Dream Memories in the Canal by Kathryn 1/25/19

 

I find myself unexpectedly emotional as I prepare to write this story.  It's been four years since my TGA episode.  The neurologist I had at the time, told me that TGA is a "one-time event", that it wouldn't happen again.  I've learned since, that, for some people, that is just not true.  He told me there would be no long-term effects.  I've learned from personal experience, and from the personal accounts of other TGA survivors, that that is also not true.  I've been left with questions and a few answers.

 

My experience was very typical TGA, except for one thing.  What was typical:  I'm a woman in my 60s.  My "episode" lasted around ten hours.  I latched onto one question about which I had some anxiety, and asked that same question, over and over again.   I have previously had migraines (though only two, in my life).  What's not typical:  I'm not aware of anyone telling their TGA story, who has talked about impaired judgment during the event, and I'm wondering whether it was just me - or whether it's not something people happen to mention when they tell their story.

 

This is my TGA story. (Most of what follows, is what I've been told happened that day, 2 February 2015, as I remember very little of it.    Those memories I do have of that day, are "dream memories".  They aren't typical memories.  For some time after the episode, I didn't realize that these "dreams" that I remembered, actually happened, that they were all that I had left of the "memories" of that day.  I call them "dream memories" because they were similar to remembering dreams - just vague snatches, without much detail, just impressions.  Not like actual memories, at all.   

 

I attended my weekly Weight Watchers meeting that morning (though I had no memory of that, until a week later, when I went back to the class and found that I had signed in and weighed in, the week before!).  I was walking my three small dogs along the canal in the cool of the morning (here in Mesa, Arizona), which wasn't unusual for me, in those days.  I "remember" walking up and down the canal with my dogs.  Seemed like ages.  (Actually, we figured out later it was probably for about 90 minutes.)  For some unknown reason, I decided to get into the canal.  I "remember" tying my dogs' leashes to a fence, and putting my cell phone up on top of a ledge.  I vaguely "remember" sliding on my butt, into the canal.  (This is the first example of my impaired judgment - this is not something I would normally do, nor would anyone else.)  I vaguely remember being in the water.  I have no idea why.  Thank God that, when I decided to get out of the water, that I remembered to get my dogs (if I had left them there, for hours in the heat of the day, they would have been in danger and that thought still chills me to the bone).  And I put my cell phone in my jeans pocket.  Thank God for that, as well.  Somewhere along the way, I lost my glasses.  I have no idea where I left them.

 

At some point, I asked some strangers for help.  I don't remember them.  I have a vague sense that there were a man and a woman.  I wish I had had the presence of mind to get their names, so I could have later thanked them for their help, but I didn't.   The woman asked me if there was someone I could call.  Well, duh!  I had my cell phone in my pocket, but it hadn't occurred to me, until she asked me about it, that I could use it to call my mother!! 

 

So, I called my mother.  I asked her where she was.  She told me that she was at home, in her house.  I asked her again, where she was.  She responded the same way, for the second time.   Finally, frustrated, I explained that I wanted to know what city this was, what city she was in, what state this was - that I had no idea where I was, that I thought I'd had a stroke.  She heard the "helper" woman talking in the background, and asked me if there was someone there with me, and she told me to hand the phone to the woman.  So I did.  And the woman told my mother where I was, and said that she would wait with me until my mother got there, and my mother said she would be right there. 

 

When my mother came, she said I was shivering and chilled because all my clothes were wet.  We brought my dogs to her house, and then she took me to a nearby Urgent Care Clinic, where they took my vitals and called an ambulance to take me to the local Stroke Unit at a nearby hospital.  I remember none of that, but I have a vague, very brief "memory" of riding in the ambulance.  (It was very weird, months later, to go to that Urgent Care Clinic for a minor medical condition, and, know that I had been there before, because I'd heard the story, but have absolutely no memory of having been in that place.)  I remember none of the hours that I spent in the emergency room.  I have a vague "memory" of them wheeling me on a gurney down a hall, from the emergency room to a hospital room, where I was admitted.   

