The Janus Look 1

 

Thursday Jan 27

12.02 a.m.

 

Up to the toilet, as usual.  Back in bed now, but how strange. I can’t shut my right eye. I will hold it closed, and behind the pillow. My ear hurts again too. More behind and beside it rather than the ear itself. 

 

3.00 am.

 

Up again. What a nuisance. My eye still seems determined to stay open. And my mouth feels a bit odd. I wonder what might be wrong.  I wonder if it could be a stroke.  But I can move my arms and legs without any problems. I probably had a problem of numbness due to my position or something.  I expect it will be fine in the morning. And I can’t really face the idea of an ambulance ride in the middle of the night - waking my kids up so early.  

 

6 a.m.

 

I think the thing with my mouth is worse. I will put on the light and check in the mirror. 

 

Zounds. This is it. This is a stroke. I remember seeing the TV Ads - FAST pictures of a drooping mouth for the face, and boy do I have that. And when I smile, what a freak show - one side cheery and happy, the other as dumpish as you can get.  I will have to face the consequences and get on with this. I know getting it sorted quickly is important.

 

My mother had a stroke when she was 65 - two months after retiring. She found out by trying to get mail out of our outside mailbox, and then not being able to hold the letters from her right hand to her left.  Her left side was completely paralysed for a few weeks but she gradually was able to walk with a cane. But she could never cut her meat up when we were eating. She was in the hospital off  for another 3 months and died at 67. I’m more than 20 years older than that now. 

 

So I put on my dressing gown and went downstairs and phoned 111 first of all. But they had a long queue of callers and I didn’t think I could wait. So 999. Which service do you require?  I had to think - Ambulance, I finally said. My voice sounded very odd, deep and gruff.   FAST - I think the S stands for slurred speech.

 

Another sure sign of a stroke.   I expected a long wait but the lady answered straight away. I explained who I was and my symptoms. She asked if I was a man or woman.  Again my voice was very odd. She ordered an ambulance and said that it was on the way. She then asked me loads of questions - basic stuff  about any other problems, any medication I was on - could I walk? Was there anyone else in the house with me. Stuff like that.  She then said she had other calls to take, but that she might call me back again just to see how I was getting on.

 

I woke my son and told him an ambulance was coming and that I thought I was having a stroke, and would he call my two daughters who each live about 50 miles away in opposite directions. I got dressed, found a book or two to read, and waited downstairs, having turned all the lights on to make the ambulance people aware that we were the house they were looking  for. My house is awkward as the front door is not on the road that it is called but around the corner. 

 

My son had got dressed and announced that he would go with me.  My older daughter who is a physio called and told me that it might not be a stroke, there were other better options for the same sorts of symptoms - so that was a nice thought.

 

The ambulance arrived quickly, and my son went out to invite them in. There were three of them, with a bunch of equipment.  They introduced themselves to me and asked if we could go into a room where we could sit and they would do some preliminary tests on me.

 

So we went into the living room.  The first question : when had I first noticed the symptoms?I said 3 a.m. as I hadn’t really thought about a stroke with just the eye that wouldn’t close. “So that 's 4 hours since it started,” she said. “Strokes can be treated if you get to the hospital within a six hour period, so we are okay on that.”

 

“ Well, I did notice my eye wouldn’t close at 12,”  I said, but didn’t think of a stroke then.

 

“Well, I’m afraid that it was. So that puts us outside the six hours so not such a panic about getting you treated straight away.”

 

They took my temperature (normal) BP (138/85) did blood oxygen levels and took a pinprick of blood from my thumb.  Then they started with having me do all sorts of things - like lifting my legs and arms and pushing against  chair arms etc.

 

The lady then said that she thought it was a good chance that it wasn’t a stroke, but they did not have the power to make that diagnosis. They had to carry on as if it were. So I was loaded in the ambulance, but sitting, not lying down, and we went to the local hospital, but not with the siren and speeding. They said my son couldn’t come with me. He said my daughter was on her way, and would bring my phone to me in the hospital. I had lent it to her the week before. 

