Help needed

[Fuli Chang]

I lost part of speech on the morning of Nov. 10, 2003, and didn't go to hospital until the evening
of Nov. 11. At that time I had only speech difficulty, but nothing else. I drove 25 miles on the
highway, sometimes at the speed of 70 mph, from my residence to the hospital.

At the hospital I was diagnosed as having a stroke, and given some pills. A while after taking those
pills, my body started sweating profusely, and I became extremely weak and drowsy. In the meantime,
both the left and right sides of my body were numbing. I complained to the nurse about it, but
nothing was done about it.

Then the left side became better. The numbness was decreased and eventually gone. But the numbness
on right did not go away.

After leaving the hospital, I found the administered medication was 'clonidine' from my medical
records, and got some information about it from following web sites:

http://www.edutechsbs.com/adhd/00019.htm http://www.rxlist.com/cgi/generic/clonidin_ids.htm
http://www.whatmeds.com/meds/clonidine.html http://www.healthsquare.com/newrx/CAT1072.HTM

All the sources say the starting dose for clonidine is 0.1 mg, and must be adjusted for each
individual's response to it. But the medicine was administered to me 0.2 mg only one time, and
changed to Norvacs after that.

I have been out of the hospital for more than three months. My speech has improved a lot. But the
numbness is not alleviated at all. The muscles on my right always ache. I feel a rope tightened
behind my right knee. My right should and side always feel tight and stiff. It is difficult for me
to walk, drive and lift things. My right side does not cooperate with my left side. I am not able to
do my regular job, and must retire.

I talked to a doctor from China by phone. She said that if blood pressure is dropped too fast after
a stroke, it will make the stroke worse. She told me that I was feeling numbing because the flow of
my blood became too slow. Unfortunately the doctor is not allowed to work in the U.S.

Now I need opinions from American doctors. For above description, was my stroke made worse by the
clonidine? Or was my body numbness and stiffness caused by it? Why did I became so sick after taking
the medicine?

Thanks.

Fuli Chang

 

[Julianne]

The Chinese doctor might very well be correct and I understand that it is frustrating when you feel
you don't have information.

First of all, you said you complained to the nurse but nothing was done about it. Do you know that
for certain? Why the change from Clonidine to Norvasc if she ignored your reports of increased
numbness and physical symptoms. Did she continue to monitor your blood pressure? Are you certain
that she didn't reach behind you and increase the rate of your IV fluids? Most times, it is very
inappropriate for a nurse to stand at a patient's bed with a horrified look on her face and
proclaim, "Oh my word, you are getting so much worse!" Patients are sensitive creatures.

Stroke patients often present with alarmingly high blood pressures. It would be really nice if there
was a drug that worked so precisely that it could be given with an exact result. I would invest
heavily in a company who could promise that for every mg of a drug, blood pressure would drop by
five points. Then, if I wanted to slowly drop blood pressure, I would give it one mg at a time.
Alas, it does not work that way. Some people respond very dramatically to medications and others
make you wonder if they have a built in immunity to them.

Without looking at your entire chart, I cannot know what your blood pressure was. I do know that
when it is very high as it often is when presenting with a stroke, you are at risk for multiple
events. It is a challenge to work with imprecise medications and patients whose response varies to
establish a happy balance between having a pressure so high that it causes another stroke vs
dropping it too rapidly. Besides the imprecise nature of meds, blood pressure is influenced by many
other factors. The elasticity of your arteries changes with age, diet, genetics, race, fluid
status, electrolytes and the number of alpha and beta receptors you have tacked on your smooth
arterial walls.

The reason why clonidine is often started off at a lower dosage is because it can cause a condition
called orthostatic hypotension. In ambulatory patients, this means that when they stand up, they
have a sudden but brief drop in blood pressure which causes falls and broken hips, etc. Not a good
thing. So, the med is started at a low dose and gradually ramped up. Since you were likely in the
bed, this wouldn't have concerned the docs.

Although it is alarming that you continue to have symptoms, it sounds as if you are doing well. You
state that you are driving but are having some residual coordination problems and numbness. I have
seen physical therapists do terrific work with stroke patients who had much worse residual damage.
Since you are still able to drive, you should focus on therapy that both assists you in
rehabilitation as well teaches you an ongoing home/gym exercise plan. By becoming fully involved in
your continued recovery, you might very well reduce the risks of a future event. As a neurologist
friend of mine says, "A CVA is no accident!"

