Prelude: Many people have approached me in the three weeks since my temporary amnesia/aphasia event saying something like “It must have been scary.” It was scary in 2002. At that time, with similar symptoms, I had no idea what the future held. It scared the sh%$ out of me.
Since it happened before, this time wasn’t so scary. For the first hour in 2017, I had no idea what was happening. Why would I be scared if I had no idea what was going on!
During the second hour I could sense I was remembering more and speaking a little more clearly. I was not scared; I was encouraged, especially since I remembered that previously in 2002 I came out the other end just fine.
If it happened again in the coming year, now that would be scary!
So, what do we know with any certainty? Not much.
Fact #1: On June 27, 2017, I had a temporary episode of amnesia (I didn’t remember squat) and aphasia (gibberish flowed from my mouth).
TIA or TEA are acronyms being thrown around as possible diagnoses.
TIA stands for a transient ischemic attack (ischemic relating to the heart).
Re: TIA. My echocardiogram and carotid artery tests suggest that my ticker is doing just fine. No surprise, my parents lived healthy lives into their 90s. To cover all bases, the neurologist wants me to start taking baby aspirin daily, just in case. Aspirin prevents blood clots from forming in the arteries. It can help certain people lower their risk of a heart attack or stroke.
I have no limit on my physical activity; pickleball, ping pong, and working out at the gym top my agenda.
Next week, the neurologist wants me to wear a Holter monitor for 48 hours, which will continuously record my heart’s activity as I go about my daily activities. I’ll keep you updated.
But a TIA is not the neurologist’s first choice.
It’s the TEA. TEA stands for transient epileptiform amnesia (which in my case might apply since the neurologist couldn’t rule out some form of epilepsy after reading my EEG (electroencephalogram). So, there’s no certainty, but it’s the leading choice in the clubhouse.
To cover all bases again, I have been put on a low dose (500 mg twice a day) of Keppra to prevent seizures, if some form of epilepsy is what I have.
The bottom line is that the neurologist doesn’t know what caused my temporary amnesia/aphasia.
So, a reasonably wide net has been thrown to cover a host of possibilities. I get that and am thankful for the caution.
After such an event, by law I am not allowed to drive for three months. I get that caution, too. Not driving will be inconvenient but hardly a sacrifice. I am retired. Hannah and I regularly play pickleball and go to the gym together. I have a modest social life (read: limited).
So, for three months, we err on the side of caution despite an uncertain diagnosis and no explanation for a cause.
I wonder whether dehydration due to caffeine consumption and not drinking enough water (2002) and not drinking enough water (2017) might have triggered the temporary amnesia/aphasia. The medical professionals never suggest such a connection. And why this time, when I have been dehydrated many times before?
Without any explanation for the cause of my two events (2002 and 2017), I still wonder.
Whether dehydration had anything to do with my temporary amnesia/aphasia, I have become a zealot for drinking water daily. Each morning when I awake, I drink two eight-ounce glasses of water. Three more follow: mid-morning, before lunch, and with lunch. Dehydration will not be the cause of any future such event.
I live in a town on the coast of Maine with a great community hospital and in a country with excellent Medicare health coverage for seniors. I’d recommend York Hospital for its effective loving kindness health care.
Since posting of these blogs, I have appreciated many people contacting me and wishing me well.
I heard from a childhood friend who referred to me as Brother Dan in his email of support.
Thank you, Brother Tom.
As I am wheeled up to room 220 at York Hospital for the night, much is on my plate.
First, I love the ER staff, nurses and docs of York Hospital; even though I don’t remember their names, I thank them for their kindnesses. Being more “with-it” later in the evening, I do remember Jo, Tracey, and Nicki, up on the second floor. I felt their loving kindness and professionalism. Pretty sweet combo for my nurses.
As I nestle into bed this Tuesday night, some five plus hours after coming into the ER, I am pretty much coherent, speaking intelligibly, and remembering how good life is. One helluva far cry from a few hours ago.
Tomorrow morning, I have three bad boys lined up to see if there are answers for my temporary amnesia/aphasia; 15 years ago there were no answers.
The echocardiogram will look at how blood flows through the chambers of my heart, heart valves, and blood vessels. Might some blockage be the reason for my short-term amnesia/aphasia?
