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TIA post surgery: 6 YEARS POST surgery! (Read 4924 times)
alysonsuj
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TIA post surgery: 6 YEARS POST surgery!
Aug 27th, 2008 at 9:59pm
 
Hi all.

I'm new to the message boards, though not the site.

I was diagnosed in 2001 after years of seizure misdiagnoses.  Bilateral EDAS was performed in February of 2002.  (Mark Mayberg, formerly of the Cleveland Clinic, now working in Seattle) I had a pretty significant TIA this afternoon after years without problems.  I did have some post-operative anxiety in the past but this is well under control.  I am in my 2nd year of my Ph. D in molecular neuroscience and this could not come at a worse time.  Things are finally falling into place after years of struggling with anxiety/depression/attention-difficulties.  I have never experienced intellectual deficit or cognitive issues nor residual symptoms resulting from stroke.

Is it normal to experience TIA this long after the successful surgery?  Is this something I will always need to be conscious of?  I do admit that in the 2 years after my operation I would have the occasional ischemic episode but these have long since subsided.  I am reluctant to receive the gamut of diagnostic procedures if all they can tell me is that I may be symptomatic every now and then.  My life is excellent right now and I am opposed to putting it on hold again!

Best,

Aly

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leemyd
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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #1 - Aug 27th, 2008 at 11:27pm
 
My daughter at the age of 9 had her bypass a year ago with Dr. Steinberg at Stanford.  According to the team, the surgery was a success.  Tests after surgery and at 6 month showed ample blood flow.  However, she continues to have TIAs lasting between a minute to 5 minutes about once or twice a month.  Most TIAs have been triggered by strong emotional event, bump on the head, or while eating food with MSG.  She has also experienced couple of severe migraine headaches accompanied by vomitting that lasts the better part of a day.    We've yet to receive a clear answer from Steinberg's office, although I believe they are trying.  Nevertheless, she went back to her swimming this summer and placed third in the 100 IM during Divisionals.   She's read several books over the summer including the popular 600 page book 'Twilight.'  This disease has yet to stop her from pressing forward.  We're planning to conduct SPECTs within the next couple of weeks so that Steinberg has more data to compare.  No noticeable permanent damage but TIAs are always terrifying to both daughter and parents.  Hope to see more post-surgery messages on the board.

Michael
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Mar
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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #2 - Aug 28th, 2008 at 9:29am
 
Hi Aly, Smiley Welcome to the boards and to our MM family!

I wish I had a specific answer for you, but with so many individual factors involved with each patients' case, and every MM case being different, there’s no way anyone could say generally speaking, whether it was normal to experience TIA’s long after a successful surgery. What’s normal for one may be a warning to another. That’s why I firmly believe that follow up check-ups are so important, even if it was a successful surgery. The only way we’ll learn more about this rare disease and perhaps be able to answer that question in the future, is if ALL MM patients have continual follow-up testing. I also feel that a TIA is something you should ALWAYS be conscious of. A TIA is very serious and should ALWAYS be of concern in any case. That gamut of testing just may save you from a stroke.

Many have mentioned that they have TIA’s or similar episodes after surgery if they’re under a lot of stress, not enough sleep, and especially if they’re NOT staying hydrated, which is so important for a MM patient. So there are numerous reasons as to why someone could have a TIA after a successful surgery, but it’s best to have it evaluated, IMO.

Also, this may not be exactly what you’re referring to, but just incase, I thought you may want to read some other posts on a similar discussion we had last year.

http://www.moyamoya.com/cgi-bin/yabb/YaBB.cgi?board=news;action=display;num=1183435786

I also have to say I’m so very proud of you for all that you’re accomplishing through your MMD. God love ya! That isn’t easy any time; let alone doing it with a rare brain disease, stroke and all you’ve been through. God love ya!! Keep up the good work. You’ll certainly be in my thoughts and prayers!

Mar
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MrsDeej
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it....and it's beautiful!

