This Was Spinal Tap
July 18, 2008 2:01 PM Subscribe
Retro-diagnosis filter: Can the hive mind figure out what disease sent my mom to the hospital in the early 1960s and still affects her to this day?
My mom is in her late 70s. Back in the early 1960s she was pushing me in my stroller one summer day when one of her legs felt heavy, like a tree stump. By the time she pushed me back home, she was dragging that leg behind her. In subsequent days she ran a high fever and vomited frequently. Any sort of motion (like watching a someone in a rocking chair) made her nauseous and caused her to throw up. She ended up in the hospital and underwent a spinal tap and various other tests and treatments (including being subjected to baths with "hot packs" placed on her). I've since gotten copies of her records from that stay (that particular hospital has long since closed) and the diagnosis was "possible encephalitis." When she was discharged from the hospital, she was unable to fit into her regular clothes; she'd somehow gained weight despite being unable to eat and keep down food. (She never did get back down to her pre-illness size.) However, in the last 10 or so years when I've been the one taking her to the various doctor appointments required by newly aging patients (cardiologist, oncologist, etc), and sitting in on the consultations, whenever she mentions the encephalitis diagnosis and then describes her symptoms (both then and now), the doctors immediately snort "that wasn't encephalitis." But she had something wrong with her back then. To this day, whenever the weather is humid, she gets nauseated and complains of feeling "like I'm two feet tall." Likewise summer weather makes her head and legs "feel like mush" and she tires easily. Her sense of balance has always been precarious since that original illness (if she turns too quickly, she has to reach out and steady herself), and it also left her with something of a wide, waddling gait. Some of her symptoms sound like post-polio syndrome to me, but supposedly polio was ruled out during her original hospital stay.
Any ideas as to what Mom might have had back in the day? We never lived near horses (one source of encephalitis), she had never vacationed in a tropical area, and there had been no epidemics of any sort in our area (metro Detroit). I would just like to put a more definite finger on it so that her specialists don't immediately discount her various symptoms by saying "Oh, encephalitis doesn't cause this or that" and then completely discount said symptoms.
My mom is in her late 70s. Back in the early 1960s she was pushing me in my stroller one summer day when one of her legs felt heavy, like a tree stump. By the time she pushed me back home, she was dragging that leg behind her. In subsequent days she ran a high fever and vomited frequently. Any sort of motion (like watching a someone in a rocking chair) made her nauseous and caused her to throw up. She ended up in the hospital and underwent a spinal tap and various other tests and treatments (including being subjected to baths with "hot packs" placed on her). I've since gotten copies of her records from that stay (that particular hospital has long since closed) and the diagnosis was "possible encephalitis." When she was discharged from the hospital, she was unable to fit into her regular clothes; she'd somehow gained weight despite being unable to eat and keep down food. (She never did get back down to her pre-illness size.) However, in the last 10 or so years when I've been the one taking her to the various doctor appointments required by newly aging patients (cardiologist, oncologist, etc), and sitting in on the consultations, whenever she mentions the encephalitis diagnosis and then describes her symptoms (both then and now), the doctors immediately snort "that wasn't encephalitis." But she had something wrong with her back then. To this day, whenever the weather is humid, she gets nauseated and complains of feeling "like I'm two feet tall." Likewise summer weather makes her head and legs "feel like mush" and she tires easily. Her sense of balance has always been precarious since that original illness (if she turns too quickly, she has to reach out and steady herself), and it also left her with something of a wide, waddling gait. Some of her symptoms sound like post-polio syndrome to me, but supposedly polio was ruled out during her original hospital stay.
Any ideas as to what Mom might have had back in the day? We never lived near horses (one source of encephalitis), she had never vacationed in a tropical area, and there had been no epidemics of any sort in our area (metro Detroit). I would just like to put a more definite finger on it so that her specialists don't immediately discount her various symptoms by saying "Oh, encephalitis doesn't cause this or that" and then completely discount said symptoms.
She may have had a stroke, most probably one or more small focal strokes as opposed to one big devastating bleed. In young women, stroke is most common during the postpartum period. You didn't say how old you were at the time, but if you were in a stroller, she must have given birth relatively recently.
Stroke would explain the unilateral motor deficit. Nausea and vertigo often accompany. If the site of her stroke was deep in the brain and involved the hypothalamus, this would explain how her homeostasis (body temperature, energy level, fluid retention, metabolism) was upset.
The brain can repair itself to some extent following small strokes, especially in younger individuals. This may explain why she recovered from the worst of her symptoms but had some lasting problems with her balance and gait. Being under physical stress, such as hot weather, may tax the damaged areas of her brain and cause some of her original symptoms to flare up.
posted by oceanmorning at 10:58 PM on July 18, 2008 [1 favorite]
Stroke would explain the unilateral motor deficit. Nausea and vertigo often accompany. If the site of her stroke was deep in the brain and involved the hypothalamus, this would explain how her homeostasis (body temperature, energy level, fluid retention, metabolism) was upset.
