A Stroke (Part V) From A Vertebral Artery Dissection In Jiu Jitsu.
Part 5 — By Chris Martin
Just hours after I posted a video on YouTube Called “BJJ after Stroke”, Josh Vera contacted me on the YouTube link and mentioned that he also had a BJJ stroke just weeks ago on January 4th, 2019.
Here is Josh’s Story:
From Josh’s Post in the “Carotid and Vertebral Artery Dissection and Jiu Jitsu Survivors” Facebook support group:
“I am an ER PA for one of the largest ERs in California. I have been working in emergency medicine for the last 9 years. This is my story of my vertebral artery dissection with multiple cerebellar strokes.
I had the flu over this last Christmas/New Years eve break. It took me out for about a week but I still went to work. Unfortunately, in the ER we go to work whether sick or not. The alternative is people may die and the shift can’t go unmanned. That mixed with my Marine Corps mentality from my military service before medicine. After a grueling week of work in the ER with other multiple call offs due to the flu, I started feeling better and I decided to go to jiu jitsu practice. Brazilian Jiu Jitsu is my outside passion. Whenever I have a hard stressful day in the emergency room, I had jiu jitsu to go to relieve stress. I have been training, coaching, and competing in jiu jitsu for the last 14 yrs.
I was rolling (doing jiu jitsu) with my best friend on January 4, 2019 when Chris, my best friend, placed a darce choke. I have had one of my best rolling/sparring sessions in months and no one finishes the darce choke on me, he then changed to a simple gi choke on the bottom. It felt like he was using it to set up a sweep. The choke didn’t even feel close and to be honest, he didn’t have it that tight. I was thinking in my head while defending, “I’m going to pass you guard to side control, my strongest position.” I all of a sudden became super dizzy. Now I realized it was extreme vertigo. Vertigo on steroids. I remember thinking, I can’t tap because I was just not coordinated to tap and I couldn’t even call out “tap”, whether it was ego or just uncapable at the time, I’m not sure.
My buddy finally realized my body movements changed and let go. Fortunately training together for so long we know how each other moves and he knew something was wrong. I tried to sit up then face planted into the mat. Tried again with the same result. Chris then thought I was out on my feet. So, Chris being the pro he is, put me on my back and raised my legs to push more blood flow to the brain. I was thinking in my head I was likely dehydrated and where the choke was placed it was likely impeding even less blood flow to the brain making me even more dizzy. We are both high level competitors and see this all the time. Chris knew something was different this time. I was trying to convince him and everyone else I was just dehydrated from the flu.
I finally was able to partially sit up to get some fluids in me. At this time I was still super nauseated and dizzy. I then started to vomit so Chris called 911. While the paramedics were placing me in the ambulance I was reassuring Chris after a few liters of fluids through the IV I would be fine. I also promised to beat him up the next week. My friend and neighbor Mike, a San Jose Police Officer, was called by his wife because my wife had her watch my kids while she meets us at the hospital. Mike came to the gym then followed the ambulance to a level 2 trauma/stroke center. I remember the paramedics asking if I wanted to go to my hospital which is a level 1 trauma/stroke center but for one thing I did not want preferential treatment and I didn’t want my coworkers seeing me half naked in half of my gi. What was nice when I got to the hospital Mike was the 1st face I seen coming off the ambulance but I had double vision so I could see 2 of him. They brought me in to the hospital and I a familiar ER doctor I knee from working at a different hospital seen me. I told her, “I recognize you…I think this is just a dizzy spell from dehydration” “But I am worried I dissected an artery in my neck because it happened immediately with the choke.” Finally I vocalized it. My wife says, “What’s that?” I said, “You don’t want to know.”
My ER doc buddy then said, “I am worried about that too.” Then she called a stroke alert. After 5 hours in an extremely busy ER and after meclizine, Ativan, and Zofran, I was able to stand up without vomiting. I was still super ataxic though but I was high because I don’t even drink alcohol. I was super tired. The ER physician that was taking care of me was different from the familiar one I knew. He came and said, I think you have vertigo, likely BPPV which is usually brought on by a virus. I then asked, “How was the CT scans?’ “No stroke…no dissection?” He then said, “They are perfectly normal. Just follow up with you primary care provider.” Then they discharged me.
About a day went by and I started having worsening headache and right posterior neck pain. I kept thinking in my head, “This is not peripheral vertigo.” “This is central vertigo and I still think this is coming from my neck” So, like any other ER provider, I started calling colleagues. My colleagues are smart, some of them train Stanford residents. The vast majority of my MD/PA friends said, if CTs of the head and neck were normal just follow up with a neurologist. Finally, my other buddy who is a Internal Medicine doctor talked me into going to my hospital to try to get an MRI/MRA of my head and neck after I told him I’m not comfortable working up central vertigo as an outpatient. I would have been ok with seeing a neurologist and them telling me I was overthinking it. I would have totally went home. One of my buddies, Aaron, came in after he ordered the MRI/MRA and shut the door behind him. I was think in my head, “Oh crap, I do that some in and shut the door move.” He then said, “I’m sorry but you had a cerebellar infarct.” I started to cry, “I had a stroke.”
“I can’t do jiu jitsu anymore.” If anyone of you do jiu jitsu, you know it is a huge lifestyle. My world came crashing down. He then came back and said, “Just like you said with all your symptoms, you have a right vertebral artery dissection.” I knew it. Vindication was what I wanted the least. A few minutes later Aaron came back in again. He said, “You ready for the kicker?.” “I had they radiologist read the CTs from the outside hospital.” “Read the wet read.”
Wet read from radiologist at current/my hospital: “Cerebellar infarcts with right posterior vertebral artery dissection which is better seen on CT scans from outside hospital.”
I couldn’t believe they missed it at the other hospital after I repeatedly said I was concerned for a dissection in an artery in my neck. In hind site, If I wasn’t super drowsy and exhausted at the 1st hospital I would have tried to push for an admission for MRI vs Neurology consult given it happened immediately with the choke. I know a neurologist would have caught it. If the radiologist caught it, they could have gave me TPA. How many strokes did I have after they released me? If I started on blood thinners or aspirin, would I have had so many strokes? Now I am asking myself, Can I ever do jiu jitsu again? Can I go on roller-coasters with my oldest daughter? (That is our thing). So far what I have come to realize is that my vertebral artery dissection with my cerebellar strokes is going to be a long road and I have so many unanswered questions.”
As Josh mentioned in the video, it is important that as coaches and teachers or Jiu Jitsu we make our community aware of the signs of a stroke. If we are going to continue training and attacking each others necks then we must also we aware of the complications that this sport could bring to us. At the end of the day we all love Jiu Jitsu and it is hard to think of life without it, but with the right support and understanding of the way that we train each day we should not have to be without it in our lives.
Follow other stories like Josh’s:
Part 6 of this series — https://medium.com/@bizjitsu/a-jiu-jitsu-choke-that-caused-a-stroke-82f8c8136d
Part 4 of this series — https://medium.com/@bizjitsu/bjj-afte...
Part 3 of this series — https://medium.com/@bizjitsu/another-...
Part 2 of this series — https://medium.com/@bizjitsu/my-brazi...
Part 1 of this series — https://medium.com/@bizjitsu/my-strok...
Josh has created a Facebook (support) Group for survivors like us: https://www.facebook.com/groups/12565...
