possible TIA?
Posted , 6 users are following.
My dad has had temporal arteritis for more than 10yrs now. He has been treated with prednisolone and latterly also methotrexate too. He has never been able to reduce to less than 12mg steroid daily.
On thursday morning he had an event that occured within 2hrs of being fine whereby my mum found hin collapsed and shaking, totally unresponsive verbally though not unconcious.
He was transferred to local hospital by emergency ambulance.
There he continued to be unresponsive to all stimulus, non verbal and vague.
He was also incontinent, pyrexial and chesty.
Immediate treatment with iv fluids and paracetamol then work up of bloods and ct brain are allegedly negative.
We are awaiting an urgent MRI now but two days on he has become gradually more alert and coherent but with tremor and headache. The headache was prevalent on becoming awake as he was post ictal following the event.
His only active treatment now has been with 30mg pred now and he states that the headache and tremor and weakness begin to recur as they wear off after approx 5-6hrs.
Docs on the ward today were going to discharge him but as he has not had the promised MRI or had definitive diagnosis we declined to take him home.
The only suggested diagnosis has been possible TIA?
They havent even asked his neurology team to be involved.
Do you out there think there is
Any other diagnosis to consider?
We are right to insist he is scanned before discharge?
Should see his neurologist?
Being too precious?
Should i be doing anything else?
0 likes, 26 replies
tina-uk_cwall angela1988
Posted
you say that he has recently started mtx. Could this episode be a side effect of that?
i have just looked up Tia and from what I read it doesn't sound as if that is what he suffered from but to be honest we all have different symptoms to one given condition so maybe it was a Tia.
has he as yet actually seen a specialist? Because I think a specialist is who he should be seeing and you say that he is at a local hospital and very often these hospitals do not have the specialists, so perhaps he should be transferred to a larger hospital.
but I am glad you refused to take in home. They haven't even given him a definitive diagnosis or a proper treatment plan and they wanted to send him home? What next?
i can't help you with any other diagnosis as I am not medically trained. I think you should insist on a specialist and also the Mri scan.
you are definately not being too precious, this is your father you're talking about here and therefore he is very precious. he has a chronic medical condition that has over the ten years could be described as atypical as he has not been able to reduce the medication by any real significance. There is quite clearly a new development either to the existing condition or a new condition.
Hopefully a member will be along soon to offer some better advise, but please hang on in there and do not allow them to push either your father or you about. All the best, christina
marie_loui19398 angela1988
Posted
I can't beleive they haven't done it already! I had mine clipped with tantanium in 2001. I beleive the symptoms are worse than the surgery. I was fine a couple months later.
I hope everthing turns out fine, hang in there!
doreen25667 angela1988
Posted
EileenH angela1988
Posted
If he still isn't well then I would also refuse to take him home until he'd had an MRI and the neurologist had assessed him if he is already under them. But more than that I don't think anyone here can say. If you are in the UK he will have an early appointment with the TIA team - it should be within a week. A TIA is taken as a warning of an increased risk of stroke in the next few years so they investigate to see if there is evading action that could taken. However - Im not sure I'd accept TIA as a diagnosis at the moment because I have always been led to believe the criterion is full resolution of symptoms within 24 hours and it doesn't sound as if that has happened. The stroke lead consulant I saw insisted on ruling out an epileptic episode and what you describe could be that.
Above all - since it is the weekend I would want to know what qualifications in neurology the doctors wanting to discharge him have. My daughter was in last week after a very severe asthma attack and on the ward round the "consultant of the day" from AMAU (medical assessment unit), a gastroenterologist, told her that her breathlessness was probably due to being overweight. Er - no! The respiratory consultant was a bit more informed.
angela1988
Posted
The consultant on call over the weekend is endocrinology speciality so that is why i challenged her decisions to discharge my dad home.
Certainly I feel the discharge is premature and unsafe.
I would want at least the MRI as was promised done prior to him coming home incase it then is further delayed in the ether.
I also would want to have his consultant consultant neurologist made aware of his collapse and admission let alone the dose increase if his steroids.
I shall keep you posted as to the outcome and once again thank you xx
EileenH angela1988
Posted
angela1988 EileenH
Posted
They took a battery of samples, blood, urine, sputum.
His raised crp was most abnormal result thus far from bloods and had risen from 25on admission to 90 yesterday.
We are still waiting on culture from sputum n urine.
EileenH angela1988
Posted
angela1988 EileenH
Posted
Considering hes usually pretty good for his age and has had TA fir ten years!
I feel sure that if we had brought him home yesterday that would def happen!
He hadnt even been mobile for more than 4hrs when the consultant saw him yesterday.
The trouble is with hospitals, all comes to a juddering halt at weekends and communication plus continuity is lost.
(and i work for the nhs:-!).
EileenH angela1988
Posted
Do let us know how your dad gets on. That CRP seems a bit high even for a chest infection though - but untreated I imagine anything can happen.
angela1988 EileenH
Posted
Sadly this is not an isolated incident nowadays and sorry to hear your experience is the same as ours.
In fact my 15yr old neice has been terribly ill since last oct with numerous visits to gp and hospital due to tonsillitis and now glandular fever. Her crp three days ago was 239!!! And a consultant paed asked why she wasnt attending school or eating properly!
He then asked if my sister had been reported to social services because of the absenteeism!
For g sake, shed be in school if fit!
So as you can tell as a family its not a good time.
EileenH angela1988
Posted
If your niece didn't have glandular fever I'd say we should get them together but that's the last thing she needs!
Never used to be like this did it?
angela1988 EileenH
Posted
Dad was a bit brighter today and eating a bit more but then who wont on 30mg pred lol :-)
EileenH angela1988
Posted
Now as soon as I started on 15mg pred the cravings for carbs every afternoon just WENT! Older daughter is the same! I DO know people who lost weight on higher doses of pred...
linda17563 EileenH
Posted