As you may recall, my husband had a right side lateral pontine stroke, apparently his second one, although we still don’t have the straight scoop on the first one. Two specialists said there as no evidence of the first stroke and it was a transient ischemic episode related to the inner carotid artery dissection. One specialist and one other doctor said the first episode was a very mild stroke and our family doctor said it best when he just shrugged and asked who cares? It really doesn’t matter except possibly for insurance companies. Since the second stroke is absolutely for certain a stroke, it doesn’t make any difference now what we call the first episode.
So background: Hubby dearest was released from hospital the first time on a very complex multi drug regimen that caused him all kinds of side effects which made him miserable and made my life feel really hard some days. We eventually weaned him off all the drugs except the blood thinner clopidogrel bisulfate (generic form of Plavix), daily aspirin and his regular blood pressure med cilazapril, and I got my husband back. A January MRI showed the carotid artery had healed, there was no sign of any stroke or micro strokes and he could stop the blood thinners after a final CT confirmed what the MRI showed. That was scheduled for March 10.
On Feb 28th we noticed his toes had turned red/purple and his baby toes looked nearly black. The bottom of his feet were solid bruises and the tops speckled red. After a quick consult with our family doctor we stopped the blood thinner before the confirming CT assuming it was the blood thinner causing this. After two days the awful black and blue look had resolved and his feet looked normal. He felt fine through it all.
March 3rd I came down with an awful bug. I had only a low grade fever (37.6 at the highest) but for four days it was all I could do to get in and out of bed. The bug included a horrific headache that stabbed all the way down my spine. My sense of smell was gone even though I had no runny noise or any cold symptoms but the glands in my neck were swollen and sore and I was wracked by coughing. I also felt short of breath and my usual asthma bronchodilator did little to nothing to fix that sensation. At one point I also called the health department’s number to see if I should get tested for the coronavirus. At that time you only got tested if you have been to China or had a confirmed close contact with someone who had a positive test after being in China.
I also had a bizarre collection of neurological symptoms included come and go weakness on one side, dizziness, weird twitches and my vision came and went in one eye. I recalled thinking I should probably get up and call an ambulance because maybe this was meningitis or encephalitis but I was too tired so I went back to sleep instead. When I woke up a few hours later I was finally feeling better so I reassured my worried husband all was well. The headache finally eased and on the fifth day, March 7th, I felt well enough to get up and go back to my household chores. For the next two weeks I was dragging myself around feeling absolutely awful but functional. I napped and rested a lot. March 8th Dick was feeling a bit off and he had a low grade fever in the evening and I thought, here we go, he got my bug now, but by morning he was feeling fine.
It was the early morning of March 10th when Dick’s second stroke occurred. I was still recovering from the bug I had. I told the paramedics about my recent flu-like bout and they put a mask on my husband before doing anything. He arrived at the hospital with the mask on. A nurse took his temperature, decided he was normal and the mask was gone. I bring all this up because there are now reports out there about COVID-19 causing COVID toes in mild cases. Also COVID-19 infection is associated with stroke. The doctors have poo-poohed my thought on this because my husband is in his seventies, had a previous query stroke and we had no history of confirmed exposure. Admittedly there was nothing in imaging and no reason for him to have had the second stroke. His carotid artery showed as healed in the CT and MRI he had in the immediate aftermath of the stroke so that was deemed not part of the picture. This second stroke had nothing to do with the carotid artery dissection, but could COVID be causing blue toes and a stroke? No way, the doctors said.
We will not know if we have been exposed to COVID-19 until the antibody test finally comes out. Even if we do test positive, we will not know if that was the cause of the stroke. Such is life’s uncertainty. I prefer to think that it was COVID-19 because one of the doctors told me I needed to think about quality of life not quantity during his hospitalization. This whole second stroke episode indicates my husband has diseased brain arteries that are not showing up as such in the imaging. He will likely have repeat strokes and drop dead one day sooner or later, probably sooner. (Okay the doctor said it using far nicer words than that but that is what he said.) That prognosis is far worse than thinking he got it and is now recovering from a stroke caused by COVID-19 unrelated to the carotid artery dissection. In any case, he’s not dead yet.