Before the afterstrokeparty, Kate told a friend they’d enjoy the evening because it was “such fun” seeing me drink!
It’s true: one glass of wine is enough to make me seriously tipsy, so I drink less than most. In fact during the whole afterstrokeparty I actually only had two drinks (and a couple of diet cokes). Equally, I get sober really quickly too. I mention this because I’ve now got an explanation that also explains my warfarin experience. I metabolise drugs very quickly. It explains the higher doses of warfarin, it explains getting tipsy and sober on alcohol faster. It’s not at all uncommon either, nor anything to cause anyone any angst.
Yes, obviously I saw the consultant at Hospital Number 2 for the Cadiss trial today! This could be a long post. I was in there about 40 minutes. So if you really want to read on, make a cup of tea, find a comfy spot, and then proceed.
You may need a quick reminder about the Cadiss trial for context. It’s a trial that compares the post-stroke-as-a-secondary-to-vertebral-dissection effectiveness of warfarin verses aspirin. I’m on warfarin. As part of their data collection, Cadiss provides drugs without prescription charges for 3-6 months, a follow-up scan at 3 months, and a senior neurological consultant to tell you what the new scan says. We were hoping that the 3 month scan, which I had the other Friday, would show the artery was healed and the warfarin could be stopped earlier than the 6 month regime prescribed by the NHS standard protocols. As it turns out, there are now additional benefits for me (in my opinion) as ongoing care is moving back from Hospital Number 3 (and the nice Dr D) to Hospital Number 2 (and the more senior Dr A).
Why are we talking about ongoing stuff? The scan showed that my artery is still occluded (blocked) and so, for now, I remain on the warfarin. As my boss texted, “not what we wanted”.
Dr A started out by reading the notes on each scan, which was kinda cool because I could see the screen over his shoulder and spot key words. I’d forgotten quite how many I’d had. A CT on 11 Oct, an MRI on 12 Oct, and another CT with contrast (dye) on 13 Oct. He was most interested in the scan from the other Friday. It was supposed to be an MRI but due to a mix up it was actually a CT with contrast. I don’t know what the difference is in output but it seemed to give him the info he needed.
Dr A’s taken my case back over to Hospital Number 2. I “can still go” to Dr D’s February appointment at Hospital Number 3 (which is when I’d expected to be signed out of the NHS stroke system) but Dr A told me to tell him that “he isn’t allowed to make any decisions, I’m in charge now”. I like Dr D of Hospital Number 3; he’s great. But the place I felt safest and like everyone knew exactly what they were doing was in Hospital Number 2. I know this is because I was in the HASU there, so it was all about the setup, but it still remains that I’m glad about this decision.
As well as showing that the artery’s still blocked, the scan also showed a load of other things from the event in October; a little “meteor shower” of hits to my brain, which isn’t that surprising given I had a clot breaking up all over the place for a day. It’s disappointing I have to stay on the Warfarin, and this all goes on until at least May, but these things happen. The beauty of the scan is that we know what’s going on and it can be managed, and that’s the important bit. So what next?
In May there will be another scan, followed by another clinic with Dr A. Apparently the artery may or may not remain blocked. An occluded artery isn’t a problem, as there are 3 others supplying blood to the brain, as long as it’s not capable of repeating the ‘meteor shower’ activity. I will be on “something called aspirin” (!!) forever, but what happens in the immediate future – i.e. getting me off the dreaded warfarin – now gets decided in May.
What else? The snippets:
- There’ll be no thrombaphilia test, he agrees with Dr D that would be a waste of time
- He became the first to ask about stress at the onset of the issue; it can be ‘associated’, though my blood pressure is perfectly controlled… (I’m secretly quite proud of my blood pressure: it’s been measured a gazillion times and, while I wasn’t paying attention for the first few days, since I’ve been out of hospital its always been on the low side of normal, which is where all the medics seem to think is rather excellent)
- Don’t get pregnant until I’ve seen him in May… no, I haven’t any immediate plans!… but “I wouldn’t want to see a planned pregnancy until I’ve seen you in May”. Um… ok!
So basically, it’s not over yet. Ho hum. Updates will occur, sporadically. I’m neither joyful nor upset about any of it, but instead just glad we know where we’re at. The continuation of the warfarin, however, is a bit of a drag.
But two more lovely things also happened today: another lovely friend commented on how welcome and part of it all they felt at the party which again is testimony to both you and she. And my flatmate E, well, she decided that scan-day meant presents. So she got me these: