Hello. I will start with giving a summary of Joel Sr's past few days so that everyone can gain a full understanding of the events that have occurred with Sr's health. We apologize for not getting this information out sooner; however, as you might imagine, we've had alot to deal with and until today, we did not know alot.
On Saturday, May17th, at 2:30 Joe Petty (Sarah's husband) walked into Joel Sr's office and found him curled up in his chair. Apparently Sr had just gone to the bathroom and noted some difficulty in getting his belt buckled because his left arm was weak and numb. As he was finishing up, he heard the phone ringing so headed to his office to answer the phone...because his left side had gone numb...he fumbled with the phone and it got knocked off the hook...we believe it was at this time he had a stroke. When Joe found him, Sr was having difficulty speaking and his left side was non-functional. Luckily, Joe found him within a few short minutes of Sr having his stroke and 911 was called.
Upon being admitted to St. John's ER, Sr underwent a battery test including a 64-slice CAT scan, blood work, and neurology exams. The initial CAT scan came back showing no signs of damage and no brain bleeds which was great news; however, we found out that the CAT scan was taken so quickly after the stroke occurred that the results were not completely accurate. To get the most accurate reading, a CAT scan needs to be performed at least 12 hours after the stroke occurs. They gave the initial scan to ensure he was not having a hemorrhagic or intracerebal hemorrhaging of the brain.
Further neurological assessments that evening showed extreme weakness on Sr's left side, muscle coordination problems, and vision and fine motor skill problems. After being seen by a team of stroke specialists, it was first thought SR had a mini-stroke on the right side of his brain (the right side of the brain is what controls the movements and feelings on the left side of the body) known as a TIA...transient ischemic attack..which produces temporary stroke like symptoms that typically resolve within 24 hours. We now believe it was a full-blown stroke called an ischemic stroke.
If a stroke is caught within 3 hours after the onset and if the patient is a candidate, doctors like to start an IV treatment of t-PA - which is a clot busting drug that can greatly reduce brain damage and prevent subsequent strokes from occurring. Strokes occur one of 2 ways: 1. blood clots or 2. plaque build up in the carotid arteries.
Unfortunately, the stroke was not Sr's only problem...his heart was showing weakness and the EKG showed his heart to be unstable because of his congestive heart failure. Therefore, the t-PA, clot busting treatment, could not be administered because he didn't meet the medical criteria to be deemed a good candidate for the treatment. So doctor's decided to put Sr on a blood thinner with hopes of dissolving any more blood clots he might have.
Saturday evening, SR was moved to ICU where he continued to undergo more testing to determine the cause of the stroke and was seen by a team of doctors (heart specialist, neurologists, and a stroke team).
On Sunday, Sr was given a carotid artery dye test which came back perfect - no signs of any blockage or build up in the veins of his neck. Great news!
So, that confirmed that the stroke was caused from a blood clot somewhere in his body. He underwent an esophageal EKG test yesterday to assess his heart. Doctors believe that the stroke was caused from his congestive heart failure. To explain, SR's has a very weak heart and it does not pump blood or fluids the way it should. They believe Sr had fluid build up around his heart which caused an excessive amount of blood to pool around his heart...this blood, most likely clotted, and then traveled to his brain causing the ischemic stroke.
Sr will remain on a blood thinner with hopes that no more clotting will occur. Sr's heart rate was very low yesterday due to all the medicines that were given for the various procedures he underwent. For the time being, they have removed him from all of his heart medications and will slowly wean him back on over the course of the next several days. He is currently being given dopamine to increase his heart rate and is responding to the medicine wonderfully.
While Sr's congestive heart failure is very serious, his heart specialist and neurologist are confident that with proper medical care, appropriate medicines, and a "common sense" approach Sr will be okay.
As of this morning (Tuesday, May 20th) Sr has regained movement on his left side. His vision is great and he his fine motor skills are quickly improving. The dopamine continues to keep his heart rate up and he has no diet restrictions. He is still experiencing numbness on his left side but overtime doctors believe feeling to the area will come back. He was even able to get out of bed and walk a little this morning...first time he has been out of bed since Saturday. He was in great spirits this morning, ate a full breakfast, and read the paper and carried on many conversations with me.
He will be moved a cardiac floor sometime today and they will work to get his stamina built up and will continue to re-introduce the heart medications as his body allows. He will also be going through some physical therapy to help his left side. The recovery he has made since Sunday is absolutely miraculous!!
He'll have to do a little lifestyle adjustment (ie- no mowing the grass when it is 102 degrees outside)! But, at this time, doctors have not given him too many restrictions other than saying to use a common sense approach when doing things. And, we all know that this is something that Sr's lacks once and awhile which has nothing to do with his stroke, mental state, or his medical condition but rather his sheer stubbornness!
I am working closely with the doctors and specialists to ensure nothing is being overlooked and that Sr is getting everything he needs. I will continue to post information as I get it...so please check back often! Over the weekend, Pam asked me to bring my broom along to deal with the doctors (you know how specialists can be) ;).
Much love, Michelle
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