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    • CommentAuthorCarole
    • CommentTimeAug 17th 2008
     
    When I was giving my husband a shower this AM, he started trembling and almost fell. With the help of my daughter, I was able to get him out of the tub without falling and into the bedroom where we could sit him down. I called 911 to ask the signs of a stroke but his speech is garbled as it is and he did respond when I called his name. We were able to get the diapers on and with the help of a walker, into the LR and into a chair where he's sleeping. Have any of you dealt with this. Now I'm thinking the disease is just progressing and it's time for a hospital bed as he's sleeps on his stomach for 10-12 hours and his back spasms and we really struggle trying to get him up.
    • CommentAuthorSunshyne
    • CommentTimeAug 17th 2008
     
    Carole, strokes can have all sorts of different symptoms, depending on which part of the brain is affected. For example, I've heard of people who appear fine otherwise, but one pupil is larger than the other.

    My husband had a TIA -- his symptoms were feeling a little dizzy (although he appeared to walk OK) and having "trouble pushing words out" (although he sounded OK to me.) The symptoms seemed trivial, but he was complaining, which was unusual, so I zipped him to Urgent Care -- and they scolded me roundly for not rushing him to the ER right away since it was "clearly a stroke".

    Anything new / unusual, I'd be talking to his doctor, bare minimum.
    • CommentAuthorSunshyne
    • CommentTimeAug 17th 2008
     
    Am going to keep looking for more info, but right now:

    American Heart Association web site -- Stroke Warning Signs

    If you notice one or more of these signs, don't wait. Stroke is a medical emergency. Call 9-1-1 or your emergency medical services. Get to a hospital right away!

    The American Stroke Association wants you to learn the warning signs of stroke:

    * 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

    Be prepared for an emergency.

    * Keep a list of emergency rescue service numbers next to the telephone and in your pocket, wallet or purse.
    * Find out which area hospitals are primary stroke centers that have 24-hour emergency stroke care.
    * Know (in advance) which hospital or medical facility is nearest your home or office.

    Take action in an emergency.

    * Not all the warning signs occur in every stroke. Don't ignore signs of stroke, even if they go away!
    * Check the time. When did the first warning sign or symptom start? You'll be asked this important question later.
    * If you have one or more stroke symptoms that last more than a few minutes, don't delay! Immediately call 9-1-1 or the emergency medical service (EMS) number so an ambulance (ideally with advanced life support) can quickly be sent for you.
    * If you're with someone who may be having stroke symptoms, immediately call 9-1-1 or the EMS. Expect the person to protest — denial is common. Don't take "no" for an answer. Insist on taking prompt action.
    • CommentAuthorSunshyne
    • CommentTimeAug 17th 2008
     
    WebMD says:

    If you have symptoms of a stroke, seek emergency medical care. General symptoms of a stroke include sudden onset of:

    * Numbness, weakness, or paralysis of the face, arm, or leg, typically on one side of the body.
    * Trouble seeing in one or both eyes, such as dimness, blurring, double vision, or loss of vision.
    * Confusion, trouble understanding.
    * Slurred or garbled speech.
    * Trouble walking, dizziness, loss of balance or coordination.
    * Severe headache.

    Symptoms vary depending on whether the stroke is caused by a clot or bleeding. The location of the blood clot or bleeding and the extent of brain damage can also affect symptoms.

    * Symptoms of an ischemic stroke (caused by a clot blocking a blood vessel) usually occur in the side of the body opposite from the side of the brain where the clot occurred. For example, a stroke in the right side of the brain affects the left side of the body.
    * Symptoms of a hemorrhagic stroke (caused by bleeding in the brain) can be similar to those of an ischemic stroke but may be distinguished by symptoms relating to higher pressure in the brain, including severe headache, nausea and vomiting, neck stiffness, dizziness, seizures, irritability, confusion, and possibly unconsciousness.

    Symptoms of a stroke may progress over minutes, hours, or days, often in a stepwise fashion. For example, mild weakness may progress to an inability to move the arm and leg on one side of the body.

    * If a stroke is caused by a large blood clot (ischemic stroke) or bleeding (hemorrhagic stroke), symptoms occur suddenly, within seconds.
    * When an artery that is narrowed by atherosclerosis becomes blocked, stroke symptoms usually develop gradually over minutes to hours, or (in rare cases) days.
    * If several smaller strokes occur over time, the person may have a more gradual change in walking, balance, thinking, or behavior (multi-infarct dementia).

    It is not always easy for people to recognize symptoms of a small stroke. They may mistakenly think the symptoms can be attributed to aging, or the symptoms may be confused with those of other conditions that cause similar symptoms.
    • CommentAuthorSunshyne
    • CommentTimeAug 17th 2008
     
    I should emphasize that ANY ONE of the symptoms can mean the person is having a stroke. He doesn't have to have all of them.

