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Transient Ischaemic Attack

transient ischaemic attackWell! My weekend was interrupted on Saturday night when I heard my father wet himself! Looking up, I was horrified to see he was white as a sheet and staring into nothing. When I reached him, he was stone cold and soaked in sweat and beginning to dribble from the mouth, leak water from his nose, burp air as if he was going to vomit and his left arm was twitching.

Holding up his head, I noticed his eyes had rolled upwards and he did not hear me. He was lifeless for over three minutes, though he was just about breathing, he was completely unresponsive!

Calling over my shoulder for aconite 10m, my student sprang into action like superwoman. The remedy appeared from nowhere in a cup of water which I dipped my fingers into and began to rub over my father’s head and back of neck. The phone had already been dialed 999 and handed to me. She had just come round to talk through running a homeopathic acutes clinic, and this was the real thing!

The 999 service stayed on the phone and talked me through the routines we awaited the ambulance, and of course I had the phone under my chin and cut her off!! She rang back immediately and continued talking me through the situation while we awaited the first responder. For three minutes, I though dad was dead, but then he answered me ‘yes’, slurred but recognisable.

The door bell rang and my student darted off to answer it. The 999 woman said goodbye as the first responder took over, taking his blood pressure, fitting an oxygen mask and taking his blood, a spot from his finger, which the first responder analyzed immediately and he took his temperature with a gadget inserted into his ear. The ambulance arrived and my student left, unaware of how marvellous she had been and because she thought she would be in the way, she left to deal with her shock as best she could as I turned to the NHS crew and my dad, who was asking to fight the ambulance man at this juncture!

Dad didn’t want to go to hospital, who would? He had no idea what had happened, why should he? He had had a partial seizure and the ambulance crew were as one. He must go to hospital and that was that. I overruled him and we were off to the Homerton Hospital, and that was that!

Straight into the resus room on a trolley, within ten minutes they had rigged him up to monitors, put him on oxygen, taken bloods, got an ECG done and a chest x-ray, and all the results were already in and four doctors were discussing hs case. He had a heart irregularity on ECG. Atrial Fibrulation! Why? His bloods were normal apart from a slightly raised white cell count which shows he has a slight infection somewhere which he was coping with, he had some fluid in his lungs, nothing to shout about, his blood pressure was normalising. Shortly thereafter, he was in for a CAT scan. Multiple minor infarcs, old episodes only, with no signs of any recent bleeds, no major damage. ‘The damage is in a part of your brain you don’t need’ they told him, but ‘you must be admitted for echo and further tests’. ‘He won’t like that!’ I told them and they shook their heads at me. Well he wouldn’t like it!

An hour or so later, when they had observed him on the monitors and discussed his case, his history, anything and everything I could tell them over and over again, and he was questioned again and tested for his reflexes and for his cognitive function and neurological function over and over again, they said to me ‘he is very strong isn’t he?’ They were very unimpressed with his swollen ankles and told me he had a large hernia over his stomach which they would not bother to do anything about because it was just his muscles being weak. The medical consultant came over and said ‘do you want to take him home then?’ We both nodded vigorously. The resus nurse quipped ‘not many people are discharged home from the resus ward you know!’ The Homerton Hospital were so incredibly marvellously wonderful, it is hard to know where to begin to thank them. He could not have had better service and attention if he had been a millionaire with his own private hospital. They were simply fantastic!

Fifteen minutes later, discharge summary, ECG report and medication in hand we were taking a taxi home, a wonderful ride with an Afgani man who chatted reassuringly to my dad all the way home, bless him. When we got home we opened a bottle of red wine and had a glass. Sensible? Most definately! A light meal followed, and then we sat down to watch the episode of Morse on TV, my dad’s favourite programme. It was the one where Morse has a heart attack and dies in the resus ward! We laughed and went to bed! He slept right throught until 10am and woke feeling ‘normal’ for him.
Dad is OK tonight, shaken and a little bit stirred and practicing his Tibetan breathing routines, determined to build up his cardiovascular fitness and regain his composure. I have just phoned him and he thanked me for a very interesting weekend! He is 85, disabled and as strong as an ox. If he had gone, he would have known nothing about it at all. He found that quite reassuring.

These episodes are very common in the elderly and do not mean that he will die, far from it. When he has been up to the stroke clinic, the next move in this emergency, they will do all the specialised tests to see if there is any structural damage to his heart or his brain to try to determine why this episode happened. We cannot put our finger on the cause at this time, he was previously strong, but he has had a recent chest infection, a recent infection in his swollen leg and weepy blisters on his shin, a few good psychological shocks this autumn and a stressfull past few years. The final straw could have been the drop in pressure and lack of oxygen before the storm we had that afternoon, or the fatty lunch he had a couple of hours previously, or the struggle to get his clean trousers on or the walk downstairs or the fact we did not open the french doors to let him have the fresh air that he craves… but we really don’t know the cause yet.

Tonight, I am exhausted. We are all OK. I am not yet sure how I feel and that’s that!

See essay on Ischaemic Heart Disease

One Response to “Transient Ischaemic Attack”

  1. on 08 Jan 2007 at 2:08 amDzesika

    I’m so glad to hear that he’s okay - and hope you are doing okay as well!

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