Random, Random 2.0

[Fastbackss]

[dmforever]

Definitely Kevin. The callers purpose was to shame and embarrass the newscaster for being non-White. It's too bad that that was the intent.

It's hard to even know what to do with that, isn't it? It sometimes feels like we have progressed so very little, if at all.

Kevin

[ponchi101]

Ok. My 2022 started just like my 2021 ended.
On Tuesday I woke up and I felt something odd in my right eye. My eyelid was drooping, and it felt extremely wet. I took a picture and sent it to my brother-in-law (eye surgeon and ophthalmologist) and he did say that it looked as if there was nothing wrong with the eye, but the lid was certainly not looking fine. One call led to some at home testing of my face, and we reached the conclusion that there was something wrong and asymmetric with my face. As both him and I know that that is early symptom of a stroke, I went to the clinic. Walking (about ten blocks). 12:30 PM
There, I went through some tests, and the ER resident started saying it was Horner's Syndrome. By now, my BIL and my sis (also a doctor) were telling me that, if I was not feeling anything else ANYWHERE in my right side of my body, it was probably a mild face paralysis, virus related (non-covid).
The Dr. decided that a MRI was needed. However, that would take a long time waiting, so we agreed (I was getting tired of this) to settle for a CAT and see the results. Which came back saying that indeed there was something VERY wrong and the MRI was needed, urgently. That moved me up the list of triage. 5:00 PM
By now, all my family was worried sick, because the Dr said she could see something abnormal in the CAT. A bit later, around 8:00 PM, I am wheeled to the MRI. By now my GF has come to be with me in the clinic, which I allowed because the news kept getting worse (the clinic is so full of C19 that the ER we were in was the pediatric ER, because the regular one is to the max with C19 patients). I got the MRI and had to wait about 2 hours for results. By then, about 10:30PM, I ask if I can go home. The Dr tells me that no, because I HAVE HAD A STROKE. A mini stroke, but a stroke. But to me, the words MINI STROKE are the same (expletive) as MILD HEART ATTACK; there is no such thing. A stroke is a stroke. But I ask her, how can I have a stroke and I have lost NO FACULTIES? I am talking, I am walking with no strange gait, I have lost no cognitive functions (I am reading a book on math, so I gather THAT section of the brain is not soaked in blood). How is that possible? But she is adamant and tells me I have to stay overnight because she does not want to release me with my condition. I have been given I don't know how many packs of dexamethasone and an IV drip, and what I am is fuming. Not at the Dr, but at the universe. Me, a stroke? Give me a (expletive) break. I don't get strokes, I don't get sick. I am going into "I am angry at the universe", which makes me more angry because, as it is well known, I do not believe in any of that. When somebody asks "Why Me?" when something bad happens, I think "Why not you? The universe does not care about you because the universe is not sentient". And now I am pulling the same (expletive)? C'mon.
So we both spend the night in an uncomfortable ER cubicle, unable to sleep, and at 7:30AM I ask if the neurologists have seen my case. Response: "No, they have not come down, they are checking the patients". Which I guess I gather makes me not a patient, and not worthy of triage level 2, a weird concept in view that I HAD A STROKE. Not only that, these doctors should be coming down and talking to me because a MRI says I had a stroke yet I am totally conversant. And angry.
Time passes and then another doctor (shift change, since I had been there now for 20 hours) comes to me and explains. He was checking the MRI and will call the neurologist and ask for my release because THE MRI IS PERFECT. I interrupt him and as him in ways more polite that my mental "WTF are you talking about?" to clarify. Did I or didn't I have a stroke? No, the MRI came perfectly clean, perfect image of my noggin, so I can be discharged. By now I know my mom has not slept one hour, neither has my sister and my GF and I are bent. They even had upgraded me to "possibility of falling" in my little board on the wall, which if I had had a marker, I would have corrected with "due to sleep depravation". The real diagnosis is indeed a mild face paralysis, virus related, and easily corrected with regular meds: acetaminophen, acyclovir, something else.
The Dr. signs my release, we walk back home. I have gone, in less than 24 hours, from mild discomfort, to suffering a bit of a strange syndrome, to having had a stroke, to nothing at all happening to me other than some condition easily treatable.
Days 4 and 5 of 2022. I wonder what the other 360 have in store.

[dryrunguy]

No words, ponchi. Except to say... I'm glad you're basically okay. And I'm really sorry it was such a horrendous experience.

[Jeff from TX]

Thankful that it was not a stroke and glad that you will be okay based on the prognosis. I'll look forward to your thoughtful reflections after you have had some more time to process the events.

