My weekend adventure in modern medicine
I posted about this on another forum on Wednesday. It makes an interesting read.
It's been a rough Friday through today. I had a small stroke. Here're the details (if I can get through it all).
Thursday afternoon (a week ago) was a busy time at work. About 4 PM after I'd managed to get through almost everything when my right hand started tingling like it was asleep. It was merely annoying at first, but it wasn't going away. I got up, but didn't get very far when I realized I should go back to my desk. I was very woozy. I called my wife and she said she was on her way to get me and to call the doctor. I called the doctor and spoke with a nurse who said, "Get to the emergency room." Apparently a clinic wasn't good enough (I eventually found out why). A coworker walked me to the ground floor just as my wife was arriving.
The next question was which hospital? With all the construction the question was as much a matter of which is easiest to get to as it was which is the best hospital. I ended up in the ER at Iowa Methodist.
After checking in I saw the traige nurse within 5 - 10 minutes and after talking with her for 5 minutes and taking some vital signs (pulse 46, BP 143 over 88) they sent me straight through (that's never happened to me before). After speaking with a doctor initially it turned into a hurry up and wait situation. Eventually during the course of the next 3 hours I had a CT scan, a box lunch, and a lot of alone time with Shelly watching the Red Sox lose to Cleveland.
Eventually a new doctor came in who suggested I could go home since tingling in the hand can be caused by many things. Shelly asked what about the numbness in the face and foot? The doctor had an astonished look and said, "Why didn't you tell anyone about that, that changes everything!" We responded that we did tell everyone about that. To which he responded, "Well it's not noted in the chart!" I was then given the option of going home or staying at the hospital for observation. I deferred to Shelly (my head hurt) who decided that I would stay. To this point the doctors were thinking I was suffering from a TIA (Transient Ischemic Attack). More detailed tests the next day would show conclusively what happened (though not why).
They found me a bed (thank God in a private room) and asked if I wanted anything to help me sleep, foolishly I declined. I was awakened several times during the night for them to take vital signs (blood pressure, temperature and pulse). Needless to say I didn't sleep well and the next day had some truly unique experiences which were made more vivid by the fatigue.
To cut to the chase for those lacking the stamina to read all of this, I had a stroke which killed a small part of my brain (an area perhaps the size of my pinky fingernail). Fortunately, it was in a noncritical sensory area and I'm told nearby parts of the brain will remap to do the work of the affected area. So I should enoy a full recovery, but that wil probably take a few months. Now back to the story.
It was maybe 6:30 AM when my day got underway when the nurse came in again for vital signs. About 7:30 three lovely young ladies accompanied by an older nurse invaded my room. The pleasure of the experience was short lived when it was revealed that they were training new staff and one of them would have the task of giving me an IV. After two tries and about 5 minutes of poking a needle into me and digging through my flesh trying to get through a vein wall the grizzled veteran nurse took over and had it
installed in under 30 seconds.
My next task was breakfast and then calling work to tell them where I was and why I wouldn't be at work that day. About 9:30 they came to take me to my first "procedure," an MRI. This is the one where you lie completely still in the little tunnel in a large loud machine. The ear plugs took the edge off the sound, but there was no meditating through this experience. The first scan was 12 minutes, there were perhaps five more shorter ones. All in all I was in there for about an hour. The relief I felt upon leaving that room was extraordinary. Little did I know that later I would have the joy of experiencing a Trans Esophageal EchoCardiogram (TEE). Go ahead and Google it, that's what my wife did and she wouldn't tell me what was involved.
The middle of the day was spent resting. I was alone because Shelly had a full work day and there wasn't much she could do. In retrospect I wish she had been around but me being brave told her to do what she needed. She arrived just in time for my TEE. They performed a TEE because they were looking for the source of a clot that could have caused my stroke. This could be a hole in the heart between chambers (allowing a clot from the legs to pass through the hole and not be filtered by the lungs) or calcification of the aortic valves.
I had been briefed ahead of time, but the nurse told me what was involved in a TEE. It's an internal sonogram of the heart using a probe in the esophagus. This involves them passing a probe through my mouth into the esophagus. To reduce the gag reflex they would numb the back of my throat and give me drugs to make me sleepy (Demerol) and not remember the experience (Versed). I was told I would have to swallow this large probe and attached wire and there would be a bite guard in my mouth to prevent me from biting the wire and I would have to breathe through my nose. A couple of items to note, the spray to numb the back of the throat is some of the nastiest stuff you'll ever taste. Also at this point I have no memory of the procedure itself. My memory goes from dimming the lights and feeling the moderate effect of the drugs to coming to perhaps a half hour later.
It was all better after that. My pastor visited during the early evening. I got a briefing from the doctor on what happened (yes you had a small stroke). The doctor wanted me to stay one more night so I could see a stroke specialist, the doctor on call the next day (Saturday) and I gratefully accepted a sleeping aid (Ambien is wonderful stuff).
When I met with the doctor on Saturday (the stroke specialist) he asked me if I wanted to see my stroke. "Heck yeah" was my response. So we walked down the hall to a station for viewing radiology stuff and he pulled up the pictures from my MRI. He started at the top of the head and went through the "slices." As we worked our way through my brain from top to bottom what struck me was that it was all either black or dark grey. The
bone was black and the brain itself was dark grey. Then we get to the bottom of my brain and there next to the brain stem was a white spot, perhaps the size of the fingernail on my pinky, that was the area affected by the stroke. Then he showed me to scan of the blood vessels on my brain and neck and commented on how smooth and healthy everything looked. So my problem was that a tiny blood vessel closed up for an unknown reason. Isn't it funny how real life doesn't usually have an explanation, things usually happen because of our intentions, but sometimes life surprises us. I usually love good surprises, I'm looking for the silver lining in this experience and I'm finding some things, but I suspect it'll take some time and perspective to get a greater understanding of it.
It was a scary event. I'll recover completely in time. For now, I tire easily and I'm not supposed to do any significant physical exertion for a few weeks. I'm scheduled to see the doctor in a month and I have to take an Asprin a day for the rest of my life. For me the biggest challenge is taking it easy, I'm just not wired to do that, but I guess I will be for a while.
If you've read this far thank you for your attention.