Non-Stroke

[stevenpiziks]

A Non-Stroke

 

Last weekend was quite the adventure.

 

Saturday evening, I was eating and had some trouble with food leaking from one part of my mouth. I had a canker sore, though, so I assumed that was the problem and didn't think anything more about it.

 

By Sunday, however, the symptoms were growing. Parts of my cheek became numb. The lack of sensation crawled up my jawline to my ear and took the right side of my tongue. I couldn't smile with the right side of my mouth. Oh, shit. Stroke?

 

I was trying not to freak out. Darwin agreed that I needed to go to the hospital. During the drive, I kept checking to see if the numbness was still there. It always was.

 

The ER wasn't especially busy, even for a weekend evening. Once I described my symptoms, I was taken back to an exam room fairly quickly. An ER doctor checked for numbness other than on just my face by running his hands fast up and down my sides and limbs, which was a little startling. No numbness, though. He also tested for limb and hand weakness. None. He checked hand-eye coordination. ("Look at my eyes and touch my fingertip with yours. Again. Again.") No problems.

 

The doctor ordered more tests. EKG. Scans. Imagings. Blood tests. For this, they said, the hospital had to admit me, which required some paperwork. At that point, it was closing in on one in the morning. Poor Darwin was exhausted—he was recovering from being ill himself—so I sent him home. "There's nothing you can do here. I'm not going home tonight. You and I both need to sleep." He agreed and left.

 

I lied. I didn't sleep. I was too wired for it. 

 

I'd thought to grab my iPad on the way out the door, and the next day was a school day. No way I was going in, of course, so I used the pad to set up lessons for my students in Google Classroom. This ate up about an hour, and it was closing in on 2:30. 

 

It turned out there was quite a backup at the scanners and imagers that night, so it almost three before an orderly wheeled me down for a CT scan, and then more time passed before I could get into the MRI for two more scans.

 

When I wasn't in a machine, I was in the ER bed. And it was uncomfortable. Hard mattress. No pillow. I was hooked to a blood pressure cuff that went off every fifteen minutes and a blood oxygen/pulse sensor that clung to my finger like an angry clam. I tried sleeping anyway and was just dozing off when three staffers zipped into my room to say they were moving me out of the ER and into some kind of holding room between ER and my "real" room. They gathered up my things and trundled me away, bed and all.

 

I was hungry. About an hour after I came in, I asked for and got a sandwich, but more than four hours had passed by now, and I was headache-level hungry again. I asked for food, but the holding room nurse said I wasn't allowed to eat because the doctor hadn't given permission. They had to confirm what medications I was taking first. I said, "I can give you the list right now," but no—it had to be on their schedule, not mine.

 

The holding room nurse came in with a set of EKG leads. Apparently someone had decided I needed to be on a heart monitor. Here I flatly refused. The last time I was in the hospital like this (kidney stones), they became alarmed when they gave me pain meds and my heart rate went below 50, even though I told them my resting heart rate is usually 55, so a rate of 49 isn't a problem. Even so, they insisted on putting me on a heart monitor, which is wildly uncomfortable and difficult to handle. Just getting up to use the bathroom becomes a nightmare of wires and tangles and trip hazards. So this time I flatly refused.

 

"I won't wear one," I said, both gently and firmly. "I'm not here for heart problems and I have no history of them. You can tell the doctor that I'm recalcitrant, if you like. But if you try to put that on me, I'll take it right off again." The nurse clearly didn't like the idea, but she left it at that. You have to make a stand somewhere, I guess.

 

But at least I had technology. Like most medical facilities, St. Joseph's has a patient portal with an app. It sends alerts, so I got test results at the same time the doctor did, and I can read medical-ese. My phone pinged like a spring peeper on my night stand. 

 

All blood tests: normal. Urine tests: normal. CT scan: no indication of stroke. MRI: no evidence of stroke.

 

Relief. 

 

It was past four in the morning by now. I was wrung out and hungry and having a post-anxiety crash. Large chunks of my face and half my tongue were still numb. It wasn't a stroke, but I still didn't know what was wrong with me.

 

The ER physician came in and told me what I already knew—no stroke. But I had to stay in the hospital until I could see the neurologist, which would happen at some point Monday.

 

They moved me into a short-stay room, which was really a curtained alcove, and took me off the blood pressure cuff and blood sensor. I just sat on the side of the bed. I had nothing left. I was so exhausted and hungry, I couldn't think straight. I answered the nurse's questions with one-word responses and just sat staring at the floor.

 

I did text Darwin to let him know it wasn't a stroke. If he was asleep, I didn't want to wake him with a phone call about something he could read about the instant he woke up later. But he texted back right away that he was happy for the good news.

 

I stared at the floor, retreating into the interior fortress I've adopted for hospital stays. I think I was getting cold, but I didn't really notice.

 

Darwin called and said he was coming to the hospital, so where was I? I gave him the information and texted him a list of stuff to bring, including sweats. And food.

 

He arrived a few minutes later and we were very glad to see each other. I got out of the hospital gown and into clean sweats and socks and had a snack from the food Darwin brought and somehow didn't expire on the spot. 

 

A moment later, the nurse showed up with a food tray. Apparently they had gotten hold of my med list. I ate and felt rather better, though it was difficult to chew with my face partially paralyzed.

 

A few hours later (it's always "a few hours later" in a hospital, innit?), I received a lunch tray and was just finishing when the parade of doctors finally began, starting with the PA, proceeding to the on-class physician, and ending with the neurologist.

 

The final diagnosis? Bell's palsy. 

 

Probably. Maybe.

 

The short version is that in a case of Bell's palsy, a virus (in my case, probably varicella) attacks certain facial nerves, causing inflammation and preventing them from conducting impulses properly, which results in inconvenient paralysis and numbness. The condition is almost always temporary, and it can be shooed along with anti-virals and steroids.

 

The weird part is that I don't have =all= the standard symptoms. One universal symptom is an inability to raise both eyebrows. One side is always paralyzed. But not for me. I can raise both eyebrows. This puzzled the doctors, because in every other way, my symptoms present as Bell's. 

 

"Maybe the forehead symptom would show up later, if you went untreated," the neurologist said. "Other than that, I couldn't tell you what's happening."

 

But the meds will be the same, regardless. The scrips were sent off and, after the usual long wait, I was discharged to home.

 

I was glad I didn't need to work the next day—schools were closed for the election—because I had nothing. I could move and walk all right, but I was so tired that just walking from one end of the house to the other exhausted me.

 

I've been on the meds for almost a week, and my symptoms have greatly improved. At the moment, I have only a little numbness. My smile is still noticeably crooked, but much less so than at first. My biggest problem right now is eating. I can't get through a meal without catching part of my lip and chewing it hard before I realize what's happening. It's frustrating and painful. But I seem to be on track to be past this soon.