Transient Ischemic Attacks--need practical advice

chris_at_lucas_RN, RN · Jul 1, 2004

Hi--my 87 year old Dad takes great care of himself (good diet, walks a mile a day, stays happy and involved, exercises his mind). He has been experiencing what have been described to me (third hand, so who knows) as TIA's. I haven't been with him when he has had an "attack." Yesterday in the doctor's office was the most recent one. They MRI'd him right away, I don't know what the results were, if there are any yet. They did let him drive home (:angryfire what if there had been an accident???). My husband said his fine motor was such that he had great difficulty getting his eggs on his fork at lunch an hour or so later.

Basically, he loses his balance. The problem seems to be focused in motor and maybe balance, but we think the balance problem might be because of the motor issues. One time the EMS was called and his BG was around 45, they gave him some sugar PO and it was around 150 in the ER. This was the worst one, and there did seem to be some short-lived cognitive issues (wasn't sure where he was at the time, and this was a place he goes with his friends almost weekly). He later said some of the the cognitive problems hung on "for a while" (he said he recognized that he wasn't thinking as clearly as he is accustomed to--he is an engineer and critical thinking is a big deal).

He also has some vertigo at times for which he takes diphenhydramine po prn. He takes some HTN meds, aspirin, not sure what else. He has no chronic problems (other than this, and this doesn't slow him down much), is thin, has a good appetite and as far as I know, all systems are go. Coordination is fine, except for when he has these.

I am looking for suggestions as to what we should be watching for or doing, to minimize the frequency, intensity and duration of these events. We recognize that at 87, these kinds of things start to happen to the best of us.

Any suggestions? Ideas?

Thanks

Destinystar · Jul 1, 2004

i am sorry but it is out of a nurses scope of practice to be offering medical advice and to be making a medical diagnoses. sounds like your dad needs to go to an md he can trust and follow up on any referrals. these are questions with your dads permission that you would want to ask his md or any other health care provider that has first hand information about his condition. it is also a violation of his privacy to post information about his medical problems without his permission (hippa).

hi--my 87 year old dad takes great care of himself (good diet, walks a mile a day, stays happy and involved, exercises his mind). he has been experiencing what have been described to me (third hand, so who knows) as tia's. i haven't been with him when he has had an "attack." yesterday in the doctor's office was the most recent one. they mri'd him right away, i don't know what the results were, if there are any yet. they did let him drive home (:angryfire what if there had been an accident???). my husband said his fine motor was such that he had great difficulty getting his eggs on his fork at lunch an hour or so later.
basically, he loses his balance. the problem seems to be focused in motor and maybe balance, but we think the balance problem might be because of the motor issues. one time the ems was called and his bg was around 45, they gave him some sugar po and it was around 150 in the er. this was the worst one, and there did seem to be some short-lived cognitive issues (wasn't sure where he was at the time, and this was a place he goes with his friends almost weekly). he later said some of the the cognitive problems hung on "for a while" (he said he recognized that he wasn't thinking as clearly as he is accustomed to--he is an engineer and critical thinking is a big deal).
he also has some vertigo at times for which he takes diphenhydramine po prn. he takes some htn meds, aspirin, not sure what else. he has no chronic problems (other than this, and this doesn't slow him down much), is thin, has a good appetite and as far as i know, all systems are go. coordination is fine, except for when he has these.
i am looking for suggestions as to what we should be watching for or doing, to minimize the frequency, intensity and duration of these events. we recognize that at 87, these kinds of things start to happen to the best of us.
any suggestions? ideas?
thanks

Destinystar · Jul 1, 2004

i am sorry but it is out of a nurses scope of practice to be offering medical advice and to be making a medical diagnoses. sounds like your dad needs to go to an md he can trust and follow up on any referrals. these are questions with your dads permission that you would want to ask his md or any other health care provider that has first hand information about his condition. it is also a violation of his privacy to post information about his medical problems without his permission (hippa).

