Mom had her first appointment with the neurologist today. We haven’t met him before. He’s yet another doctor that we are establishing care with. I probably should have gotten her in to see the neuro sooner than this but I felt like there were other things that I needed/wanted to get stabilized first. The doctor reassured me that it was OK – there has been a lot going and it’s completely understandable.
It was quite an interesting appointment. Everything moved so quickly. Honestly, I think that’s how these types of doctors are wired. They aren’t there to give you warm fuzzies. They are all business. It’s not that he wasn’t nice, he definitely was, but I get the feeling he’s not a “small talk” kind of guy.
I think at most he took a cursory glance at her file before our appointment just to get the highlights. 73 year old woman suffered a stroke in April 2017, left side deficient, aphasia, dysphasia, and other symptoms. Got it. Nothing unusual. He asked me if I was shown her MRI images before and I told him no. He was explaining the different types of strokes to me, verifying that hers was in the pons (brainstem) as he was opening his laptop to show us the cross-section of her brain. He pulled up a couple of images and as he zoomed in I heard him make a noise that sounded like a little gasp. I think he was expecting to show me the clear outline of her brainstem (as he could with other parts of her brain) with a dark circle somewhere in the middle that he’d point to so I could identify that as the clot. There really was no need. The entire pons was a clot. I really couldn’t believe what I was seeing. He said that he has had several patients who had this type of stroke and they did not survive. I am under the impression that mom is probably the first of (or maybe one of a very few) that he knows who survived something this serious. We will likely have new scans done to see how that part of her brain is getting its blood supply. He’s not sure if the brain stem is getting blood from collateral arteries (ones that don’t normally feed the brain stem) or if the brain stem has somehow healed itself enough to do so. Either way – it’s almost as if he’s looking for an explanation on how she is still living.
Based on the severity of the stroke, we know that she will never be 100%. The doctor said that most recovery happens in the first 3-4 months. He’s surprised that not only has she regained as much function as she has, but that she’s continuing to make gains. His word of advice – continue with the therapy and do as much as she can tolerate. Even increase it if she can handle it. The fact that she was so healthy before the stroke is what’s helping her to make this recovery. If there was ever a question before, today’s meeting answered it… It simply was not her time to go.
Tomorrow she has an appointment with a radiologist for another modified barium swallow study. We’ll see how much her muscles are improving and understand what that prognosis may be, particular with regard to thin liquids. I’ll report back in afterwards.