A Matter of Forgetfulness
As we had good weather at the end of October 2017 I was in the garden with our gardener getting things ready for winter. He was up the ladder trimming the trees and I carting off the cuttings to the local recycling area. Also we painted the garden shed replacing rotten panels beforehand. We had to move two 200 litre rainwater tanks to get to the rotten panels. This meant draining them first. As they were two thirds full this took time and flooded the pavement behind the garden. Luckily nobody passing got wet feet.
As I was in full swing I went to the rubbish tip a number of times as a part of our clearing out campaign. After working in the garden from dawn to dusk over ca 10 days, I must admit I was feeling quite good, even got a tan. It made a change to being inside the house and I was enjoying the time outside doing something that needed to be done.
It was a typical Indian summer and I made the most of it.
Well It seems my body didn't like all this physical exercise and fresh air..
I had taken H to her weekly hour of ReHa sport in the morning and after returning home I continued to do some more work in the garden. I finished securing the water tanks to the shed and connected a water pipe between them and a tap. It was a bit strenuous with all the bending down in the cramped space between fence and containers but I took my time, coming up for air now and then. When I was finished I went inside, made myself a cup of tea and started writing an email.
It must have been about twelve o'clock and that's the last thing I remember until I found myself sitting on a hospital bed in the stoke unit at about five o'clock with shunts in both arms chatting to H and being brought up to date on the hours in between.
When I didn't answer her SMS at about half twelve to say I could pick her up, she rang me and as soon as I answered she realised I wasn't my usual self. It took at least ten minutes of repetitive persuasion to make me go to the next door neighbour and wait there until she got a taxi home. As soon as she arrived she rang 112 (I have been told that I was strictly against this) and I was 'to-ta-ta-ed' off to the hospital.
I had had an attack of TGA (Transient Global Amnesia). I was in the stoke unit because it could have been a Transient Ischemic Attack (TIA) which show similar neurological dysfunctions. Well I'm ok now [Ed: Self assessment, see below] but have no knowledge of being picked up in an ambulance, going through ER and then on to the stroke unit. A bit weird when one slowly realises one is somewhere else and not at home and experiencing the ambivalence that comes with it. A mixture of surprise and ok what next.
I have a mental blackout for about five hours and it will stay that way. After being brought up to date on the missing hours, I 'think' I have distance memories of the beginning of the attack as if from a dream that one just can't recall in detail. In those five hours I was fully capable of conversation even through somewhat incoherant, but my short memory just did not what to function (no storage for later recall).
I was repeating myself all the time which was I'm told confusing me considerably and this got me panicking and frustrated with bouts of crying in between. I kept saying that there was something wrong but I couldn't figure out what! Not a pretty sight for H who was having a hard time trying to carm me down, which you can imagine wasn't easy! In some aspects I'm glad I have null recollection of it all.
Well the CT made in ER didn't show anything.
The next morning just as breakfast arrived and I was about to dig in a doctor interrupted me to take blood. As this was happening a nurse came in and told me I had to have some tests done and started to tell me in which rooms and on which floors. I told her to write it down otherwise I would add this to the other stuff I had forgotten in the last 24 hours!
Actually I would have probably forgot as I was being distracted due to being not very professionally peeked in the hand after aborting an attempt to stick a needle in my arm. All this while I eyed my untouched breakfast and cooling coffee. [Ed: Note one does not ask for black tea in hospital because you can't get black tea in hospitals! Hence second choice coffee.]
The doctor left and the nurse handed me a note with a list of the room co-ordinates. Looking at it I was remined of a game of D&D I had created as dungeon master in my youth (find lift, enter, select 3rd floor, leave, turn left, go 20 meters, turn right, look for room 315, knock..).
So on an empty stomach, and by the feel of it an empty hand/arm, I set off all on my own on a grand tour of the hospital.
First stop EEG.
