A Stroke of Luck or Not ?

Lets start this one carefully and please keep in mind as you commence reading that I tend to have a better end result. Timeline here is also important

Monday 4th November 2019

8:15PM and I was heading upstairs at home, about 1/2 up the stairs I got a massive sudden headache to the right side of my head. This was nothing like I had ever experienced in my life. Now I can’t remember exactly what happened next but I was face first on the stairs. I couldn’t move my left arm or my right leg. This felt as painful as the peripheral neuropathy that has never gone away but it was nothing compared to the massive pain in the right side of my brain. I called out within seconds to Anita who was basically in the TV room. She got a fright as she has never seen me completely unable to move, even though out all the treatment over the past 5 years. I could communicate with her but couldn’t hear her properly. Initially my right eye went back to zero visibility and I was blind again in one eye. I felt I was having a massive eye stroke but the paralyses to my arm and leg started to worry me.

It took nearly 20 minutes for me to actually move, Anita wanted to call an ambulance when she first came to help but I asked her not to. I managed to drag myself up the remaining steps, I am still quiet strong and if I grab something I have a grip that is stronger that a prize fighter, gripping Anita would lead to injury and I wouldn’t have that. But I got to the top of the stairs and managed to climb up onto a chair. It took me a while to gain enough strength to stand up. But 40 minutes into this and I was now able to walk again. We went back downstairs and I sat down in the TV room and relaxed.

But what the hell just happened.

The next day I went into work as normal but I have serious issues centring. It was a really busy day and I had not told anyone in work about what had happened. I worked my way through the day as it was the start of the month and pressure was on every second. The previous week was a build up to Brexit that yet again never happened, the anti climax caused by this ridiculous political activity is to say the least difficult. Ireland’s transport industry has the task of handling whatever happens, Irish businesses felt that the chances of Brexit actually happing on the 31st of Oct was likely and therefore they ordered large stock orders, this placed the Transport industry into serious distribution bulk out problems that people like myself handle. But I am normally able to handle this without issues, not this time though. I got through the day and headed home. I felt weak and worried about the previous day. So Anita called my doctor. Unfortunately he was on a weeks holiday but the cover Doctor made an appointment for me the next morning.

Wednesday 6th

On my way to work I called into meet the doctor. A really professional lady. She examined me and went through specific details about Monday over and over again. My blood pressure was high and she felt that I had some weakness to the left side of my body. In her words “The only two things that are stopping me calling a ambulance for you right now is that you did not black out on Monday and that you are able to converse at a very high level with me right now” I asked what she felt had happened and she said that she was unsure but the chances of a TIA Stroke was extremely likely. Transient ischemic attack (TIA, Mini-Stroke): A neurological event with the signs and symptoms of a stroke, but which go away within a short period of time. Also called a mini-stroke, a TIA is due to a temporary lack of adequate blood and oxygen (ischemia) to the brain.

Oh My God

She gave me a letter to go into CUH emergency unit but we managed to get the consultant that takes care of my eye strokes, he wanted to see me first and made an appointment for 5:30pm.

So I headed into work for 8 hours.

Went into see the consultant and he was waiting for me. He examined my right eye and to my surprise he said it had improved since the last operation however he agreed with the GP that the likely hood of a TIA was close to 90%.

Oh My God

That was two highly qualified professionals telling me that I most likely had a stroke less than 48 hours ago.

The consultant was very aware that I have a zero immune system and because of my medical history his preference was to get me to the oncologist that takes care of all my cancer issues, this oncologist is in a different hospital and that hospital does not operate an A&E unit. Nor do they handle TIA’s as they have no Stroke Unit. But we needed to insure that this was not lymphoma related.

This is the part where getting your medical partitioner to know you is vital. This consultant knows me well, we have formed a great patient doctor relationship. So he decided to let me go home but with the understanding that if I felt ill during the night I would immediately go to his A&E – he also gave me a cover letter so that the emergency doctors on call in the A&E would know whats going on. So off home, it was 6:45pm and very dark out.

What I have failed to mention so far was that my Sister had run the New York marathon on Sunday 3rd of Nov, we had the pleasure of minding her two lovely dogs since last Wed. Susan was not only going for her New York medal but she was also going for her Majors (This is where marathon runners achieve an award for completing 6 major city Marathons). She had nearly beaten her best marathon time in this run, but she succeeded in getting both the Big Apple marathon and her Major medal on that Sunday.

The plan was that she would pick up her two pets on Thurs 7th. She had flown back into Ireland on the Wed at 8:30am and was jet lagged. We had not told her what was happening with me till about noon on the Wed and as we thought I would be admitted on Thursday we needed her to collect the two pets a day early. She set out from Dublin shortly after 4pm.

