A life-changing experience ...

Yes, I had to stay. "Could I run home to get my clothing and to put my life in order first?" "No," was all they said. Back I went to my room in the E.R. and waited for the next visit from the doctors.

"The MRI showed that you have a number of blood clots in the left hemisphere of your brain. You also have a dissection (or tear) in your right carotid artery. In addition, you have a 60% narrowing in that artery. The flap of the tear 'caught' the blood and formed a clot, which is affecting the blood flow and oxygen to your brain, hence the TIA's." For the record, TIA'S stand for transient ischemic attacks. A TIA is like a mini-stroke that produces similar symptoms as a full-blown stroke, but they usually last only a few minutes and do not cause permanent damage. These mini-strokes should be considered a warning that a bigger stroke is coming; maybe in a week, maybe in a year.

I looked at Barbara as if to say, "What do you think of that?" The Neurologist brought in an intervention radiologist to offer her viewpoint, as she would be the one to put a stent in my carotid, if I chose to go that route. The neurologist continued, "We can send you to the ICU and give you Coumadin and then wait and see if the clot dissolves on its own over the next two weeks." "What are the side effects of this drug, and how long would I have to remain on it?" "You would be taking Coumadin for six months to a year."

He read me the side effects, including the fact that people have a hard time clotting, should a cut or injury occur. I would have to stop most of my active sports during this period. I was not into that, at all. "What other choices do I have?" The radiologist piped in, "You could have a stent inserted into the carotid artery through the femoral artery. It's a reasonably simple procedure and not too invasive. The stent would open the artery and restore you to full blood flow."

The doctors left the room for Barbara and me to talk about this option. We both agreed that this would be the preferable direction. We called the docs back in and listened to the details; the stent would be inserted with an "umbrella" on the top to catch particles of the clot that might become dislodged during the procedure and shoot north to the brain. If even a small piece of the clot should get past the umbrella, you could end up with a stroke or brain damage. This is not a common occurrence, so try not to focus on that too much. She added that the normal procedure in cases like this is to do the ICU and Coumadin, as a "wait and see" process. However, it is possible – given the number of TIA's that you've already had that you might have a major stroke while in the ICU. They would try and mitigate the condition should this occur. I asked her which procedure she favored. She seemed pretty sure of herself that the stent was a better way to go.

We asked the docs to leave us alone for a bit to discuss this.

Best,
Steve - The Stroke Survivor