 

Around 7 PM that evening, I asked my mother, "Are my dogs okay?" ("Yes.")  "Are you sure?"  My mother told me that, yes, they were okay, that they were at her house.  Then she turned to my sister and said, "That is about the 50th time she has asked me that."  About 30 seconds later, I asked, "Are my dogs okay?"  Then, I remembered that I'd just asked that same question.  And I said, "I just asked that question, didn't I?"  And that was the last time I asked that question. That was the beginning of my "recovery period".  I had started "making memories", again.  

 

Besides the obvious medical questions, there were two big dilemmas:  1. Where was my car? and, 2. Where was my purse?  All I had on me when my mom picked me up, was my car keys, and my "doggy pouch", with doggy bags in it.  (Not too helpful.)  That made my admittance to the hospital somewhat problematic (no insurance information nor ID).  My niece's husband offered to go by my place to try to find my car/purse.  He reported that my car was not at my house, and he couldn't find my purse inside, either.  I had this thought, that I should tell him about the places where I usually parked my car when I was walking the dogs at the canal, but I couldn't do it.  It was too complicated, not something I could handle mentally.  (By the next morning, I was able to tell my niece the places where I usually parked my car, and she found my car, with my purse and license and insurance cards!  That was a relief.)  

 

When the neurologist assigned to my case, came to visit me that evening, he asked me the usual questions - did I know what year it was (no), did I know who the president was (no).  He said that he'd been told that I had some dogs - could I tell him their names (no).  That was upsetting to me, that I didn't know my dogs' names.  I'm glad he didn't ask me if I knew my name.  Because I don't know what I would have said.  And that could have been even more upsetting.  He mentioned three things (penny, apple, table), and asked me a couple of minutes later if I could tell him what they were (I couldn't).  

 

He told me and my mother that there were several possible causes for this, and he listed them on the whiteboard.  But he circled "TGA", and explained that he thought that was probably what it was, but that the only way to find out, was, basically, to rule out everything else (TIA, stroke, brain tumor, seizure, meningitis).  He said they would be doing lots of tests over the next couple of days, which they did.  

 

This whole thing was so scary for my mother, as a retired nurse.  She was sure I'd had a stroke, and was devastated.  She called my father, who lives out-of-state, that evening, crying, and told him so.

 

So, after ruling everything else out, he said it was a TGA, and that it was temporary, that I would get my memory back, that it would take about three weeks to get back to normal.  He discharged me with "no restrictions" and only one medication change: that I should take a regular-sized aspirin, as a stroke preventative, every day.  (I don't know whether he prescribed the aspirin because I'd had a TGA, or because of the stroke history in my family.)  That first morning back home, it took me about two hours to remember which pills I was supposed to take in the morning (I'd been taking these same pills every day for years) but that didn't happen again.  Slowly my memory functions and cognitive functions came back - to almost normal. 

 

When I went back for a follow-up three weeks later, I told him I thought I was about 95% "back".  I still had some trouble with word-finding, and memory, cognition, and multi-tasking.  And that's pretty much where it stayed, for 2 1/2 years.   Then, during a very stressful time in my life (my mother's illness), I had a "relapse".  Was it a TIA?  A mini-stroke?  I don't know.  But all of a sudden, I was forgetting things.  Every day.  Sometimes important things, like appointments I'd made, my friends' names.  I couldn't do math calculations that previously would have given me no trouble.  I couldn't multi-task at all.   I went back to my neurologist and we did all the tests again, plus a neuro-psychological exam, which confirmed the short-term and mid-range memory loss.  The Alzheimer test was negative (Thank God!).  

 

Since then, things have improved again, and my latest neuro-psychological exam confirms that.  My new neurologist has put me on a "blood thinner", as a stroke preventative.  But I've accepted the fact that I'll never be 100%, back to where I was, pre-TGA.  It's one of the many losses I've had to deal with in my life.  I've learned to laugh about the memory lapses.  Luckily, I'm retired, so I can "get by" with less cognitive skills than I used to need to function in my jobs.   

 

I would love to know what causes TGA, and whether the memory/cognitive issues I'm dealing with now, are just a continuation of my TGA experience, or something completely separate.  But there was the "before" me, and there is the "after" me, and they are quite different.   

 

At least to me.