As I was sitting and all wired up with a cold feeling all over my head from the conductivity gel the nurse took a private mobile phone call. As she was chatting I took the opportunity to send H a SMS that I'll be having tests done the whole morning and she could take her time coming to the hospital. Later I kicked myself for not taking a selfie under the 20 channel EEG rubber headset.
Typically something one would put on Facebook if I had an account that is. After 20 minutes and almost falling a sleep, which is not allowed when the monitoring is running, I was unwired. I was given a hand full of paper towels more like sand paper and as I tried to remove the excess cold guley from my head I wandered off to have Doppler and Ultrasound done on my vertebral arteries to see if my cerebral blood circulation was blocked in some way.
Well after one and a half hours of heavy painful pressure with the ultrasound wand and intermittent finger taping all up and down my neck bds., I was pronounced 'blockage free' and was then allowed to wander back to the ward.
It was after 11 o'clock. I suspected in the mean time my untouched breakfast would have been cleared away. But no it was still there! The coffee was cold but there was still some left in the thermos flask out in the hall. I finished it all off just as H arrived. We chatted and then lunch arrived so I tucked in again. I was told I would be picked up to have an MRT at about three o'clock.
After googling TGA I saw that the MRT was the last examination on the check list, in this case to see if there was any brain damage (cavities in the hyppocampus).
Well at three o'clock to my surprise a wheelchair arrived. I said I could walk, I had been walking around the place all morning! But no my chauffeur insisted, otherwise he would get into trouble. So with some embarrassment I sat in it and we were off, H running along behind.
The MRT was in a separate institute not connected to the hospital complex and we went thought the catacombs. On arrival I was left waiting with a clip board and a four page questionnaire about all my past problems and current medicine intake. Why can't they standardise these things! Everybody thinks they can create questionnaires, most of them are in places contradictory or illogical. Ok I'm biased after spending 25 years putting simular forms together.
I sat there kicking myself (difficult) that I still haven't got round to listing all my medical history for times like these. And here I was [Ed: Remember, after an attack of memory loss] racking my brains to try and recall what happened when, and trying to spell the drug names correctly!
I suspect they only give you the paperwork to occupy you while waiting and then just store them away for possible insurance regress without even looking at them. I think this is true as I have never been asked to decipher my quasi German/English scribble into proper German.
After about half an hour I was called and entered a cubicle. The nurse said I need to remove my trousers! I gave her a funny look and asked why, as the MRT was to be taken from my head! I got one of those 'get them off, I don't care what's been taken' looks. I suspect it's to do with metal objects or she was just being grumpy.
Now this was going to be my first MRT. I had no problem that it was going to be loud and a little claustrophobic, but as I got onto the table and laid back I did have a problem.
I could not lie down with my head in the cradle without my lower torso going up in the air and for support having to bring up my legs.
My hyperkyphosis was getting in the way. I don't normally have that much of a problem when lying down on my back its just that I can't lie flat! If I try and my head is not supported I don't look straight up but at an angle of about 45 degrees and left dangling in mid air! For the MRT my head had to be parallel to the table in the cradle. But that would mean my body would be up in the air and eventually collide with the MRT head as I moved down!
We had to abort. [Ed: see picture right for an example how close the head of the MRT is.] The radiologist said there was another machine in the main hospital and I should try there. So I got dressed and let my frustration out as I was propelled back to the ward again with H running along behind.
On my return I was informed that I had a MRT appointment in the morning.
Later thinking about it, I had an idea that the machine in-house could be the same as the one I had tried to lie down in earlier. I explained the situation to the ward nurse and asked if she knew if the MRT model in-house was the same as the one in the other building. She just looked at me with a blank stare on her face. Probably the first time a patient had asked such a weird question. To top it all I followed with "Can you see that I get a 'probeliegen' [Ed: a lay down test] this evening in the MRT? Because if I can't lay down in it, I could go home now?". This was too much, she backed up a bit and with a stutter in her voice said she would ask.
Well she didn't ask and I had to wait to the morning.
