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Dr. Bob is Robert Hsiung, MD,
[email protected]Shown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by Dinah on March 28, 2012, at 17:12:58
My mother's been falling a lot lately and having extreme difficulty getting back up. She has had all sorts of tests, all of which show that nothing is wrong. According to the tests, she hasn't had a stroke or any brain trauma or really anything in the brain.
Today I saw one of her episodes. She was slumped, or even more than slumped, to one side. She had a hard time speaking. Her words were intelligible if maybe very slightly slurred when she did speak, but she had trouble finding words and would wave her hand instead. She was unable to move her left leg or arm.
At least one of her doctors think this is a problem with her spine. But that seems wrong given her difficulty speaking and the confusion that others have reported during these episodes. It was hard for me to tell today given her difficulty speaking. She's had these spells while in the doctors office, so it's not like they haven't seen it.
Does anyone have any ideas whatsoever?
Posted by Dinah on March 28, 2012, at 17:19:47
In reply to Scared, posted by Dinah on March 28, 2012, at 17:12:58
They've also checked out her heart and said that's fine.
Posted by Twinleaf on March 28, 2012, at 18:02:29
In reply to Scared, posted by Dinah on March 28, 2012, at 17:12:58
It sounds as though she might be having TIAs - transient ischemic attacks. It's very important to have MRIs and CT scans, followed by maximal preventive efforts, as these will lead to a stroke eventually. I'm surprised these didn't raise more alarm bells with her doctors.
Posted by Dinah on March 28, 2012, at 18:29:08
In reply to Re: Scared, posted by Twinleaf on March 28, 2012, at 18:02:29
She has had MRI with and without contrast. I'm not sure about CT scans. They say there is no sign of stroke or TIA or anything else. According to them, her brain is perfectly healthy.
It didn't seem that way to me today. For the first time ever, I thought it possible that my mother wouldn't outlive me. She didn't seem indomitable today.
I suppose they are taking it seriously in that they keep doing tests. But all the tests are negative.
She's giving me permission to talk to her doctor. It's possible that she's ignoring anything she doesn't want to hear. My mother can do that.
Posted by Phillipa on March 28, 2012, at 18:37:14
In reply to Re: Scared » Twinleaf, posted by Dinah on March 28, 2012, at 18:29:08
Dinah sounds like TIA's also to me. MRI of brain would tell. Is she on any meds that could cause this in combination. What health conditions does she have and age? Phillipa
Posted by jane d on March 28, 2012, at 18:48:35
In reply to Re: Scared » Twinleaf, posted by Dinah on March 28, 2012, at 18:29:08
Can TIA's be identified after the fact?
Definately a scary situation. I hope talking to her doctors helps.
Posted by SLS on March 28, 2012, at 19:16:31
In reply to Re: Scared, posted by Twinleaf on March 28, 2012, at 18:02:29
> It sounds as though she might be having TIAs - transient ischemic attacks.
This was my initial reaction as well.
- Scott
Posted by Dinah on March 28, 2012, at 20:49:40
In reply to Re: Scared, posted by SLS on March 28, 2012, at 19:16:31
Y'all are right. They don't necessarily show up.
I'm glad she gave me permission to speak to the doctor (although I suppose it might take time to arrange the paperwork). It is probably far better to hear it firsthand than through my mother or her brother.
It really does look like it fits. She says she does get a headache with the spells. She mentions the feeling of dizziness or vertigo. I'll have to check with her about vision changes. She didn't seem to have a droop to her mouth, but everything else fits perfectly.
I also want to check on her medications. I know she takes a statin, which I read can cause problems in some people.
Posted by Beckett on March 28, 2012, at 21:17:42
In reply to Re: Scared, posted by Dinah on March 28, 2012, at 20:49:40
Dinah, I'm wishing you the best with your mom.
Posted by Phillipa on March 28, 2012, at 22:07:05
In reply to Re: Scared, posted by Dinah on March 28, 2012, at 20:49:40
Dinah pretty sure you have done this already but hope this helps. Phillipa
Posted by SLS on March 29, 2012, at 3:47:00
In reply to Re: Scared, posted by Dinah on March 28, 2012, at 20:49:40
> Y'all are right. They don't necessarily show up.
