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Mini Stroke - Advice

Vince1001 profile image
19 Replies

Advice please on my bad news following my recent post: -

healthunlocked.com/afassoci...

I felt comfortable that I was getting on top of the mongrel AF condition and planning a private consultation with an EP to see way forward with my AF. The feedback to the post was really useful. I was therefore going to get a second opinion on my use of 2.5mg of bisoprolol as a weak anti-arrhythmic as it’s not really working and also reviewing the need for A/C which my cardio and doctor said wasn’t necessary.

As ever, life throws a curved ball, and I had a mini-stroke last week. I was having problems speaking correct words and phoned 111 for advice and later ended up in A&E. Lots of questions, a blood test and an ECG (which showed NSR!) and a brain scan showing “right temporal lobe infarct”. They didn’t do an Echo as I only had one 6 months previously which showed my heart was structurally ok.

I was kept in for 2 days for monitoring in the stroke ward which was a challenging experience. Physio and other observations fortunately confirmed that there was no permanent after effects and that they were happy to discharge me. I played a couple of holes of golf today on the practice greens with no issues which really cheered me up. I’m not allowed to drive for a month and then need an optician’s review. Have I got off lightly?

I have been prescribed 5mg Apixaban together with 40mg Atorvastatin as my cholesterol was 5.2. No problems so far with this new medication. Understand that the chances of preventing another a stroke are better than 70%. Note that I’m very fit and active and have a good diet. No other comorbidities as I have lowish blood pressure and don’t smoke nor drink alcohol. Not sure what else I can do…

I’m obviously very fearful about the future and seek advice from the forum as to my situation.

Vince

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19 Replies
BobD profile image
BobDVolunteer

Sorry to read that Vince and yet another example of why we are so keen on AF patients being on anticoagulation.

The CHADSVASC system is not foolproof rather sadly and many doctors (GPs) are often overly cautious about prescribing anticoagulants as for some reason they fear bleeds more than strokes. It is a battle AFA have been fighting since we started in 2007!

Of course it is always a balance of risk which frankly I believe patients should be fully educated in to make up their own minds. There are several members here who have been told either they can come off their anticoagulant or that their risk was low so not to take one, who later suffered TIA or even full -blown stroke,

Yes your future stroke risk is now greatly reduced by Apixaban to a level close to that of a patient with no risk factors so I think you can relax on that score. I would mention that bisoprolol as a beta blocker is mainly used for rate control and whilst it may have some very slight ryhthm control properties that is not usually what it is used for. I think it time to make an appointment to see an electrophysiologist to get some facts and good advice about your future treatment.

Vince1001 profile image
Vince1001 in reply to BobD

Thanks Bob....very interesting

CDreamer profile image
CDreamer

I had a TIA a few years ago when I was on a break from anti-coagulants after successful ablation. I recovered within a week or so and have not had anything since. I couldn’t get back onto the anticoagulants fast enough.

MarkS profile image
MarkS

I had a TIA 11 years ago. My wife (a GP) picked it up as I was talking incoherently and had a lop sided face and weakness in one of my arms. I had a "greyed" out vision which I had last previously experienced in the Navy in a jet pulling high G. It lasted about 5 mins before I started feeling better. An ambulance was called and they picked up the AF (I had had it for at least 15 years previously). They checked me over in A&E and I was chucked out the same afternoon. I went on warfarin within 24 hours and have remained on it since.I was 58, had a CHADS2VASC score of zero and was super fit, playing hockey every week, which came to a prompt halt. It was quite a blow mentally as I thought I was invulnerable. I had an ablation a year later, partly to reduce the risk of another stroke (this was controversial at the time and still is).

It seemed pretty disastrous at the time, but looking back, there have been some positives. I'm not affected physically or mentally. I gave up hockey but I was at least able to come down stairs in the morning pain free, so that just brought forward the inevitable. I moderated my exercise, which was probably a good thing. I remember the cardio saying I shouldn't be so competitive against others or myself (by which he meant against the clock on my bike).

I think the fact that you were fit means you had a TIA rather than a full blown stroke. So I would continue with the exercise, perhaps not pushing yourself as hard as you might have. Take your apixaban like clockwork, that is vital. Consider an ablation (but that may only reduce your risk a bit, you would still need to carry on with the anticoags afterwards). Otherwise, relax, your life will continue pretty much as before and be just as good!

CDreamer profile image
CDreamer in reply to MarkS

I have come to understand that the fitter people are, the harder it is to cope with things like AF, especially when it comes to restricting activities that you previously enjoyed.

