|Image courtesy of Heart.org|
When I had my T.I.A. they also found a hole in my heart. Talk about a double whammy. When a person has a stroke or transient ischemic stroke (TIA) "out of the blue" with no obvious risk factors, doctors often check to see if the event was caused by a "hole" in the heart called a patent foramen ovale (PFO). About 1 in 5 Americans has a PFO. Many don't know it until a medical condition like a stroke or TIA occurs. PFOs often have no symptoms but they may increase your risk for stroke and TIA. Many PFO-related strokes are called cryptogenic, meaning they have no apparent cause. It is normal for all infants to be born with a small hole between the two atria, which usually closes within the first few weeks of life. (National Stroke Assoc.) Some people like myself have no symptoms and even during physicals I was never told anything was wrong- not even a murmur so we lead very normal lives. Do you remember back in 2005 when New England Patriots linebacker Teddy Bruschi suffered a mild stroke? His story was similar to mine – major headache, blurred vision and numbness on the right side of his body.
One way to confirm the PFO is to perform what they call a bubble echocardiogram. Basically you are hooked up to an IV and a monitor and they inject saline in the arm so that the bubbles can be seen as they pass through the heart's chambers. Where the bubbles go confirm the PFO – I got a confirmation. The doctor then referred me to Massachusetts General Hospital for further evaluation. This was May 2007. The remainder of the year consisted of testing and evaluation with Neurologist, Cardiologist, Hematologist, and Ophthalmologist. The problem and frustrating part was that no one could pin point what exactly caused the T.I.A. The specialist were stunned. I was even more frustrated because I was loosing precious time with starting IVF again but I totally understood the importance of finding out the why before IVF again – too much of a risk. My cardiologist spoke to us about a team of doctors that studied these particular cases and asked if I wanted to be a part of it – I said of course especially if it would help speed up the process. The team consisted of a group of expert specialist from various departments evaluating all of the information they were given from all my doctor visits and coming up with a plan.
|~Photo via Google Images~|
February 20,2008 – the day has arrived for my procedure and I’m admitted into Mass General. The plan is to place a catheter like device over the hole. This device is called the STARFlex. The device actually looks like a little umbrella you get in those fruity drinks. I wasn’t completely out when I had the procedure done. My doctor wanted me to see the device. The process that they chose was to go in through the groin and up to my heart. I don’t remember feeling anything when that was done so I’m thinking that I was somewhat out for that. On the monitor it looked like a spider that was crawling all over the screen. It was pretty cool. I think the whole process took about an hour. I don’t remember much after that so fast forward I’m now in my room. The nurses are checking in and seeing how things are going. This is the part that I don’t like. For the next few hours I am supposed to lay as still as possible but they want me to pee and I can’t. I mean I really couldn’t go no matter how much I tried to go all while trying not to move in bed. My kidneys where filling up and I was getting extremely uncomfortable. We tried a few different things but nothing worked. The next step was to insert a catheter. Now I’ve never had one but heard stories and I was practically begging not to get one but no dice mice – a catheter it was. And do you know what a bitch it was to get that thing in! It wouldn’t go in. The damn nurse had to call in back up to help her. I was surrounded by a few nurses and a bunch of nursing students trying to insert a fricken catheter – seriously, you would have thought I was the 7/11 the way… well I’m sure you can imagine what position I was in and again the dang nurse kept telling me not to move. You can imagine what I wanted to tell her. Finally, after who knows how long they get the stupid thing in and I am able to pee. You just can’t imagine the relief I felt but hated I did not like having a 3rd leg, it was beyond uncomfortable!
Since they had gone in through my groin I had two shunts, one on each side. Again, I really don’t remember having any pain but I’m sure I got some local pain meds. I believe it was later on that afternoon I got a visit from nurses or specialist who were going to remove the shunts. They explained how they were going to go about and remove them and I knew it would hurt but the pain that I would experience was beyond imaginable. There really was no easy way to remove the shunts other than by just pulling them out. The nurse applied pressure on my groin and just yanked it out. The pain was incredible! I had to hold on to the bed rails for support and had to catch my breath. OMG, they had to do the left side now. I kept stalling because I knew what was to come but this was just making it worse. I kept making jokes because that’s how I deal with sh*t – make jokes and laugh. Finally we had to do it. It was like ripping off a band aid but the pain would be much worse. I had no choice, had to get it over with. I took a deep breath, held on to the rails, closed my eyes and told them to do it. Bloody hell, it hurt! The worse part was over. The rest of the night was just to try and relax, if only the nosey old lady in the bed next to me would mind her business and shut up. Generally I don’t mind talking and she was nice but a chatty Kathy and a nosey one at that. I was looking forward to going home the next day.
The next morning the nurses got me up early to walk and make sure that I can get around without getting dizzy or passing out. My heart rate was a bit high but that was expected and I learned signs of when I was over exerting myself. I had a few test done to make sure my device stayed in place and then I was good to go. The first few weeks I was able to feel my device even though they said I wouldn’t. It was just a throbbing here and there almost like saying here I’m here doing what I need to do. Everything looked great and I was able to go home. My first thought was IVF and how soon I could start again. My Cardiologist said I had to wait at least six months. I was heartbroken but it was a necessity and I had to wait, in the meantime and some follow up visits ahead of me at 1 month, 6 months, and 1 year which included a chest x-ray, electrocardiogram, and echocardiogram.
I am one of the lucky ones. I had no lasting side effects from my T.I.A. but it still scares me every time I get a migraine and always on my right side. Sometimes my right arm feels like it is going numb. It starts to tingle a bit and I start to worry again. I am not on any blood thinners because It would have interfered with IVF but I do have to take a full dose aspiring every day for the rest of my life. I am so thankful for my amazing team at Mass General especially when I finally did go through IVF and they were all monitoring me very closely. The inconvenience of driving an hour for every single appointment especially when they were just for blood work at 6AM into Boston was so worth it. I love them all and I’m glad that we still keep in touch.
My advice to you is don’t ignore those headaches. If they are stronger than usual and you feel a bit different go see your doctor. I have no history of stroke in my family and I was extremely healthy and worked out when it happened to me. I know this is a long post but I needed to tell my story.