Stroke

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Jamieann;n866854 said:
The exception was a male nurse who kept touching my feet to see if I "had any effects from the stroke in my feet" and then said everyone thinks he has a foot fetish but that he really doesn't. Very awkward.
You weren't tempted to kick him in the head?
 
Strange, isn't it that they seem to like the hour of 3 AM? My last hospital stay, for the new pacemaker and lead, the phlebotomist came in at precisely 3 AM, just when I had finally gotten to sleep, and demanded to draw blood - for what I know not. She wasn't very good or gentle, either. I made sure to tell the nursing supervisor that even if I was to stay another night (which thankfully I did not need to do) there would be no more midnight blood raids.

A note about the warfarin for tissue valvers -- It has been fairly common for some surgeons to prescribe warfarin for tissue valve recipients for 3 months post-op. They do this as a preventive measure, in case any clots are forming immediately following surgery, and also just in case the patient develops undiagnosed (or transient) afib. I know that in my case, my last significant bout of afib came just about 1 full month post-op, so the 3 months of warfarin wasn't a bad idea.
 
I like to call the 3 am phlebotomists the vampires. Definitely not a fan of them! They also don't like that I ask them to tell me every single blood test they are using my blood for.

Judging by my current situation, it may have been a wise idea for them to have put my on warfarin for several months after surgery. But oh well, you can't go back in time!
 
Must be like that everywhere. Post surgery I shared a room with another patient and they would come in and take his blood at 2 A.M. and wake us both up. Then once we got back to sleep they would come in and take mine at 3.
 
I had a stroke at 57 with the clot buster that didn't work. I was in the er within 30 minutes of my stroke. It was before my valve replacement. It is a tough recovery but it can be done. I still have a little weakness in my right arm, very slight drooping to my right side of my face and some speech problems... but I don't think most would know. They probably think I am slow ;)
 
I'm sorry that I've been away from this forum for a few days and didn't see your post until now.
I have a St. Jude valve in my chest. I had a TIA three years ago and, suspecting that it may have been a stroke, I immediately took 2 mg of aspirin and took my INR -- the meter said 2.6. Symptomatically, my left leg felt kind of heavy, and it felt a bit odd when I walked.
I had no medical insurance, and trusted my meter, and dragged this leg around for two days before finally going to the hospital to check out this persistent weakness.
I didn't say the 'magic words' (stroke, heart attack) to get their immediate attention, so I waited in E.R. before they finally decided to dig further into it. An MRI, eventually, showed that I had, indeed had a TIA. The doctors insisted in calling it a STROKE. They put me on a 'stroke protocol.' This 'protocol' included Lipitor (a statin drug used to lower a person's cholesterol). Of course, the study that they used to create this protocol didn't include those like me who took coumadin/warfarin and whose stroke was not caused by cholesterol.

My motor functions seem to have all resolved. I have what may be considered a slight change in my brain -- when I hear words, I often convert them into written text, and process them more strictly than most people would process the free form speech that we all use. As an editor, this may be something of an advantage.

As others have noted, the physical defects often resolve. In my case, I'm assuming that the motor circuits rewired so that the deficits were overcome.

I'm glad to hear that your motor deficits are also improving - in a month or less you may not even know they were there.

I've been taking coumadin for decades. I monitored my dosage and INR since 2009. I trusted my meter - and it let me down. My meter said 2.6 - the hospital said 1.7.

If they put you on coumadin be sure that your INR is tested weekly. If it looks like you'll be on it for a long time, I strongly suggest that you get a Coag-Sense or CoaguChek XS meter, self-test weekly, and check the results against a blood draw every month or so.

I wish you a complete recovery and a competent medical team
 
I also had a TIA. I had AVR 1/11/2016 and my pacemaker implanted on 1/16/2016. I went home 1/17/2016. On 1/21/2016 I woke up from a nap and was completely confused. I could not remember having heart surgery. I asked my wife, "How did I get here? Did I have heart surgery?" She showed me my incisions. I told her that I remembered. I looked up and again asked "Did I have heart surgery".

She took me to the ER immediately. I had a CT scan of my brain that revealed what I now know to be a Rathke's Cleft Cyst. They thought I had a brain bleed. They wanted to do an MRI, but couldn't due to the newly implanted pacemaker. I spent the next 11 days in the hospital on a heparin drip (due to the concern that my brain was bleeding). 8 of those 11 days were in ICU. I was constantly being asked my name, DOB, where are you, why, what year is it, who is the president, etc. They also constantly tested my peripheral vision. I experienced about 12-18 hours of confusion and memory loss. I haven't had a problem since.

​6 weeks after my pacemaker implant, I finally had an MRI. The neurosurgeon finally felt comfortable diagnosing the Rathke's Cleft Cyst (a benign congenital condition caused during the development of the pituitary gland). Pituitary gland issues do not cause confusion. They can cause hormonal imbalances and loss of peripheral vision due to proximity to the optic nerve.

The neurosurgeon concluded that it must have been a TIA and that the Warfarin must have stopped it before it caused permanent damage.

I think I have difficulty placing names with faces that I didn't have before.

I went to the nearest ER to my house. I walked in on my own power. I was then transferred back to the hospital where I had my AVR. I do not remember the interior or any employees at the ER at all.

