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Finally, some info on Bob's original stroke, Feb 29, 2012


SandyCaregiver

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Well, some of you might remember that when Bob was in the big hospital, getting test after test, not one time, did anyone come to me and say, "we have the results of his latest test, and what we find is..." - Never. I didn't ever know more about what his MRIs & catscans had shown, then the original information that he had a blocked caratid artery and the stroke team was standing by to do emergency brain surgery on him, if I gave permission. His 'doctor' from that hospital, never had anything to say, and it was a teaching hospital, with loads of doctors/interns constantly in and out, I didn't even know if I ever saw his doctor. The only contact I had with him was when I finally was able to send a message thru one girl to his other right hand girl (not) that he had not sent a report to the disability at his company and we were not going to get a paycheck and I couldn't make our mortgage payment. He called and said he was sorry he hadn't done it, and he said about Bob, 'well, at least he didn't have any blood clots'. I'm going, 'what?.... he had clots!?' He answered, 'oh, guess I should have looked at his file before I said something'. Now wait.... he was only in that hospital 5 days... and he was 'his doctor' - but he didn't know this.

 

Later, when he got out of his month of live-in rehab, I asked why he wasn't getting a blood thinner and they said because he had a bleeder. I'm going, "no, he didn't"..... Them, "yes, he did". Now I was upset all this time because he had had a bleeder and 'his doctor' hadn't mentioned it to me. It was only 2 weeks or so ago, that I realized he didn't mention it, not because he was hiding info, but because he thought that's what he came in with! The doctor had not even bother to read his 5 day history of when he came in with clots, had brain surgery there, and THAT gave him the bleeder! So, you can see why I was not bother to go back to see him.

 

At any rate, found a local neurologist finally, and complained about this, and he followed thru with telling me nothing either, just kept saying, 'he had a stroke'. When I asked him about the 'white matter disease' that I saw in his records, he totally invalidated my quesstion by saying anyone could have it, it had nothing to do with the stroke. Now, him being the brain doctor, I was looking to him for info on this white matter disease, but he wasn't interested. Actually, it CAN come from having had a stroke - anything that causes the tiny vessels in the white matter to close off and then info can't go from neuron to neuron thru the white matter, where it needs to travel.

 

So, the day after that we had a reg doc appt, and I complained about the neurologist doing the same thing as the old one - telling me nothing. To which he replied, that the other doctor had already sent his notes to him, did I want a copy? So, finallly! I have info on my husband's test showings from his stroke:

 

==============================================================================================

 

Embolic shower of left MCA territory and some right hemisphere also left PCA with occlusion left ICA and throbus of left MCA.

 

The stroke is possibly cardiogenic. Echo doppler showed mild diffuse hypokinesia, but no throbus was seen.

 

PAFIB is possible vs hypercoabuable state.

 

Since the stroke is cryptogenic embolic I advised to use max and safest antiplatlet therapy, aggrenox.

 

Lab test:

2-29-12 Ct head w/o contrasat Left MCA hyperdense M2

3-1-12 left frontal and temporal embolic shower, right side as well slightly.

MRA brain neck LICA occluded

Echo mild diffuse HK

 

*ok, the only thing I really get here is the embolic shower, any comments on what the rest means are welcome.

 

 

===============================================================================================

 

-I notice he didn't mention the bleeder, and only said, 'oh, there is always a little seepish with clots - so I don't know if he even got to the info about his bleeder, and still have no idea to what extent it was.

 

He also saw a cardiologist, which has him on a 30 day heart monitor. He said, that there was another thing that could have created an embolic shower, besides fibrilation. He could have had a plac rupture in his carotid artery, which would have caused many red blood cells to fly in there to try to cover it, like make a scab - blocking it, and sending either some of the plac or blood clots, or both, to his brain. He didn't really have much plac on a 2 year before ultrasound, but freak things happen.

 

I had known he had had more than one blood clot. I mean, I knew the minute I saw him, because both sides were affected. When I called 911, I told them I thought my husband had a double stroke. I believe the TPA cleared out the lesser one on his dominant side - thank God.

I have read on the internet that embolic showers are usually fatal, so I am so thankful to still have my guy with me!

 

So the neuro guy ordered a new catscan and carotid ultrasounds, and what looks like probably pro-time type blood test. The cardiologist did the heart monitor and ordered lipid panel. We will find out next year, what he is left with, damage wise. I'm not restless about the delay in time before our next appts, because it is not new symptoms, just finding out where his brain is now, technically. Hopefully the neurologist will bother to tell me the results of the test, if not, the family doctor will!

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Sandy,

it seems that the do not know the cause of thes stroke. Best guess is that is has some origin in the heart function.

I does seem that is was a clot. (ischemic) and not a bleeder. Therefore the prescription for the anticoagulant. (aggrenox).

It is hard to believe that you have only just learned this.

The docs were really confused.

It is disturbing that they did not take the time to read and learn about their patients.

 

I am glad that you pursued and found out what was really going on.

