has anyone had a TIA while on Pred and having PMR
Posted , 5 users are following.
I was rushed tohospital 4 days ago with a suspected stroke, Cat scan brain with perfusion showed no acute pathology, and no carotid stenosis. No haemorrhage or collection. No space occupying lesion. There was a slight abnormality in my heart beat hence having a 24 hour Holter Monitor next week and also an MRI booked in as well, to check on heart beat. My trip to a Haemotologist for abnormal blood results is cancelled for 3 weeks, whilst I have these other tests performed. Am now on Aspirin as well as a higher dosage of my Crestor (for high cholesterol).
I was just wondering if any of you on this forum had a TIA problem, could this be the prednisone causing this as well?
I had a nice English Dr in the Hospital who said it may well be, though none of the Drs are sure about this. The Haemotologist may well be able to help with this question....
Track
0 likes, 24 replies
EileenH track
Posted
I have had two episodes of transient global amnesia during the years I have had PMR - which have to be distinguished from a TIA in the differential diagnosis. One was with PMR, without pred, one was with PMR and on pred.
I also have atrial fibrillation - the signs of which (palpitations) started in the early days of PMR but was never diagnosed (neither was the PMR) until a few years ago when I had a bad adverse reaction to a drug in the form of a/f. Once it was identified and treated - I realised the episodes I'd had previously had been a/f. The cardiologist is confident it was due to the autoimmune part of the PMR having damaged the electrical cells in the heart. The a/f is managed with medication including an anticoagulant (not aspirin) and BP meds. NO statin - a/f does not count as a cardiovascular event and I reacted horrendously to Lipitor, almost ending up in a wheelchair!
track EileenH
Posted
I have gone back onto Cholesterol lowering drug as I was taken off it about 4 months ago as it can create more pains which my Dr thought was happening. I had been on these drugs for 35 years, my Mother was the same with very High Cholesterol. The Neuro. in hospital thought I had better go back to taking Crestor as while being off it for a few months my Chol. had jumped from 4 to 7.8 and this concerned him, he thought this may have been the problem with my having a TIA.
They are doing the MRI to see if anything, at all shows up, also I am having an Echocardiogram next week.
I will keep you informed as to results, and thanks again for answering so promptly.
Track
amkoffee track
Posted
I just had a TIA four weeks ago. But I've also had a stroke about 4 years ago, before I had PMR. And a year before my stroke I had a blood clot. So I have a tendency to clot. So I don't know if I'm a fair comparison. They put me on Plavix since I was already on aspirin when I had the TIA.
track amkoffee
Posted
Sorry to hear you also had a TIA. I don't appear to have a problem with my blood clotting. It is a bit of a worry to hear you were on aspirin when you had the TIA. I will talk with my GP about that and mention Plavix as well.
Thanks for answering my questions.
Hope you keep well.
Track
amkoffee track
Posted
They said that the aspirin saved me from having a full stroke. They did put me on Plavix after this to keep me from having another stroke. They also changed my cholesterol medicine because my cholesterol was up. But for the life of me I can't think of the name of it right now. Anyway I am hoping that I don't get a third stroke because how many strokes can you get and not have any deficits. I've lucked out twice I don't want to take a chance because I think the third stroke is going to be bad. This time when I woke up I could not use my right hand at all and I could hardly speak. I got most of my arm movement back relatively quickly and it took a few hours to get my speech bad. But I was able to call for help even with my speech problem. Are you having an MRI done of your head? Because I can describe it to you if you want me to but they didn't tell me what to expect and it was probably a good thing because I really would have worried so I don't know whether you want to know or would rather not know until the day of.
track amkoffee
Posted
My left side went all funny, I knew what was happening though, and my walking went off, this lasted for about 6 hours then back to normal.