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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #3 - Aug 28th, 2008 at 2:02pm
 
Aly,

I wish I had better answers as well, however, like Mar stated, each person is different.  I do know that is common for people to experience TIA's, however, not sure to what extent isn't "normal". 

A couple months ago DJ had a TIA while he was at work, that lasted about 15 minutes.  (he about 6 years out post-op too) He had weakness in his arm/hand (with tingling).  He has NOT had a TIA since December of 2005.  Nothing has happened since (KNOCK ON WOOD) and we chalked it up to being dehydrated! 

I would obviously suggest that if it continues you seek professional advice immediately!!

You will be in my prayers!!!

Steph
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Live everyday as if it were your last, ALWAYS say 'I love you' when leaving someone dear to your heart and NEVER go to bed angry!
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Shan
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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #4 - Aug 28th, 2008 at 9:53pm
 
Aloha Aly,

I read your post and wanted to respond...  I was diagnosed in 2005 and had an emergency double by-pass and EDAS on my right side at the Wake Medical Center in North Carolina by a MM expert, Dr. Takanori Fukushima.  Up until a couple days before my surgery, I too was misdiagnosed/or not diagnosed until a local neurosurgeon and personal friend of Dr. Fukushima went to the hospital to look at my films.   ;Grin  Anyway, prior to surgery, my TIA's progressed--from numbness in a portion of my lip, to my finger, to my top and bottom lip, then half of the left side of my face.  Thank God, since my surgery I haven't experienced any TIA's.

As Mar stated, many have shared situations of when/why they feel they had a TIA; however, I would recommend that in order to be on the safe side, I would get checked out.  I understand that this may not be the "right time", but truly, there is never a "right time" for illness.  The American Heart (americanheart.org) says that Quote:
A TIA is a "warning stroke" or "mini-stroke"....
They go on to say Quote:
..."Recognizing and treating TIAs can reduce  your risk of a major stroke."
(see below)

Transient Ischemic Attack (TIA)
http://www.americanheart.org/presenter.jhtml?identifier=4781

What is a TIA or transient ischemic attack?

A TIA is a "warning stroke" or "mini-stroke" that produces stroke-like symptoms but no lasting damage. Recognizing and treating TIAs can reduce your risk of a major stroke.

Most strokes aren't preceded by TIAs. However, of the people who've had one or more TIAs, more than a third will later have a stroke. In fact, a person who's had one or more TIAs is more likely to have a stroke than someone of the same age and sex who hasn't.

TIAs are important in predicting if a stroke will occur rather than when one will happen. They can occur days, weeks or even months before a major stroke. In about half the cases, the stroke occurs within one year of the TIA.

What causes a transient ischemic attack?

TIAs occur when a blood clot temporarily clogs an artery, and part of the brain doesn't get the blood it needs. The symptoms occur rapidly and last a relatively short time. Most TIAs last less than five minutes. The average is about a minute. Unlike stroke, when a TIA is over, there's no injury to the brain.

What are the symptoms of a TIA?

It's very important to recognize the warning signs of a TIA or stroke. The usual TIA symptoms are the same as those of stroke, only temporary:


  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause
    The short duration of these symptoms and lack of permanent brain injury is the main difference between TIA and stroke.

TIAs are extremely important predictors of stroke. Don't ignore them!



Additional information from the National Stroke Association
http://www.stroke.org/site/PageServer?pagename=TIA

What is TIA?

TIA means:  
 T = Take
 I = Immediate
 A = Action


A transient ischemic attack (TIA) is an event, sometimes called a mini-stroke, or stroke symptoms that always last less than 24 hours before disappearing. While TIAs generally do not cause permanent brain damage, they are a serious warning sign of stroke and should not be ignored!