Finally, it disturbs me that you are not able to talk to your physician or other health care
provider about this. For future health care, you might be well advised to find someone you can talk
to comfortably.

j

"Fuli Chang" <[email protected]> wrote in message
news:[email protected]...
> I lost part of speech on the morning of Nov. 10, 2003, and didn't go to hospital until the evening
> of Nov. 11. At that time I had only speech difficulty, but nothing else. I drove 25 miles on the
> highway, sometimes at the speed of 70 mph, from my residence to the hospital.
>
> At the hospital I was diagnosed as having a stroke, and given some pills. A while after taking
> those pills, my body started sweating profusely, and I became extremely weak and drowsy. In the
> meantime, both the left and right sides of my body were numbing. I complained to the nurse about
> it, but nothing was done about it.
>
> Then the left side became better. The numbness was decreased and eventually gone. But the numbness
> on right did not go away.
>
> After leaving the hospital, I found the administered medication was 'clonidine' from my medical
> records, and got some information about it from following web sites:
>
> http://www.edutechsbs.com/adhd/00019.htm http://www.rxlist.com/cgi/generic/clonidin_ids.htm
> http://www.whatmeds.com/meds/clonidine.html http://www.healthsquare.com/newrx/CAT1072.HTM
>
> All the sources say the starting dose for clonidine is 0.1 mg, and must be adjusted for each
> individual's response to it. But the medicine was administered to me 0.2 mg only one time, and
> changed to Norvacs after that.
>
> I have been out of the hospital for more than three months. My speech has improved a lot. But the
> numbness is not alleviated at all. The muscles on my right always ache. I feel a rope tightened
> behind my right knee. My right should and side always feel tight and stiff. It is difficult for me
> to walk, drive and lift things. My right side does not cooperate with my left side. I am not able
> to do my regular job, and must retire.
>
> I talked to a doctor from China by phone. She said that if blood pressure is dropped too fast
> after a stroke, it will make the stroke worse. She told me that I was feeling numbing because the
> flow of my blood became too slow. Unfortunately the doctor is not allowed to work in the U.S.
>
> Now I need opinions from American doctors. For above description, was my stroke made worse by the
> clonidine? Or was my body numbness and stiffness caused by it? Why did I became so sick after
> taking the medicine?
>
> Thanks.
>
> Fuli Chang

 

[Fuli Chang]

"Julianne" <[email protected]> wrote in message news:<lyJZb.6512$rd2.2110@lakeread05>...
> The Chinese doctor might very well be correct and I understand that it is frustrating when you
> feel you don't have information.

Dr. Julianne:

Thanks a lot for your response. Now I understand more about what was happening. Clonidine is a
medicine for lowering blood pressure. My blood pressure was high, so was administered to this
medicine. My blood pressure was reduced, and blood flow became slow. So the numbing was taking
place, and subsequently stays.
>
> First of all, you said you complained to the nurse but nothing was done about it. Do you know that
> for certain? Why the change from Clonidine to Norvasc if she ignored your reports of increased
> numbness and physical symptoms. Did she continue to monitor your blood pressure? Are you certain
> that she didn't reach behind you and increase the rate of your IV fluids? Most times, it is very
> inappropriate for a nurse to stand at a patient's bed with a horrified look on her face and
> proclaim, "Oh my word, you are getting so much worse!" Patients are sensitive creatures.

After taking the pills, my blood pressure was measured automatically by a machine by my bed every
few minutes. I knew that because each time when the machine was working, I felt the cuff pressing
on my arm. I was measured many times. I assume the readings were stored somewhere. Now I've
received my records from the hospital, but the readings of blood pressure for that period of time
are not in there.

At that time, I was not on any IV. My medication was changed to Norvasc, if this is counted as 'she
did something'. Also she asked me to move my fingers after I complained about the numbing.
>
> Stroke patients often present with alarmingly high blood pressures. It would be really nice if
> there was a drug that worked so precisely that it could be given with an exact result. I would
> invest heavily in a company who could promise that for every mg of a drug, blood pressure would
> drop by five points. Then, if I wanted to slowly drop blood pressure, I would give it one mg at a
> time. Alas, it does not work that way. Some people respond very dramatically to medications and
> others make you wonder if they have a built in immunity to them.

I wish we had the medicine, too. The doctor was trying to lower my blood pressure with Clonidine. I
took is as instructed, and got the numbing. As patient, what I want to make sure is the numbing was
caused by the Clonidine. It might be my fault that I responded to the pills too dramatically.