[JazzNU]

Hope you're feeling better @ponchi. Good that it seems like something that will go away quickly.


I'm not trying to further freak you out, but...

Symptoms with a mini stroke do include eye drooping and temporary facial paralysis (also other things like speech impairment). Mini strokes can last for a very short amount of time, making them hard to identify at times, some people ignore the symptoms that they get. And symptoms typically disappear in under 24 hours. So yes, there is such a thing as a mini stroke, and they are appreciably better than a regular or major stroke by leaps and bounds.

Mini strokes are also called TIAs (transient ischemic attacks). It is possible to show a clean MRI if the mini-stroke has passed. Do you know if they ran the MRI with contrast?

I'd say, read up on them and follow up with your regular doctor soon to potentially make an appointment with a neurologist to make certain you didn't have a mini stroke and imaging just couldn't catch it the second time. Mini strokes can be an important warning signal for a future stroke, it can and has helped with identifying something that can be treated that will prevent the major stroke from occurring.


** My mom worked in rehabilitation medicine for most of her career and with stroke patients for many years. I paid attention. And I also volunteered on the stroke service.

[ponchi101]

Thanks to all. It was a very hard 24 hours, specially for my family because they are so far away and, being Venezuela, there was no option anybody could come if the situation demanded it.
@JazzNu. Sure, there are mini strokes, and I have read about them. I perhaps didn't phrase it well, but the point is that it is something that can not be taken lightly. They did run a MRI with contrast and that is the one that they read. My question is that, despite the lid drooping (there was no face distortion) there were very few symptoms. For example: I have the gene that allows people to roll their tongues (like, make a little pipe with it). I lost that ability yesterday, and now, as I am recovering it, it is a bit twisted to that side. But coming back.
Good part of the story: relying solely on my Colombian Social Security ($35/month), a CAT Scan, a MRI, two drips and a full night at the ER cost me... $0. 11 years living here, and this country still surprises me.

[ti-amie]

Thank goodness you're okay!

[Deuce]

If it continues, or recurs, take a look at this... A friend of mine had it and had no clue at all what was happening to him - it's a rather strange and mysterious thing...

Bell's Palsy...

.

[ponchi101]

I did not want to go technical, but that is what has been diagnosed. Bell's Palsy or Syndrome. Treatable, in about two weeks. My GF says I look loser to normal already. Heck, I can still frown and brood and sulk, so I must be going back in track

[JazzNU]

@JazzNu. Sure, there are mini strokes, and I have read about them. I perhaps didn't phrase it well, but the point is that it is something that can not be taken lightly. They did run a MRI with contrast and that is the one that they read. My question is that, despite the lid drooping (there was no face distortion) there were very few symptoms. For example: I have the gene that allows people to roll their tongues (like, make a little pipe with it). I lost that ability yesterday, and now, as I am recovering it, it is a bit twisted to that side. But coming back.

I'm not sure, but I'll ask my mom, I'll talk to her in the next hour. Pretty certain that very few symptoms is not at all uncommon. But I'll report back soon.

[dryrunguy]

Hope you're feeling better @ponchi. Good that it seems like something that will go away quickly.


I'm not trying to further freak you out, but...

Symptoms with a mini stroke do include eye drooping and temporary facial paralysis (also other things like speech impairment). Mini strokes can last for a very short amount of time, making them hard to identify at times, some people ignore the symptoms that they get. And symptoms typically disappear in under 24 hours. So yes, there is such a thing as a mini stroke, and they are appreciably better than a regular or major stroke by leaps and bounds.

Mini strokes are also called TIAs (transient ischemic attacks). It is possible to show a clean MRI if the mini-stroke has passed. Do you know if they ran the MRI with contrast?

I'd say, read up on them and follow up with your regular doctor soon to potentially make an appointment with a neurologist to make certain you didn't have a mini stroke and imaging just couldn't catch it the second time. Mini strokes can be an important warning signal for a future stroke, it can and has helped with identifying something that can be treated that will prevent the major stroke from occurring.


** My mom worked in rehabilitation medicine for most of her career and with stroke patients for many years. I paid attention. And I also volunteered on the stroke service.

Dolphins had a TIA a few years ago. I probably told the story here already, but in case I did not...

I was working at my desk, which is in my living room. He was sitting on the sofa. He wasn't feeling well. Dolphins looked at me and mumbled something. I did not understand him. I ask him to repeat it. Twice. He couldn't speak properly.

So I got up and looked at him face to face. He said it again: "Can you make me some cereal?" But I could clearly see the droop on the left side of his mouth.

