Tuesday, June 07, 2011

See, here's the thing:

If you're working on some massive project or presentation for work and you suddenly get a dull headache and lose half your visual field, it's not normal. The dull headache might be, but the loss of half of your eyesight isn't.

If you wake up in the middle of the night totally blind and without the use of one side of your body, that's not quite right either.

And when you're sitting at breakfast and can't talk, well, that's out of the ordinary. Especially if you've already had a cup of coffee, and doubly-especially if one side of your face quits working, causing you to drool.

All of these situations would warrant, at the very least, a call to your doctor. I mean, it's conceivable that you might, in the first scenario, be having some sort of atypical migraine...but wouldn't it be better to know? If something is going wrong with your sight or coordination or speech, wouldn't that freak you out just a little bit?

I would think it would. Yet all of the people who experienced those symptoms above either went back to bed to sleep them off or kept on chugging along with their respective days. By the time they got to me, all three of them had had massive embolic strokes. They'd delayed long enough that there was nothing we could do except start 'em on aspirin and do rehab. One dude kept cutting hay until his entire back forty was done, then dragged his no-longer-working left side up to the barn and called his wife.

This puzzles me. I know that getting the hay in is important, especially with rain in the forecast. But isn't...I dunno, the fact that you can't feel one side of your body a little more important? Don't you think that being able to lift your arm should have priority here?

If you have a seizure, you go to the hospital or somebody calls 911. Same deal with losing the function in your legs, or losing control of your bladder: you'll go to the doctor if you think you've got MS. What is it about strokes that makes people not start worrying? Don't tell me that it's a function of the stroke itself, because it happens no matter where the stroke is.

It makes me wish that strokes came with some sort of awful green discharge or a rash, or something. Maybe if people could see that something's wrong, they'd be a bit more panicky.

>shakes head<


messymimi said...

Shaking mine, too. When i have symptoms i don't like -- not a stroke, but the times i've had bad SVT that wouldn't stop or when i had pneumonia with pleurisy and the first symptom was pain when breathing -- i've gotten to the ER. Better safe than sorry.

Albinoblackbear said...

Have you read "My Stroke of Insight" by Taylor?

She was a Ph.D neuroscientist for crying out loud and when she had her stroke she got on her elliptical and then had a shower thinking that her symptoms would go away.

Denial is a very powerful thing. :)

The Keyes Family said...

It is so weird how the random unsightly skin issues will bring tons of people in but your so right that people often ignore the bigger problems. I can't imagine that they wouldn't know it was a sign of stroke.. I mean it seems like everyone should know what a stroke looks like by now?? Apparently not..

Silliyak said...

Apparently strokes are often accompanied by episodes of the Cleopatra syndrome, living in the middle of de nile.

RehabRN said...

Ah, yes. Sounds like more than a few patients of mine.

One of my recent favorites, "Yes, I had a horrific pain in my back but thought nothing of it until I went to bed and couldn't get up."

Now he's not walking anymore from that fracture that injured his spinal cord.

bobbie said...

Or the folk who put up with their "indigestion" for a couple of days before they come in with their massive MIs...

Mark said...

I've gotta ask though, like in the case of the farmer, what actually could have been done? I mean once you loose the sensation isn't the already irreversible damage done and anything beyond that is palliative?

Jo said...

Mark: If you get to a hospital within three hours of the onset of symptoms, we can do a LOT. TPA (it's a clot-buster) can break up and dissolve the clot in your brain, or you could have an angiographic procedure that involves retrieving the clot.

I've seen people come back from having one whole side of their body go away, plus their speech, plus their ability to look to one side or the other, just because they got interventions in time.

Anonymous said...

It's 4 now, the changed the guidelines.....again.

If you come in before 8 hours we might be able to pick the clot out like a booger.

Mark said...

Jo: I didn't realize those treatments were possible, actual removal of the clot I mean. I always thought it was a deal of "well if you're lucky and this hospital does it you can get TPA which might help some if it doesn't kill you." Thank you for enlightening me.

What if though you're in an area where those interventions aren't possible in a timely manner, again the farmer in a distant field, aren't you kind of doomed then even if you stop bailing hay right then and head for help? Or are these interventions available most everywhere? Here, for instance. http://www.pvgh.net/

Jo said...

Mark: Those interventions are available almost anywhere, and if they're not, there's a 'copter that can take you to where they are.

I used to wave at Paul's Valley on my way to college every fall, by the way.

shonyB said...

Telling on myself.

An LVN, I called in to work sick. Supervisor called back and said "You're slurring your speech, go to the hospital. I went to sleep.

She called back. Hubby answered phone. "Why is she still there? get her to hospital." Hubby listened and acted. I was pissed.

Very grateful afterwards. Worked out well for me. I was lucky.

At Mark, I used to go to visit friends in Paul's Valley while attending college.

Kim said...

When my dad has his stroke, he had no concept that he HAD a left side, so he was not even aware that he could not use it. Of course, he could not DO anything, so the option of remaining half paralyzed on the floor was not an option. His emotions were so bland he wasn't even upset. (FULLY recovered all function within 10 days, with NO deficits, despite blowing his entire right hemisphere out in a bleed. Neurosurgeon used the term "miracle". Then he died a week later of a massive coronary. Age 62.)

Anyway, that's what I first thought when I read the post - that they were somehow not aware/emotionally connected with what was happening.