Medical Odyssey

My latest medical odyssey began about 8:00 AM Monday, May 10. I was at home sitting at my computer when all of a sudden, I couldn't see out of my left eye. Over the next 15-20 minutes it resolved itself and my vision returned to normal. I knew I needed to have this checked out so Chuck drove me to the Urgent Care Center at the Hammond Clinic.

I got to see a doctor fairly quickly at the clinic. After I described my symptoms and history to him he immediately told me that he would need to send me to the hospital. In the meantime he ordered some blood work and a CT of my head. While this was going on Chuck ran some errands. After the CT I was waiting in the urgent care waiting room when Chuck arrived. A little more waiting and we were called back to an exam room.

The doctor said that blood tests and CT were both clean but that I needed to go to the hospital since I had either had a stroke or a TIA (transient ischemic attack; a warning sign of a stroke). So off we went to the Community Hospital ER. I was brought into an exam room right away and repeated the story for the first of many times. They started an IV and then we waited for the ER doctor and for a room to open up.

After being in the exam room for about 1.5 to 2 hours, I sent Chuck home since there was no sense for him to sit there with me while nothing happened. About 10 minutes after Chuck left, they moved me into the hall, since the ER had gotten fairly busy. I was parked in the ER hall way for the next 6 hours with one trip for an MRI. Finally about 10:15, they moved me upstairs to a room. There was a preliminary diagnosis based on the MRI but noone had spoken about it to me.

The next morning, I started a getting a stream of visitors. Since I had originally come to the ER as a possible stroke patient, I was getting the stroke protocol. The nurses were checking that my speech and vision were okay and that I had no loss of muscle control or strength. I was also visited by various therapists: speech therapist, occupational therapist, physical therapist. I finally saw a doctor about 11:00 AM and was told exactly what the MRI had shown. There was a blockage in my left internal carotid artery with a possible dissection (meaning the blood might be flowing through the wall of the artery to get passed the blockage) of the artery. Now the important thing they need to find out was whether the blockage was 100% or less than that.

More tests were the order of the day: ultrasounds of my heart and the arteries on both sides of my neck as well as a transcranial doppler imaging of parts of my head (both temples, both eyes, and the back of my head.

I did also see a neurologist who explained some more about what the tests were showing so far and what more would be done. I also got a visit from my cardiologist (I've been seeing him on regular basis since my double bypass in 2007). He discussed with me what had had happened so far and what he felt should be the next step. The cardiologist went to discuss my case with the neurologist. When he came back, he told me that they disagreed on what the next step should be. The cardiologist thought I should have an regular angiogram to determine if the blockage was 100%. The neurologist thought I should a CT-angiogram to determine the same. The CT had been scheduled for 6:00 PM Tuesday but the cardiologist canceled it and scheduled a regular angiogram for 2:00 PM yesterday. The neurologist would be coming by to talk to me Wednesday morning and then I would have to decide which of their recommendations to follow.

The most important aspect of both recommendations was that if the blockage was 100% then neither doctor would recommend surgery to clear the blockage, but if the blockage was less than 100% then they would recommend surgery to clear the blockage.

During all of this time, I was experiencing no other symptoms. I felt fine in fact. But because I was admitted as possible stroke patient, I was on strict bed rest until Tuesday afternoon when I was told I get out of bed to go to the bathroom.

So Wednesday morning about 11:00, the neurologist come by and we talked about the procedure she recommended and why she didn't recommend what the cardiologist did. She also told me that regardless of the outcome of the CT, she would recommend a followup at the UIC (University of Illinois-Chicago) hospital which has a very good stroke care program. I was more uncertain than ever what I should do. So I called Chuck and we discussed the options and decided that since the regular angiogram was scheduled for 2:00 that day and that I had been under the care of the cardiologist for 3 years, we would go with his recommendations despite the very small risk.

Chuck arrived at the hospital at about 12:15 since I would be taken to be prepped for the angiogram at about 12:30. The nurse from the cath lab arrived right on time and we headed downstairs but instead of heading to one of the prep rooms, they took me right into the cath lab and started prepping me there. In no time the cardiologist arrived and the procedure started. During my previous angiogram in 2007, I was completely unconscious but not so this time. It was an odd sensation feeling the doctor insert the instrument into my leg. I could watch any of that but I did watch the monitors to see what was happening, especially when they were taking the pictures. The procedure was over as quickly as it had started and the cardiologist said it was 100% blocked. Woohoo, no surgery. By 1:30, I in a recovery room and at 2:00 they gave me something to eat. At 3:00 I sent back up to my room. A short while later, my primary care physician came by to check on me. I told her that I'd had the angiogram and that the cardiologist said the blockage was 100%. She went out to call him and discuss what should happen next. In a few minutes, the nurse came in with discharge papers and two new prescriptions. By 5:00 PM I was out of the hospital and heading home.