Neurologist

Maybe I am becoming immune to more news, maybe I expected to hear what I heard. It is just another step.

Dr. Blair's office on the morning of the 2nd. Results of transcranial doppler performed by the heart center.

Mean doppler flows are ok
Doppler flow directions are ok
No spontaneous emboli

Then came the agitated saline injected in the right arm - monitored of right middle cerebral artery.

Injection at rest: zero hits
Injection with valsalva number one: 16 hits
Injection with valsalva number two: 26 hits

Impression:

Normal baseline transcranial doppler.
42 embolic tracks with valsalva during intravenous infusion of microbubble contrast. This represents a grade 3 right to left shunt.

Grade 3 right...what the heck does this mean. Let me explain - there are complex journals out there that talk about Grade III RLS and then others that are technical papers with strange images. But in normal person talk it means that I have a hole in my heart. We are all born with this and it closes up in most of us. They used to think it was only a small percentage that it stayed open in but when they see healthy (for the most part) people with strokes at a young age they started looking and 50% of those people the whole did not close up. So now we have about 25% of the people wandering around with holes in thier hearts. This holes can create disturbances that cause clots that can do exactly what they did to me.

So my brother and I are sitting there and I say OK. Now I know Dr. Blair's opinion is to operate and close that hole. But I need to have a transesophageal electrocardiogram. Now I know what a TEE is and I am not happy about it. You can click on the links to learn more but once again we are getting invasive.

Sad thing is that my doctor (Dr. Garcia) said that this is what we would have to do in the very beginning. I was not happy then and I am not happy about this now but I guess I will have to see a heart specialist to figure out exactly what needs to be done. Then the cardiac specialist and the neurologist can have a thumb wrestle to see whose opinion is good.

Oh and by the way I did have two TIA's not just the one. The one on the right side was the big one and the one on the left side was rather small. But it does confirm the suspicion from before that I saw two areas of disturbance on the MRI results. Sigh. Two strokes for the price of one...