# 109 Rode in on a Hell's Angel Harley: Mary Lu Spigarelli Toren of Big Sur.

Mary Lu had a stroke* on October 18, 2024. 

In this episode she speaks of the moment it happened and a bit about the past five months of slow and steady recovery.

The episode is followed by a conversation from 2015 where Mary Lu tells of how she got to Big Sur "on the saddle of a Hell's Angel Harley" and what happens after that...

>>>>>>>>>

* some deatil about the stroke and treatment:

Mary Lu had a serious stroke on the right side of her brain. The stroke was caused by a blockage in a major artery (the right internal carotid artery) due to a condition called ICAD (intracranial atherosclerotic disease — meaning hardening and narrowing of arteries inside the brain).

At the time of her stroke, shortly after arriving at CHOMP, she was given clot-busting medication (TNK) and also, after flying up to Stanford, underwent a procedure (EVT) where doctors tried to physically remove the blockage. They used a balloon to open up the artery and made three attempts to retrieve the clot, eventually getting partial blood flow back (about 50-70%, known as TICI 2b reperfusion). Unfortunately, there was some bleeding afterward in the area of the brain where she had the stroke, including bleeding into the fluid spaces of the brain (IVH = intraventricular hemorrhage).

An MRI before the procedure showed:

• A major stroke deep in the right side of the brain (basal ganglia area).
• Some smaller strokes in nearby brain areas (insular and temporal lobes).
• A small brain bleed in the right frontal area.
• Ongoing blockage in the main artery supplying the right side of the brain.

Cause of Stroke:
The stroke likely happened because pieces of plaque from the narrowed artery in her neck broke off and traveled into her brain (called "artery-to-artery embolism").

Post-Stroke Symptoms and Recommendations:
Mary Lu is dealing with some ongoing issues, including:

• Sleep problems
• Pain on the left side of her body (the stroke affected the right side of her brain, which controls the left side of the body)
• Some vision issues

Recommendations:

• Drink less water before bedtime to help with sleep.
• Talk to her primary doctor, Danielle Glazer, about adjusting sleep or nerve pain medications (like Lyrica or Trazodone).
• Increase movement as much as possible (to help both pain and sleep), and continue physical and occupational therapy.
• She's been referred to a rehabilitation specialist (PM&R doctor) to help with recovery, and to an eye doctor for her vision problems.