>
> I'm glad she gave me permission to speak to the doctor (although I suppose it might take time to arrange the paperwork). It is probably far better to hear it firsthand than through my mother or her brother.
>
> It really does look like it fits. She says she does get a headache with the spells. She mentions the feeling of dizziness or vertigo. I'll have to check with her about vision changes. She didn't seem to have a droop to her mouth, but everything else fits perfectly.
>
> I also want to check on her medications. I know she takes a statin, which I read can cause problems in some people.Was epilepsy mentioned? I don't know enough about its epidemiology to know how often it appears later in life, but perhaps you will see some similarities with respect to dysphasia and facial numbness appearing on one side. I still think it could be TIA. I'm sure it will be resolved. You are approaching this whole thing methodically.
Time for new specialists?
- Scott
Posted by sigismund on March 29, 2012, at 16:46:44
In reply to Re: Scared » Dinah, posted by jane d on March 28, 2012, at 18:48:35
>Can TIA's be identified after the fact?
I was under the impression they could be.
My mother told me they had found evidence of them in her case.
And she had no symptoms to speak of, beyond getting old and a bit silly.
Posted by Solstice on March 29, 2012, at 21:12:24
In reply to Scared, posted by Dinah on March 28, 2012, at 17:12:58
> My mother's been falling a lot lately and having extreme difficulty getting back up. She has had all sorts of tests, all of which show that nothing is wrong. According to the tests, she hasn't had a stroke or any brain trauma or really anything in the brain.
>
> Today I saw one of her episodes. She was slumped, or even more than slumped, to one side. She had a hard time speaking. Her words were intelligible if maybe very slightly slurred when she did speak, but she had trouble finding words and would wave her hand instead. She was unable to move her left leg or arm.
>
> At least one of her doctors think this is a problem with her spine. But that seems wrong given her difficulty speaking and the confusion that others have reported during these episodes. It was hard for me to tell today given her difficulty speaking. She's had these spells while in the doctors office, so it's not like they haven't seen it.
>
> Does anyone have any ideas whatsoever?
Dinah.. it sounds neurological. It doesn't have to be a stroke or injury, but it could be stroke and it just hasn't been recognized.Impaired language, comprehension, confusion, word-finding difficulty and hemiparesis or hemiplegia are all neurologigical.
I would take her to a neurologist for a complete work-up.
Solstice
Posted by Solstice on March 29, 2012, at 21:20:56
In reply to Re: Scared, posted by SLS on March 29, 2012, at 3:47:00
> Was epilepsy mentioned? I don't know enough about its epidemiology to know how often it appears later in life, but perhaps you will see some similarities with respect to dysphasia and facial numbness appearing on one side. I still think it could be TIA. I'm sure it will be resolved. You are approaching this whole thing methodically.
>
> Time for new specialists?
>Dinah. Scott's got a good point here. Seizures are what I 'do.' The elderly are the largest group to get what we call "new onset seizures." There are a lot of reasons for that. The brain has a complex system of blood flow, and as vessels weaken with age, there are a number of different things that can cause the type of symptoms you're describing. The headache she complains of is key.
Again.. take her to a neurologist.. and it'll be a bonus if you can find one that specializes in geriatrics.
Solstice
Posted by Dinah on March 29, 2012, at 23:46:01
In reply to Re: Scared, posted by Solstice on March 29, 2012, at 21:20:56
Thanks everyone. I talked to the doctor who saw her episode in person. He also thought it was neurological, although I don't think he realized that she isn't like that most of the time. I got the impression that he was aiming his tests with the idea that this was a degeneration. Apparently she acted oddly at that appointment and I doubt she explained herself well. He was very nice and very concerned and said that it looked neurological to him but that he didn't have expertise in that area.
So he had me call her neurologist, who doesn't know her nearly as well. I think he hadn't quite grasped what was going on either, since she didn't have an episode in his office and I can vouch for the fact that she doesn't explain it anything like it looks in person.
