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Suffering stroke has changed the way this JFK nurse will treat patients

BY AVALON ZOPPO
For NJ.com
"This is the worst headache of my life."

Those are the eight words nurse Philip Castillo texted his wife Robin shortly before a searing pain ripped through his body. The 31-year-old was working his last shift in JFK Medical Center's stroke unit one Friday afternoon in November.

Extreme heat and vomiting came next, followed by Castillo passing out on a stretcher.

But amid the chaos, the Union resident had a flashback to nursing school textbooks. His final thought prior to waking up in the Intensive Care Unit: "This is a stroke."

When his wife and parents arrived at the hospital, they were told Castillo, suffering from a rare hemorrhagic stroke spurred by an undetected AVM present since birth, would immediately undergo emergency surgery and likely not survive.

Instead, the Kean University graduate is returning to work next week with deeper empathy for his patients and a story to tell.

For one year, Castillo worked as a telementary nurse at the JFK Johnson Rehabilitation Institute, helping inpatients suffering from brain aneurisms and hemorrhages. But his sudden stroke flipped the script.

Weeks passed with hours of laying in a hospital bed wearing a helmet, an array of tubes and trying to adjust to a life with fewer freedoms.

"I learned so much about being a patient all in one session," he said. "I now understand what they're going through."

After waking up Sunday on a vent, he learned the left side of his body no longer functioned. Suffering from facial droop and slurred speech, he used his right hand to scribble "I love Robin" on a notepad for his wife, along with a question mark for his doctor.

Like so many patients he has treated, Castillo said he found himself desperately wanting to know details of his condition and afraid for his loved ones.

"I just wanted to know more. I can't talk yet, but tell me what happened and why," said Castillo, who has no family history of strokes.

Castillo says he now understands the emotions swirling through his patient's head. Every day came with anxiety leading up to a 16-hour surgery in late January that was "always on his mind."

The surgery, performed by neurosurgeon Dr. Thomas Steineke, successfully removed the three-centimeter AVM from his brain.

And the road to recovery was long.

He spent hours in a mock town, "Independence Square," housed within JFK Johnson Rehabilitation Institute. The room is a replica of local Middlesex County areas used by thousands of inpatients annually looking to regain motor skills following injuries. It's complete with a fake Ford car, bank teller's window and grocery store.

After the stroke, Castillo had to relearn skills that seem embedded within us: tying shoes, climbing stairs and counting numbers. Even his senses were warped. For Castillo, hot coffee felt icy and cool Gatorade felt scalding.

"The first time I went to walk up stairs, it was scary," he said. "I felt anxiety and this fear of falling. But my improvements were daily here."

After his December discharge, Castillo continued outpatient care with Talya Fleming, director of the institute's Stroke Recovery Program. Fleming helps survivors navigate the world again through speech therapy, multitasking activities and emotional counseling-- the side of recovery that Castillo did not witness as an inpatient nurse.

In Castillo's case, she said, the focus was perfecting his coordination, cognition and fine motor skills related to nurse work.

"Often times people think, 'I did therapy for a month after (the stroke) and nobody told me there was more to do,'" Fleming said. "There is more to do if you go to a place that knows what they're doing."

Castillo considers being at JFK Medical Center at the time of his AVM rupture a stroke of luck. His 12-hour nursing shift placed him in a hospital at exactly the right time.

JFK Medical Center, which specializes in strokes, is a a one-stop shop for treatment. More than 35 percent of the highly rated institute's patients are stroke survivors and outpatient and inpatient care is just an elevator ride away.

"If I was not in a stroke hospital, I wouldn't be here," said Castillo, who previously held jobs as a band teacher, an EMT and then a firefighter.

Now, Castillo is familiar with nearly every corner of the hospital and can't walk the hallways without being greeted by at least one physician.

Castillo, who will begin as an Operating Room nurse soon, added: "I'll be scrubbing up with the same doctors who saved my life."