kelliem: flower in the desert (hope)
( Jul. 30th, 2010 01:38 pm)
I've been worried that it is too early to say something about this- that I might jinx things, but I decided to post anyway, as a PSA if for no other reason.

On Monday afternoon I was on the phone with my 84-year-old mother when in mid-sentence, she stopped making sense-- groping for words, using words that did not make sense in context, and saying 'uh' a lot. The weather has been very hot, and thinking it might just be dehydration, I asked if she was staying hydrated, and she exasperatedly snapped "Yes!" so I knew it was more serious than that. I told her I thought she was probably having a stroke, and that I was going to call my brother and SIL and have them come get her and take her to a doctor right away. They live about 5 minutes away from her. She'd had a couple of TIA's in the past, but they never caused any perceptible symptoms other than brief dizziness. They took her to the emergency room where she was evaluated and they confirmed my suspicions- she had had a full-blown stroke (not a TIA), and her speech/language processing area was affected. When I got to the hospital, though she clearly recognized us, she was unable to identify any of the family by name, and kept inserting 'schedule' and (oddly) 'Obama' when she tried to convey complex meanings.

After a couple of hours with no improvement, the doctors told us that there was a chance that she could be helped if they gave her a tissue plasminogen activator (tPA) which must be administered within 6 hours of the initial event, but that there were serious risks of side effects involved, especially in the elderly, though her general good health made her a better candidate than some. After discussing the situation, we decided she would be upset with us if we did not make every effort possible, and okayed the drug. They administered it in an IV drip over several hours during the night, keeping her in the ICU so they could closely monitor her reaction to the drug.

By the next morning, she was using full sentences and was able to identify everyone by name again. By mid-day she was remembering phone numbers of friends she needed to call, and facts about her youth (prompted by the bizarre coincidence of discovering that her ICU nurse was from the same tiny postage-stamp of a town in another state that my mother was born in!) so we knew she had both good short-term and long-term memory. By the next evening, she was shaky, but had all her vocabulary back and was allowed to eat after an evaluation by a couple of speech and occupational therapists. Yesterday afternoon, they released her to go home!

On Monday, we were sure she would be in the hospital and/or rehabilitation for months. The fact that she got to go home yesterday seems rather like a miracle. The confluence of events were so fortuitous it's almost hard to believe. If I had called her just ten minutes earlier, we'd have been done talking before the event occurred, and we would most likely not have known about it for quite some time, which might have ruled out the use of the tPA. That, coupled with the the fact that she was a good candidate for the tPA therapy to begin with despite her age- it's all pretty damned amazing.

This all comes on the heels of someone I work with being diagnosed with permanent short-term memory loss (think Memento) due to several small strokes caused by uncontrolled high blood-pressure. He's younger than I am and may never be able to hold more than a menial job again, despite having a doctorate and years of teaching experience.

I guess what I want to say to you all is this: make sure you take care of yourselves (and your loved ones) and have your blood-pressure checked regularly, know the symptoms of stroke, and get to the hospital ASAP if you ever experience them. Don't blow it off thinking it's no big deal.
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