hi--my 87 year old dad takes great care of himself (good diet, walks a mile a day, stays happy and involved, exercises his mind). he has been experiencing what have been described to me (third hand, so who knows) as tia's. i haven't been with him when he has had an "attack." yesterday in the doctor's office was the most recent one. they mri'd him right away, i don't know what the results were, if there are any yet. they did let him drive home (:angryfire what if there had been an accident???). my husband said his fine motor was such that he had great difficulty getting his eggs on his fork at lunch an hour or so later.
basically, he loses his balance. the problem seems to be focused in motor and maybe balance, but we think the balance problem might be because of the motor issues. one time the ems was called and his bg was around 45, they gave him some sugar po and it was around 150 in the er. this was the worst one, and there did seem to be some short-lived cognitive issues (wasn't sure where he was at the time, and this was a place he goes with his friends almost weekly). he later said some of the the cognitive problems hung on "for a while" (he said he recognized that he wasn't thinking as clearly as he is accustomed to--he is an engineer and critical thinking is a big deal).
he also has some vertigo at times for which he takes diphenhydramine po prn. he takes some htn meds, aspirin, not sure what else. he has no chronic problems (other than this, and this doesn't slow him down much), is thin, has a good appetite and as far as i know, all systems are go. coordination is fine, except for when he has these.
i am looking for suggestions as to what we should be watching for or doing, to minimize the frequency, intensity and duration of these events. we recognize that at 87, these kinds of things start to happen to the best of us.
any suggestions? ideas?
thanks

chris_at_lucas_RN, RN · Jul 1, 2004

I see you are a new member. Welcome to allnurses.com. I've certainly made errors, here and elsewhere, although this is not one of them. You, my dear, are wrong.

We share lots of ideas here, not the least of which is clinical information. Look around, read a few posts, you'll see what I mean. There is a lot posted about specific patients--their clinical info, no identifying info, of course. Nurses supporting nurses, that's what this is about.

I know for a fact I am not out of line. Who are you to tell me that I am? You are not even right about the HIPPA issue. It does not apply to family members.

Even so, this is an anonymous BB--and I have not revealed my Dad's identity, and I am not his nurse, so I haven't violated any rules, HIPPA or otherwise.

Obviously he has a doc, he was there yesterday when he had his TIA. I am looking for nursing info of an educational nature for us, his caring family.

Thanks so much for your comments though. (NOT.) ( :stone )

Now, do you have anything that can help me? (If not, please don't bother responding to this thread--it takes up space and makes me think there is something of value for me when I got the notice in my email box.)

chris_at_lucas_RN, RN · Jul 1, 2004

I see you are a new member. Welcome to allnurses.com. I've certainly made errors, here and elsewhere, although this is not one of them. You, my dear, are wrong.

We share lots of ideas here, not the least of which is clinical information. Look around, read a few posts, you'll see what I mean. There is a lot posted about specific patients--their clinical info, no identifying info, of course. Nurses supporting nurses, that's what this is about.

I know for a fact I am not out of line. Who are you to tell me that I am? You are not even right about the HIPPA issue. It does not apply to family members.

Even so, this is an anonymous BB--and I have not revealed my Dad's identity, and I am not his nurse, so I haven't violated any rules, HIPPA or otherwise.

Obviously he has a doc, he was there yesterday when he had his TIA. I am looking for nursing info of an educational nature for us, his caring family.

Thanks so much for your comments though. (NOT.) ( :stone )

Now, do you have anything that can help me? (If not, please don't bother responding to this thread--it takes up space and makes me think there is something of value for me when I got the notice in my email box.)

CoffeeRTC, BSN, RN · Jul 1, 2004

Sounds a little like my Gramm. She's a little older and has had multiple TIAs. Unfortulalty she doesn't live alone anymore She is still in her own house tho. We take turns spending time with her. Basically no more strenuous stuff...(trimming hedges, vacuming etc)

CoffeeRTC, BSN, RN · Jul 1, 2004

Sounds a little like my Gramm. She's a little older and has had multiple TIAs. Unfortulalty she doesn't live alone anymore She is still in her own house tho. We take turns spending time with her. Basically no more strenuous stuff...(trimming hedges, vacuming etc)

jayne109, RN · Jul 1, 2004

I work on a Neuro floor and I have a few questions:

Have they done and Ultrasound or an MRA on his Carotid arteries?

Does he get any other problems ( i.e. weaknessin one hand, slurred speech, mouth droop)?

Have they drawn a Homocysteine level on him lately?

The homocysteine level, I learned, affects the clotting factors in his blood (or something like that) .

I also have a couple of textbooks that have really helped me with the Neuro stuff. Let me know If I can help you.

jayne109, RN · Jul 1, 2004