13 December 2024

I think I aged four years today. We are both fine, but Kelly was in the ER for four hours today.

At 10:15 he called me saying something was wrong with his brain. He thought he may have had a stroke or TIA. Immediately in high alert mode, I looked up the acronym for stroke (BE FAST) and ran through the tests—no problems. Calmed a little bit. He was still feeling weird, so we decided to go to Urgent Care.

He had been in the hot tub and lost some time and realized something was wrong with his brain. This was probably 9 or 9:30. He didn’t know what day it was and didn’t remember getting into the tub. His self-preservation kicked in and he got out of the hot tub very carefully and called me.

On the way to Urgent Care I got more worried because he repeated a few things he had said just minutes before.

We went to the top of the triage list and got into a room. Kelly was not quite himself, and was repeating a few phrases over again. Stress levels rising. His blood pressure was 147/81, but the nurse wasn’t worried since being in there tends to lead to higher blood pressure.

In the ER room, he was using the same phrases and questions over and over. I was keeping track. Within an hour he’d asked “Was I in the hot tub?” over 10 times. “I am so sorry this is so stressful for you.” was over a dozen.

Over the next 3 hours he was on a five-minute loop tape. “What happened?” “Did I call you?” “Was I in the hot tub?” “There is a big hole in my memory.” “I am so sorry this is so stressful for you.” “I feel coherent and lucid now.”

I don’t know how many times I answered before I handed him his phone (after about three hours) and told him to write down the answers. Then when he asked again I told him to read.

It was terrifying. He had no short-term memory for nearly 5 hours. Just a loop tape of the same things over and over. No memory of the two CT scans, of five bathroom visits, three blood draws. I waited in the hall when he went to the bathroom so he wouldn’t be lost wondering where to go when he was done.

I didn’t want to leave to go to the bathroom myself, or get lunch, because he was on such a short loop. He wouldn’t remember that I was there with him. He didn’t know why he was in the hospital. I did eventually run down to the cafeteria for some food. Thank goodness, Mayo has a well-labeled and wide selection of GF food.

One of the fascinating things about this awful experience was that it was a good peek at his basic personality—very analytical. And uxorious. He had a problem (blank spot in memory) and was analyzing it to try to explain it. And he wanted to reassure me.

The first CT scan came back negative—no stroke. Reassuring, but still, WTF was going on? Second one also negative—no aneurysm. All the blood work looked good. Kelly is disgustingly healthy.

A large part of my terror was not knowing if I would ever get Kelly back again. He has a family history of dementia and strokes. Would he ever get out of this five-minute loop?

I am going to throw away my copy of 50 First Dates; that would be a PTSD trigger for sure.

Answering the “Was I in the hot tub?” question over and over wasn’t the hard part. It was responding to “I am so sorry this is so stressful for you.” After an hour or so, I just wanted to cry every time he said it. Every five minutes.

At some point I started telling him how many times he had asked a certain question. He managed to shift to occasionally asking “How many times have I asked XYZ?”

He remembered that we needed to let the county folks know that he was not available. He remembered that we needed to tell his mom.

At some point, our dear friend Stewart sent me a link to something called “Transient Global Amnesia”. It matched Kelly’s symptoms exactly. I calmed down a lot at that point, since it typically resolved on its own within 24 hours.

After about five hours of symptoms, he actually remembered what room we were in. (Room #5.) He started remembering to check his phone for answers before asking me questions. Then a few more bits of things he could remember. Then a few more. More personality began to reappear: mostly humor and teasing.

The discharge nurse noticed his change in behavior from admittance to discharge. It was significant. Taking off the bandages and electrodes he was joking and making her laugh.

Finally someone came in to go over everything, and we all think it was TGA. It can be triggered by extreme temperature changes. Hot tubbing at 0 deg F would probably count.

I never want to go through this experience again. The websites on TGA mention that it is often harder on the relative/caregiver. Yeah. Kelly doesn’t remember anything. In the moment, he was pretty cheerful and calm, just a bit irritated to have a big hole in his memory. He won’t remember much of the hospital visit, if anything. That’s probably a blessing.

Home again, seven or eight hours after onset, he is still a bit spotty on the short-term memory, but he does remember things now. I sent him downstairs for a pop and some dried mango and he remembered them both.

There were a few grace notes. Today was a study day at school and I only missed one meeting. On the way to the clinic, Kelly was still worried about stroke and would occasionally blurt out “I don’t have aphasia. I remember the word aphasia.” And once he said “supercalifragilisticexpialidocious”.