Vince1001 profile image
Vince1001 in reply to MarkS

Thanks Mark... you handled it well Your success is very comforting to me

bassets profile image
bassets

Sorry to hear you were unwell, but you have had good advice here. Hope all goes well from now on .

secondtry profile image
secondtry

That is bad news, hope your recovery is progressing. You might want to look into acupuncture, my London Naturopath said I should come and see him for some if I ever had a stroke.

Vince1001 profile image
Vince1001 in reply to secondtry

Thanks secondtry! Never heard of that one before. I might give it a shot once I get the vaccine...

Dodie117 profile image
Dodie117

I too had a suspected TIA in 2013. I was put on warfarin, and later apixaban and had an ablation in late 2013. I am AF free and no other TIAs or stroke. 🤞. Good luck.

Vince1001 profile image
Vince1001 in reply to Dodie117

Excellent news lallym...The ablation has obviously worked for you!

Auriculaire profile image
Auriculaire

I had a mild TIA in March 2019. It was extremely subtle - some weakness in my right leg and just feeling a bit "odd" . No speech problems other than feeling a slight hesitation in saying things, no droopy face. But the next day I tried to write a shopping list and could not write properly - just squiggles. The scan showed nothing but my GP wrote the prescription for Apixaban immediately. My last afib attack had been 6 months previously.

irene75359 profile image
irene75359

I am one of those firmly in the 'anti-coagulate' camp. You are not the only person on here who has had a TIA after being told anti-coagulation was unnecessary. It must have been very worrying for you but moving forward there are huge positives to take from this. You are here, fit and well, anti-coagulated and no lasting side effects from your TIA. Try not to dwell on the 'what ifs' (must be difficult, I completely empathise) and get on with your new life. It won't be a lesser life, just slightly different, that's all.

When I was first diagnosed I went through a period of bereavement for the loss of the old me. I was baffled, I was (am) fit and well, not overweight, took no medication and didn't have any co-morbidities and I was in shock. I found this forum, visit it every day and take from the huge knowledge-base right here. The last time I saw a different GP in my practice we were discussing AF and I saw his eyes widen and flicker and I realised 'I know something he doesn't'. He was open enough to tell me he had learned something that day.

Best of luck in your journey, and please let us know how you are getting on.

Vince1001 profile image
Vince1001 in reply to irene75359

Thanks Irene. Your input and that from others has been incredible!

leelec profile image
leelec

Apixaban is your safety net, well done. Apart from you there are four posters (above mine) in this thread who have had mini-strokes. I personally know of another three in my comparatively small circle of friends and acquaintances. Two of those had AF without being aware of it before their strokes and the other, who was diagnosed with AF, was waiting for his cardiologist to make up her mind about anticoagulation! Now here's my point which may or may not inidcate levels of risk. You know this virus thingy that is currently raging the world carrying off thousands daily in the UK alone? I don't know anyone who has had it.........

Vince1001 profile image
Vince1001 in reply to leelec

Thanks leelec...I had no idea that so many people have suffered to same experiences as I did. All very scary... but I feel more comfortable knowing this info.

Aus19 profile image
Aus19

Hi from Australia, Vince1001.

At age 51, I had a stroke (no risk factors, non-smoker, very fit). Probably caused by AF (though it took the cardiologists a month even to detect AF on an ECG - it was sub-clinical). The takeaway being: even very mild or almost non-existent arrhythmias may put you at risk of a stroke.

With my stroke, I lost the ability to speak for about 10 minutes. It was a minor stroke - there is certainly permanent damage to my brain, but not much. When I am tired, I still sometimes struggle with speech. Though I did have neuropathy and weird sensations in my limbs for about three months after the stroke.

Anyway, I was a runner and one story that interested me involved Michael Johnson, the great American sprinter and Olympic medallist. He had a stroke a month before me in 2018. His stroke, I think, hasn't been explained ("cryptogenic", as the neurologists say). Anyway, his strength and attitude to life are, I think, inspirational. You can watch it on YouTube and other places. I think he is now a spokesperson for the US Stroke Association. Check it out if you have a chance.

Cheers mate.

Vince1001 profile image
Vince1001 in reply to Aus19

Thanks Au19 for sharing your story with me. Looks as though you've got through it ok.

I'd forgotten about Michal Jackson and I've just watched a couple of his videos per your suggestion. As you say he is very inspirational and his attitude is amazing. There's no doubt that I'll come back to his videos when I need a boost...

Thanks again, Vince

Melchet profile image
Melchet in reply to Vince1001

Michael Johnson - there is quite a difference!

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