On Monday, October 22 at 1145 AM, I tried to stand up from my chair. I fell
backwards. I hit my head and nose on various pieces of furniture )table, nightstand, trash can.) Fortunately, the handyman was here. He called 911. I was taken by ambulance to St. Francis ER an arrived at 1230. After a 2 hour wait, I was given stitches on the bridge of my nose between my eyes. I also have 3-4 staples in my upper left head. The numbing agent used was Lytocaine. I also received a tetanus shot. I was in ER room 16. A concussion was ruled out.
It appears that at around 10-1030 until 11-1130 I sleep a little. I hope it is just sleep. I do not eat much for breakfast (a bowl of cereal and some juice.) From 930-10 I use my PS3.
I sent this letter to my GP and Neurologist. I don’t see the Neurologist until Nov. 27. I want an MRI. Who should I ask?
You may ask that they do CT, this is easier to manage and organize than an mri, which you will probably not get immediately. As i had my bad fall in May 2012 i had a CT done in the EU. The neurologist wrote me a paper that i then should do a MRI in "intervall". This has not been done for several reasons. Some day ago i discussed this with a young doctor in the ambulance- she told me , that bleeding, which had not been evident in the CT , also later would not apppear on the MRI (i am not sure if she is right.) In my hospital the CT is possible day and night hopefully you can clear this.
Also an EEG should be done. This is not difficult to perform and could rule out some problems probably caused by your fall..
Good Luck! Hopefull nothing severe has happened (besides your vulnerations and shock, so far as i understood).
In the EA units they are sometimes not so nice to patients, because of so much stress. Hopefully you have got kindful carers..
Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States. ■■■■■■■■■■■■■■■
Abstract
OBJECTIVE:
To evaluate whether EEG performed within 30 min of referral by an ED physician helps establish diagnosis and/or changes management and in which clinical setting.
METHODS:
Single-center prospective cohort intervention study 1 day/week, of sequentially referred adult patients with clinical seizures or altered mental status (AMS). Standard EEGs were performed by an EEG technician using a commercially available cap, interpreted by an epileptologist, immediately reported to the ED physician and a utility survey completed. Quality and interpretation of 20 min EEGs was compared to pre-specified 5 min segments of each EEG using the kappa coefficient.
RESULTS:
Over 1 year, 82 patients underwent ED EEG. Tonic clonic seizure activity had occurred in 33%. Mean time for EEG setup was 13.1 ± 6.2 min. EEG assisted the diagnosis in 51%, changed ED management in 4% and would be ordered again if EEG was available in 46%. Positive utility of EEG was significantly associated with toxicologic, psychiatric and endocrine/metabolic causes of AMS vs. other causes (p<0.001) and sudden onset AMS (p=0.007). Independent predictors of whether ED EEG would be ordered if available were witnessed seizures (p=0.01), no prior head trauma (p=0.001) and survey respondent being a physician assistant (vs. MD) (p=0.02). The 5 (vs. 20) min EEG presented good agreement on waveform shape/amplitude (kappa=0.78), artifact (kappa=0.75) and interpretation categories (all kappa levels ≥ 0.70).
CONCLUSIONS:
Rapid availability of standard full-montage EEG in the ED is feasible and helps establish a diagnosis in about half of AMS patients, but rarely changes management. An abbreviated 5 min full-montage EEG presents adequate reliability which may improve use in the ED.
SIGNIFICANCE:
Specific presentations of AMS offer the best diagnostic benefit for EEG in the ED.
As patient with Ataxia your are potentially always at risk, mental state altered or not.. It s your brain which could have got a damnage even without having convulsions/seizures, and the earlier the intervention the better. Have a good sleep this night!
Hi,
I convey my heart felt sympathies and wish you a speedy recovery. I also wish that you are surrounded by nice and kind people to come out of this fall with ease. I too keep falling off and on and escape with a sprain. Lets keep up our spirits to fight. We cannot conquer Ataxia still we can fight.
Hi Eric, I feel your pain, hope you heal fast! Maybe using your cane inside until your legs and your body can get stronger would help you. I know that having ataxia we tend to get weaker than normal people do so its impurities that when we get out of a chair that we totally in gage our weight on our whole foot as we get up. If we don’t the weight will be going automaticity to our heels or just our toes and we will fall. Check out www.walkingwithataxia when you get some time! Sorry you fell but hopefully it will be your last! :0)
Thanks, Jeannie, for the link of www.walkingwithataxia.com The walking man - on the left "today" - he falls down and on the right "tomorrow" - he knows how to walk- does not fall any more. Just this sort of fall- first the head then the body, was what i experienced once. Never again! Horrorful.
So sorry about your fall Eric. I've fallen several times over the years...,not my idea of a good time! I fell over a year ago and severely injured my back. I started using a cane to prevent falls, and am very mindful of how I move now! Unfortunately, with ataxia, we have to be. In answer to an MRI or CT scan, you could call your neurologist or GP, talk with the receptionist or a nurse, tell them what happened to you, and have them talk with you doctor about an MRI or CT scan. Seems that would be quicker than sending a letter. Just a thought...,hope you're feeling better!
I am currently sporting a very bruised and swollen face,eye and neck. No matter how careful I am I have a really bad fall about once a year - fortunately nothing permanent so far though I have had my fair share of A&E waiting with all it entails.
My husband thinks I have fallen over something.I just went today including the rollator .Luckily it was on the grass but you end up feeling shocked and winded.
That was the third time this week.My sympathies Eric.
Oh Marie, I sympathize with you and your falls. Fortunately the one you took today was on grass (a bit softer) rather than the floor! I fell over a year ago and really hurt my back (micro-tears in the muscle)...not my idea of a good time...ha! We have to be so mindful of EVERY move, don't we? It's exhausting sometimes! Hope you're alright!
I'm so sorry you took such a nasty fall Lindilu! Our balance is so compromised, we can fall easily! One minute we're up and the next second down, as it happens so quickly! Glad you haven't done any permanent damage!!! ;o)