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Employee Suffered With Acute Parietal Infarct. Should She Be Continuing Her Job?

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Posted on Tue, 11 Jun 2013
Question: Our employee suffered an acute parietal infarct - should we be worried about her ability to continue her job - we are a CPA firm and her documentation in workpapers related to calculations has completely diminished, her speech is clear and then becomes semi garbled - almost sounds intoxicated at times. We were advised while she was out on a "hurt back" for 2 weeks that her "diagnosis was high blood pressure; was prescribed lisinopril/HTC, and additionally was seen for right sided weakness associated with aphasia with an MRI showing an acute parietal infarct. She is on Plavix, statin, and the lisinopril/HTC and has also returned to work with restrictions of lifing above waist level. As an employer should we be worried? Her doctor has stated: "Ms. D__ is a healthy middle aged woman, and therefor I do not anticipate any additional problems. The doctors note also said she had a "negative carotid, negative bubble study", what ever that means?
doctor
Answered by Dr. Visvanathan K (1 hour later)
Hi,

It seems that your employee has suffered a stroke in the are of the brain which is concerned with controlling the speech, higher functions like calculation etc. The left side of the brain is considered "dominant" for most people. As to whether you need to be worried - I understand this relates to her ability to continue working in a job that needs her higher mental functions to be intact and the job involves calculation, communication etc. There is always a possibility of recovery as the function of the portion of the brain that has been damaged is gradually taken over by the adjacent areas of the brain. Usually most patient's with stroke recover at-least partially. Speech therapy would certainly help in recovering her communication ability. Since you mention that at times her speech is clear, the chances are that this may recover well. The meds she has been prescribed are aimed at reducing her risk of suffering her stroke. Her ability to recover cannot be accurately predicted a priori but depends on her age, health of the remaining brain etc. "Negative carotid" probably means that she does not have plaques in the carotid arteries that could make her prone to having more strokes in future.
Hope this helps?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Visvanathan K (14 minutes later)
She is a probationary employee at present, her review was to happen prior to her being off work (again) due to an ongoing "back" issue, the review is going to be very negative and we were planning on discharging her - her work has been sub-par at best- - our concern is for wrongful discharge now that we have this doctor's note in hand. She was originally off in March for 6 consecutive days because of her back, an additional 7 consecutive days in April related to her back, and this time in May, originally out because of complaining about not being able to get files out of top drawer due to it hurting her back - for her safetly and our own protection we asked her to get a doctors note to continue to work as there were no restrictions previously, and then all of a sudden she can't lift much above waist level. She does have a lifting restriction as well of no more than chest level for the next 6 weeks related to her back issue and all of the other stuff was also included now in her doctor's note - we are concerned that the Doctor divulged so much personal information unrelated to her absence and our request to confirm or not she would need lifting restrictions - no we've been given this plethora of non-related information and we are suspicious of the reasoning behind it. ARe not those drugs prescribed for someone who has suffered a "stroke" and/or to prevent further strokes?
doctor
Answered by Dr. Visvanathan K (9 hours later)
Hi,

you are correct- the medications are to prevent further strokes in the future- to thin the blood, to keep the lipid level in the blood under control and to keep the blood pressure under control. I would not be able to comment on the other issues regarding her motivations or the doctor's actions since I do not have an understanding of the occupational health regulations as they apply in the US and the legal implications of the same.

Hope this helps?
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Visvanathan K

Neurologist, Surgical

Practicing since :1997

Answered : 96 Questions

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Employee Suffered With Acute Parietal Infarct. Should She Be Continuing Her Job?

Hi,

It seems that your employee has suffered a stroke in the are of the brain which is concerned with controlling the speech, higher functions like calculation etc. The left side of the brain is considered "dominant" for most people. As to whether you need to be worried - I understand this relates to her ability to continue working in a job that needs her higher mental functions to be intact and the job involves calculation, communication etc. There is always a possibility of recovery as the function of the portion of the brain that has been damaged is gradually taken over by the adjacent areas of the brain. Usually most patient's with stroke recover at-least partially. Speech therapy would certainly help in recovering her communication ability. Since you mention that at times her speech is clear, the chances are that this may recover well. The meds she has been prescribed are aimed at reducing her risk of suffering her stroke. Her ability to recover cannot be accurately predicted a priori but depends on her age, health of the remaining brain etc. "Negative carotid" probably means that she does not have plaques in the carotid arteries that could make her prone to having more strokes in future.
Hope this helps?