The carotid artery ultrasound builds on the info from the “echocardio.” It creates pictures to show how blood is flowing through my arteries. When arteries become clogged with cholesterol (i.e. the technical term is “excess crap”), they can become dangerously narrow. Could clogged arteries be a cause of my brief whacked-out-ed-ness?
The EEG (electroencephalogram) detects electrical activity in my brain. The test diagnoses seizures and epilepsy, which could be the cause of my temporary-out-of-mindness.
As the Red Sox game ends this evening, I am with-it enough to appreciate the health care I have. My mind takes a simple leap to the question – How many millions will lose such health care if Republican Washington has their way? I’m begging you, Senator Susan Collins (R-Maine), don’t be bullied. I have my fingers crossed.
From 11P to 1230A, I flip between the Red Sox game highlights and ESPN Sports Center, but little is of interest and still I don’t fall asleep.
At 1230A, still wide awake, I buzz for some Tylenol for a slight headache and for a sleeping pill. I never take sleeping pills, but I’d like to get a little sleep before dawn, less than five hours away. The doc approvals Tramadol, but it does little and I muddle through the night, occasionally sleeping.
Sometime around 2A, I buzz the nurses for another pit stop as I am hooked up to a saline solution which keeps me well-hydrated. And then, all of sudden, I am looking up at the faces of four beautiful nurses. It seems my blood pressure was 65 over 35! I got up a little too quickly from my bed. Fortunately, one nurse caught me as I tumbled. Unfortunately, I have to use a bottle to pee in from now on!
At 540A, I give up and turn on Sports Center; amazing how boring baseball highlights for 15 separate games can be. I mute the TV, then text on my iPhone to pass the time. Thoughout the morning, three angels visit: thank you, Corky and Scott and Tree.
My morning line-up of heavyweights: electrocardiogram at 8A; carotid artery test at 11A; and the EEG immediately thereafter. Dr. Mark Graziano, my PCP (primary care physician of 35 years), will fill me in on the details tomorrow. Does everyone get such prompt care? I am guessing it’s the norm at York Hospital, here on the Gold Coast of Maine. Rural and inner city America? I’m not betting on that.
After the 90-minute EEG test at 1230P, I am wheeled passed a waiting area where Hannah, Owen, and Max talk to Corky. Delighted as I am to see them, I am chomping at the bit to transition home (discharge seems like such a disgusting verb filled with sewage and waste).
While I wait, Owen and Max lounge on my hospital bed and watch their favorite show, Dinosaur Train on PBS.
Released after 2P, I have instructions to take a baby aspirin once a day and don’t drive until the neurologist checks me out.
On Saturday, part 6 is a wrap (to use a Hollywood term); my temporary amnesia/aphasia saga concludes with the test results, what could be an explanation of what has happened to me, and the changes that are coming to me for the short and long term.
In a side room off the ER at York Hospital, dressed in my hospital johnnie, I am aware something is changing. And that’s a good thing. Having entered the ER in a haze an hour ago, now, just after 7P, I can tell the fog is lifting because I am starting to sense what is happening around me. Though I don’t know the answers to the medical staff’s basic questions, previously I didn’t know they were even asking questions. That’s progress.
Earlier in the evening at home when all hell was breaking loose, Hannah had called Mandy with the apt summation that Dan is acting weird. Mandy said she would come when Hannah needed her. At this point, Mandy’s daughter Sammie said, Mom you can’t wait, you have to go now. Is that a great kid, or what!
When Mandy arrives at our house on Chases Pond Road, Hannah has already taken me to the ER. Mandy then drives on to the hospital where she watches Owen and Max while Hannah tends to her whacked-out husband of 45 years.
Once it seems that I will be staying for the night, Hannah asks Mandy to follow her home and then return to the hospital with my overnight bag. While Hannah puts our grandsons Owen and Max to bed, Mandy returns with a change of clothes, my journal, my iPhone, my Scrabble dictionary, shaving kit, and latest Sports Illustrated. But something much more.
Her presence. You see, Mandy stays when I need someone. As Woody Allen says, 90% of life is showing up. And show up Mandy does.
What I need is someone just to listen. After being totally unaware of what the hell is going on, things are now less fuzzy in my brain. Slowly, pieces of information are starting to come into focus.
