I described the transient ischemic attack (TIA), arriving like a freight train and departing before dawn (see I Am Dying). Instinctively, I knew this was a warning shot, an enormous detonation. As a former medic, I knew of strokes. I now understand a lot about TIAs but knew nothing relatively several years ago. There are moments when I felt as though I am the only one taking it seriously. Getting medical professionals to understand a patient’s concern can be challenging. A Stroke Association survey concluded 16% of TIA victims didn’t feel taken seriously, and 25% reported that health professionals didn’t realize that they had had a TIA. If a TIA occurs, the patient is likely to be prescribed aspirin, receive a pat on the shoulder, and an escort out the door with a recommendation for a further clinical study.
Unlike my father, I consider my events with mixed emotions as my cognitive skills and memory were not affected during the October episode. Still, research suggests more TIAs are in my future. Some patients realize they had suffered a TIA when reading medical notes with no clinician confirmation of the diagnosis. My experience was similar, as I read my tumor diagnosis via an online patient visit summary posted 21 months ago. Only when pressed did I confirm ‘prognosis was poor.’
TIAs are hard to diagnose. Symptoms vary. Facial weakness, drooping mouth, arm or leg weakness, speech difficulty, blurred vision, and dizziness can occur. Each TIA tends to be specific to the individual, and not all symptoms arise. Initially, my neurologist kind of dismissed my concern. Should the TIA occur again, ‘… we’ll review.’ However, out of caution (since I kept asking inquisitive questions), ‘we’ll schedule an echocardiogram.’
Upon arrival, the echocardiologist greeted, “You’re here today for an echocardiogram because your doctor diagnosed you experienced a TIA.” “Fantastic,” I quipped. Forty-six days later, it was the echocardiologist who stated the obvious, something I already knew but couldn’t receive confirmation. Undoubtedly someone will ask how I know when everyone else cannot. After completing the medical summary (discussed in the post Lists), my intrinsic gut feeling became clearer. My first TIA occurred in March 2019, with loss of vision, foggy sight. Although I improved throughout the following day, the impact lasted three days. My second TIA occurred in May 2019, with left side facial paralysis and mouth drooping. The effect lasted six days. During the third week in October 2020, my third TIA produced no coordinated functionality in arms or legs, no balance, could not stand, unable to lift myself, foggy. The impact was significant and lasted over six days. Should something in the heart be amiss, an echocardiogram will help detect cardiac sources of stroke or TIAs.
The echocardiologist performed a transthoracic echocardiography (TTE) using an ultrasound imaging technique that allows the heart structures to be seen. A hand-held wand placed on the chest provides pictures of the heart’s valves, chambers, and helps the clinician evaluate the heart’s pumping action. It was a ‘matter of fact’ test procedure. A ‘no biggie’ I’m told. ‘Good I thought. At least I didn’t hear, ‘I’m not used to this version of the software. Do you know what this message [Not Currently Recording] means?’ Results come in a week.
Wait another week? I envision doctors talking after my death, “He was in his usual state of humor — right up until his heart quit. Damn. That’s gotta suck.” But here I am. Two days post test, I am still alive. Still kicking. The Chinese Book of Changes (I Ching) states, ‘Waiting is not mere empty hoping. It has the inner certainty of reaching the goal.’ Goal? I have no plan. At this point in my life, if I had dreams, they were created by comedian George Carlin, “… get up, work eight hours, eat three meals, take one good shit and go back to bed.” The mind hates uncertainty, and living in a state of “not knowing” is intolerable.
To understand how inharmoniousness waiting is, I remember working in the emergency room one night listening to one friend comforting another. “You know, Mike; we give ourselves no credit for taking time to be present. The doctor’s said there’s just a few others ahead of you. How about if we pass the time thinking of things we can do in a week or two?” Horridly, Mike stares as if a flamethrower was pulverizing his friend, “F*** that s***.”
To counter such emotions, I become more aware of my feelings and come into the present moment, where everyday activities still take on a joyful, miraculous quality. If I am mindful or fully present in the here and now, anxiety disappears, and a sense of timelessness takes hold, allowing the best highest qualities, such as kindness and compassion, to emerge. And most of the time, it works. Other days, I want to say, “F*** that s***!”