take care, Track
amkoffee track
Posted
Well they put your head in a box and lock it down and then you go into the MRI. The doctor that ordered it did not tell me that that's what was going to happen and he said they did that on purpose. And because of my bad back I've had many MRIs and I'm very claustrophobic so I've worked out a system on how to get through them. And what I do is I ask them for a cloth to put over my eyes so I put it on my eyes right away then I didn't see what they were doing. I was just psyching myself up for the MRI. So they said they were going to put some pillows around my head to muffle the sound of the MRI and so I never realized they also put the box over my head. And I would have not known had I not reached up because something pulled my hair and that's when I felt the box. It was as they were pulling me into the MRI machine. I realized I had two choices I could totally freak out or I could deal with this. So I decided that I would just start thinking about something else and of course I did and I got through it all. She said it would take 20 minutes and that's probably what it took. So I hope I haven't worried you or stress you out too badly. The box is not tight against your face and I do suggest you use the cloth for your eyes that way you don't see them put the box on your head. Good luck on that and I hope they don't find anything
track amkoffee
Posted
Where do you live? I am in nsw Australia, very hot here this summer, came very early, the humidity is horrendous. I saw a news report last night that Brittain is experiencing very cold weather with snow,hope all is okay over there. Strange happenings world wide with weather patterns.
take care,
T
amkoffee track
Posted
I hope you don't spend the next six days worrying. Do bring a cloth to put over your eyes here in America which is where I am they always have something to put over your eyes but I can't say what it's like there in Australia. On your way there think of subjects that you can think of while you're in there. Make sure the subjects are ones that will keep your mind occupied. For example I kept thinking about all the bills I need to pay because I was going to have to spend the night in the hospital and I was worried about how I was going to get the bills paid if I had to spend more time in the hospital than just one day. Concentrating on that kept me from freaking out about the head box. Also whatever you do, do not reach out and touch it at any time. I think by doing that it makes it all the more real. I can't think of any other suggestions but if I do I'll post them here. Good luck
track amkoffee
Posted
Hi Amkoffee, sorry I just replied to Anhaga thinking it was her who gave me advice on the MRI.
Well all went well, a real Rock n Roll ride, table shaking etc. They gave me a blind fold which I did not use,and also head phones with my choice of music which came in handy with the noise. Thank you for your in-put, it is all over with now and I get results back tomorrow, so will let you know how it went, also results for Holter Monitor (24 hr) and Echocardiogram tomorrow as well.
Sorry for replying to Anhaga, she will most probably wonder what I am talking about
Track
amkoffee track
Posted
Lol Anhaga would surely wonder.
I'm glad you were able to make it through it. I asked them for headphones and they told me it wouldn't work with my situation. But I'm certainly glad that it did in your case because when I've used them for my lower back it made a huge difference for me.
Good luck on the results of that MRI. I don't know if it's good luck to find something so you know what it is or not find anything.
Lastly I to have worn a Holter monitor too. Unfortunately for me I reacted to the glue that was on the stickers. By the time I took the stickers off there was a huge rash for each sticker. I certainly hope that does not happen to you.
Best of luck.
track amkoffee
Posted
Track
amkoffee track
Posted
I don't get the left right thing either. But it's my understanding that the right side of the brain operates the left side of the body and vice versa. When I had my last stroke, my TIA it was my right side that was affected and he told me that that means the TIA was on my left side. I also had a Holter monitor done too. Just like you but mine was normal. I'm sorry that yours had a problem. Did they want say anything about why they did a Holter monitor? It checks your heart not your head. So that would have me a little concerned. What milligram aspirin are you taking? Because I've had a blood clot prior to my stroke they wanted me on 325 mg which is a full strength aspirin rather than a baby aspirin. I'm glad you going to go see a neurologist. I've never saw one other than it I think I saw one when I was in the hospital. That was when I had my full stroke the first time. Well if I were you I would probably try to send I laid another message to Eileen because if you haven't heard from her yet she probably didn't get it. Good luck to everything try to keep that blood pressure down. Fortunately that's one thing I have not had a problem with
EileenH amkoffee
Posted
One very common cause of stroke/TIA is cardiac arrythmias. It is important to identify the risk and use (at the very least) anticoagulants to reduce it.
The heart doesn't expel all the blood each beat - a small amount lies around at the base of the ventircles and there can be sort of sludge and clots forms. During an arrythmia it stirs up the blood and these clots are more likely to be expelled from the heart, where they do no damage, into the blood circulation. If the "bits" are very small they will pass through the circulation without catching on anything until they get to the capillaries (the smallest blood vessels in muscles, and organs, especially heart, lungs and brain). They may get stuck there - and too many piling up in the traffic jam can eventually block the blood vessel. The result is a TIA/angina (when the symptoms resolve in under 24 hours because it was a very temporary stoppage) or a stroke/heart attack when it was longer. The best way to deal with the risk is to avoid it - and to put the patient on anticoagulant medication to reduce the formation of clots in the first place.
