He recognized the signs of his own stroke – and got treated within 30 minutes

Jim Johnson woke up at his usual time of roughly 6 a.m. Something, though, was different.

His right side felt numb.

He shifted onto his back, thinking that changing positions would make a difference. It didn't.

"This could be bad," he said to himself.

He managed to get out of bed but noticed his right leg was dragging.

Definitely bad, he thought.

Johnson, then 67, knew that numbness on one side was a sign of a stroke. He was pretty sure he was having one. He knew he needed help right away – and he sought it.

Within 30 minutes, Johnson was in an emergency room in his hometown of Chattanooga, Tennessee.

After running diagnostic tests, doctors determined Johnson was having a stroke in the form of a cerebral hemorrhage. A weakened blood vessel had ruptured and was causing bleeding within his brain.

Doctors started treating him with a coagulant to stop the bleeding and admitted him to the intensive care unit.

He remained alert and didn't recognize any speech or cognition issues. During the treatment, his right-side symptoms decreased quickly.

Doctors told him that if he had waited even 15 minutes longer to get to the hospital, the stroke and his prognosis would likely have been much worse.

In general, Johnson was healthy and fit. He was a walker, runner and cyclist, and he ran a company focused on European bicycle travel. But during a neurological exam later that day, the doctor learned of several factors that might have contributed to the stroke.

Johnson had sleep apnea, and he'd been seeking relief from herbal supplements; the doctor told him to stop those and to return to using the CPAP (continuous positive airway pressure) device he'd shunned. The doctor explained that sleep apnea causes intermittent low blood oxygen, which in turn can cause spikes in blood pressure that raise the risk of stroke.

Another red flag was that Johnson had two bouts of COVID-19 by the time his stroke occurred in October 2021. He also had indications of long COVID that already had caused brain fog. The doctor said that in some cases, the inflammation often caused by COVID could lead to brittle blood vessels and, in turn, to brain bleeds.

By his fourth day in the hospital, Johnson's physical symptoms had all but disappeared. He was discharged directly from the ICU to home.

Still, he had more healing to do.

The stroke likely worsened his COVID-related brain fog and balance issues from Ménière's disease, which he'd been diagnosed with 18 years earlier. It's a disease of the inner ear that can cause episodes of vertigo, tinnitus and hearing loss.

During physical therapy, Johnson learned that his current balance issues were caused by his eyes not sending simultaneous signals to his brain, an effect of the stroke. Even the slightest difference could cause problems. He continued physical therapy several times a week for 10 months.

During that time, Johnson continued to run his business and work on his local passion projects: advocacy work for cyclists and pedestrians, along with promoting greenways.

Work had become extremely stressful. First, he lost two years' worth of business when travel abruptly stopped during the pandemic. He also had to considerably reduce his staff. Then, when travel started to roar back, he had to deal with rescheduling canceled trips and serving new customers – with fewer employees to help.

His doctor warned him that if he didn't lower his stress level, he'd be at risk of a second stroke.

"And the outcome probably won't be so favorable," the doctor added.

At about the same time, a competitor offered to buy the business and take over the debts caused by the pandemic.

"It was a painful but easy choice," said Johnson, who sold the business in 2022, when he was 68. "Health over wealth. Not the retirement I'd planned on, but one that might offer me a better long-term quality of life."

Indeed, by the end of that year, Johnson took his first overseas trip since the stroke. He visited Germany and Austria. His fears of such a long trip were eased by the fact that he was visiting friends, including a lifelong friend who's a doctor.

When Johnson returned home, he was ready for more physical therapy but wanted something in a less clinical setting. He reached out to Monika Patel, a friend and fellow greenways advocate who is also a physical therapist.

"Jim was ready to work on more of the functional things he loved, like cycling and hiking," she said. "I love doing that kind of work outside if people are open to it, which of course Jim was."

One exercise they did for his visual stamina and balance required Johnson to stand on one leg and move his eyes from tree to tree, including those far away. Patel also had him walk on fallen trunks, hop over branches and even roll down a hill.

"It was very progressive PT in an environment I loved and had great comfort in," Johnson said.

With Patel's help, he also reached an important goal: feeling comfortable bicycling again.

"We went on a road bike ride together and that was a full-circle moment," Patel said. "To see Jim's smile and his confidence in going off into the world, that was something."

Since then, Johnson has indeed gone off into the world.

He's done bike and boat tours in Croatia, Turkey and Greece, and visited family in South Africa. His most recent adventure was traveling for four months this year in Croatia, Turkey, Bulgaria and Georgia. In the Georgia mountains, he went on hikes so rigorous he had to put his hands on a guide's shoulders to stay upright.

"Maybe I'm still at a 15% deficit," he said. "I don't really know. But the more I do, the more I want to do. I'd rather look at what's ahead than what's behind."

Stories From the Heart chronicles the inspiring journeys of heart disease and stroke survivors, caregivers and advocates.