 

The last time I had been in the ambulance, was the week before my husband died, so all those memories came rushing back.  When we finally got there, I was put into a wheelchair and we proceeded in an almost empty hospital, certainly no queque of ambulances waiting to discharge their patients.  When we got to the stroke centre, the nurse seemed quite surprised, but  called the consultant. I noticed two patients - one who kept calling out feebly, “Help me, help  me,” but nobody took any interest. And another who you could only see was about ¾ down under the blankets on her bed, which showed somebody breathing.  Then the woman consultant came rushing in out of breath as she obviously had thought I was an emergency. 

 

She seemed disgusted when she looked at me. One look was all it took. “Bels Palsy,” she said, without a doubt.  She had me try to blink and raise my eyebrows which I can only do on one side, and asked if I had had any ear problems. “Yes, for the last few days,” I said.  “There you are,” she said, but nobody had asked me that question before.  She berated the ambulance staff for bringing me to this unit.  “Take her back to A and E reception,” she said. The ambulance woman defended herself.  “We had been told to pick up a possible stroke patient,” she said, “and we are not allowed to change our routine if we think that there is a better diagnosis.” 

 

So the consultant rushed off and still in the wheel chair, I was taken down many very empty areas and finally arrived in A and E, where I had sat for 6 hours in September when I had a very painful back injury. They then left me there - with probably no more than four other patients, waiting to being seen.  I hoped it wouldn’t be so long and without my phone I had no way to tell my family that I wasn’t having a stroke after all. Luckily I had brought the books and I frinished one and made good progress in the other before I was called for a blood test.  

 

 A young woman in her pajames came in and sat next but one to me. She started making terrible retching noises, and I didn’t know if she was really vomiting but it did turn out she had a bowl to be sick in. I asked her if I could get anyone to help her, but she said, “I’m just being sick. I’m pregnant.”  But it was still a good half hour with her declaring herself about to faint, before they took her in.   I was so glad she was being senn, but I didn’t see what happened after that to her, because it came to be my turn.

 

A young  doctor and his junior student doctor called my name.  We went into a side room set up for examinations. I was to lie on the bed this time, and  they did the ame sort  of tests.

 

“How can you tell I don’t have a stroke,”  I asked.

 

“The fact that when we ask you to scrunch up your forehead, and only half works,” he said. “A stroke victim forehead is not included at all. And the fact that you can’t close your eye. A stroke affects the face, but only the lower bits - the mouth in particular, and your mouth certainly seems very much like a stroke patient would have. And of course, you haven’t any problems with your arms or legs. And your voice sounds like a stroke victim might, so that was why there was some doubt for some time.

 

“Bels Palsy is a very odd medical problem - not all that uncommon, but mostly found in a younger age group than yours.  It strikes suddenly, and men and women equally, and equally in various times of the year and equally on either side. It was used to think it was caused by sitting in a draught. Nobody knows what causes it for sure. Some think it is related to shingles so that is why we asked you if you had had it.”

 

“How long will it last?”

 

“The paralysis will gradually go away as the nerves regenerate - with the help of your medication of Prednisolone, a type of cortisol steroid.  You will take 50 mg which is a big dose - for 10 days, and then stop. But we will have you seen both the eye hospital and ENT in 10 days time and they will decide if any further treatment is necessary. Also you will have to wear a mask  on your eye to prevent it getting infected as you can’t blink which is the normal method of cleaning your eyes. And there will be drops for you to take every hour to moisten your eyes, and others at night to coat the eye.”

 

“So how long all together is it likely I will look so misshapen?”.

 

He laughed.  “Probably until Easter. But you will gradually regain control of your face.  Almost everyone is back to normal by three months, although some take longer and a very few unlucky souls have it for the rest of their lives.” 

 

So I went back into the waiting room for another two hours before the results of the blood test confirmed that I was fit for release. The doctor and student came again, and he put the patch on my eye and watched me take my first 10 tablets. He did ask me if I had had steroids before, and I said no.  My husband took them for a few months before he died, and several of my friends had been prescribed them for bad backs.  So maybe a side effect for me would be that my bad back would disappear too. 

 

Once discharged I made it to the pharmacy to pack up my medication, and then, since I had had no messages from my daughter (who still had my phone) I took a taxi home, little realising that she had come to pick me up, and was one of the cars we passed en route home.