Anyway I got home at 7:30pm and I had been told by both the GP and the consultant to expect to be kept in hospital. My sister took the dogs back to Dublin that night (we live about 165 miles from Dublin) She left for home very concerned.

Thursday 7th

Got up at the normal time and headed for work. I had only walked into the office when my phone went, it was my GP calling basically to see how I was and to get an update on the previous day. I told her I met the consultant and he was arranging for me to meet my oncologist today, I also told her that I was more than likely going to be admitted today. She then heard one of our forklifts in the background… “Why are you in work?” …. I talked my way around that somewhat but she was not impresses. I got “Ian you do realise that there is a 90% positivity that you had a stroke less than 72 hours ago? I literally had no idea what to say. She then told me that she was also going to call the oncologist.

Time ticked away and by 3pm I had had both the GP call me back and the eye consultant. My oncologist was on holidays – just my luck this week.

So between them they had organised for me to see a Professor the next morning, I was told to report to the radiology department at 8am for an MRI and that the professor would meet me either just before the scan or just after it.

Friday 8th

Got to the hospital with Anita 30 minutes early. I was sent to the MAU unit Medical assessment unit. (The medical assessment unit (MAU) is an essential part of the larger medical unit. Patients are usually sent to us from the emergency department and from their GPs. Their role is to provide a timely and effective evaluation and to initiate a patient’s treatment. They see patients with a wide variety of complaints) This was intentional as they needed to understand what exactly happened on Monday and if it was Lymphoma related. So I had bloods done and full workup and then met the Professor. He explained that they were going to do a Brain CT first in case there was a bleed on my brain or a blockage, he would then access the situation and send me for further test.

I had the CT scan at 12:30 and was told by the medical team to turn off my phone. I had about 20 in coming business related calls and they wanted me de-stressed for the scans. I had the scan and returned to the unit. Anita had headed off on an appointment that she had. The professor came in to discuss.

He commenced by saying that the CT scan was excellent, no sign of a stroke – what a relief. However he needed an MRI to confirm and try to establish what happened.

I had the MRI an hour later. Anita returned to the unit and we sat back till the results came back close to 5pm. The Professor took us into a private office. I got the feeling that something was seriously wrong.

The debrief

It was not a Stroke, it was not a TIA and it was not a pre stroke. What a relief but what the hell was powerful enough to buckle me >

Here it comes – a Migraine

Bet your thinking like I was. I have had migraine attacks as a teenager but that was 40 years ago and at the worse I would have said they were extreme headaches – Anita suffers from bad migraines and I could tell by the look on her face that she felt the diagnoses was a million miles off. The Professor smiled, he went on to explain. What I had on Monday was an extreme end type of Migraine called a Hemiplegic Migraine. The word hemiplegic simply means paralysis on one side of the body. A person with hemiplegic migraine will experience a temporary weakness on one side of their body as part of their migraine attack. This can involve the face, arm or leg and be accompanied by numbness, or pins and needles – they mimic Stokes. About 1% of people admitted for strokes are actually diagnosed with Hemiplegic Migraine

Not sure about you but I have never heard of this before. Took a lot of reading and Dr Google to really understand this. But these are quiet serious, they mimic storkes and leave you physically drained – an extreme attack can place you in a coma . I know what they are now and we are going to commence looking at the triggers on Monday. Whatever has triggered this level of attack is going to suffer. I have beaten Cancer twice – this hemiplegic migraine is about to learn a lesson…

So I was not admitted – I was told to go home, rest and come back in for blood analyses on Monday. But the Professor did not expect any surprises. He also went on to say that they will commence prevention management on Monday with a view to having my GP oversee it. Reports are been sent to my eye specialist and oncologist.

I’ll update this blog on Monday.

Monday 11th

Blood analysis was good. Very low red blood cell count and zero immune system (this has been like this since March so no changes)

Blood pressure was higher than Friday but I had just come from work so not surprised. It was not high enough to cause concern- more bloods taken for micro screening (results take weeks).

Referred back to GP for further investigations but it’s not lymphoma or stroke related. This one is starting to bug me as we need to find the trigger.

Just a little update : Visited the GP to get updates and see how they intend to manage this. The visit was on the 15th of Nov and he had all the answers ready for me. I can’t go too far into this at the moment but we have the trigger and we are now working around tackling it. That was two weeks ago and the new medication appears to be working. I feel a lot better knowing both what caused this Hemiplegic Migraine – my doctors insisted that I stop calling them Migraines and to stop underestimating what a Hemiplegic Migraine can do. December will be a real test to see how the meds are working