We didn’t expect much from Andy’s appointment today with our substitute doctor (ours is on sabbatical in France) at our local medical group, but we were pleasantly surprised.
Once we checked in and were ushered into the exam room, we had to wait about a half an hour. That can often be a bad sign, but in this case the doctor had been reading the information from the hospital and was trying to make sense of it all. She took notes when Andy told her what has been happening, and she agreed with the neurosurgeon that the carotid artery dissection was a more serious problem than the blood on the brain. She excused herself at one point to talk to the head of the group, a cardiologist, to get another opinion, and they said that Plavix plus aspirin (and the vitamin E he takes in his eye supplements) was the best treatment — Andy shouldn’t worry about how easily he bruises now, the dissection is more important. They don’t think a stent is advisable, not just because of age, but because the dissection is too close to the brain — a stent would be too dangerous to take the risk. And, as we’ve read, with medication dissections often heal themselves.
Andy’s discharge papers from the hospital said he had acute renal deficiency, and we asked about that. She said the dyes they inject for an MRI with contrast can be hard on the kidneys but the effect can be temporary so she gave him an order for blood tests to check if it’s still a problem.
We also asked about the discharge orders to take Keppra twice a day for 14 days, then stop — we have read that it’s best to taper off gradually. She said go down to one a day until Andy finishes all 28.
We have a follow-up appointment with her in a month.
I was very pleased. We will still go to the Mayo Clinic just to be sure, if/when they set up an appointment. It usually takes two to three days to hear, so presumably in the fullness of time….
I should point out the cardiologist said that to be safe (close to the ER) Andy should take his walks around town for a while, but that clearly isn’t going to happen. When the doctor told us that I told Andy, “That means don’t go up to the land!” His body language gave his answer and the doctor laughed and threw up her hands. That was on him, not on her.
July 13, 2018