These last 2 weeks have been stressful and exhausting and frustrating, to say the least.
Early in the morning on June 2, I got a call from my mom saying that she thought my 79 year old Dad had a stroke. He had fallen that morning while working outside and was dizzy and having trouble walking. I took the news very well – I was very calm and dignified and stoic. (That is a total lie – I lost it and started crying hysterically. My husband had to take over things like dialing the phone and driving because I was FREAKING OUT.) We drove to my mom’s house, picked her up, then drove to the hospital where the ambulance had just delivered my dad to the ER.
The EMT who arrived at my parents’ house first, checked for signs of a stroke – had my Dad raise both arms (he did), had him answer basic questions (he passed, all without slurred speech), had him do basic fine motor skills test (he was able to count to 4 while touching his thumb to the tips of all four fingers on the same hand)…they determined that he probably had not had a stroke, he was most likely dehydrated.
At the hospital, they did labs and took his blood pressure and monitored his heart – all came back good (well his blood pressure was a little high, but not alarmingly so). They gave him 3 bags of fluids and he seemed to improve. I think he was still feeling a little dizzy, but he didn’t say so then. They agreed he was probably just dehydrated, and Dad said he was feeling better, so they sent him home with orders to follow up with his primary care physician. WHEW! Okay, cool. We can deal with dehydration. No problem!
But later that day, he wasn’t really any better. And the next day he was much, much worse.
Turns out, he’d had dizzy spells and fallen twice before in the previous week, but those were minor compared to Saturday’s spell.
At that point we knew we weren’t dealing with just dehydration.
Fast forward 10 days later and we finally get an MRI which confirmed that he had 3 mini strokes and one larger one caused by a clogged blood vessel in the pons area of the brain.
So all those dizzy spells he was having were actually strokes. It played out like this: he would get dizzy, fall, have trouble walking for a bit, then it would all clear up and he would be fine. That last one though, he got really dizzy, passed out and fell, and then he stayed dizzy for quite a while. His speech didn’t get very slurry until later that Saturday night and into the next day. It was almost like a slow progressing stroke, if that’s such a thing.
His face never drooped on one side, he never lost complete feeling on one side of his body (his left hand and leg are just a little weaker than his right), he didn’t have a severe headache, he had no loss of vision in one eye, he was never confused…I mean those are the symptoms, right?
I take a CPR/First Aid course every year for work and those are the signs we’re told to look for. My dad didn’t really have any of the obvious signs but you would think that a hospital ER would know to look for this, right? Not necessarily:
Another alarming finding from the study was that across all ethnic and age groups on average, if you use an ER of a nonteaching hospital—that is, a hospital that is not connected to a medical college—you face rather high odds of having a stroke missed: 45%. And, worse, if you are in a low-volume ER—meaning one that doesn’t see very many patients compared with other hospitals—the odds of being misdiagnosed increase to 57%! The take-home message here is that, if at all possible, use a busy university hospital when you need to get to an ER.
(Source: David E. Newman-Toker, MD PhD, associate professor, department of neurology, The Johns Hopkins University School of Medicine, Baltimore. His study appeared in the journal Diagnosis.Date: June 30, 2014 Publication: Bottom Line Health)
The hospital we went to is in a very small town – it is definitely not a university teaching hospital and it is very low-volume.
So here’s the symptom that should have tipped us off: he got dizzy for a few minutes.
That’s right. Plain ol’ Dizziness. Out of the blue, unexplained dizziness was the only sign of the first mini stroke. He had been outside, looking up at something, and he got dizzy and fell. The dizziness went away after a few minutes, so he didn’t really think much of it, in fact, he didn’t even tell my mom about it until a week later, when he got dizzy and fell the second time. The next day though, when the dizziness came back again, it didn’t go away for several days.
That’s not to say that every time you get dizzy, it means you are having a stroke. But if it comes on suddenly and out of the blue (not as in if you were laying on the couch for 3 hours then stood up suddenly – that’s different) and you are at risk for a stroke, then call 911 and tell them to take you to the nearest university teaching hospital (if that’s a possibility).
My dad spent a couple of days in the hospital and is now on blood pressure medication, a blood thinner, a statin for cholesterol, and an aspirin, and will start physical therapy this week to help improve the weakness on his left side, his walking, and his speech. He has a good chance to make a full recovery if he does what he is supposed to – I think he will because it really scared him. And the rest of us too.