From what I understand ...the docs really want to know the reason for the stroke. If it can be corrected surgically or has to be handled by drugs.

 

Wm's was not something that could be corrected by surgery. He is on coumadin because of the clot.

 

In the hospital, wasn't your husband on a blood thinner?

 

Ruth

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I know that most people never find the cause of the stroke, my bafflement with the way all this was handled was that they never told me anything about his damage areas from looking at his test. Like people on here are always saying, "so and so had a stroke in the frontal lobe, or brain stem, etc. No one ever bothered to even tell me that much. I knew he had clots, more than one, because I could see both sides were affected. I knew he had language center because that was obvious. But his other symptoms, I didn't know the areas that were hit to create those problems. Imagine never talking to a doctor about it, not once. A month later I knew he had a bleeder. But it was that no one had ever told me the areas of the brain that were hit.

 

Now I know he had mostly left frontal and temporal embolic shower, right side as well

 

He didn't have A clot, he had a SHOWER of clots. And their treatment of running a wire up thru is groin to his brain, and squirting each clot separately, trying to dissolve them, produced a bleeder. They did give him the belly shots both at the hospital and at rehab or warfarin, but didn't feel like giving him anything to use after he was released! I had to fight to get him blood pressure meds - which is insane.

 

I'm going to be picking up the results to these test, and hopefully scans before our appts, so I won't be stupid when we get to the appts, and can worm answers out of the doctor.

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strokes are so confusing --- i get asked was dans stroke a bleed or a clot --- the real answer both -- he tripped which dissected ( tore on the inside) his carotid artery which then caused a clot, that moved and caused a stroke.. and tpa was not an option due to er doc screw up ( dans might have been resolved with either tpa or surgery to repair the dissection --while it was still just a dissection -- but since er doc read his own film and missed what - others who read it do not- he just sent dan home with the diagnosis of a migrain.. well the clot moved and oops total occlussion and the window to tpa is closed and the surgery to try to fish the clot out was unsuccessful.... no one told me any of this either -- but i got dans records and read them about a month after the stroke -- as it was a work related injury and i was fighting with W/C here in ND-- so i had to understand what happened in order to fight.... ( i won with a formal meeting from W/C and apology - 8 months after the incident) but through it all the nuerologist said dans dissection was trauma related and that turned into the clot that caused the stroke--- i picked up on the ER doc screw up-- and have done a lot of research into it.... so basically the docs are not gonna come out and tell you much -- but luckily we have terrific resources right here to help each other out ---- your a good advocate for your hubby---- nancyl

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Sandy,

 

Good luck thinking that educating yourself will help with doctors. They seem to be cunning in protecting their secrets!

 

Truthfully, it surprises me when I read those things too and read of those who have pictures or scans of their brain. They wouldn't give me mine--You would have thought I asked them for international secrets or something! The only reason they told me as much as they did was they thought I wasn't grasping the seriousness of the situation because I didn't freak out like they expected and wanted to scare some sense into me I guess they would know that had happened when I started wailing.

 

You're a smart and reasonable lady and like any smart and reasonable lady you probably think these doctors are too. Don't give up but don't count on it! Do your best and and keep trying.

 

Jamie

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oh yes i did have a battle obtaining dans records --luckily i did get good advice early on from our family atty who got full gaurdianship of dan for me -- so i had absolute legal right to one copy of his medical record.. but i have found out since --- there were a lot of records not given me.... you have to be very specific in asking for records.... all films, nurses notes, docs notes , pharmacy notes, lab results, radiology findings,and therapy notes and updates and specific about both hand written, computer ..... like jamie says -- international secrets--- seemed like it... but man oh man what a battle just to get his records --- that darn HIPPA law that assures you access - just seems to work against you --- it really is a law meant to help us - it is designed to help with the --sharing of information for doc to doc and insurance --instead it just creates a big mess for all of us... don't even get me started ( basically corporate greed is the root of it now) and that is not what it was designed to do... off my band wagon--- keep it up sandy - the answers are there now ( sorta) - just to understand them, and that is the really tough part....

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It's really hard on many of us that just don't know all the terms and conditions of what really and actually happened from the small hospital or treatment facilities to the big hospitals when they don't tell us the situations!!

 

In my case it was sorta cut and dried, a brain bleed with several hours before getting to the hospital to be seen or saved as it was! Taking the skull of was avoided by the head doctor and now I'm glad that procedure wasn't done!!

 

I know I lost pretty much all of my right brain but I'm so glad I can do what I do, can drive again and still got my wife regardless of how I am!! We got a life together regardless of my condition, that's a good thing!!!!!!

 

They told my wife upfront most of my brain had died but I would be OK, so it's very true time lost is brain lost, every minute counts in getting to a hospital ASAP!!!

 

I'm so glad you now got some answers for references and future plans to get the right things done by knowing what to do in his case!!! Knowledge is great to have when you are asked what happened??

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Sandy: you could be reading Bruce's results to me, other than the embolic shower. Bruce's was plaque. Wow, just set me back a bit. I'll get back to you more later. Debbie

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