This is an emergency. Go to the E.R. now!
In which I learn the meaning of the letters TIA.
You may think of me as a mild-mannered former newspaper reporter, but I have another identity: Generalissima Wadler, Commander in Chief of the Get That Thing on Your Nose Looked at Immediately It Could be Cancer Patrol.
Unusual breathlessness after exercise? A headache that’s lingered for three days? Vaginal bleeding three decades after menopause?
GET TO THE E.R. NOW! That’s the message I try to instill in my pals.
I’ve spent a lifetime time telling friends, especially women friends, to take unusual physical symptoms seriously. Do NOT worry about bothering the doctor, I say. Do NOT think you’re being neurotic. Do NOT be apologetic.
So it’s odd that when I had a moment of mental confusion so severe that I was unable to understand a sentence earlier this past week, I told no one. I saw the words, but I did not know what they meant.
“That’s weird,” I thought, “Maybe I can sound it out by the letters.”
But I could not identify the letters. I stared at the first one, but I could not figure out whether it was a ‘T’ or a ‘P.’
What remote spot in the New York State wilderness was I when this happened and I did not tell anyone?
A Manhattan medical center. It wasn’t the only weird event of that visit, either. Twenty minutes earlier, when I was waiting in an exam room to see a new doctor, there was a fluttering of bright lights zig-zagging across my right eye.
My eyes are sometimes irritated by bright lights and there was a neon light in the room, but there was something different about this, so I called my eye doctor, who works out of one of the big city hospitals.
Rather, I should say, I tried to call my eye doctor. I do not have a direct line to my eye doctor’s office. I was stuck in a phone labyrinth and while I attempted to get through, the doctor I was there to see came into the room. I put moisturizing drops in my eyes, the zig-zagging lights went away and I forgot about it
Twenty minutes later, waiting to have blood taken and reading a story on my phone, I find myself unable to understand a sentence. I do not have the rush of pure panic that hits me when, say, a plane hits an air pocket and drops a few thousand feet – good, true panic, Hemingway would have called it. It’s just, “Huh, that’s weird.” Then a tech calls me to take blood.
Does Commander Wadler, who urges other patients to speak up, tell the medical professional what just happened?
No, Commander Wadler is feeling odd and shaken and -- okay – embarrassed.
Commander Wadler tells the tech what she always says when she has blood drawn: My veins shrank after chemo years ago and you’re going to need a baby-sized needle. Commander Wadler feels a little outside herself as she does this, she feels it is taking concentration to form these words. It’s possible she is so shaky that the tech asks if she is okay, but she nods. After the tech takes the blood, I am fine. I can stand. I can read.
Do I try to get through to my eye doctor again now that I have time?
No. I get on the subway, go home, and have an unusually long and deep nap.
I’m concerned enough, however, to have a consult with a girlfriend later that day — another writer, so her medical expertise rivals mine. She tells me she has had similar light flashes over the years; her doctor said they were ocular migraines and was unconcerned. She never , however, had reading incomprehension.
I decide to follow up with my own eye doctor. I send a note in the patient portal. You know, the ones that say, “It will take two to three days to reply to this message. If this is a medical emergency, go to the nearest hospital now.”
“Shortest stroke ever?” I ask in a playful tone, because God forbid I come off like a neurotic worrier.
Then I go about life, watching television, going to the theater, working on the final edits of my comic novel, “The Satyr in Bungalow D,” which it would be off-subject and blatanlty promotional to mention here and will be out this summer. The new cover is gorgeous, by the way.
My eye doctor calls back two days later, on Friday. There is no caller ID and I’m talking to my brother, who’s just gotten out of the hospital, so I let it go to message. A few minutes later, I read the transcript.
You know that sound your phone makes when there’s an emergency alert? A sound so loud and urgent it’s like neon flashing red? This transcript feels like that.
This is not an eye issue this is a TIA you need to go to a neurologist or a hospital it’s obviously passed and you’re better now but you need a thorough stroke evaluation to assess further risk of a stroke this is very, very important… this is not an eye problem this is a TIA ocular migraine becoming a TIA…do not sit on this, get to a hospital now
I don’t know what a TIA is – something to do with impeded blood flow, maybe. But the word ‘stroke’ unhinges me. My greatest fear, my whole life, has been something happening to my brain.
I call my friend Herb, tell him to meet me at the Northwell Health Center, which is three blocks from my apartment, and walk over. I tell myself, as I do, that there is no need to panic: worrying could increase my blood pressure, which is not good for strokes, the doctor said this TIA thing has passed, and anyway, I have a smart brain. If something has happened, my brain should have enough cells to compensate for the ones lost in battle.
Also, since I’d had an appointment earlier that morning, I am nicely dressed: cashmere sweater, wool trousers, a beautiful old Dolce & Gabbana scarf a personal shopper convinced me to buy years ago. If I collapse in the street, I will register as an upper-middle-class person with the means to sue. Even if I lose the ability to speak, somebody will pick me up.
I walk, petrified, into Northwell. This is not one of those situations where you have to sit in the ER for four hours waiting to see a doctor. Use the words “my doctor said I am at risk of stroke” and within minutes, a nurse and a Physician’s Assistant are there, asking me who the president is and taking my blood pressure. Three days earlier, it was 118/80. Now the top number is 168.
“High,” a nurse says.
“ Do you blame me?” I say.
They keep me for four hours, doing blood tests and CT scans, and find no aneurysms, clots, or hunks of cholesterol floating through my arteries. I learn that TIA stands for Transient Ischemic Attack, which has the same symptoms as a stroke but goes away quickly. It also means you may be at high risk for a stroke.
The doctor gives me the name of a neurologist who will be expecting my call, prescriptions for aspirin, Plavix, and Lipitor, and an information sheet that lists dangerous symptoms for which I should return to the E.R. One of the symptoms is a“very bad headache.”
I won’t be able to get through to the neurologist until Monday. I head home, picking up a container of Chunky Monkey and the drugs. Every time during the weekend that my head tingles, I wonder if it’s a piece of plaque elbowing its way through a too-tight artery. Visions of nursing homes dance in my head. In not one, can I get to the bathroom by myself.
A commemorative address to all my Get That Thing on Your Nose Looked at Immediately troops: Learn by my mistake. Do NOT delay calling your doctor. Do NOT think you’re being neurotic. Do not shrug it off as merely “weird” if something happens to your mind or body, especially if you are unable to read this sentence. Call your doctor now.
Also, do NOT send me horror stories about strokes. That’s why I turned off the comments. I’m nervous enough as it is. If you want to do something helpful, send ice cream.