As breakfast was being rolled in the direction of my bed. I was being rolled out under protest in the direction of MRT number two. Being still half a sleep I couldn't even grab a bread roll as it past by.
Again I was annoyed that I couldn't walk, it felt daft being carted about.
Surprise! On arrival I was parked in the corridor and presented with a new four page questionnaire. Same questions as before just a different layout and sequence! I just rolled my eyes in silent protest and filled it out in record time. Finally I was wheeled into the anti room and as I got up and saw the MRT it was clear it was the same model. I rolled my eyes one more time, turned to the unexpecting Radiologist and told her what happened the day before. She was annoyed that nobody had informed her. I told her someone could have had this time slot and I could have been in my own bed last night. She agreed and I left and walked back to the ward not waiting to be wheeled back.
I found the ward sister and said there's a wheelchair looking lost in radiology and returned to my room. Later after H arrived I asked the doctor if I could go home as all the tests apart from the MRT were done and in my mind negative as I hadn't heard anything to the contrary. The doctor agreed and the paperwork was completed and in the afternoon I was allowed to go home. With the letter for my internist I was asked to get him to find an upright MRT and make an appointment. Well that was at the end of October.
The day after getting home, I visited my Internist, he contacted by phone an Institute in Cologne with an upright MRT and asked them to send a quotation to my medical insurance (TTK). They in turn sent it to the MDK [Ed: This is a medical service provider that advises the German medical insurance companies from a medical point of view in cases like this.]
After four weeks I received a no go from the TKK based on the report from the MDK and a recommendation to have an open MRT. This is stupid as I can't lie down in an open MRT either! The only difference is the sides are open, but the MRT head is still just over the body and my knees would hit it as with the closed version!
Back to my internist this time he sent a report mentioning my Hyperkyphosis. After a futher two weeks I received a second rejection with the excuse that the 'evidence' didn't show that I couldn't have a normal MRT!
I wish they would tell us what they need! This is getting ridiculous and going around in circles. Next step was a talk to the TKK again. They 'advised' I get my Orthopedician to write a detailed report. I have no intention of paying the MRT out of my own pocket.
My appointment with the Orthopedician is in March.
I feel alright and H says I'm just as crazy as before, but to close this case I would still like to have a report that confirms this!
I'll update when I remember to do so...
As I was in full swing I went to the rubbish tip a number of times as a part of our clearing out campaign. After working in the garden from dawn to dusk over ca 10 days, I must admit I was feeling quite good, even got a tan. It made a change to being inside the house and I was enjoying the time outside doing something that needed to be done.
It was a typical Indian summer and I made the most of it.
Well It seems my body didn't like all this physical exercise and fresh air..
I had taken H to her weekly hour of ReHa sport in the morning and after returning home I continued to do some more work in the garden. I finished securing the water tanks to the shed and connected a water pipe between them and a tap. It was a bit strenuous with all the bending down in the cramped space between fence and containers but I took my time, coming up for air now and then. When I was finished I went inside, made myself a cup of tea and started writing an email.
It must have been about twelve o'clock and that's the last thing I remember until I found myself sitting on a hospital bed in the stoke unit at about five o'clock with shunts in both arms chatting to H and being brought up to date on the hours in between.When I didn't answer her SMS at about half twelve to say I could pick her up, she rang me and as soon as I answered she realised I wasn't my usual self. It took at least ten minutes of repetitive persuasion to make me go to the next door neighbour and wait there until she got a taxi home. As soon as she arrived she rang 112 (I have been told that I was strictly against this) and I was 'to-ta-ta-ed' off to the hospital.
I had had an attack of TGA (Transient Global Amnesia). I was in the stoke unit because it could have been a Transient Ischemic Attack (TIA) which show similar neurological dysfunctions. Well I'm ok now [Ed: Self assessment, see below] but have no knowledge of being picked up in an ambulance, going through ER and then on to the stroke unit. A bit weird when one slowly realises one is somewhere else and not at home and experiencing the ambivalence that comes with it. A mixture of surprise and ok what next.