A single ECG rarely identifies arrythmias unless it is something that is going on for a long time and you go to a doctor or call emergency services who will arrive with an ECG machine while it is still happening. Most arrythmias aren't even noticed by the person - they complain of palpitations or feeling a bit dizzy but that is all. They can last for hours - but are far more likley to last minutes. They are just as dangerous though. The Holter monitor looks at 24 hours-worth - but even that may not be long enough to catch what is called paroxysmal arrythmia. There are various sorts, some are more risky/serious than others and obviously there are different ways of treating them.
That's why the heart is significant in stroke risk.
EileenH track
Posted
No - no post to me from you! You'll have to try again!
track EileenH
Posted
Sorry Eileen don't know what happened with previous post. My MRI showed subacute infarct in the posterior limb or right internal capsule and multiple ischaemic foci in the cerebral white matter due to small vessel disease, consistent with age, so Dr said. I have been refered to a Neurologist for follow up. blood Pressure up so now on bp tabs, also 40mg of cholesterol. Had to cancel apt with Haemotologist, seeing her in 3 weeks, bloods still showing abnormalities. Asked my Dr if Predn. could have caused TIA, of course he does not have a crystal ball, so this could not be answered. Echocardiogram was normal. 24 hour Holter showed rare atrial ectopics 12 only, not to worry about plus 2 couplets. One interesting remark in MRI report stated "Incidentally noted is an empty sella" I googled this and found an interesting article, the sella is where the Pituatory Gland sits, and the Gland can be squashed down flat as though it does not exist and from what I can make out sometimes it does not exist, would like your input on this one, quite strange I think.
I am going to ask the Neuro about this one.
Thank you
Track
EileenH track
Posted
I think it is very unlikely the pred caused a TIA - but the vasculitis that is found in PMR and GCA could be implicated in that it causes damage to the inner lining of the blood vessels which can "catch" passing bits as I described above.
I can't remember - is it GCA or PMR you are dx'd with? I see you mention PMR on your profile - but also being on 60mg pred which is REALLY OTT for PMR but would be used if there were any signs of GCA.
There is a significantly increased incidence of cardiovascular events like TIA and stroke in the first year after dx of GCA - so I think that is where you will find the link.
I see headache is a symptom that may occur with empty sella syndrome.
amkoffee EileenH
Posted
As always you make things more clear to me then some doctors do. I had no idea the significance of the heart was to a stroke. They did have me do something that I can't remember the name of but essentially it was a sonogram of the heart but with bubbles. I'm sure you know the name of it. Mine was normal thankfully. My question is what would that have shown them?
EileenH amkoffee
Posted
Was it this: A bubble saline contrast echocardiogram?
"You may already have had an echocardiogram performed; a safe, non-invasive procedure that uses ultrasound waves to see the heart. A bubble saline contrast echocardiogram is similar but during this procedure a small sample of your blood will be mixed with a saline solution (sterile salty water) and injected through the thin plastic tube in your arm. You may be asked to hold your breath for a few seconds during the test. The injections will be repeated several times and the whole procedure will last approximately 30 to 40 minutes. This procedure gives much clearer images of the heart as the saline solution helps enhance the quality of the pictures."
I'd never heard of it - but my husband had.
track EileenH
Posted
I believe there is a blood test to check to see if the Adrenal Glands have kicked in I expect my Dr will request this when I reduce down some more with the Prednisone.
with thanks, Track
EileenH track
Posted
However - I suspect it was the GCA that gave rise to the TIA.
amkoffee EileenH
Posted
Yep that's exactly it. I had had one echocardiogram already which was normal but after my TIA they wanted me to have this one. And fortunately it was normal to. I will say I thought it was performed by a couple of complete buffoons but I hope that their process was good.
When I sat up I almost passed out. I told him I was very dizzy and then I fell back into the wall. He asked if I was okay and told him I told him I was not sure. At that point he left the room and said I could get dressed. I was really frustrated with that kind of lack of caring attitude.
EileenH amkoffee
Posted
Delightful patient skills! I'd make a complaint...
track EileenH
Posted
much appreciated.