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Is A Seven Day Car Trip Advisable After Inguinal Hernia Surgery?
Question: Hello,
First, I know you cannot offer medical advice but only provide information or opinions. I have my own doctors and will continue to interact with and rely solely on them for my medical care.
Three weeks after my open inguinal hernia surgery, I had sudden onset double vision, which uncovered "vertical phoria" by an optometrist. When I asked my XXXXXXX and New York doctors what to do, they both said "just stay on aspirin." I am 72.
This attack was sudden onset, lasting in it's dramatic form for 15 minutes but not fully resolving for around an hour or more. The optometrist noted that I was very sleep deprived. But I responded by saying that "I am very, very often been very sleep deprived but have never had any type of visual disturbance before." Obviously, I think it was a TIA.
Giving that my d-dimer is predictable elevated (large inguinal seroma) as well as my fibrinogen and all inflammatory markers, is there any testing that can be done to evaluate whether or not it is safe for me to get in a car and take a seven day car trip from XXXXXXX to NYC? The timing of this trip is totally at my discretion. I don't want to be "in the middle of nowhere" with a follow-on TIA or stroke.
My XXXXXXX doctor is a very close personal friend and I have not doubt that he will happily welcome any input I can get for him.
Thank you,
XXXXXXX
First, I know you cannot offer medical advice but only provide information or opinions. I have my own doctors and will continue to interact with and rely solely on them for my medical care.
Three weeks after my open inguinal hernia surgery, I had sudden onset double vision, which uncovered "vertical phoria" by an optometrist. When I asked my XXXXXXX and New York doctors what to do, they both said "just stay on aspirin." I am 72.
This attack was sudden onset, lasting in it's dramatic form for 15 minutes but not fully resolving for around an hour or more. The optometrist noted that I was very sleep deprived. But I responded by saying that "I am very, very often been very sleep deprived but have never had any type of visual disturbance before." Obviously, I think it was a TIA.
Giving that my d-dimer is predictable elevated (large inguinal seroma) as well as my fibrinogen and all inflammatory markers, is there any testing that can be done to evaluate whether or not it is safe for me to get in a car and take a seven day car trip from XXXXXXX to NYC? The timing of this trip is totally at my discretion. I don't want to be "in the middle of nowhere" with a follow-on TIA or stroke.
My XXXXXXX doctor is a very close personal friend and I have not doubt that he will happily welcome any input I can get for him.
Thank you,
XXXXXXX
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would agree with you in the fact that you may have had a stroke or TIA.
You should know that after surgery, some changes in the coagulability of the blood occur and they lead to an increased tendency for blood clotting.
This is more prominent in the venous system (deep veins) as you have to stay in bed with a reduced physical activity.
Anyway, I think your doctor has been thinking the same as he prescribed aspirin.
I would recommend performing a brain MRI in order to possibly find traces of this TIA or stroke (as the symptoms lasted for a prolonged time) and changes in the brain (or brainstem, as vertical double vision is typical of brainstem lesions). Brain MRI would be the more sensitive test to detect those possible changes.
I would also advise performing some tests to investigate for the possible causes (the heart or blood vessels):
- a resting ECG and cardiac ultrasound to examine your heart structure and function
- an ambulatory 24-48 hours ECG monitoring to rule in/out possible cardiac arrhythmia
- A Doppler ultrasound of the cervical vessels to exclude possible atherosclerotic narrowing in the carotid or vertebral arteries.
- A Doppler ultrasound of the leg vessels to exclude possible varicose veins. As you are going on a long trip by car it is necessary investigate the possibility of deep vein thrombosis which can occur in such cases.
You should discuss with your doctor on the above issues.
Feel free to ask me again if you have any other questions!
Hope to have been helpful!
Kind regards,
Dr. Iliri
I would recommend as follows:
Detailed Answer:
Hello!
Welcome and thank you for asking on HCM!
I carefully passed through your question and would agree with you in the fact that you may have had a stroke or TIA.
You should know that after surgery, some changes in the coagulability of the blood occur and they lead to an increased tendency for blood clotting.
This is more prominent in the venous system (deep veins) as you have to stay in bed with a reduced physical activity.
Anyway, I think your doctor has been thinking the same as he prescribed aspirin.
I would recommend performing a brain MRI in order to possibly find traces of this TIA or stroke (as the symptoms lasted for a prolonged time) and changes in the brain (or brainstem, as vertical double vision is typical of brainstem lesions). Brain MRI would be the more sensitive test to detect those possible changes.
I would also advise performing some tests to investigate for the possible causes (the heart or blood vessels):
- a resting ECG and cardiac ultrasound to examine your heart structure and function
- an ambulatory 24-48 hours ECG monitoring to rule in/out possible cardiac arrhythmia
- A Doppler ultrasound of the cervical vessels to exclude possible atherosclerotic narrowing in the carotid or vertebral arteries.
- A Doppler ultrasound of the leg vessels to exclude possible varicose veins. As you are going on a long trip by car it is necessary investigate the possibility of deep vein thrombosis which can occur in such cases.
You should discuss with your doctor on the above issues.
Feel free to ask me again if you have any other questions!
Hope to have been helpful!
Kind regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you,
If the tests are all negative--some of which
I have already planned for--we can still not rule out a TIA.
My cardiac and cervical vessels untrasounds have been negative recently. My holter has been very, very good (but could be checked again post-surgery.)
Legs are fine.(i am still using a sequential compression device at night.) Radiologist says that brain MRIs of transient events that are three days old rarely yield results.
So, assuming that it was a TIA, what should be done other than aspirin?
Thanks, XXXXXXX
If the tests are all negative--some of which
I have already planned for--we can still not rule out a TIA.
My cardiac and cervical vessels untrasounds have been negative recently. My holter has been very, very good (but could be checked again post-surgery.)
Legs are fine.(i am still using a sequential compression device at night.) Radiologist says that brain MRIs of transient events that are three days old rarely yield results.
So, assuming that it was a TIA, what should be done other than aspirin?
Thanks, XXXXXXX
Brief Answer:
My answer:
Detailed Answer:
Hello again!
Thank you for the additional information!
Coming to this point, assuming that it was a TIA aspirin would be the best treatment option.
If your blood lipid profile is altered(dyslipidemia), I would recommend a statin ( atorvastatin, pravastatin,etc), but it is not really necessary as your Doppler ultrasound did not reveal any atherosclerotic plaque or arterial narrowing.
Hope to have been helpful!
Best wishes,
Dr. Iliri
My answer:
Detailed Answer:
Hello again!
Thank you for the additional information!
Coming to this point, assuming that it was a TIA aspirin would be the best treatment option.
If your blood lipid profile is altered(dyslipidemia), I would recommend a statin ( atorvastatin, pravastatin,etc), but it is not really necessary as your Doppler ultrasound did not reveal any atherosclerotic plaque or arterial narrowing.
Hope to have been helpful!
Best wishes,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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