I have a mental blackout for about five hours and it will stay that way. After being brought up to date on the missing hours, I 'think' I have distance memories of the beginning of the attack as if from a dream that one just can't recall in detail. In those five hours I was fully capable of conversation even through somewhat incoherant, but my short memory just did not what to function (no storage for later recall).
I was repeating myself all the time which was I'm told confusing me considerably and this got me panicking and frustrated with bouts of crying in between. I kept saying that there was something wrong but I couldn't figure out what! Not a pretty sight for H who was having a hard time trying to carm me down, which you can imagine wasn't easy! In some aspects I'm glad I have null recollection of it all.
Well the CT made in ER didn't show anything. The next morning just as breakfast arrived and I was about to dig in a doctor interrupted me to take blood. As this was happening a nurse came in and told me I had to have some tests done and started to tell me in which rooms and on which floors. I told her to write it down otherwise I would add this to the other stuff I had forgotten in the last 24 hours!
Actually I would have probably forgot as I was being distracted due to being not very professionally peeked in the hand after aborting an attempt to stick a needle in my arm. All this while I eyed my untouched breakfast and cooling coffee. [Ed: Note one does not ask for black tea in hospital because you can't get black tea in hospitals! Hence second choice coffee.]
The doctor left and the nurse handed me a note with a list of the room co-ordinates. Looking at it I was remined of a game of D&D I had created as dungeon master in my youth (find lift, enter, select 3rd floor, leave, turn left, go 20 meters, turn right, look for room 315, knock..).
So on an empty stomach, and by the feel of it an empty hand/arm, I set off all on my own on a grand tour of the hospital.
First stop EEG.As I was sitting and all wired up with a cold feeling all over my head from the conductivity gel the nurse took a private mobile phone call. As she was chatting I took the opportunity to send H a SMS that I'll be having tests done the whole morning and she could take her time coming to the hospital. Later I kicked myself for not taking a selfie under the 20 channel EEG rubber headset.
Typically something one would put on Facebook if I had an account that is. After 20 minutes and almost falling a sleep, which is not allowed when the monitoring is running, I was unwired. I was given a hand full of paper towels more like sand paper and as I tried to remove the excess cold guley from my head I wandered off to have Doppler and Ultrasound done on my vertebral arteries to see if my cerebral blood circulation was blocked in some way.
Well after one and a half hours of heavy painful pressure with the ultrasound wand and intermittent finger taping all up and down my neck bds., I was pronounced 'blockage free' and was then allowed to wander back to the ward.
It was after 11 o'clock. I suspected in the mean time my untouched breakfast would have been cleared away. But no it was still there! The coffee was cold but there was still some left in the thermos flask out in the hall. I finished it all off just as H arrived. We chatted and then lunch arrived so I tucked in again. I was told I would be picked up to have an MRT at about three o'clock.
After googling TGA I saw that the MRT was the last examination on the check list, in this case to see if there was any brain damage (cavities in the hyppocampus).
Well at three o'clock to my surprise a wheelchair arrived. I said I could walk, I had been walking around the place all morning! But no my chauffeur insisted, otherwise he would get into trouble. So with some embarrassment I sat in it and we were off, H running along behind.
The MRT was in a separate institute not connected to the hospital complex and we went thought the catacombs. On arrival I was left waiting with a clip board and a four page questionnaire about all my past problems and current medicine intake. Why can't they standardise these things! Everybody thinks they can create questionnaires, most of them are in places contradictory or illogical. Ok I'm biased after spending 25 years putting simular forms together.I sat there kicking myself (difficult) that I still haven't got round to listing all my medical history for times like these. And here I was [Ed: Remember, after an attack of memory loss] racking my brains to try and recall what happened when, and trying to spell the drug names correctly!
I suspect they only give you the paperwork to occupy you while waiting and then just store them away for possible insurance regress without even looking at them. I think this is true as I have never been asked to decipher my quasi German/English scribble into proper German.
