The Missing Morning

It’s been 13 days since I experienced what is being called a Transient Global Amnesia (TGA) event. Seemed worth blogging about this weird experience.

It had snowed a lot in a relatively short time Monday and the roads were in very poor condition on Tuesday morning. There were tree branches down everywhere, and many areas were without power – ultimately for days for some. We only had an outage for about 8 hours on Monday, so we were fortunate on that end.

Roads near my neighborhood

On Tuesday, I was scheduled to work and I packed a bag in case I needed to stay overnight at the hospital with potentially bad driving conditions. I headed out after my usual oatmeal breakfast. I took a couple of pictures of the road as I left our driveway (and recalled doing this when I saw them on my phone), and continued on out of the neighborhood. Although I have only 2 or 3 foggy memories of the early morning, my husband – who was working from home – says I was not acting confused prior to leaving for work.

I have texts on my phone from my colleague that I was going to be working with – discussing the issue of the roads, the people trapped for hours on I-95, and how the neighborhood roads were pretty bad and the text was sent at 6:44am. No confusion yet. I can vaguely remember this text once I was reminded it had happened and looked at it.

I left the house at about 7:40 – confirmed by the time stamp on the photos I took as I left. Dan called me while I was on my drive shortly after I’d left and after a minute or two, I told him I needed to concentrate for the drive, and this is another of my foggy memories – the phone call.

My phone shows the texts I’d made to J who’d asked me about the condition of the main road since she had an appointment and wondered about driving to it. This was at about 8:12am. I only have a vague memory as I now look at the text, but I texted her that I was in a parking lot and felt “confused”. J ended up calling me, and I drove the rest of the way to work (about a mile) while she kept me on the phone for 12 minutes. She asked if she should call the rescue squad, but I assured her I could get to work (she says). I could not remember who I was supposed to work with. I assumed I was on the way to work since I was in scrubs. I met S in our lactation office on the third floor. She had been notified about my confusion by J once I’d reached the parking garage and our call dropped. S texted me a couple of times trying to find me but once we met in the office, S confirmed that I did not know what day it was or who the president was. She walked me to the ED for evaluation and I did not protest this decision. I had no motor symptoms of a stroke (facial droop, one sided weakness) but what WAS happening was very frightening to S. During the neuro assessment in the ED, I was asked who I lived with and I said my parents and my husband. She let me know after the doctor left that my mom had died and that I was “shocked” that this had happened. (June 13) I did not remember whether my sister was at my house or in CT (she’d returned home two days before after her week long visit in VA). This was a day earlier than planned due to the pending storm, and I also didn’t remember the snowstorm.

I have no memory of the neuro evaluation, the CT Scan, the IV, the Covid test, S taking me to the bathroom a couple of times, my manager K visiting for 1/2 hour (and kindly letting S stay with me), or anything else. I can remember my husband arriving to the room I was in at about 1:30pm. He looked worried and I remember that. He tells me I still cycled through the same questions for another couple of hours and then stopped asking them as my short term memory returned. Based on what I read, I will not likely ever remember the Tuesday morning events as short term memory was being laid down in the brain (which gets placed into long term memory for recall).

One of the classic symptoms of this phenomenon is this repeating the same questions over and over every few minutes. Even my responses were the same. I was asking if I’d had the CT, did I have the MRI, confirming that it looked like I was supposed to work, saying that this was very inconvenient. These questions are not from my own memory, but from those witnessing it. S said she was looking on the internet for a description of TGA after the Neuro doctor explained that this was likely what was going on – especially when the CT showed no stroke and there were no physical symptoms present. Typical length of an episode can be about 2-8 hours. Mine was about 6-7 hours. I retained who I was, knew familiar people, could drive, could follow directions, but the repeated questions again and again were certainly concerning until everyone knew what was happening.

Waiting in the hall

Dan left the hospital by about 4:30pm since I seemed to be ok at that point, and knowing I would be admitted, he wanted to be available to my dad and his sister in case the power went out again and definitely wanted to drive in daylight with the horrible roads. He had been texting our kids, and my sister to keep them updated, and they were all very concerned.

I had the MRI after he left and have full recall of that. The ED was very full as the Covid admissions are very high – and once it was obvious I was just needing observation, I sat in a hallway on a stretcher next to the nursing station for hours. I was able to look on MyChart to review the various test results (CT, UA, MRI, Labs) and finally got to a room in the Observation Room by midnight. A couple of co-workers checked on me in the early evening and I finally got something to eat.

Once the short term memory returned by mid afternoon, the previous memories were just there – no rushing back of all the memories that I couldn’t remember that morning (i.e. snowstorm, mom dying, sister leaving).

MRI

I got some interrupted sleep overnight (lab, vital signs) and tried to process what had happened. The next day, the hospitalist came by to do an assessment and asked me year, month, and day. I got them right after a very brief pause on year – I mean we were only 5 days into 2022! But when I said it was the fifth, he comforted me about not getting them all right. Note to doc: Check what day it is before you come in to assess a neuro patient. I showed him my phone that had the correct date so he could see that I was actually oriented.

I spent Wednesday waiting on lab results, doing another urine specimen (could not truly vouch for my “clean catch” the day before), getting a prescription called in for antibiotics for a UTI, and by 5pm – was discharged.

I had a follow up with my primary on 1/7 so I could get clearance to work the next day (Saturday) and all has been “memory intact” since Tuesday afternoon. I still have an EEG tomorrow and an ECG on 2/1 to rule out anything missed in brain (seizure?) and heart (tiny clot?) and I’m really hoping this is a “one and done” event. Based on what I’ve read, less than 10% have a future event. I may never know what precipitated it as some of the possible causes are not what happened to me that morning, other than potentially stress from the drive on very poor conditioned roads. Maybe cumulative stress from this very challenging year. And I’ll never know if I had a close call in the drive, I guess.

Here are some links to read about TGA.

https://my.clevelandclinic.org/health/diseases/21028-transient-global-amnesia

https://rarediseases.info.nih.gov/diseases/8172/transient-global-amnesia

https://www.mayoclinic.org/diseases-conditions/transient-global-amnesia/symptoms-causes/syc-20378531