More than one-third of all people who have experienced a TIA will go on to have an actual stroke. In fact:



5% of people will have a stroke within two days of their TIA



11 % of people will have a stroke within 90 days of their TIA

14 % of people will have a stroke within one year of their TIA

20 % of people will have a stroke within 2 years of their TIA


I know you are a very intelligent woman, and thank God you have never experienced any deficit resulting from a stroke-- My opinion, again, would be to make an appointment and speak to your medical team about conucting follow-up tests.  I'm not sure when your last MRI/MRA or perfusion, etc. tests were done, but if none were done recently, it wouldn't hurt.  Someone also mentioned follow-up appointments, and I definitely have to agree with keeping those too.  Wink

Take care,
Shan  Smiley
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« Last Edit: Aug 28th, 2008 at 9:57pm by Shan »  

"Love, Accept And Respect All Things And All Situations In Life … They Are Especially&&Designed For Your Personal Learning" ~Howard Willis
 
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alysonsuj
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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #5 - Aug 29th, 2008 at 8:07am
 
Hello Again:

First of all I'd like to thank everyone who responded with advice and concern.  I would like to update:

I did have an appointment with my neurologist (whom I haven't followed up with for 3 years now) yesterday morning.  He did not perform the surgery as my surgeon is now across the country.  We discussed the episode and he opted to place me on aggrenox once again, along with a couple of headache treatments (of these I'm skeptical: the headaches are always secondary to the episodes).  Unfortunately, my history of anxiety following the operation always makes this a difficult call.  As he put it, "anxiety tends to mimic our weaknesses, and only I can tell if I had a TIA".  I am still reluctant to say "YES, this was a TIA", partly from the years of misdiagnoses, mostly in the psychiatric field (attention seeking behaviors, bipolarity, & personality disorders were among my favorites) I don't know anymore what is real and what isn't! I did inform him that my anxiety is completely under control and I was in a particularly un-stressed state, and have been for the past 3-4 months.

So we decided to go ahead with the prescriptions for 2 months and if I remain symptom free we will hold off on the angiogram (my last one was 3 years ago).  In all honesty he pushed for the scans but I urged him to hold off.  I mentioned in my original post that I am a graduate student.  With graduate studies comes a minimal stipend and nearly no extra money at the end of the month.  I was recently denied coverage by 2 insurance providers due to my moya moya history.  I am barely making ends meet and currently paying a large sum to remain on my parent's insurance until another option becomes available.

Sorry for the lengthy update...please...feel free to respond further.

Best,

Aly
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Shan
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Re: TIA post surgery: 6 YEARS POST surgery!
Reply #6 - Aug 29th, 2008 at 6:34pm
 
Aloha Aly,

i understand finances may be tight right now, and I truly don't want to harp on you--but i do want to be sure that your health is a priority.  without your health, all the other things won't really matter if you're not able to function.  Embarrassed  i was a little surprised to see that you have not seen your neurologist in 3 years. although i have been asymptamatic, for the most part, my medical team still has me following up with them.  i remember having an annual angiogram after my first year of surgery as well.  Undecided 

as for your doctor wanting you to have scans done, i would recommend taking his advice.  at least it will give you an idea of what exactly is going on--and possibly vital information as to why you experienced a TIA recently.  i believe the scans may also help with preventative measures as well.

i am taking aggrenox too.  i  have been taking it twice a day ever since my surgery in 2005.  i also take 325 mg aspirin.  i truly understand that the rising cost of medical care doesn't help any--but if there's a will, there's a way.  if your scans are deemed necessary by your physician, will it be covered?  hmmmm... maybe you can work out a payment plan with your local hospital/radiology center?  i know you mentioned you are a graduate student, and you possibly have student loans...but maybe you can take out a personal loan?

again, i wouldn't want anything serious to happen to you--especially if it could've been prevented.  it is my wish that you re-think your physician's recommendation to at least have scans taken.

take care,   Smiley
shan

of course..just my Smiley
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"Love, Accept And Respect All Things And All Situations In Life … They Are Especially&&Designed For Your Personal Learning" ~Howard Willis
 
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