Yes, TIAs are a thing and should be taken seriously. They are a far cry from the kind of stroke that kills you immediately or severely debilitates a person, but they are also a symptom of something much worse that could occur further down the road and require ongoing treatment.

[JazzNU]

@JazzNu. Sure, there are mini strokes, and I have read about them. I perhaps didn't phrase it well, but the point is that it is something that can not be taken lightly. They did run a MRI with contrast and that is the one that they read. My question is that, despite the lid drooping (there was no face distortion) there were very few symptoms. For example: I have the gene that allows people to roll their tongues (like, make a little pipe with it). I lost that ability yesterday, and now, as I am recovering it, it is a bit twisted to that side. But coming back.

Okay, mom said few symptoms can be common for a mini stroke. There can be more, there can be less, can last for a few minutes, can last for longer like many hours, it all varies for the person. Some symptoms so minor that they can be missed, or from the way she described it, more overlooked or dismissed, and why some people do not get medical attention for it when it occurs. She thinks your healing timeline, already showing improvement seems like it could be a TIA. But that really, you should consider seeing a neurologist either way. Bell's Palsy is also a neurological condition, she said it affects the cranial nerve, so they'd be able to evaluate which one it is and any further steps.


FWIW, I have had family members and family friends that have had mini strokes and they have not had major strokes afterward. It is by no means a certainty that a mini stroke means a major stroke will occur down the line. But addressing it like they all did, being cautious is the best course of action just in case.

[JazzNU]

Dolphins had a TIA a few years ago. I probably told the story here already, but in case I did not...

I was working at my desk, which is in my living room. He was sitting on the sofa. He wasn't feeling well. Dolphins looked at me and mumbled something. I did not understand him. I ask him to repeat it. Twice. He couldn't speak properly.

So I got up and looked at him face to face. He said it again: "Can you make me some cereal?" But I could clearly see the droop on the left side of his mouth.

Yes, TIAs are a thing and should be taken seriously. They are a far cry from the kind of stroke that kills you immediately or severely debilitates a person, but they are also a symptom of something much worse that could occur further down the road and require ongoing treatment.

Yes, I remember. And the way that he presented is quite common. That's what I meant by speech impairment as well. They'll be talking but it'll be like gibberish, but the person speaking won't know it's coming out that way.


For those that are not that familiar with strokes, hopefully this discussion was at least a little bit helpful in learning more about them. Strokes are common, and the leading causes of disability in the US (which is why I said mini strokes are appreciably better, major strokes are a beast to come back from), but the average person knows very little about strokes and what to look for. They know about heart attacks.

[dryrunguy]

Dolphins had a TIA a few years ago. I probably told the story here already, but in case I did not...

I was working at my desk, which is in my living room. He was sitting on the sofa. He wasn't feeling well. Dolphins looked at me and mumbled something. I did not understand him. I ask him to repeat it. Twice. He couldn't speak properly.

So I got up and looked at him face to face. He said it again: "Can you make me some cereal?" But I could clearly see the droop on the left side of his mouth.

Yes, TIAs are a thing and should be taken seriously. They are a far cry from the kind of stroke that kills you immediately or severely debilitates a person, but they are also a symptom of something much worse that could occur further down the road and require ongoing treatment.

Yes, I remember. And the way that he presented is quite common. That's what I meant by speech impairment as well. They'll be talking but it'll be like gibberish, but the person speaking won't know it's coming out that way.


For those that are not that familiar with strokes, hopefully this discussion was at least a little bit helpful in learning more about them. Strokes are common, and the leading causes of disability in the US (which is why I said mini strokes are appreciably better, major strokes are a beast to come back from), but the average person knows very little about strokes and what to look for. They knew about heart attacks.

Given ponchi's story, I should mention that, obviously, I called 911 and had an ambulance take Dolphins to the hospital. They did all the tests, including an MRI. Nothing showed up. But I think that's how most TIAs go. They are very short term, disappear, and tend to leave no lasting evidence of any kind.

And you're absolutely right. Many people have a mild stroke, don't even know it, or loved ones don't even know what to look for or how to recognize it. THAT is when people can run into serious problems later on.

FULL DISCLOSURE: I should point out that, in Dolphins' case, the insurance company wasn't completely convinced he had a TIA. They balked about covering it.

So I sent them a slew of links to HHS agency educational videos (with those from the National Institute of Neurological Diseases and Stroke at the top) describing best practices for how to handle a potential stroke, all of which included high-ranking NIH officials urging consumers to seek treatment at an emergency room ASAP and how a TIA may not show up on an MRI hours after it happens.

Within a week, they paid.