Thursday, October 30, 2008

Blogger issues

Blogger has been less than friendly these last couple of days (or Firefox, not sure which) - so every time I get a minute or so to blog, I can't get in, and then... I get busy again.

So, been to the doctor. This time I went to the only guy in the state who does PFO closures (along with procedures for other heart defects) - an outpatient procedure.

He does not believe that what I am currently experiencing is related to the PFO combined with a clotting disorder. Here's the theory we've been working on....

I clot in my veins - that makes me more likely to have a PE, not a stroke.
However, I also have a small, (quite normal & normally harmless) hole between the left & right atrium of the heart that allows some blood from the veinous side of the system to pass through it and enter the arterial system.
That hole allows very small clots (given its a small hole) to pass through to the arterial side - which leads to an increased risk of stroke.
I suffer from short periods of time where my right side repeatedly goes numb.
In the past, if my blood is more thin (the medicine I take to reduce clotting) - I don't have these episodes; but if my blood is more thick (the medicine isn't working effectively) - I have more of these episodes.
Problem started a few weeks ago when my medicine was registering normal (normally means no more episodes) - yet, I was still having episodes.

So naturally, the thought is a) medicine is no longer preventing issue - go to treatment step b) close the hole to stop clots from going through.

Here's his side of the arguement (and he is, an expert and when I called him on a couple of things, he admitted to it; and seems to be looking out for my best treatment)....

When people have clots passing through this hole in the heart - sometimes the clots end up in the arms or the legs or the left side of the brain, or the right side of the brain. They don't land in the same place time & again. (makes sense right?)

So, since my symptoms are always right-side and identical symptoms (i.e., I don't have slurred speach some days or vision changes some day or muscle weakness, nor pain in any extremeties beyond my "norm")... what are the odds that it could be clots?

Sheer randomness would argue that at least once in a while I would have different symptoms - not identical symptoms.

So far, I get it....

So, what is it? -- still don't know; but this time he suggested something that hadn't been suggested in the past two years.... that just perhaps, this is recurrent issues from damage from my original stroke. So, I need to get scheduled with a nuerologist to see if they think that might be it.

If it is - it's good news/bad news - good news is that if it isn't clots going through the PFO -- not only do I not need to have a heart procedure; but the medicine probably IS doing it's job and I'm not at risk for a second stroke in my near future... and? I could probably drop down to a more "normal" target range in medication treatment which has less risk of trouble if something goes wrong. Bad news? There might not be any treatment nor prevention for the symptoms... so I might have to learn to live with it. I think I'd be ok if there was an 'upper limit' to how bad these things are going to get and I knew what that was going to be... however, these symptoms are so VERY similar to my initial symptoms pre-stroke and basically got worse and worse until they became permanant. I really don't want to lose all sensation on my right side. I really don't.

So - more tests next week --- MRI on monday - if they find clots in my brain (odds are really unlikely) then we've proven that the PFO is still an issue and I still need the procedure... a TEE (shove an ultrasound wand down my throat while I'm sedated to look at my heart) on Wednesday - determines size & location of PFO to determine if I'm even a candidate for closure (depending on location - this won't always work)... and then the neurologist.

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