"TIA?" Neurologist says to "Just Ignore it."

[fernblossum]

I am a 55 yr old female office worker. I had a very frightening "episode" at work, unlike anything I have ever experienced. Suddenly lost use of right side of body, could not even hold a pencil or type, began to fall out of my chair as right side had no feeling (did have tingles) or strength. When I tried to stand I nearly fell and had to grab the cubicle wall with my left hand , while calling out for help, nobody heard me until I felt like I was screaming, finally someone looked up saw me and called help, everybody says they didn't hear me, so I am not sure if I was making any sound or not, my lips and tongue were tingling and numb. The ambulance came and my bp was a little high (140/78) and my blood glucose was also elevated (180 this was about a hour after eating), cat scan, ultasound on carotid arteries and doppler on heart were all normal, the ER Dr diagnosed a TIA--all follow up testing was normal including an MRI. I have had 3 of these "episodes" in the last month. My Dr told me to get to the emergency room each time it happened, ER Dr said to see if it last more than 10 min. before going to ER, Neurologist said that based on the excellent results of all test, I am in no danger of stroke and to stop taking the plavix, use baby asprin instead and if I have any more of the "strange sensations" to just ignore them.  I am understandable very confused, I asked the Neurologist what could be causing these "episodes" and he shrugged his shoulders and said, "Some things we never know." He then told me about a mystery pain he has in his right arm, I did not get a consultation fee, by the way.
I thought TIAs by definition don't have residual effects? Are there other things that could cause TIA, other than heart problems, high cholesteral or Diabetes? Is telling me to ignore these events normal advise? He of course did not fill out any paper work for fmla. I have taken a leave of absence to try and get my self together, but am afraid to drive or even be alone as I am completely helpless when these things happen. Does anyone out there have any experience with this? Should I call my Dr and try to get into another Neurologist? Or will he/she just read the same test results and tell me the same thing? I am really bewildered and, believe me, that is not my normal MO. Help please.

[eandp]

I agree with Londres70. your doctor saying "ignore these symptoms" is very wrong.
a TIA (transient ischeamic attack) is like a WARNING SIGN to a CVA (stroke) (cerebrovascular accident). your symptoms should not have been ignored.

hope all works out for you
x

[curious337]

I had a TEE done two months ago. I am still coughing. I believe when the test was done, swallowing the camera or whatever it is, I believe my throat was severly scratched. I've had a very dry cough but severe at times. I was told because the throat is always moist it will take some time to heal??? Anyone experience this.?? It's two months later with very little relief.

[Justice9]

Just read ur post. Wanted 2 share my 2 cents. When I was 23 I had my first TIA. I was put in. Variety of meds, had tests, etc. Well, long story short, had a stroke @ 37. Had 2 holes in my heart which weren't caught until AFTER my stroke. I went threw 4 neurologists before I found the "right fit". I will live w my stroke affects for the rest of my life. PLEASE remember YOU r the customer. YOU employ him! Fight for ur life before u regret not fighting.

[fernblossum]

I accidentally selected a best answer! I think they are all "best":-}

[Londres70]

Keep us posted.  Hope all works out for you.  :)

[fernblossum]

Thanks for responding,

I have decided that I do need to talk to my Dr Monday to see where to go from here. Frankly I was so shocked that I didn't quite know how to react to the Neuro. I know when he told me to ignore it my chin was on the floor because he looked shocked and said "Well isn't this good news?" I said of course I'm happy there is no damage and of course I am happy all the test show me to be healthy, but I really hoped for an explanation and a plan of some kind to deal with this. I mean what am I supposed to do when one happens again? That is when he told me to ignore it. Not much of a plan, IMHO.

I am on lipitor also as I do have high LDL. I also have diabetes, although that is new development and appears to be very controlable.

Londres, my Mom had a "mini stroke" when she was my age and actually lost vision in one eye for awhile, it did mostly come back, although she recently had lasic and it didn't work as well in that eye. Still her Dr said it wasn't a major stroke just a "mini"  so I know there can be lasting effects, but many people have these things with no lasting damage, I'm glad, at this point that is where I am, and I hope it stays that way.

Anyway thanks again to both of you for your imput, insight and concern

Fernblossum

[KLA51]

Hi again,
I forgot to add that in addition to the Plavix, I was also put on Lipitor. My LDL was 2.9 (5 and below is considered healthy) but my neurologist said that after a TIA, the LDL needs to be below 2, and diet alone can only affect the level by about 0.4. Also, I did have after effects for a couple of weeks each time; funny tingling sensations, extreme fatigue, word retrieval issues etc. I hope everything works out well for you.

[KLA51]

I would recommend that you seek out a different neurologist for a second opinion. I had a TIA in March 2010 (age 51) and all the preliminary tests also came back normal. My neurologist said that just means we have to dig deeper and ordered a second battery of more detailed tests, including a TEE test (trans-esophageal echocardiogram) which showed I had a PFO (patent foramen ovale) and ASA (arterial septal aneurysm), both of which may increase the likelihood of having a TIA or stroke. I am on Plavix for life unless the cardiologist I see in June recommends putting me on Warfarin or having surgery to close the opening. I also had a suspected TIA in 2002 and the tests (CatScan, stress test, bloodwork) were normal. I was told to take low dose aspirin daily and was never referred to a neurologist at that time. The tests I had in 2002 missed the PFO and ASA. I think you'll feel much better if you seek out another opinion. The one you received seems inconsistent with best practises for TIA's.

[Londres70]

First, yes one can have residual effects from TIAs.  

Secondly, yes there are other things that can put one at risk for TIAs; Diabetes and Heart Disease increases this risk greatly.

Thirdly, any physician telling your to "ignore these symptoms" is IGNORANT; not
prudent and/or normal advise that a COMPETENT physician would give.

Lastly, my father had a TIA and still has residual effects; it has been 14 years ago.  He is Diabetic.  He was followed up appropriately and lives an independent life with my mother.  Please seek a SECOND opinion ASAP.  The first Neurologist was a "wash out."  Nowadays, it is getting more and more difficult to get the help you need the first time around.  I can't tell you how this next Neurologist will act; hopefully it will be better for you the second time around.  

Keep us posted.