What do you remember about getting the CT scan?
KES: I was very focused on staying still since they said there was too much movement during my first scan. I was also worried about the radiation’s effect on the baby, because there were multiple signs saying to tell the radiologist if you were pregnant, and my Mayo Clinic pregnancy book said radiation is one of the three major things you should avoid Weeks 5–10.
2019/05/15 12:00 AM
I notified one of Katherine’s best friends, who is a registered nurse, about Katherine’s stroke, and then called Katherine’s mom to give her the bad news. I called my mom next. She asked me if I was OK, and I completely broke down for the first time. It’s funny how your mom can have that effect on you.
2019/05/15 12:30 AM
Katherine and I had our first mini conversation, and she began appearing much more cognizant.
2019/05/15 Midnight to Early Morning
The nurses came in every hour to give Katherine a neurological examination, which involved performing various tasks — like moving body parts — and answering basic questions (e.g., “What year is it?”). We later found out this exam was the NIH Stroke Scale. You can take the exam yourself here. One of many scary moments for me after the stroke was when Katherine initially answered “C” in response to being asked to identify the cactus in the picture shown below:
Katherine’s mobility rapidly improved throughout the night. She moved her right arm and hand first. Later, with a lot of effort, she was able to slightly move her right leg, but the effort seemed to induce a “spastic” state in her foot (KES: this was the reason I cried for myself [as opposed to crying in response to Michael crying] for the first time — the spasticity was really annoying and I was scared thinking it would last the rest of my life). Spasticity is actually a typical part of stroke recovery, along with unintended “muscle synergies”. For example, in Katherine’s case, when first trying to flex her foot at the ankle, Matherine would also flex at the wrist. When Katherine was first relearning to walk a few days later, she would have to be deliberate about placing her right foot down heel to toe, and Matherine would follow suit:
Around 1:00 AM, a technician came in to do a second ultrasound and check the fetal heartbeat. This was the first time we saw the baby, and Katherine held my hand and teared up.
2019/05/15 Day
We were visited by the OB. Katherine began using her phone again in the afternoon.
2019/05/15 Night to 2019/05/16 Early Morning
We spent another night in the ICU, which meant another night of me trying to occasionally sleep in an upright chair. The nurses continued to come in every hour to give Katherine her neuro exam.
2019/05/16 Day
Katherine continued to see small improvements. While she still didn’t have much sensation in her right side at this point, she could now at least lift her right leg. It’s hard to convey how miraculous moments like this felt to me. In her first physical therapy session, she was able to, with the therapist’s help, stand up and move to a chair and walk to the hospital room sink. That evening, we were moved out of the ICU and into the transitive care unit, which meant I was upgraded to a single sofa pull-out bed. Both of our moms arrived that night.
Science aside: How does the brain recover from a stroke?
There are two physiological processes occurring during stroke recovery: (1) the healing of injured neurons and (2) the “rewiring” of neurons.
The first process is straightforward to understand. When neurons quit receiving blood, they become “injured” (i.e., enter a physiological state that is not normal; yet again, Wikipedia does an excellent job of describing this process), and will eventually die if blood flow is not restored. If blood flow is restored, neurons that did not die will begin to “heal” (i.e., return to a normal physiological state). The impression I got from the neurologist is that much of the rapid initial recovery often observed in stroke patients is due to neurons healing.
The second process is much more mysterious. The technical term doctors use to describe neural rewiring is “neuroplasticity”, a word that (at least to me) suggests a specific physiological phenomenon. However, the actual definition of “neuroplasticity” is remarkably trivial:
the ability of the brain to change continuously throughout an individual’s life
Given that definition, it’s perhaps unsurprising so many consumer products work “neuroplasticity” into their marketing (and you’re welcome for all the neuroplasticity I’m currently providing you!). Regardless, the brain is extremely adaptable, and it is literally capable of rewiring itself.
