View from a Park Bench by Peter 2/15/19
As a former international track runner, getting some form of exercise, preferably in the outdoors, has become part of my daily routine. With increasing age, joint wear and tear and other injury problems, running as a core activity has been replaced by more joint friendly activities - cycling, swimming, hiking, skiing etc. However, when time is tight an occasional run in the park is a good way to get a moderate work out in a short time. My runs these days are confined to less than 30 minutes. And so it was on a relatively busy day last June, the car had been in for service; I had picked up some parts to repair our bicycles and bottled some cider at a do-it-yourself wine/beer store. It was approaching 5 pm and supper time and I had not had a chance to get any exercise. A lap of our local park (about 3 miles) – the entrance is about 400 yards from our house, would have to do. I set off on route as I had done many times before. It was a warm day but not excessively so. Little did I know when I set off that the “activity” was not going to come to an end until about 2 am the following morning!
Point Pleasant Park in Halifax, Nova Scotia is at the tip of the peninsula bordering the Halifax Harbour hence it provides very pleasant and popular running routes through woodland trails and along the waterfront. My route took me down to the waterfront with a moderate incline on the return to the park entrance to finish. It was on this incline, in retrospect, that I felt something was not quite normal. I seem to remember getting to the top and thinking, that was quick, how did I get up so fast without putting in any extra effort! Then, having reached the park entrance, I did an unusual thing, I decided to sit down on a park bench, something I had never done before as my home is only about another 300 yards away. That was the last thing I remember doing until approximately 21/2 hours later when I was in the hospital being wheeled to a CT scan. For a record of the intervening 21/2 hours or so, I have to rely on my wife Avril’s scary experience. Reassuringly, I did find my way back to the house, although only 300 yards it does involve crossing a road and making a left-hand turn so on some level, I must have been aware of what I was doing. Avril will take over to fill in the intervening time…
Before Peter returned from his run, our student boarder arrived back from college and told me that for some reason there was a set of keys in our side entry door which is the way we usually enter and leave our home.
“Strange,” I thought. They were Peter’s keys.
Shortly afterward there was a ring at the side door. It was Peter. He looked a bit puzzled. He didn’t say anything but came in the house and went straight to our kitchen table. He picked up a bicycle spare part he had purchased that afternoon, and asked,
“What is this? What is this doing here?”
He looked really confused, so I answered quietly explaining what it was and reminded him that he had bought it this afternoon. He moved to other items on our dining table and asked the same of each one. He seemed to have no recall of buying them and no recognition of what the items were. Then he turned to me and looked at his clothing. His t-shirt was wet with sweat. Our conversation went like this:
Peter:
“What’s this?” he asked, pulling at his wet t-shirt.
“Why is it wet?”
“Why am I wearing these clothes?”
“Why am I wearing these shoes?” (sneakers)
Me:
“They are your running clothes and your running shoes.”
Peter:
“Why am I wearing these things?”
Me:
“Because you have been running.”
Peter:
“Why would I go running?”
Me:
“Because that is what you sometimes do, when you have had no chance to get any other type of exercise in the day.”
Peter:
“What a stupid thing to do!” (Very strange response, from someone who was a competitive runner for many years and still ran periodically to maintain fitness.)
By this point, I was getting more than a little concerned.
Me:
“I think you should sit down.”
Peter:
“Why would I want to do that?”
Me:
“Because, you do not seem your normal self. I think you should sit down quietly for a little while. Don’t you remember going to the bicycle shop?”
Peter:
“Did I?”
At this point, I told him that I thought we should go to the hospital for a check-up.
Peter:
“Why would I want to do that?”
As I saw that persuading him might be difficult, I called my neighbor and asked if she had a little time, because I thought it might take two of us to persuade him to go with us to the hospital. She actually came with her husband. Peter recognized them both and did not really argue about going to the hospital. I got him to change some clothing and put on sweatpants and so on. He needed some help but could do it. The whole time, he just seemed pretty puzzled and frustrated to some extent.
At the hospital (fortunately less than a mile from our home) we went to the Emergency Room and went through their entry procedure. Peter was asked for his name, age and date of birth. He could not remember the last two. He was asked the day of the week, the date and the year. He was not able to give an answer. He was asked if he knew why he was there, and he was not able to answer.
From there, Peter went straightaway to have some tests. The doctor did some basic neurological tests, following a moving finger in front of his eyes, asked to walk a straight line, one foot in front of the other across the floor. This was followed by a blood test and tests to check heart function.
From there, he went for a CT Scan. Peter cooperated willingly to all these tests. He repeatedly asked what he was doing at the hospital and how he had got there. When I explained that our neighbors had brought him to the hospital, he had no recall. When I ran through the events of that day, he still had no recall. He retained nothing I told him during this period; however, many times I explained how we had got to the hospital and with whom.
After he returned from the CT Scan, things seemed to have changed a little. He began to have some inkling of what was going on. He began to remember having gone for a run, but not what happened before. He focused on the run and went over and over again for the next hour, trying to piece together the course of the run, the route he had taken, and why he had stopped at the bench.
Avril has filled in an approximately 21/2 hour period of my life of which I still have no recall. As I mentioned earlier, my first memory was being wheeled for a CT scan but only partially. I do not recall the full period of the scan itself. After returning from the scan I started to become more fully aware of my surroundings and immediate memories were being laid down again. The doctor who had been overseeing my treatment was satisfied that at least my longer-term memory had fully returned - I knew my birth date and the current date. I could now begin to recall events of the day up until reaching the park bench. As the tests that had been undertaken showed no signs of a TIA, there was no longer a sense of urgency, but I would remain in hospital to be seen by a neurologist.
As it was a busy Friday evening, we ended up having a wait of around 5 hours. The neurologist repeated some of the same basic tests I had previously taken and then diagnosed Transient Global Amnesia telling me that there was no known cause and it may not ever happen again - much to the relief of Avril and me. I was then discharged from the hospital.
Eight months later I have had not experienced any other episodes. From the literature, I suppose for age (67) plus I have suffered occasional periods of depression/anxiety and I do have occasional migraines, I “tick most of the boxes” for TGA pre-disposition. What caused the episode at this time is hard to identify, although I was running, it was nowhere near a level of physical stress I have exerted previously or since. I don’t recall being stressed emotionally or mentally at the time.
As far as affecting my life since, I would say, hardly at all, although I realize that Avril probably has more concern about a recurrence. It is a fascinating phenomenon; the closest analogy I can come up with is a computer whose hard drive is temporarily overloaded. On some level, I was still able to function – found my way home, able to change clothes, etc. although no immediate memories were being laid down. When I “came round,” I noticed the band-aid where I had had the blood test – I have no recall of a needle entering me – would it be possible to perform surgery on a person undergoing a TGA episode without anesthetic???