Tuesday, September 24, 2013

20 Hours In The ER

Tuesday, August 27, 2013 was quite like any other Tucson summer day: mid to upper 90’s, a little more humid than usual since we were still in Monsoon Season, with enough cloud cover to give a little break from the unrelenting sun.

Tuesday, August 27th I rode, as I do most every day, averaging about 40 miles/day 27 days/month. Today I would ride to Sabino Cycles with the intent of buying a pair of Specialized S-Works 2013 cycling shoes, grabbing a summer salad at the Epic Cafe right next to Sabino Cycles, and then scouting out a bike route from my house to Kino Stadium. Kirk and I would be riding to the Stadium two days hence to meet some friends for the Tucson Padres last ever home game. They would become, henceforth, the El Paso farm team. 

I accomplished that agenda fully.

I arrived home about 4:00, settled in at the kitchen island over my computer to catch up on emails, social networking, data entry from my ride all while goozling a couple of glasses of iced tea.

Kirk left about 4:15 to go to the gym and attend a meeting expecting to return about 8:15 to a home-cooked Indian dinner.

I was surprised to notice that somehow it had gotten to be about 6:15. I would need to hustle to get some dinner underway and get showered. 

Ingredients all prepared and showered by 7:15, I decided to do my exercises on the 2nd floor so I could keep my eye on some boiling water.

Water boiled, I got up to turn off the stove and that’s the last thing I remember.

I did know I didn’t feel good, although I can’t tell you what not feeling good means. I felt like I wasn’t thinking clearly, but didn’t and don’t know what that means. Decided I better sit down, and so I did. I sat down in a recliner in the living room and hoped Kirk would come home soon.

When he came home about 8:15 I told him 10 times I was confused and I thought I had taken a shower. I don’t remember saying it even once.

Kirk told me we were going to the hospital and I meekly complied, surprised he knew where to look for my shoes. 

He asked me on the way to the hospital (4 miles tops) if I remembered that I had picked him up at the airport the day before. 

I did not.

He asked me if I remembered where he had gone the preceding weekend. 

I did not.

He asked me if I knew where we were going next weekend, Labor Day, (we’d be going to Breckenridge, CO for a friend’s wedding). 

I did not.

He asked me if I knew what day it was. 

I did not.

Did I remember where I rode today?

I did not. 

I asked him who the President was. He told me it was Obama and that I had voted for him twice.

Having practiced most of the questions on the way to the hospital  that I knew I’d be asked as part of my Mental Status Exam that I’d be asked when we got to the ER, I was sure I would PASS with proverbial flying colors. 

I failed. We hadn’t practiced what year it was. When asked, the best I could come up with was I thought it was in the 20’s.

And so for the next 20 hours we were in the University of Arizona Medical Center’s ER with everything there is to be monitored, monitored. There were lab tests, a CT scan of my brain, an MRI and MRA of my brain, a Lumbar Puncture, traditional x-rays, and a clean bill of health. No diagnosis.

It’s reassuring to know I didn’t have a brain tumor, cerebral arterial disease, infections, or...

But it is not reassuring to not know who our President is and what year it is and yet be given a clean bill of health.

Three days later I used that route I scouted out on August 27th, to ride my bike to the U of A South Campus to the Neurology Clinic. They diagnosed me as having had a Transient Global Amnesic Episode (TGA), a phenomenon of unknown cause, that typically only happens once in a person’s life-time; usually happens to people between the ages of 60-80, equally often in men and women. Interestingly, two days later a NY Times reporter wrote about his experience with a TGAwhich sounded exactly like  own, replete with the repetitive questions and comments. 

The Neurologists recommended I have an EEG, the one test not done in the ER the night of Tuesday, August 27th and Wednesday, August 28th. No idea whether EEG’s are even done 24/7 as part of acute care. Anyhow, rode my bike back to the South Campus (10 miles one way) a couple of more days later for my EEG, fully expecting it to be 100% normal, as every other test had been. And, having no history of seizures, head injuries, or brain infections, why would I, or anyone suspect an abnormal EEG. Guess you could say I have had a pretty ordinary, uneventful head life. 

To say it was a surprise would be a gross understatement when I received a call from the Attending Neurologist’s secretary from the Neuro Clinic, two days after the EEG, who said, and I quote: “We got the results from your EEG and it was abnormal. You have a Complex Partial Seizure Disorder. The Neurologist wants you to take this medication. What is your preferred pharmacy?”

Knock me over x3! 

First gut punch: My EEG was abnormal 
Second gut punch: I have a seizure disorder
Third gut punch: to receive all of this news from a secretary 

This is not good medicine, true that.

Over the next 10-14 days I got to know my PCP real well; I found an Epileptologist (you guessed it, someone who specializes in Epilepsy) who will oversee my brain; I accepted the fact I will not be driving until I’ve been seizure-free for 90 days (actually not a big deal for me as I’ve driven maybe only 2x/month since we’ve lived in AZ, but nonetheless it’s a restriction I need to take seriously); and I’ve adjusted nicely to my anticonvulsant medication.

No one has said I can’t ride my bike, and everyone knows I do. (By the end of September, despite all the doctoring, I will have ridden over 1,200 miles). What it does mean, riding-wise, is I am more intentional about sharing my routes with Kirk before I leave home, and he is more intentional about keeping his phone nearby when I’m out on the road.

Well why, you ask, at age 67 and 10 months did I have a seizure now? I’ve been asking the same thing. And, yes, I did, indeed have a TGA, which can be triggered by seizure activity. Frankly, I feel more comfortable knowing where the TGA came from rather than that it just happened. I’m not an easy subscriber to “It just happened” for anything. Cause and effect, even a perfect storm of causes and effects, makes a lot more sense to me than, “It just happened.”

Here’s the part of this whole thing that’s been hard for me to accept graciously and gracefully. At least 5 times in this doctoring process I have heard statements like this:

  • Seizure thresholds decrease in the elderly.
  • I recommend you take this medication as it is more easily tolerated by the elderly.
  • I recommend you take this dose of this medication because of your age.

C’mon now! I frickin ride my bike 12,000 miles a year; I climb a minimum of 20 flights of stairs a day in my 3-story house, I’m registered for a 12-hr Time Trial in Palm Desert in early November (racing age 68) where I have a realistic shot at completing 200 miles in 12 hrs. Dammit, I may be Senior, but I’m not elderly. I know, it’s semantics, but it sure is reminiscent of the little bullying rhyme of early childhood: “Sticks and stones can break my bones, but names can never hurt me.” I never got that when I was in grade school, because names hurt then and they hurt now. What I get called now is just different. 


Thanks to all of you who have been far more compassionate than the medical community who dubbed me “elderly”. I’m ready to get on with my life: my life of advocacy for cycling in Tucson, my life of being an active grandma with my 7 grandkids (heading to Eugene, OR in a couple of weeks), my life of leadership at our church, my life of knocking off riding goals like the Time Trial in Southern CA, Kirk’s and my bike tour across Viet Nam in January, and riding in 5 more states in the US in 2014. By the end of 2014 I will have just one more state to ride in to have ridden in all 50. What’s kind of funny is, that one last state is South Carolina. I should have ridden in that State in 2011 when Kirk and I drove for 99 days to get from Chicago to Tucson. But, I broke my foot in Georgia and was off the bike for 6 weeks when we drove through South Carolina. 

Oh well, good reason to go back to the Southeast to pick up SC in 2015.

Thanks for caring, thanks for listening.