Wednesday, September 27, 2017

It Wasn't A Stroke But All The Signs Pointed That Way

“Mom?” the middle-aged man asked. He recognized the voice, but the words were muffled and strange. I’ll be right over, he said into the phone. The 15-minute drive from his small Connecticut town to his mother’s seemed to last forever. Had she had a stroke? She was 94, and though she’d always been
healthy, at her age, anything could happen.

By Lisa Sanders, M.D. SEPT. 26, 2017 - New York Times Magazine

He burst into her tidy brick home to find her sitting in the living room, waiting. Her eyes were bright but scared, and her voice was just a whisper. He helped her to his car, then raced to the community hospital a couple of towns over.

The doctors in the emergency room were also worried about a stroke. Her left eyelid hung lower across her eye than her right. She was seeing double, she told them. And the left side of her mouth and tongue felt strangely heavy, making it hard to speak. Initial blood tests came back normal; so did the CT scan of her brain. It wasn’t clear what was wrong with the patient, so she was transferred to nearby Yale New Haven Hospital.

Not Looking Your Age

Dr. Paul Sanmartin, a resident in the second year of his neurology training, met the patient early the next morning. He’d already heard about her from the overnight resident: a 94-year-old woman with the sudden onset of a droopy eyelid, double vision and difficulty speaking, probably due to a stroke. As he entered the room, he realized he wasn’t sure what 94 was supposed to look like, but this woman looked much younger. She did have a droopy left lid, but her eyes moved in what looked to him to be perfect alignment, and her speech, though quiet, was clear.

The patient’s story was also different from what he expected. She had macular degeneration and had been getting shots in her left eye for more than a decade. Her last injection was nearly two weeks earlier, and she’d had double vision and the
droopy eyelid on and off ever since.

Did she have double vision now, the young doctor asked? She glanced around the room. Not just then, but it would come back, she was sure of it. Other than the macular degeneration, the woman had only high blood pressure, for which she faithfully took a pill each day. She lived alone, and until all this happened, drove herself to all her appointments and volunteered at a local school for the disabled.

Unrevealing Tests

The young doctor held up a finger, ... Continue Reading at NYT

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