Because something like touching our nose is so second nature to us, it’s hard to imagine what it’s like to learn to do that action, but learning to touch your nose is really not all that different from learning to do any new behavior. Take learning to play an instrument. The first attempts are often extremely clumsy. Your fingers don’t go exactly where you want them to, and you rely heavily on your eyes for feedback on their exact positioning. Practicing strengthens neural pathways that result in the correct motions. As your brain perfects the motions, you can rely on visual cues less and less, and one day you can play an entire song without really consciously thinking about it.
KES: The process of regaining the ability to control my limbs and sense where they were in space didn’t really feel like learning to play an instrument (although I like the analogy!). For me, it felt like I “knew” how to do actions and behaviors, but my brain wasn’t correctly processing the feedback from my nerves in order to carry out those actions. Instead of doing repeated actions to learn a specific skill (as you would do when practicing an instrument), the therapists told me it was important to stimulate the nerves in lots of different ways and through different familiar tasks.
MAA: This sounds like learning a new behavior to me ;).
2019/05/17
We found out we weren’t going to be moved to the acute rehabilitation facility until Monday (because health insurance doesn’t process things on weekends apparently???). A speech therapist gave Katherine a cognitive/speech exam, which she passed. For her first occupational therapy session, Katherine brushed her teeth, put on pants and socks, washed her face, and wiped a counter:
She was also visited by two physical therapists who really enjoyed working with her. They determined Katherine had a full range of motion in all of her joints and some strength on her right side, but that she needed to work on her control and coordination. The therapists said she was an “overachiever” and were actively challenging her during the session. Katherine walked a little bit with their assistance and got a few small steps in with a quad cane.
Science aside: Diagnosing the cause of a stroke (by Katherine).
After verifying my stroke with a CT scan and administering the tPA, the doctors shifted their focus to figuring out why I had the stroke in the first place so that they could prevent future strokes. This process involved tests and evaluations by neurologists, cardiologists, and a hematologist. As I had no lifestyle risk factors that may explain the stroke (e.g., smoking, high blood pressure, obesity, or diabetes), the doctors looked for other explanations, such as blood that is prone to clotting (i.e., “hypercoagulable”), genetic risk factors, or heart defects. As a heads up, 25% (!) of strokes are “cryptogenic” (meaning the cause is unknown), and, as of August 1st, 2019, my stroke is still frustratingly classified as such. However, the investigation is ongoing through my excellent neurologist at UAB, although, based on the evidence so far, I’m not holding my breath for a diagnosis.
One realization we’ve had through this ordeal is that many doctors do a poor job explaining mechanisms and relevant statistics. When it came to providing a probability that I would one day fully recover, my neurologist in San José danced around the question. For two statistics-loving scientists, this was obviously frustrating. As a result, the following information came mostly from my own readings (although my new UAB neurologist has been much better on this front).
Based on this great resource from OU Neurology, there are six general causes (i.e., “etiologies”) of an ischemic stroke:
“Atherosclerosis” (i.e., hardening of the arteries) and small-artery disease both occur only with old age and poor lifestyle choices, so these were ruled out. “Nonatherosclerotic vasculopathies” are other problems with arteries in the brain or leading to the brain, such as those due to trauma, genetic abnormalities, or diseases. My MRI scans of these arteries were normal, and genetic screens for associated diseases were negative. “Hypoperfusion” is when there is very sudden drop in blood pressure (as opposed to a clot in the brain), and so was ruled out upon my admittance to the ER.
This leaves “cardioembolism” (where a clot originates in the heart) and “hypercoagulable states” (HCSs) as the possible causes. A cardioembolism usually occurs when there is abnormal flow in the heart, which leads to blood stagnation. My heart was monitored in the hospital for an abnormal rhythm, and I went through two “echocardiograms” — including one that required sedation and a tube down my throat :( — so that they could look for other heart defects and clotting. While no clotting was observed, they did identify a “very small hole” between the chambers of my heart. These heart holes are known as “patent foramen ovales” (PFOs) and are present in 25% of the population. Because they are so common, it’s difficult to diagnose a PFO as the cause of a stroke (even when other stroke etiologies have been ruled out). The risk of stroke recurrence in patients with cryptogenic strokes and a PFO appears to be higher when another defect called an “atrial septal aneurysm” is present (which I do not have) and/or when the PFO is larger (although this is still under academic debate).