So.... he of course said to go to the emergency room if she had any problems. But he'll move up her next appointment, he and her other doctor will get together to discuss what happened and to make sure they are covering all the tests in their own specialty, and then they might suggest that she have other consultations.
I guess specialists are a good thing, but it would be nice to have a doctor who coordinated all the specialists. They seem to keep sending her from one to the other without anyone keeping track.
I wouldn't say I'm positive or optimistic, but I do think both doctors have a better understanding of what's going on with her. And I will probably have to go with her to the doctor appointments since I don't think I can rely on second hand reports.
I'll mention the possibility of seizures when I go in with her. I'm familiar with seizures in dogs, and it didn't quite have that "feel". But I know there are different kinds and some might not have that feeling of hmmm.... static? I also want them to look at all her medications. Different doctors are prescribing different meds.
I am worried about her situation. I think this is a whole lot to ask of her brother. Maybe I should talk to him privately. Although what I'll do I have no idea. She's very... independent. And she has decided ideas of what she does and doesn't want for herself that don't always seem all that realistic. To put it very very politely.
The whole thing makes me very sleepy. I feel responsible without having any real power in the situation.
Posted by Phillipa on March 30, 2012, at 0:13:26
In reply to Re: Scared, posted by Dinah on March 29, 2012, at 23:46:01
I think a good neurologist can do all of the above review meds, look at MRI, and diagnose her. I still lean to TIA's but then don't know anything about geriatric seizures. Phillipa
Posted by Solstice on March 30, 2012, at 4:13:29
In reply to Re: Scared, posted by Dinah on March 29, 2012, at 23:46:01
> I guess specialists are a good thing, but it would be nice to have a doctor who coordinated all the specialists. They seem to keep sending her from one to the other without anyone keeping track.Yeah.. that really does make it difficult.
> I wouldn't say I'm positive or optimistic, but I do think both doctors have a better understanding of what's going on with her. And I will probably have to go with her to the doctor appointments since I don't think I can rely on second hand reports.
Not only that, the doctors will get better information from you. If they are talking to her, they may not be getting a good enough picture to make sense of it.
>
> I'll mention the possibility of seizures when I go in with her. I'm familiar with seizures in dogs, and it didn't quite have that "feel". But I know there are different kinds and some might not have that feeling of hmmm.... static?Temporal lobe seizures are particularly difficult to recognize because they often simply look 'behavioral.' The patient doesn't lose consciousness or awareness.
> The whole thing makes me very sleepy. I feel responsible without having any real power in the situation.
Take care of yourself, Dinah..
Posted by Dinah on April 2, 2012, at 20:28:11
In reply to Re: Scared » Dinah, posted by Solstice on March 30, 2012, at 4:13:29
She had an episode at her doctor appointment today (not anything directly related to all this). They sent her by ambulance to the hospital where she'll stay at least overnight.
There seems to be some disagreement whether the tests show a mini stroke or a seizure. But her brain has changed since the last CAT scan a couple of months (?) ago.
I have to confess to feeling relieved that someone is looking into it, and it is no longer falling on me to try to figure out what to do. Worried for her of course. But not so frazzled as I was.
Posted by jane d on April 2, 2012, at 20:42:30
In reply to Followup, posted by Dinah on April 2, 2012, at 20:28:11
Good luck. I hope they figure it out quickly. I'm sure it's a huge relief not to have to fight to have this taken seriously any longer.
Posted by Phillipa on April 2, 2012, at 21:30:20
In reply to Re: Followup, posted by jane d on April 2, 2012, at 20:42:30
Dinah call frequently for updates as having worked in hospitals seems at times the only way to get someone to check on her. Is it a regular unit or CCU ? Phillipa
Posted by Raisinb on April 2, 2012, at 22:57:00
In reply to Followup, posted by Dinah on April 2, 2012, at 20:28:11
I'm glad there's is at least a small,, temporary relief for you
I hope your mom is okay.
This is the end of the thread.
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