>
> Without looking at your entire chart, I cannot know what your blood pressure was. I do know that
> when it is very high as it often is when presenting with a stroke, you are at risk for multiple
> events. It is a challenge to work with imprecise medications and patients whose response varies to
> establish a happy balance between having a pressure so high that it causes another stroke vs
> dropping it too rapidly. Besides the imprecise nature of meds, blood pressure is influenced by
> many other factors. The elasticity of your arteries changes with age, diet, genetics, race, fluid
> status, electrolytes and the number of alpha and beta receptors you have tacked on your smooth
> arterial walls.

I will be happy to send you the chart. I was given a certain amount of medication. The doctor
might believe that if I was not given that much, I might have another stroke. I took the
medicine, so another stroke did not take place. I want to thank the doctor very much. But now I
am not sure whether or not the numbing was caused by the medicine. And I only want to make this
fact for certain.

>
> The reason why clonidine is often started off at a lower dosage is because it can cause a
> condition called orthostatic hypotension. In ambulatory patients, this means that when they stand
> up, they have a sudden but brief drop in blood pressure which causes falls and broken hips, etc.
> Not a good thing. So, the med is started at a low dose and gradually ramped up. Since you were
> likely in the bed, this wouldn't have concerned the docs.
>
> Although it is alarming that you continue to have symptoms, it sounds as if you are doing well.
> You state that you are driving but are having some residual coordination problems and numbness. I
> have seen physical therapists do terrific work with stroke patients who had much worse residual
> damage. Since you are still able to drive, you should focus on therapy that both assists you in
> rehabilitation as well teaches you an ongoing home/gym exercise plan. By becoming fully involved
> in your continued recovery, you might very well reduce the risks of a future event. As a
> neurologist friend of mine says, "A CVA is no accident!"

I am doing well now, except my body is feeling bad. But I was feeling much better before going to
the hospital. My whole body was feeling like a normal person. There was no numbness, tightness or
stiffness. The only problem was the stuttering of my speech. My neurologist told me that there is no
therapy for my body problem.
>
> Finally, it disturbs me that you are not able to talk to your physician or other health care
> provider about this. For future health care, you might be well advised to find someone you can
> talk to comfortably.

I have a doctor in internal medicine and a neurologist, but have no cardiologist. But only
cardiologists can explain thoroughly what's happening to me after taking the Clonidine. Am I right?
I am looking for the right doctor, or right division of medical science. Will cardiology give me the
right answer?

Thanks again.

Fuli Chang
>
> j
>
>
> "Fuli Chang" <[email protected]> wrote in message
> news:[email protected]...
> > I lost part of speech on the morning of Nov. 10, 2003, and didn't go to hospital until the
> > evening of Nov. 11. At that time I had only speech difficulty, but nothing else. I drove 25
> > miles on the highway, sometimes at the speed of 70 mph, from my residence to the hospital.
> >
> > At the hospital I was diagnosed as having a stroke, and given some pills. A while after taking
> > those pills, my body started sweating profusely, and I became extremely weak and drowsy. In the
> > meantime, both the left and right sides of my body were numbing. I complained to the nurse about
> > it, but nothing was done about it.
> >
> > Then the left side became better. The numbness was decreased and eventually gone. But the
> > numbness on right did not go away.
> >
> > After leaving the hospital, I found the administered medication was 'clonidine' from my medical
> > records, and got some information about it from following web sites:
> >
> > http://www.edutechsbs.com/adhd/00019.htm http://www.rxlist.com/cgi/generic/clonidin_ids.htm
> > http://www.whatmeds.com/meds/clonidine.html http://www.healthsquare.com/newrx/CAT1072.HTM
> >
> > All the sources say the starting dose for clonidine is 0.1 mg, and must be adjusted for each
> > individual's response to it. But the medicine was administered to me 0.2 mg only one time, and
> > changed to Norvacs after that.
> >
> > I have been out of the hospital for more than three months. My speech has improved a lot. But
> > the numbness is not alleviated at all. The muscles on my right always ache. I feel a rope
> > tightened behind my right knee. My right should and side always feel tight and stiff. It is
> > difficult for me to walk, drive and lift things. My right side does not cooperate with my left
> > side. I am not able to do my regular job, and must retire.
> >
> > I talked to a doctor from China by phone. She said that if blood pressure is dropped too
> > fast after a stroke, it will make the stroke worse. She told me that I was feeling numbing
> > because the flow of my blood became too slow. Unfortunately the doctor is not allowed to
> > work in the U.S.
> >
> > Now I need opinions from American doctors. For above description, was my stroke made worse by
> > the clonidine? Or was my body numbness and stiffness caused by it? Why did I became so sick
> > after taking the medicine?
> >
> > Thanks.
> >
> > Fuli Chang