Still having issues post TIA

Hi all,

I’ve posted a few times and you are all so helpful. Im just wondering if anyone can point me in the right direction, as im at a bit of a loss.

Partner had a TIA in Novemeber. One minute of left sided numbness/pins and needles. Then totally normal. All test clear and was discharged from stroke unit woth clopidogrel and statin.

He has felt ok since the event. But something that has completely changed is his driving on the motorway. After about 15 mins of motorway driving, he feels a sense of everything closing in on him/dizziness. He finds it very hard to describe what exactly happens as when it happens it takes 100% concentration for him to focus on driving. But he says it hits him in an instant, like a brick.

His consultant advised this is not related to the TIA and he should have some cbt or counselling for panic or anxiety. He has had this, but is still getting these issues. He is definitely NOT anxious when driving but anxious when these episodes hit out of the blue.

I’ve tried to research as to what this could be…came across things like vertigo and bvd but we just dont know. As his mri was clear it seems its being dismissed as anxiety. But i know there is more to it. My partner is definitely not a hypochondriac - quite the opposite!

Hes drove for many years with no issues and wants to get this sorted so he can return to work.

He is fine driving locally it is literally just on motorways. I find it hard to believe its not caused by the TIA, but this is what the consultant has told us. Where do i go from here to help him?

Im at a bit of a loss with it all, any advice?

Thank you x

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Hi @Karenemma

I’m not sure I can offer advice! But let’s see what a few minutes of sharing thoughts reveals.

I would treat anything suggested by a consultant as highly plausible and unprovable (sic) - EG with the same reliability as a sports pundit predicting the outcome of a horse race or a football match. Actually a football match only has three outcomes so I’d put assertions of anything with neurological component way down the list from competitive team sports.

I suspect the T in TIA is a mistaken supposition from the invisibility of all the impacts of an interrupted blood flow to the brain and that medical science will prove in the coming years or decades that evolution has built more sophisticated and wide-ranging component behaviours/ after effects into our journeys

I get woozy or dizzy or something. Feelings that come on like somebody has flicked a switch. I’ve had various words suggested as substitutes. How we feel is subjective, how we express it doubly so. If somebody uses the word vertigo I have no idea whether they are expressing the word that they use for exactly the same feelings or not. I suspect not because the room never spins for me.

Spacey events were particularly bad in December. I’m not sure I’m past them yet. I don’t have a contextual setting that I can link them to like your partner has with motorway driving. Sometimes they turn off as quickly generally they fade. Sometimes they last half a day sometimes an hour. The first one or two took me back to a&e where I got the predictable “have some aspirin” and the common " can’t find a reason, come back if you need to"

‘Anxiety’ (‘subconscious thought processes’) occur all the time. At any stage It’s plausible that they have self-fulfilling self-referential physical effects eg:-

Driving requires multiple cognitive processes at a lot of levels. There are the autonomic ones of steering and speed regulation, salience determination, monitoring of peripheral and central vision, awareness of destination speed limits weather conditions other road users etc etc
It could be very well be that the additional challenges of doing all of this at speeds in excess of normal commuting is triggering enhanced fatigue, brain fog, lack of spoons which the subconscious then turns into a strange feeling out of self protection?
I think we know into the territory of bar room philosophizing :slight_smile: mines a pint of draft ale please - while I repeat the not medically trained etc caveat

Ciao
Simon

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@Karenemma vertigo is a rare side effect of Clopidogrel. I have been getting a bit lightheaded the last few days but I think that may be the tablet I’m on for recently diagnosed type 2 diabetes. Hope you get it sorted out.

Steve

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@Karenemma this is a difficult one. Is it just motorways or would a dual carriageway cause the same issue? I’m wondering if it’s perhaps the speed, many things happening & needing to be aware of at the same time etc that may be bringing on an element of fatigue that is causing this reaction. Has you explored whether it is how busy the motorway is? Has he tried driving at a quiet time & does he get same reaction.

Anxiety can appear in all shapes & forms & possibly in a way we would never think of.

Don’t forget that even if he had a TIA & not a stroke it still impacts the brain & can change the way we think / react to things. It could be an emotional response to what has happened.

It may be worth him speaking to his GP to see if they can explore what’s happening with him.

Hope it settles for him soon.

Best wishes

Ann

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I think I know exactly what he is experiencing, just don’t ask me to try and describe it. It certainly doesn’t tick any boxes for BVD; mine ticked a few boxes for vertigo but I never had it investigated down that route.

I never drove motorways much before stroke, certainly don’t now…leave all that to my hubby :blush:
But, just sitting in the front passenger seat whilst on the motor, I would have the same symptoms your hubby is having. I even felt queasy with it at times and felt the pressure build in my head. So I had to stop looking ahead and just look down at my lap. Once we were off the motorway I’d be fine again.

And yet I had no problem around the B roads, even the dual carriageways. So I just start sitting in the back seat and read or do puzzles. Still do even though it doesn’t really bother me anymore. Just don’t ask me how long it took. I’m now 3yrs post stroke.

Based on my own experience, I’d say it is brain fatigue. His brain has had enough of that and want’s to shut down. Naturally, he won’t let it because he’s driving on a motorway. So the brain chucks a virtual brick at him. Because, as I came to realise early on in my recover, the brain must always get what it wants, because it is still healing! And there are other ways it still has for shutting me when it needs to.

The motorway is fast and furious, and requires a high level of concentration, The brain has an awful lot of information to be taken in and processed. That’s putting a heavy demand on an injured brain.

There’s a reason why broken legs are put in plaster casts and you’re given crutches, to take the pressure off it whilst it heals.
You just can’t do that for a brain. So it has to find alternative methods to lighten its load when the pressure builds. It’s trying to avoid another stroke.

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I’m no doctor, but it sounds like a possible Vestibular disorder, or Vision (not eyesight) issue. I have both. Vertigo is a vestibular disorder, but there are many others. My issues with both vestibular system and vision was caused by stroke. These are generally diagnosed by ENT or Opthamologist. I am lucky enough to be near a hospital that specializes in Neurological issues, with a Neuro ENT and Neuro Opthamologist. Vestibular issues are often worked out in specialized physical therapy. Very cool process, actually.

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Thanks so much for all your helpful replies above.

Well after following up again with the gp about it he thinks some sort of vertigo is at play and has sent some exercises over for my husband to try. I think they are called brandt-daroff exercises.

In the meantime he’s still experiencing these episdodes, however it appears they are somewhat shortening in their duration. So im hoping this means they will eventually dwindle out.

I definitely agree with the above comments about fatigue playing a part.

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That sounds like a positive step forward & great that the episodes are shorter. Certainly sounds like there’s every chance they will go completely. Hopefully the exercises will do their job x

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