Something else is starting to happen – I begin drinking glass after glass of water. Fifteen years ago when a similar temporary amnesia/aphasia occurred, I felt that dehydration might have been contributed to my problem. After pounding my third 20 ounce plastic cup of water, I am feeling alert and aware. Could dehydration be a connection the medical professionals are missing? Or is my condition just running its course?
I spend the next hour sipping water and talking nearly non-stop to Mandy about things in my life that I am starting to remember. My constant chatter is proving to myself that I am coming out of this rabbit hole of amnesia, aphasia, and confusion. I know I am talking a lot, but Mandy gets it. She understands that my words are going a long way in convincing me that I am going to be okay.
As I come out of the fog this evening, Mandy’s presence is a gift beyond anything material she could ever give me.
After 9P, Mandy steps out when Dr. Braden fills me in on what’s what. I am staying the night and tomorrow there will be some big-time tests of my heart and brain. Shortly thereafter, the nurse wheels me up to room 220.
Next Wednesday, part 5 highlights my overnight in the hospital and my road to recovery.
In the fall of 2002, I was beginning my fourth year of commuting 150 miles from York, Maine to my position as an assistant professor of Education at Eastern Connecticut State University.
On this mid-October Thursday, I left home as usual at 4A; after driving for two hours, I treated myself to pancakes and coffee at Zip’s Diner on I-390 south of Worcester, MA, 30 miles from campus. On campus in Willimantic by 8A, I prepared for my day of office hours, a seminar in teaching Secondary English, a faculty meeting, and my 4P class of graduate students in the Teaching Reading course.
All the while my mind was pre-occupied with the keynote address I would be giving the following morning to 900 public school teachers in northern New Hampshire, 4 hours away. To summarize, I’d finish teaching on campus by 7P that Thursday, drive to Littleton, NH by 11P, and give my keynote the next morning at 9A. No stress there!
Well, it turns out there was a lot of stress there. But, was that what caused what happened that afternoon? Let me explain.
As my 4P class was approaching, I found my eyes couldn’t focus on the class roster; I couldn’t read my students’ names. I didn’t feel well (later students said I looked pale); I decided to take a walk while my 25 students were organizing in groups preparing for their presentations. Upon returning ten minutes later, I got everyone’s attention and told them that something was wrong and I was going to drive myself to the Windham Hospital (not a half mile away).
Fortunately, the students didn’t let that happen; a student got my department chair, David Stoloff, and he drove me to the hospital. I was a mess. I couldn’t focus, was losing my memory, was forgetting my own kids’ names and was barely holding on to Hannah’s image that seemed to be disappearing down a long tube. I couldn’t speak.
The medical people ran me through the CAT scan and the MRI. Nothing abnormal, but no answers either. I remember being swallowed up by the CAT scan and thinking, am I going to have to learn to use a fork again?
Since the medical staff was stumped, they shipped me by ambulance to the Hartford Hospital 30 miles away for their big-time neurologists to give me the once over. And then a surprising thing happened in the ambulance, I started making sense talking to the EMT, just chit chat. I was getting better, remembering more and more. Not four hours later from the initial event, I was doing well enough to be considered for discharge.
My department chair had called Hannah, and she drove the 150 miles from York to Hartford with our daughter Molly, a teacher in Rye, NH at the time. By the time they arrived in the late evening, I was sitting up and ready to go home. I had to pass one final test.
A nurse came in and mentioned three unrelated items (e.g. apple, water skis, Mount Rushmore). If I could remember those three when she returned in five minutes, I could go home. I nailed them. You would have been so proud!
Hannah drove us back to Eastern and then after midnight, I followed her home in my Honda Civic Hatchback. Clearly, I was fine. Perhaps, driving home was not the best choice. I was young, well 55.
Home by 3A, I took the weekend off, received a weekend gift of a three-foot potted plant from the president of Eastern, and drove back the 150 miles on Monday for my full load of classes.
Dr. Brown, a neurologist in York, checked me out and said that of 10,000 patients, he had never seen a case like mine. He didn’t think it was a TIA (transient ischemic attack (i.e. temporary amnesia related to the heart). A GTA (global transient amnesia) never came up. And that was pretty much that. No limitations, just let him know if any of my symptoms return. And for 15 years none had! Until this afternoon.
