Out-Patient Appointment

As I covered in my post “Hospital - Discharge” I was left with very little information when I returned home, and if anything I was left with the impression that there was nothing I needed to do but monitor my blood pressure and take my meds. So you can imagine my surprise when I received a letter inviting me to an Outpatient Consultation, with the first Consultant I had seen in hospital, at 11:00 on Thursday the 19th of March 2015. As my partner and I were flying out to spend the postponed week with the step-daughter in the Alps on the Friday she had to work and could not rearrange her diary so was unable to come with me.

At 08:00 on the morning of my appointment I took my first BP reading of the day (145/94). I then investigated where the clinic was being held as I did not know the city that well. I finally set off at 09:30 giving me what I hoped would be plenty of time. I arrived at the single story community health centre at 10:30ish and after parking in the street outside I sat for twenty minutes just looking at the entrance. When I eventually made my way into the building I found myself in a classically fashioned NHS community facility from somewhere in the mid seventies. There were very few people, either staff or patient, in evidence, even the Reception was unmanned. Finally finding a non medical staff member I asked for directions to the ‘Stroke Clinic’. Following the man's directions, which took me down the archetypal series of corridors, I came across two nurses, who confirmed that I was in the right place. After handing in my invitation letter I was told to take a seat.

At 11:10 I was called into a side room where I was weighted and my blood pressure was taken (178/105) after which I was told to go to another part of the waiting area. At 11:30 my name was called by yet another nurse and after confirming my name and date of birth I was shown into a standard sized and equipped consulting room with its desk, wash hand basin and examination couch. Sitting at the desk, which was against the righthand wall, was the female Consultant from my first full day in hospital (see Hospital - Inpatient). As my last memory of her was of her sitting on my bed telling me that I might have to wait until Monday before being let out but that she hoped not, I was pleased to see her. Smiling a “good morning” I took the seat she pointed at.

Any fond memories where dispatched by her very first words.

“Your blood pressure is too high! Have you been taking your meds?”

Had she never heard of “White Coat Syndrome”?

Thinking that a simple “Good morning” would have been a much better way of starting and knowing that she was referring to that fact that five years earlier I had come off my blood pressure tablets I found myself getting defensive.

“Of course I have. I’m not stupid.”

As soon as I had said the words I knew that it would have been better if I had held my tongue. The Consultant just looked at me and moved on.

“You’ve had a massive Stroke and you are lucky to be walking and talking!’

Wow!

That went against everything that I had been told in the hospital, where I was told that my Stroke had been minor.

But the good news did not end there!

“ You’ve had numerous other strokes.” She told me in a matter of fact almost off hand way.

As I struggled to grab hold of what I had just heard I found something from my partner's past that seemed to made sense of things. Her father, who had died of dementia a few years ago, had had a number of TIA’s (Transient Ischaemic Attack), and so I asked the question. “Do you mean TIA’s?”. Maintaining her off-hand approach the Consultant dismissed my question with a simple “No”, and continued, “If they were TIA’s there would be no sign of them”.

Wow!

I did not know what she meant and told her so. In response she asked if I would like to see. Of course I said yes.

Turned her computer screen to face the open room she clicked on an icon and an image flashed into focus. Even though the monitor had been moved I still could not see clearly so got up to and stood just behind the Consultant.

The first image showed a large BLACK blob in the area that corresponded to the Central Core, which to me seemed quite large. The Consultant went on to explain that the area was black because that part of my brain was dead and would never regenerate. Then to my utter surprise she continued to flick through images that showed other BLACK SPOTS, all smaller than the first one. Due to the shock I momentarily lost the ability to take in anything but basic details so I had no idea how many there were.

The Consultant told me that there were seven or eight.

SEVEN or EIGHT?

Bloody Hell!

I don’t know how long silence reined but it felt like a lifetime.

Retaking my seat, I told the Consultant about the Headaches. In yet another example of understatement my Consultant responded by uttering the words that have perhaps defined the rest of my post strokes life.

“You get headaches with Strokes, so get used to it!”

AND THE HITS JUST KEEP ON COMING!

So I was a survivor of multiple strokes!

And I had been told this news as if the Consultant had been describing the weather for the past few days.

Moving swiftly on the Consultant told me that she was recommending an additional drug (Doxszosin) that she was sure would bring my blood pressure under control.

And then she delivered her final blow of the day by informing me that she had no prescribing rights so I would have to wait until her recommendation reached my own doctor and she would issue the drugs.

I knew that it would be at least two days before the meds would be available, which meant that I would not have them until after the holiday to the snow.

I left the Consultant’s presence in state of complete shock.