Another day, another T.I.A.

Another day, another T.I.A.

October 1, 2007, 10:33 am
Filed under: Alzheimer's, Health, Hospice, Science, Sleep, Society

I got back from my morning walk with the dog to find my wife helping her mom take her after-breakfast pills. Not just encouraging her, but actually placing the pills in her mouth for her, helping her hold up and drink from the glass of juice.

I changed the dog’s collar, put away his leash. Took off my knee braces and the little belly pouch I wear for walking the dog which contains some treats, a small bottle of water, plastic bags for droppings. Removed my light jacket and MP3 player. Went back into the kitchen and leaned against the counter opposite where my wife and MIL were sitting. My wife looked up.

“Another T.I.A.?”

She nodded.

* * * * * * * * * * * * *

From MedlinePlus:

Transient Ischemic Attack

Also called: Mini-stroke, TIA

A transient ischemic attack (TIA) is a stroke that comes and goes quickly. It happens when a blood clot blocks a blood vessel in your brain. This causes the blood supply to the brain to stop briefly. Symptoms of a TIA are like other stroke symptoms, but do not last as long. They happen suddenly, and include

• Numbness or weakness, especially on one side of the body
• Confusion or trouble speaking or understanding speech
• Trouble seeing in one or both eyes
• Loss of balance or coordination

Most symptoms of a TIA disappear within an hour, although they may last for up to 24 hours. Because you cannot tell if these symptoms are from a TIA or a stroke, you should get to the hospital quickly.

TIAs are often a warning sign for future strokes. Taking medicine, such as blood thinners, may reduce your risk of a stroke. Your doctor might also recommend surgery.

National Institute of Neurological Disorders and Stroke

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They’re coming more frequently now. We saw the first (that we noticed) early this year. I was helping my MIL out to the car for a hair appointment, and all of a sudden she just slumped, slipping straight down, knees buckling to the pavement before I caught her.

The first time you see a T.I.A. hit someone, you’re completely bewildered by it. Well, at least I was. My MIL, who was capable of standing and stepping with care and help, and who is usually somewhat plugged into her immediate surroundings, just seemed to “shut down”. I got her in her chair, but she slumped over. She seemed unaware of anything around her, barely responsive to my questions and prodding. It was early in the day, but she was acting like it was the very end of the evening, when she would usually be deep into ‘sundowning‘, exhausted and ready for bed. So, I put her to bed.

Then I called my wife, did some research. I had thought it was likely a T.I.A., and brushing up on the available info confirmed it. So did my MIL’s doctor, who my wife called.

What to do? With someone of my MIL’s age, and with her other medical issues? Nothing really to be done. Bed rest, note it. Roll with it.

* * * * * * * * * * * * *

When we’d had a couple more T.I.A.s this summer, and with the other indications we’d seen (some of which I’ve mentioned), we decided the time was here to again seek Hospice. In the month since, my MIL has had several more T.I.A.s, about one a week. Each time, the treatment is the same: get her into bed, let her sleep it off. After a couple of hours she’s back to what passes for normal. We note it, and are sure to tell the Hospice nurse when she comes for her weekly visit.

A T.I.A. itself isn’t really that big a deal, as noted on that site cited above. It is, however, something of a warning. As the Wiki page on T.I.A. states under “Prognosis”:

Patients diagnosed with a TIA are sometimes said to have had a warning for an approaching cerebrovascular accident. If the time period of blood supply impairment lasts more than a few minutes, the nerve cells of that area of the brain die and cause permanent neurologic deficit. One third of the people with TIA later have recurrent TIAs and one third have a stroke due to permanent nerve cell loss.

* * * * * * * * * * * * *

So, we wait. For either another T.I.A., or a full-fledged stroke. And we try to make her days as comfortable and enjoyable as we can, within the constraints of our own exhaustion and need to pace ourselves for what could yet be a long haul.

And in the meantime, tomorrow is our 20th wedding anniversary. For the most part, observation of same is postponed until later by tacit agreement between my wife and I, though we will make a favorite meal and bake a cake. We have one another, the details will sort themselves out later.

Jim Downey

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