Given that previous experience, I didn’t feel these symptoms were any big deal, but Doc Braden here at York Hospital, the attending ER doctor, did, and wanted me to spend the night in the hospital.
On Saturday, part 4 picks up on finding an angel in the hospital.
While waiting for all the tests, I have the medical people asking me all sorts of questions. Who is the president? I have no idea, but in this day and age that is no question to ask a seriously confused person. It seems some hospitals no longer ask the “president question” to determine understanding because it upsets so many people.
They want to know the big dates. When is your birthday? No clue. I’d like to help you out but I am coming up empty. Today’s date? Where are you? I have nothing for them.
They ask me to repeat No ifs, ands, or buts. Tongue twisters that I garble. Even saying 50-50 throws me. For the first hour, I don’t remember any of the questions. After an hour, I still don’t know the answers, but trending positive, I now understand that these are questions that I should know the answers to. That’s a significant step out of the fog.
As for tests that evening in the ER:
The CAT scan (an X-ray image made using Computerized Axial Tomography) of my brain rules out bleeding in my brain; clearly, I am not having a stroke.
The MRI (Magnetic Resonance Imaging), which gives the medical staff a more detailed image of my brain and its blood flow, shows no lack of blood flow and again no evidence of stroke.
The heart monitor determines if there is atrial fibrillation (irregular heartbeat or arrhythmia) that can lead to blood clots, stroke, and heart failure. My heart is just fine.
The chest x-ray determines whether there are any blood clots in my lungs. This test can help diagnose and monitor conditions such as pneumonia and heart failure. I have a clean x-ray.
A urinary test would indicate whether I have a Urinary Tract Infection. UTIs cause similar confusion and again the medical professionals are trying to rule out as much as possible. I have no urinary infection.
Finally, I am screened for drugs. It turns out it is routine anytime someone comes into the ER in an “altered mental status,” which is me! There are no drugs in my system.
I was passing all the medical tests and failing all the questions. Though the medical professionals didn’t know what was going on, I was not surprised at all what was happening to me. You see 15 years ago something similar happened 150 miles from home. Stay tuned for part 3 on Thursday.
I literally mean, I lost my mind. I lost the Big Three – I couldn’t speak; I couldn’t remember; I couldn’t think. Let’s make it four – I couldn’t read. There is a diagnosis, but it certainly sounds like something that happened to me 15 years ago in Connecticut. More on that later.
It’s Tuesday afternoon this late June at home with Hannah and our grandsons Owen and Max when all hell breaks loose. I don’t remember a thing. I am speaking gibberish such that Hannah doesn’t recognize me. She calls friends for help and says, Dan is acting weird. Our preschool grandsons look quizzically at me when I can’t remember their names. I am speaking but the words are not making any sense.
Calling our local friend Corky, Hannah explains my incoherence, babbling, and confusion. To which, Corky replies that there is no time to waste. You have a small window in which to get something done if it turns out it’s a vascular event (i.e. involving a blood clot).
If I am having a stroke, time is of the essence. Medical professionals will have a three-hour window to determine if I need the necessary medication to dissolve a blood clot. Corky follows up with, Don’t call 911; take him directly to the hospital, which for us is York Hospital three miles in town.
Hannah has seen enough and so packs the boys and me in the car. On the drive in, she remembers me wondering why I need to go to the hospital. I am Clueless with a capital C. Fortunately, she just smiles and keeps driving down York Street. Nothing registers in my mind and I have no memory of the trip to the ER.
So, let’s recap what Hannah is dealing with as I enter the emergency room of York Hospital: I don’t know what is happening to me; I am very confused, I have lost my memory (amnesia), I can’t speak sensibly (aphasia), and I didn’t know where I am. I am a scary package of incoherence and technically-speaking – I am out of my mind.
Once in the ER, they aren’t messing around. They schedule:
- a CAT scan of my brain
- an MRI for a more detailed picture of the blood flow in my brain
- a chest x-ray
- a urine test – urinary tract infection?
- a urine drug screen
and they also slap on a heart monitor to determine if there is atrial fibrillation
Hmmm, drug screening for Danny Boy? Part 2 follows Tuesday