    Mayo Clinic:

    Watch for these stroke symptoms if you think you or someone else is having a stroke:

    * Trouble with walking. If you're having a stroke, you may stumble or have sudden dizziness, loss of balance or loss of coordination.
    * Trouble with speaking. If you're having a stroke, you may slur your speech or may not be able to come up with words to explain what is happening (aphasia). Try to repeat a simple sentence. If you can't, you may be having a stroke.
    * Paralysis or numbness on one side of the body. If you're having a stroke, you may have sudden numbness, weakness or paralysis on one side of the body. Try to raise both your arms over your head at the same time. If one arm begins to fall, you may be having a stroke.
    * Trouble with seeing. If you're having a stroke, you may suddenly have blurred or blackened vision or may see double.
    * Headache. A sudden, severe "bolt out of the blue" headache or an unusual headache, which may be accompanied by a stiff neck, facial pain, pain between your eyes, vomiting or altered consciousness, sometimes indicates you're having a stroke.

    For most people, a stroke gives no warning. But one possible sign of an impending stroke is a transient ischemic attack (TIA). A TIA is a temporary interruption of blood flow to a part of your brain. The signs and symptoms of TIA are the same as for a stroke, but they last for a shorter period — several minutes to 24 hours — and then disappear, without leaving apparent permanent effects. You may have more than one TIA, and the recurrent signs and symptoms may be similar or different.

    A TIA may indicate that you're at risk of a full-blown stroke. People who have had a TIA are much more likely to have a stroke than are those who haven't had a TIA.

    When to see a doctor
    If you notice any signs or symptoms of a stroke or TIA, get medical help right away. A TIA may seem like a passing event. But it's an important warning sign — and a chance to take steps that may prevent a stroke.

    If someone appears to be having a stroke, watch the person carefully while waiting for an ambulance. You may need to take additional actions in the following situations:

    * If the person stops breathing, begin mouth-to-mouth resuscitation.
    * If vomiting occurs, turn the person's head to the side. This can prevent choking.
    * Don't let the person eat or drink anything.

    Every minute counts when it comes to treating a stroke or TIA. In fact, sometimes a stroke is referred to as a "brain attack" to convey that, similar to a heart attack, quick care is important. So, don't wait to see if the signs and symptoms go away. The longer a stroke goes untreated, the greater the damage and potential disability. The success of most stroke treatments depends on how soon a person is seen by a doctor in a hospital emergency room after signs and symptoms begin.
    • CommentAuthorcarosi*
    • CommentTimeAug 17th 2008
     
    All the above are spot on, but I've found out, TIAs and Strokes can occur silently, right in front of a Dr. and no one knows until the symtoms appear. I know of one person's which manifest as problems with eyesight, for which he even had surgery, and it wasn't until his autopsy they discovered it was all TIAs. His wife's only symptom was sporadic problems with her handwriting. With my hubby's 2 'old stroke scars' and 3 TIAs which I shipped him to the hospital for, and nothing showed up on the MRIs and Cat scans, I have to be watchful all the time, but have to go with my gut as to shipping him in or not. When he's tired one side weakness shows (residue from last TIA). When he first wakes up he may be a little fuzzy in his thinking, or his wordss may be a little slurry, but these clear up very shortly--ever need your coffee to jump start your day? One of his doctors told me his most valuable tool in treating hubby, is me--his caregiver--because I know what's going on with him 24/7--what's normal to him and what's not.
    So, I use the directions above, applying them to the way he is, going with my gut. So far it's working.
    • CommentAuthorSunshyne
    • CommentTimeAug 17th 2008
     
    Your gut is obviously better than mine, carosi. Could have knocked me over with a feather when they scolded me for not recognizing what they said was "obviously" a stroke. It seems that the key was that the two symptoms fit into a "cluster", that is, the centers of the brain that controlled walking/balance and speech are close together, and so a stroke in the right place could affect both. Who knew?
    •  
      CommentAuthorStarling*
    • CommentTimeAug 17th 2008
     
    Sunshyne, not only who knew, but with our LOs there are some other things going on too. First of all their behavior is deteriorating, sometimes smoothly, but most of the time in sudden jumps. Is it a stroke? Is it just the dementia doing its thing? Or do they have a cold which is messing up how they act, and it will all change tomorrow when their nose stops running. Did they have a stroke? Or indigestion?

    And if they did have a stroke just exactly what is anyone going to do about it? Stroke rehab doesn't work on dementia patients. My husband got diagnosed by a stroke rehab therapist for all intents and purposes when the rehab didn't work.
    • CommentAuthorMawzy*
    • CommentTimeAug 17th 2008
     
    My DH has had two TIAs. One in 1988 and the other one 3 years ago. Neither one of them seemed to have left any lasting damage. Last Monday morning right after he received the letter from the DMV that his driving skills had to be reevaluated, he spent the weekend very angry. Monday morning he was furious. I noticed that he was holding his left hand in an odd manner. When he tried to button his shirt he wasn't using his left hand. His hand was kind of bent like someone who'd had a stroke.