After about half an hour I was called and entered a cubicle. The nurse said I need to remove my trousers! I gave her a funny look and asked why, as the MRT was to be taken from my head! I got one of those 'get them off, I don't care what's been taken' looks. I suspect it's to do with metal objects or she was just being grumpy.
Now this was going to be my first MRT. I had no problem that it was going to be loud and a little claustrophobic, but as I got onto the table and laid back I did have a problem.
I could not lie down with my head in the cradle without my lower torso going up in the air and for support having to bring up my legs.
My hyperkyphosis was getting in the way. I don't normally have that much of a problem when lying down on my back its just that I can't lie flat! If I try and my head is not supported I don't look straight up but at an angle of about 45 degrees and left dangling in mid air! For the MRT my head had to be parallel to the table in the cradle. But that would mean my body would be up in the air and eventually collide with the MRT head as I moved down!
We had to abort. [Ed: see picture right for an example how close the head of the MRT is.] The radiologist said there was another machine in the main hospital and I should try there. So I got dressed and let my frustration out as I was propelled back to the ward again with H running along behind.
On my return I was informed that I had a MRT appointment in the morning.Later thinking about it, I had an idea that the machine in-house could be the same as the one I had tried to lie down in earlier. I explained the situation to the ward nurse and asked if she knew if the MRT model in-house was the same as the one in the other building. She just looked at me with a blank stare on her face. Probably the first time a patient had asked such a weird question. To top it all I followed with "Can you see that I get a 'probeliegen' [Ed: a lay down test] this evening in the MRT? Because if I can't lay down in it, I could go home now?". This was too much, she backed up a bit and with a stutter in her voice said she would ask.
Well she didn't ask and I had to wait to the morning.
As breakfast was being rolled in the direction of my bed. I was being rolled out under protest in the direction of MRT number two. Being still half a sleep I couldn't even grab a bread roll as it past by.
Again I was annoyed that I couldn't walk, it felt daft being carted about.
Surprise! On arrival I was parked in the corridor and presented with a new four page questionnaire. Same questions as before just a different layout and sequence! I just rolled my eyes in silent protest and filled it out in record time. Finally I was wheeled into the anti room and as I got up and saw the MRT it was clear it was the same model. I rolled my eyes one more time, turned to the unexpecting Radiologist and told her what happened the day before. She was annoyed that nobody had informed her. I told her someone could have had this time slot and I could have been in my own bed last night. She agreed and I left and walked back to the ward not waiting to be wheeled back.
I found the ward sister and said there's a wheelchair looking lost in radiology and returned to my room. Later after H arrived I asked the doctor if I could go home as all the tests apart from the MRT were done and in my mind negative as I hadn't heard anything to the contrary. The doctor agreed and the paperwork was completed and in the afternoon I was allowed to go home. With the letter for my internist I was asked to get him to find an upright MRT and make an appointment. Well that was at the end of October.The day after getting home, I visited my Internist, he contacted by phone an Institute in Cologne with an upright MRT and asked them to send a quotation to my medical insurance (TTK). They in turn sent it to the MDK [Ed: This is a medical service provider that advises the German medical insurance companies from a medical point of view in cases like this.]
After four weeks I received a no go from the TKK based on the report from the MDK and a recommendation to have an open MRT. This is stupid as I can't lie down in an open MRT either! The only difference is the sides are open, but the MRT head is still just over the body and my knees would hit it as with the closed version!
Back to my internist this time he sent a report mentioning my Hyperkyphosis. After a futher two weeks I received a second rejection with the excuse that the 'evidence' didn't show that I couldn't have a normal MRT!
I wish they would tell us what they need! This is getting ridiculous and going around in circles. Next step was a talk to the TKK again. They 'advised' I get my Orthopedician to write a detailed report. I have no intention of paying the MRT out of my own pocket.
My appointment with the Orthopedician is in March.
I feel alright and H says I'm just as crazy as before, but to close this case I would still like to have a report that confirms this!
I'll update when I remember to do so...
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