Q: I am 93 years old and, four days ago at 4 a.m., I woke up in the morning lying on the floor next to my side of the bed, not knowing how I had gotten there. I also noticed I seemed very weak, especially on my right side, and when my wife came to check on me, I couldn’t speak intelligibly. She wanted to call an ambulance, but I was beginning to feel somewhat stronger and I was able to say “no” several times.
After about 15 minutes, she helped me get to the bathroom, where I sat for about a half-hour, during which I felt steadily better. I was then able to finish my usual morning routine, including dressing and walking to the kitchen for breakfast. Since then, I’ve been feeling quite normal. I take a medication to improve circulation in my legs, and I also have a cardiac pacemaker, but otherwise take only the occasional Tylenol for aches.
This has never happened to me before, and I’m uncertain what to make of it. I haven’t called my primary doctor or my heart doctor about this yet. What do you think caused this and should I be concerned?
A: This is a textbook description of a transient ischemic attack (TIA), caused by a temporary interruption of blood flow to, from your description, the left side of the brain. TIAs (commonly referred to as mini-strokes) are nearly always a warning of impending stroke in the rather near future and need to be taken very seriously. When you and I spoke on Friday afternoon, I very strongly recommended you inform both of your doctors about these events that very day, as several important tests are needed to help guide the treatment that will help prevent a stroke.
You called your primary doctor’s office at about 4 p.m. and found them closed; the recording advised you to go to the ER with any health concerns. However, feeling quite normal, you opted to wait until Monday to call your primary doctor, who ordered a head CT scan, as the metallic pacemaker makes an MRI impossible.
When we last spoke, the CT had not yet been scheduled, nor had the heart doctor been informed of the situation. I expressed very significant concern that you could have a debilitating stroke at any time and that it was very important that the heart doctor be fully informed of all this as soon as possible, as he would most certainly spring into immediate action. You agreed to call his office right away, and I’ve been waiting to hear the outcome of that call.
I want to thank Sam J. for this question. To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website, familydoctor.org, where you can search for your topic of interest.
If you have a particular topic you would like to hear more about, please message me at paulmdake@ gmail.com.
Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.
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Transient ischemic attacks (mini-strokes) are nearly always a warning of impending stroke and need to be taken very seriously.
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