I previously remembered more of the week after AVR. Now I remember about %10 of it.

No one has been able to explain why I had a TIA. My uneducated opinion is that it had to something to do with the trauma of the 2 major surgeries in a week. I'll never know for sure. I just hope it doesn't happen again.
 
Protimenow;n866952 said:
I'm sorry that I've been away from this forum for a few days and didn't see your post until now.
I have a St. Jude valve in my chest. I had a TIA three years ago and, suspecting that it may have been a stroke, I immediately took 2 mg of aspirin and took my INR -- the meter said 2.6. Symptomatically, my left leg felt kind of heavy, and it felt a bit odd when I walked.
I had no medical insurance, and trusted my meter, and dragged this leg around for two days before finally going to the hospital to check out this persistent weakness.
I didn't say the 'magic words' (stroke, heart attack) to get their immediate attention, so I waited in E.R. before they finally decided to dig further into it. An MRI, eventually, showed that I had, indeed had a TIA. The doctors insisted in calling it a STROKE. They put me on a 'stroke protocol.' This 'protocol' included Lipitor (a statin drug used to lower a person's cholesterol). Of course, the study that they used to create this protocol didn't include those like me who took coumadin/warfarin and whose stroke was not caused by cholesterol.

My motor functions seem to have all resolved. I have what may be considered a slight change in my brain -- when I hear words, I often convert them into written text, and process them more strictly than most people would process the free form speech that we all use. As an editor, this may be something of an advantage.

As others have noted, the physical defects often resolve. In my case, I'm assuming that the motor circuits rewired so that the deficits were overcome.

I'm glad to hear that your motor deficits are also improving - in a month or less you may not even know they were there.

I've been taking coumadin for decades. I monitored my dosage and INR since 2009. I trusted my meter - and it let me down. My meter said 2.6 - the hospital said 1.7.

If they put you on coumadin be sure that your INR is tested weekly. If it looks like you'll be on it for a long time, I strongly suggest that you get a Coag-Sense or CoaguChek XS meter, self-test weekly, and check the results against a blood draw every month or so.

I wish you a complete recovery and a competent medical team
Why was your meter so out, compared to the blood draw? 2.6 and 1.7 are very different, did you approach the manufacturer and tell them their product was defective?
 
Yes, my InRatio was WAY OUT. I relied on it to give me an accurate reading, and as a result, I had the stroke. I notified the manufacturer - and all they did was replace it with a newer model. If I was litigious, I would have sued them and filed a formal issue with the FDA.

Since then, I've tested multiple meters, comparing results to each other, and to blood draws.

I quickly ruled the InRatio out - its results were so far off that I didn't trust it to do anything other than buzz for a few seconds then give an inaccurate reading.

After a long run of tests (documented somewhere on this site), I selected the Coag-Sense as my most trusted meter. (I have a Hemochron Plus Elite, the same one used in operating rooms and at some clinics, but the strips are hard to get and quite expensive). (I ruled out the Protime models because the strips require refrigeration, are not as readily available as those for other meters, and testing is a bit more of a hassle than with other meters).

The Coag-Sense gives me a result just slightly below that of my lab. If my Coag-Sense gives me a 2.1, the lab result will probably be 2.4 or 2.5 - I feel safe in that range.

The CoaguChek XS is my second choice. It's easy to use, and there are millions out there. Strips are readily available, and it's portable. To me, though, the results are the same as, or slightly higher than the labs. In some tests, the results were uncomfortably higher than the labs. To me, if this meter gave me a reading of 2.5, I'd be concerned that the lab result would be closer to 2.1 or 2.2. If it gave me a 2.2, I'd be concerned that my actual INR was below 2. Personally, I prefer a meter that is slightly LOWER than the lab results than slightly HIGHER.

I don't work for Coagusense (the manufacturer of the Coag-Sense meter), but their method of testing actually detects a clot, rather than using an electronic method to detect INR.
 
I believe that the problems with home testing, referred to above, where resolved by Alere a couple years ago........at least I hope so. I used an INRatio2 until a couple years ago and switched to CoaguchekXS as a result of that problem. I think the recent New York Times article may be using some old info and should not be used to demean the effectiveness of home testing in general.

I also noted that some of the info for the article was developed by Johnson & Johnson during their trials while developing Xarelto (one of the new anti-coagulants competing with warfarin)......and Xarelto seems to be having a bunch class action problems of their own. Could J&J be feeding out-dated info to deflect attention away from their own anti-coagulation problems with their brand new drug Xarelto.
 
Alere had some serious problems with their new generation strips. They were recalled and, if I recall, I posted the recall information on this forum. The strips were unavailable for many months - prompting former InRatio users to switch to other meters.
The InRatio strips returned -- and seemed to be much more expensive than those for the CoaguChek XS or Coag-Sense.
Personally, I wouldn't trust my life to an InRatio meter ever again -- once burned, twice...dead?

Xarelto, Pradaxa and other anticoagulant medications have not been approved for those with prosthetic valves. They've been approved for Afib. Aside from the price, the problems with reducing their effects have made them poor replacements for good old inexpensive warfarin.

Whichever meter is being used, it's always good to test against another meter or blood draw, just to make sure that they're within 30% of each other. I didn't think to do this before I had my stroke -- but I sure do it now...
 
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