The brain can repair itself to some extent following small strokes, especially in younger individuals. This may explain why she recovered from the worst of her symptoms but had some lasting problems with her balance and gait. Being under physical stress, such as hot weather, may tax the damaged areas of her brain and cause some of her original symptoms to flare up.
posted by oceanmorning at 10:58 PM on July 18, 2008 [1 favorite]
Supporting oceanmorning ...
Just my own hunch from personal experience, but I think microstrokes are much more common than most people -- even health professionals -- realize. They're insidious; presenting symptoms that are common enough to be mistaken for a host of other maladies, so that doctors don't always look beneath the surface. When my mother had a seeming rapid deterioration in health, it became evident that it wasn't that rapid at all -- that she had had a series of these. Suddenly, minor stuff like forgetfulness, odd mood swings, blanks in memory and loss of certain motor skills made immediate sense. All of these things were small taken individually and we easily attributed them to old age. A little too easily, I'm afraid.
posted by RavinDave at 1:00 AM on July 19, 2008
Just my own hunch from personal experience, but I think microstrokes are much more common than most people -- even health professionals -- realize. They're insidious; presenting symptoms that are common enough to be mistaken for a host of other maladies, so that doctors don't always look beneath the surface. When my mother had a seeming rapid deterioration in health, it became evident that it wasn't that rapid at all -- that she had had a series of these. Suddenly, minor stuff like forgetfulness, odd mood swings, blanks in memory and loss of certain motor skills made immediate sense. All of these things were small taken individually and we easily attributed them to old age. A little too easily, I'm afraid.
posted by RavinDave at 1:00 AM on July 19, 2008
Response by poster: Very interesting, Oceanmorning and RavinDave. I'd always been considering some type of disease, and Googling Mom's various symptoms under different types of encephalitis. Never considered something like a stroke. This happened circa 1963, so there were no CT or MRI machines, and did doctors even consider the possibility of stroke in so young a woman back then?
posted by Oriole Adams at 10:06 AM on July 19, 2008
posted by Oriole Adams at 10:06 AM on July 19, 2008
I had a stroke when I was 27 (I'm 39) and still have issues with nausea and vertigo. I am am able to control it somewhat with chewable meclazine. (It's possible it might be some sort of placebo effect, but I'm not going to nickel and dime that small success.)
posted by astruc at 10:28 AM on July 19, 2008
posted by astruc at 10:28 AM on July 19, 2008
RavinDave said it just right--microstrokes are probably much more common than we think, but easily dismissed or mistaken for something else. They probably weren't even on the medical community's radar back then, so your mom's doctors did the best they could for her with the information they had (a young lady with sudden neurological problems and fever? encephalitis/meningitis is a good conclusion). Even today, itty-bitty strokes aren't always visible on imaging. Good luck with your mom.
posted by oceanmorning at 11:09 AM on July 19, 2008
posted by oceanmorning at 11:09 AM on July 19, 2008
Best answer: Stroke in such a young woman, one whose vasculature had only relatively recently come successfully through that Le Mans-like road test of the circulatory system-- childbirth, seems to me to need a little further explanation.
Lupus can cause strokes, and if it did so by means of vasculitis (one of three primary modes) that could account for her not being able to fit back into her clothes when she came back from the hospital, as well, because vasculitis could also have damaged her kidneys, leading to persistent fluid retention.
Lupus would also explain that high fever. Lupus often results in pulmonary fibrosis, and that could be the source of her lung nodule. It would be interesting to know what happened to her hair around this time; lupus can cause hair loss, and I've known several people whose hair turned sharply grayer in the wake of the first significant manifestation of their lupus.
And major auto-immune diseases, such as lupus and Sjögren's, do tend to run in families.
posted by jamjam at 8:38 AM on July 21, 2008 [1 favorite]
Lupus can cause strokes, and if it did so by means of vasculitis (one of three primary modes) that could account for her not being able to fit back into her clothes when she came back from the hospital, as well, because vasculitis could also have damaged her kidneys, leading to persistent fluid retention.
Lupus would also explain that high fever. Lupus often results in pulmonary fibrosis, and that could be the source of her lung nodule. It would be interesting to know what happened to her hair around this time; lupus can cause hair loss, and I've known several people whose hair turned sharply grayer in the wake of the first significant manifestation of their lupus.
And major auto-immune diseases, such as lupus and Sjögren's, do tend to run in families.
posted by jamjam at 8:38 AM on July 21, 2008 [1 favorite]
Response by poster: jamjam, extremely interesting info. As I've mentioned previously, I have Lupus (as well as secondary vasculitis and Sjogren's). Regarding Mom's hair, she's always complained (since I can remember) of it being so thin, and mine is similar to hers - have never had significant hair loss, but have very thin, fine hair and you can see scalp through the strands in the right light. Mom has never had the facial rash that I get, but come to think of it, I get very dizzy and nauseous in very humid weather. Oddly enough, for some reason my Dad's doctor has run an ANA blood test on him a few times, saying that he suspected Lupus (although Dad has never had any symptoms similar to mine or Mom's); I think I will ask him to run one on Mom next time they both have an appointment. Thanks so much for your input!
posted by Oriole Adams at 9:29 AM on July 22, 2008
posted by Oriole Adams at 9:29 AM on July 22, 2008
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posted by zarah at 2:42 PM on July 18, 2008