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WIMD Pulse - January 2014

Fears and Reliance
Psalm 34 and Psalm 62
by Dr. Holly Austin

Friday, December 21, 2012 — The day the Mayan calendar said the world was to end. For me, it felt like, in some ways, it had. The day began as an ordinary day, driving the nearly three hours from the home in Springfield, Missouri I share with my spouse of seven years, to Kansas City where I continue to work practicing urgent care pediatric medicine full-time for the Children’s Hospital. I arrived for the noon opening of the urgent care clinic to find we were two providers short that day. In other words, we were at half-staff from a physician standpoint. It was, of course, the height of influenza season AND the Friday before Christmas. Every child in the city seemed to be ill and needed to be well to travel or attend holiday functions.

As the other physician and I struggled to be efficient and effective while providing the highest quality care, we found ourselves falling further and further behind. It was soon clear that patient waits of four hours were going to be the norm for the day. I was still using one crutch from some meniscal knee surgery I had the month before. The clinic was open until 10 p.m. and the shift would end sometime after that when all the patients who came by 10 were seen. At 5 p.m., we were scheduled to get two additional physicians. We soldiered on and the patients and families were mostly tolerant of the wait times.

Shortly after 8 p.m. I went into a patient room of two brothers and their mom, one of whom had a positive strep test. As I explained the test results to the mother, my right ear suddenly went deaf, Then, instead of the tinnitus I expected, I heard a mechanical vibrating noise and within a second felt like I was in a tilt house in an earthquake. I stumbled from the room back to the physician’s charting area holding onto the wall while the patients’ mother screamed for help.

As I reached the charting room and sank into a chair, the earthquake in my ear started to subside, but the earthquake of fear in my soul was just beginning. The two physicians who had joined us at 5 p.m. “just happened” to be med-peds physicians and they took matters in hand, checking my vitals, looking for signs of stroke and calling an ambulance. They kept telling me how pale I looked and I wondered if I would lose consciousness. My blood pressure was 173/110. I had never had hypertension before. I was terrified the vertigo would resume.

As I was moved to a treatment room, I realized my left side worked fine but felt “floaty” when I moved it. Someone borrowed my cell phone to call my husband, who was en route to Kansas City for the weekend and the Christmas holiday. He was about an hour away. I spoke briefly to him and told him I thought I had had a stroke. Why I thought this I don’t know, since I could speak clearly and had equal strength and tone bilaterally. The ambulance arrived and I was whisked off to the stoke center hospital ED at my request, about 30 minutes away.

IVs and fluids were started in the ambulance and my blood pressure gradually came down. The vertigo did not return. The four-hour ED visit consisted of CT head and CTA (angiogram), blood work and ECG. All tests were normal or negative. My neurological exam continued to be normal so the neurologist was not formally consulted. My husband arrived about 10 p.m. By this time, I had developed a significant posterior occipital headache, which was highly unusual for me. I had migraines, but they were always left supraorbital notch in location. I was given a diagnosis of atypical migraine and sent home at 1 a.m.

Over the next 10 days, I had multiple phone conversations with several neurologists and a neuro-otologist. My brain did not seem to be functioning normally, but it was terribly hard to explain what was wrong. I was exhausted all the time. It was hard to get in to see anyone as it was over Christmas and New Year’s. I had an MRI with IAC (interior auditory canals) and an MRI with contrast. The diagnosis was reached finally on January 6—bilateral cerebellar ischemic (and presumed embolic) stroke.

A stroke. I was only 50. I had no known risk factors. Normal BP and cholesterol, exercised regularly, normal blood sugar. I did have mitral valve prolapse, but so does 10 percent of the population and they do not all have strokes at age 50. After another month of tests (and an overnight hospitalization for influenza A, despite my flu shot) I was told I had experienced a cryptogenic stroke (i.e. one with no known cause). How comforting. Nothing to do or change. Just take an aspirin per day, which I had already been on due to the knee surgery.

Satan was having a field day with my fears. My brain was not functioning well, and I was having difficulty accepting the diagnosis and uncertain future. One study from Europe indicated people with young stroke (before age 50) had a mortality rate of 2.5 percent per year. I was petrified of driving alone on the highway between Kansas City and Springfield, but my husband lived three hours away from my job. Independent travel was a necessity in my life. How was I to continue to function?

The only answer was to rely completely and solely on the Lord. I had memorized Psalm 34 earlier in the fall. It was all about fear and how God takes it from us. Verse 4 states, “I sought the Lord, and he answered me; he delivered me from all my fears” (NIV 2011). I needed to put it into practice.

I recited the psalm over and over during my two MRIs, as I was scared of redeveloping the vertigo while strapped down. I recited the psalm every morning, and every time I felt afraid. My fear was constant and debilitating in the first months after the stroke.

Gradually I saw God removing my fears. I started staying alone again when in Kansas City (I had been having friends spend the night when my husband was away). I started driving again, first locally, and then on the highway. God was totally faithful and I could feel His presence fill me as I leaned on Him and chose to trust Him.

All my fears are not gone, but they are diminishing. As I reflected back on the day of the stroke, I can see His amazing protections. I was not in the car alone driving up to work when it happened. I was in the clinic, surrounded by physicians and nurses who cared about me. My husband was already on his way to Kansas City when it happened and was due to be with me for the next 10 days because of the holidays. The missed diagnosis saved me from a hospitalization where nothing could have been done anyway. It would have been too late for TPA by the time an MRI was done. I was better off recovering at home.

I did not ask God why this happened to me. I knew why it had happened. We live in a fallen world and no one is immune to the consequences of living in a fallen world. Bad things happen to everyone, different bad things, but bad things nonetheless. I could let Satan defeat me with my fears, or I could, as a follower of Jesus, tap into the power of the Holy Spirit living in me (not next to me, but IN me) and choose to trust God with my present AND my future.

Psalm 62 talks about finding rest “in God alone.” Verse 8 states: “Trust in him at all times, you people; pour out your hearts to him, for God is our refuge” (NIV 2011). In the words of Beth Moore, relying on God alone is a terribly hard place to get to but a beautiful place to stay. I am convinced God is more concerned about my character than my comfort. I, likewise, need to live a life of self-sacrifice rather than of self-preservation, and to continue to ask God to release me from fears so I may focus on His work for me.

My stroke has made me realize that, in an instant, I may not have the capacity to memorize Scripture. I need to take the opportunity while I am able. My current memory work is Psalm 62. I want to find rest in God alone. Always.