For hypercoagulability to lead to a stroke, there usually needs to be two simultaneous conditions. For example, a HCS plus dehydration, two different HCSs, or an HCS and a PFO. Pregnancy itself is considered a HCS; however, strokes in pregnancy are typically seen near the end of pregnancy or a few weeks postpartum when the body is actively trying to prevent postpartum bleeding. At 8 weeks pregnant, this should not have been a risk. To test for other HCSs, genetic risks factors, and autoimmune diseases, the doctors ran a large number of blood work tests. All of these came back normal except for slightly reduced activity levels of protein S, which is important for controlling blood clotting. However, protein S levels naturally fall during pregnancy and my levels were within normal reported ranges for pregnant women. The doctors asked a lot of questions about my family health history (health tiiiiip: write all of that down before you have a medical event!). My parents are generally quite healthy and their parents all passed away in their 60s or 70s, so this was not very informative. Finally, they performed an ultrasound on my legs to check for clots due to “deep vein thrombosis” (DVT) (all clear there too).
So where does that leave us? My current neurologist is still investigating the likelihood of the PFO being involved in the stroke, and has suggested that there is some hypercoagulability due to pregnancy that existing tests don’t pick up. During the rest of my pregnancy and for a few weeks postpartum, I have been prescribed baby aspirin and the anticoagulant Lovenox, which requires daily self-injected shots into my abdomen. The shots really suck, and they initially caused dark bruises as big as my fist, but they are becoming emotionally easier and I’m getting better at avoiding blood vessels. Unless something else comes up, I likely won’t have to take these medications again unless we have more children.
2019/05/18
Katherine walked with a quad cane with the physical therapist. At this point, further daily logs will be similarly brief since they are mostly documenting Katherine’s physical/occupational therapy progress.
2019/05/19
Katherine walked unassisted. The earlier video showing Katherine’s muscle synergy was filmed on this day.
2019/05/20
Katherine was moved to the acute rehab facility, and I was upgraded again to a folding cot. My mom left.
2019/05/21
Katherine scored a 36 out of 56 on the Berg Balance Scale (click on “INSTRUMENT DETAILS” to download the assessment). That afternoon, Katherine took a seated shower with the occupational therapist’s assistance (this was her first shower in six days, although she did receive a couple of sponge baths). She was evaluated by the new speech and cognition therapist and was again cleared, although the most challenging cognitive task was long division. She later did some Python coding exercises to verify that her cognition had not been affected.
2019/05/22
Katherine’s mom left in the morning. I was approved to assist Katherine to the bathroom as long as she also used a walker. That afternoon, Katherine practiced kneeling and getting up from kneeling while petting retired and currently-in-training guide dogs for the blind. I picked up a CD containing Katherine’s imaging results (which we had to request).
Science aside: Memento mori.
Below are some GIFs I made from Katherine’s raw DICOM data using Pydicom (script here; it’s crazy all the things you can do when you know how to program!).
2019/05/23
Katherine had a rough start to the morning and threw up during breakfast (onto the rest of her breakfast). She experienced morning sickness/vomiting daily throughout the time period of this blog post, but she usually didn’t throw up her breakfast. Katherine’s therapists and doctors recommended she spend 14 days at the acute rehab facility from the day she arrived (2019/05/20). That afternoon, she made smoothies for the other patients during “happy hour”. For physical therapy, Katherine walked down some stairs for the first time:
and did some gardening:
That evening, I picked up rolled ice cream for us from Glazier. I also grabbed some Taco Bell for myself for dinner. Katherine had a bite of my chicken quesadilla, which is how we discovered her first pregnancy craving (this is apparently a thing, and Taco Bell has embraced it).
