Different strokes …

I had to take my mom into emergency on Saturday afternoon. Her left hand, as she put it, “wasn’t doing what I wanted it to do”. It wasn’t numb or anything like that, but she couldn’t, for example, push up her glasses or scratch her nose with that hand. The message from her brain didn’t seem to be getting through to her hand.

Well, in my family, we know what THAT means. It means a stroke … except that no other parts of her body were affected, nor was her speech. It was a bit like her experience in March 2012 when just her left leg was weakened. Despite what the emergency doctor and Mom’s own physician told us at the time, a neurologist with whom Mom later consulted told us that he wasn’t entirely sure that what she’d had back then was an actual stroke, as only one of her legs was affected rather than one entire side of her body as is what usually happens with a stroke, and also because there were no permanent physical effects, really. True, her brain showed small signs of damage in one small spot, but who knows what her brain looked like prior to this incident?

Transient-Ischemic-AttackAnyway, this time there was a quick and definite diagnosis: it was a TIA – a transient ischemic attack, a.k.a. a mini-stroke. The good things (if there even CAN be any good things about it) is that physical effects are likely to be quite short-lived, usually lasting less than 24 hours and often only a few minutes, and that there is no permanent damage to the brain. The bad things are that a TIA is considered to be a serious warning that a major stroke could occur within a year, and that you have about a one in three chance of that actually happening.

Mom had a CT scan that confirmed that there was no damage to her brain, and even as she lay in her emergency ward bed, we could see that the coordination was coming back to her hand. She was at the hospital for only three hours or so, and after all the tests, she was told that everything seemed okay and none of her meds needed to be adjusted, so we could take her home. Apparently this is what they do for TIAs. The emergency doctor did mention that her left carotid artery showed a bit of blockage, and I explained that she’d had an ultrasound of that in September, and that we were told that nothing had really changed there since the ultrasound the year before. I then said that some type of scan that involved dye had been suggested by Mom’s physician a while ago, and questioned whether or not that would be a good idea at this time.

Oh yes, the doctor said, that would be an excellent idea to get an even better view of what’s going on with that artery. He would order that up right away, but in the meantime, Mom should go home. The hospital would call her next week some time to arrange for that procedure, he said.

To our great astonishment, the hospital called the very next day, Sunday, and they wanted Mom in that afternoon! Unfortunately, she was at the casino almost all day, gambling away my inheritance with one of her sisters. Mom called the hospital back on Monday morning, which was Remembrance Day, a stat holiday, and was given an appointment at 1 pm that afternoon. How’s THAT for socialized medicine?!

So back we went to the hospital yesterday afternoon. Mom had to drink a whole whack of water, then she was injected with this dye, then she had another CT scan. Took all of maybe 10 minutes, and there was pretty much no discomfort – other than Mom said she had to pee like a racehorse partway through!

Now comes the stupid part.

The procedure at this point is that the patient waits for the results of the scan there at the hospital. I don’t know why, but unlike most medical tests, you do not go home and receive a phone call a few days later to either tell you the scan results or to come in to get them or whatever. No, you are expected to wait.

And why do you wait? Because a radiologist must interpret the scan. And then a specialist must be located to further interpret the scan and decide what else needs to be done about it. And then an emergency room doctor must interpret the scan and also decide what else needs to be done about it. And then that emergency doctor must tell YOU all this.

Note that an emergency doctor is involved here. This, of course, means that if the emergency ward is busy, the emergency doctor will be tending to those people, not so much to the people who are simply hanging around waiting for their test results. And this being a stat holiday when people couldn’t go to their regular doctors or to some walk-in clinics (although some of those are still open on stats), the emergency room was packed. Like, nowhere to sit packed.

imagesSo Mom and I waited for those fricking test results for a very long time – for FOUR HOURS! They moved us to three different waiting areas, so it LOOKED like we were moving along, but our total wait time was FOUR HOURS!

And when the doctor came to tell her the results, she didn’t even take us into one of the little rooms available for privacy. Oh no, she simply stood in front of us for three whole minutes, right there in the third waiting area, with other people around us.

Not that there was anything earth-shattering or super-private or anything like that, but still! What she said was that there’s a two-centimetre piece of Mom’s left carotid artery in which the plaque build-up is starting to erode, and it seems a bit of that plaque was what briefly got stuck in Mom’s brain and caused the non-communication with her hand. The vascular specialist who was consulted wants Mom to add a daily baby aspirin to her medication regime, since that will help further thin her blood in order to minimize those clots getting stuck somewhere in her veins and causing another (bigger) stroke. He also wants to see her in a week to discuss what else could be done, and his receptionist will call Mom this week to arrange that.

Honestly, it was just three minutes in the middle of a waiting area. Not exactly a great return on a four-hour wait, in my opinion.

But we did get some answers and information, and we know what our next step is.

And my mom is still pretty healthy.

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6 responses to “Different strokes …

  1. Scary stuff. Glad your mum is (mostly) okay.

  2. Scary shit, that. As you know I have been there and done that re a TIA and the fear of a repeat performance always hangs over you despite taking all the precautionary measures. And my process was virtually the same as your mom’s except I was put on blood thinners rather than aspirin. Her symptoms also sounded identical to mine and the cause was, too. Best wishes to her.

    • Thanks, Ian. (I did think of you as I wrote the post, I must admit!) Mom is already on blood thinners due to her previous episode, but as the doctor said, “Obviously that didn’t prevent this TIA”, so they wanted to add the aspirin, which contains ASA, an agent in preventing blood clots. We’ll see what the specialist says about it all next week – Mom is expecting that he’ll want to do a carotid angioplasty, and tough old bird that she is, she is all for it!

  3. Well, I guess the 4 hour wait is the other side of socialized medicine. Glad your mom’s ok.