    I didn't fool around at all. I just took him into our GP--got right in. Everything was fine. No sign of any TIA or stroke. BP perfect. Dr. just sort of talked to him and DH told the doctor he felt fine but would feel a whole llot better if his wife would quite persecuting and tormenting him. I was floored. He had absolutely no weakness or problem with that hand.

    I asked the doctor if I'd jumped the gun and he said absolutely not. He told me the next time to get him right into the ER and have them call him. He said he didn't care if it was a false alarm or not. Whatever was going on had to be treated immediately. I will do just that.
    • CommentAuthorbriegull*
    • CommentTimeAug 18th 2008
     
    Carole, a couple of weeks ago my husband was sitting in his recliner and my daughter went in to get him to go to bed. He was slumped over on one side and twitching. She called over a neighbor (after calling me - I was out of town) and they roused him but his speech was slurred. They called 911 who took him to the hospital. No one was ever able to figure out what was going on with him, and he's back to normal now. Indeed, I had to go out of town again, got him covered with CNAs when my daughter couldn't be there, and I had a lovely four days away. Well, lovely three days; the fourth was driving home into the sun, which wasn't great. And he was FINE. Keeps telling me what the CNAs did. Only problem is that he's convinced the CNAs, Dawn and Mary Ann, were MALE!
    • CommentAuthorCarole
    • CommentTimeAug 18th 2008
     
    Thank you, everyone, for your comments. In the end, I cancelled the 911 call as I really thought it was back spasms from sleeping on his stomach for such long hours. He crawls into bed, lands on his stomach and then can't roll over. Last night my son and I forced him onto his back and today he's back to "normal". Got out of bed on his own, was able to get into the shower and is sitting down at the table for dinner. All of these things he hasn't done for a week. We were giving him finger foods so he could walk around and eat because he wouldn't "sit". So back problems or a TIA? Don't know but will certainly be more aware of what to watch for in the future.
    • CommentAuthorLFL
    • CommentTimeJun 21st 2014
     
    My husband is clearly in stage 7 now, so his speech is almost gone and what he can say is always garbled. He is also losing his ability to smile, not all the time but occasionally. I don't think he is able to tell me if something hurts, like a headache or chest pains. Sometimes he understands instructions (like raise your arms) and sometimes it just doesn't process. His walking and gait is unsteady since he broke his kneecap a year ago and the rehab facility ruined the repair.

    Given the above, how would I ever be able to tell if he's having a stroke? I've been worried about this lately because I just don't think I would be able to tell and I know getting help immediately is very important to prevent damage. Yes I know the dementia is already damaging his brain and has caused a lot of damage already, but the last thing I want is for him to be paralyzed and bedbound because he's difficult to care for as it is now.

    His BP, heart rate, cholesterol, etc. are all very good, so I don't have any particular reason to be concerned other than he's been on anti-psychotics for almost 6 years. Is anyone else concerned about this?
    •  
      CommentAuthormary75*
    • CommentTimeJun 21st 2014
     
    LFL, I lost my first post, but here is a summary from dimly-remembered patients of mine when I was a nurse (and keeping in mind your husband's condition).
    Any of the following changes:
    A noticeable change in the face: expression or sudden lack of it, possible drooping eyelid or slack mouth, drooling from one side (the slack side).
    Sudden onset of weakness of grip, or other muscle group.
    Loss of balance, dizziness, maybe vomiting.
    Paralysis one side of body.
    Agitation and new sounds of anguish, unintelligible.
    Loss of speech, vision disturbances.
    I remember the change as being sudden, dramatic. You can't miss it.
  1.  
    One interesting vision disturbance I just read about recently was a sense of dimness in one eye..

    My husband had a tiny stroke in the pons which is in the brainstem. He did not manifest the normal symptoms. He had neuropathy in his feet and when he mentioned something about his foot bothering him, I did think circulation and wanted to take him to the ER but he said no he felt ok otherwise and would just go to bed. But the next morning, he got up and was dressing himself but when he spoke he sounded like he had been to the dentist with novocaine. I got him to his doctor appt early and he is the one who did a quick check and said to get over to the hospital ER..he called ahead...

    Initial tests did not conclude stroke..it was the next day when some kind of MRI or MRA? told the tale and I was told that had it been one cm larger, it would have killed him outright.
    • CommentAuthorLFL
    • CommentTimeJun 22nd 2014
     
    Thanks Mary75* and Mimi*. I'll keep my fingers crossed that should it occur (I pray to god it doesn't) I'll know it when I see it.