2019/05/24
In physical therapy, Katherine walked quickly for the first time and did planks to work on activating her right shoulder. That evening, she requested Taco Bell for dinner again.
2019/05/25
For occupational therapy, Katherine practiced some piano and did some sensory activities. The sensory activities involved feeling different objects with her eyes open and then trying to identify them with her eyes closed. In one round, she was asked to distinguish between a sock, a comb, and a pill bottle. Not only could Katherine not tell the difference between the items, she couldn’t even reliably tell the occupational therapist when there was an object in her hand (even when closing her grip). This was the first time I noticed Katherine, who had otherwise been almost incomprehensibly positive, become visibly upset about her condition.
2019/05/26
Katherine had early therapy sessions because she needed to do a follow-up MRI later that morning. She received a bunch of occupational therapy handouts that included exercises for fine motor control and grip strength. The occupational therapist also went over strategies for home, such as stepping into the bathtub with her strong leg first. I rode with Katherine in the ambulance (my first time) when they took her to get the MRI. That evening, she had her third Taco Bell dinner.
Non-science aside: Stroke music.
Katherine and I have a tradition where we substitute the lyrics of songs to suit different contexts. We continued that tradition throughout her stroke recovery. Our most developed hit was “The Left Parietal Lobe”. Here it is (I call Katherine “Sug”, short for “Sugar”):
“The Left Parietal Lobe” — by Katherine and Michael
(sung to the melody of “The Farmer in the Dell”)
The left parietal lobe
The left parietal lobe
Sug had a stroke in her left parietal lobe
She lost her sensation
But not her motivation
Sug had a stroke in her left parietal lobe
Other tracks on the playlist include:
- “Strokin’” by Clarence Carter
- Singing “stroking” to the tune of “Jamming” by Bob Marley.
- “Everyday People” by Sly & The Family Stone (“Different strokes for different folks!”)
- Singing “stimulation” to the tune of “Take it Easy” by The Eagles.
2019/05/27
Katherine was approved to walk in the hall by herself. For occupational therapy, she played with some wall lights while challenging her balance. For physical therapy, she retook the Berg Balance Scale assessment and improved from a 36 to a 52. She also took the Mini-BESTest (Balance Evaluation Systems Test) and scored a 20 out of 28. That afternoon, we found out she was going to be discharged early (May 31st instead of June 3rd).
2019/05/28
During occupational therapy, Katherine made a beaded bracelet. For physical therapy, she walked (with her therapists) to Ace to shop for gardening supplies, and then put mulch on the facility’s garden. Katherine was also cleared to walk around the entire facility by herself. That afternoon, the doctor discussed the results of the follow-up MRI where they discovered additional, residual strokes. I honestly still don’t really know what this means since the doctors didn’t seem worried about it and Katherine was continuing to recover.
2019/05/29
Katherine went grocery shopping with the physical therapists (and me!), and made dinner in the kitchen of the home simulator at the rehab facility. The physical therapist also gave Katherine some yoga poses to try (Katherine was a fairly advanced yoga practitioner prior to the stroke). Later that day, the guide dogs visited again, so I was able to finally meet them (their handler also recommend the movie Pick Of The Litter to us — my mom is a fan). We watched the Stanley Cup Finals that night (we actually watched both the NBA playoffs and the Stanley Cup playoffs throughout this time period).
2019/05/30
The physical therapists had Katherine jog backwards, and gave her some exercises to do at home like planks and step-ups.
2019/05/31
Katherine was discharged from the acute rehab facility. The facility staff referred to being discharged as “graduating” from “Independence University”.
The next day, we went on a three mile hike (with frequent breaks!) in Muir Woods National Monument. Since being discharged, Katherine has continued to slowly but steadily improve. When not rehabbing and sleeping long hours, she’s been busy continuing her job as a postdoctoral researcher and preparing for our next exciting challenge in life… parenthood!
