Jane

So on February 2, 2009 I had a TGA. It's well documented that this happened to me so I won't bore you with details. As traumatic as this may or may not have been to me and those close to me it did not compare to something that happened to a very dear friend of mine on the very same day, at the very same time.

In the hour just before my TGA, I had attended an emergency board of directors meeting. One of the few other people attending that meeting in person (others joined via conference call) was my friend and dear colleague, Jane. Jane was what you could describe as my soul mate on that particular board. We were often synced in opinion and temperament; often strategizing behind the scenes to present a unified front.

Now, here's something that not many people know but at the very same time, on the very same day I was having my TGA, coincidentally, Jane was having a massive stroke. Weird, huh? This is something that I have never taken lightly. Jane and I were weirdly (and forever) linked in a manner that challenges many notions of fate (FTE #3, perhaps).

Jane, being a few years older and suffering a more serious episode than I, was hospitalized for a long time and went to rehab afterwards. Me? I was released the next day and barely broke stride in my long history of antics, mayhem, and ruckus. Sure, it was a somewhat difficult time for me and it took me some time to get back to normal, but I did. You'll not hear this often, but I am normal.

I just learned that Jane died on Saturday. I haven't been this upset about a death in a very long time. I hope that I can continue living in a manner that would continue to make Jane proud and giggly.

TGA Foreshadowing

Check out this November 2008 post:

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Six-Hour Donut Hole in the Brain - Revisited

So you all remember my little TGA? I'm sure you do. Even I, ironically, remember that:

Here
Here
and Here

Well, check this out from your Washington Post newspaper site. It's pretty much exactly the same thing:

Six Hours Missing
It Was a Normal Morning, Until Her Husband Lost His Memory

By Carol and Dave Ochs

Special to The Washington Post
Tuesday, September 1, 2009

What Carol remembers: I didn't think much of it when, one Thursday a few months ago, my husband asked me where he kept his vitamins...

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Article spooked me out for a minute.

Twenty-one Little TGA Heart Attacks for Louise

The question is or isn't
I mean what
Do The Doctors know
Anyhow I mean
Shouldn't we as
Individuals already know
The best of all

I do know however
That it will
Never last
Forever because I
Have witnessed and
Studied cycles and
Loops in time already

to care or not
Becomes how we
Run the string
To finish strong
As survivor or
To quit outright
On purpose

Don't You Know I'm Loco, Ese?

People know this about me, it's no secret. Those who know me well have expressed wonderment and caution. Those who don't know me so well are sometimes just baffled.

But what people know about me is: I use my brain. I use it hard. And more often than not, I'm riding that bitch like a Pony Express horse. I Juggle, multitask, and generally perform full-out and at hyper-efficient levels. I have constant output. Sometimes I have so many tasks processing and so many "routes of execution" planned out that even I tire. If I have to process at anything below 75%, I get bored and highly agitated. But I like it that way. Not bored and agitated working/processing at the maximum; pushing cognitive bubbles.

Here's an example from the very present: Even as I type, this essay is about 90% complete in my head and I'm only actually on paragraph three, but it's mostly done (sans edits). I'm also actively and clearly thinking about, in no particular order, my health, a friend's health, the book I'm writing, the album that is in progress, my friendships, the projects I contribute to, board activities, and my family. Plus I'm pondering the photos that Cass just sent, thinking about Betsy's last poem, pondering what I could photograph today, what music I could make, and I'm listening to music (E-Pro by Beck at present). Plus there are txts, emails, IMs, and the like. I also run my own business and manage a household so some degree.

See? Working hard in the membrane. If you read my back history, this is what the "I can see through knots" and "future gifting" logic is based upon. It's all there. Polymath. Competitive cognitive processing.

Functional MRI scans demonstrate that people with superior multitasking performance have higher basal ganglia, anterior cingulate cortex, prefrontal cortex, and parietal cortex activity. Every day I am burning my brain so hard for six continuous hours, minimum. I often forget to eat, go outside, or shower. I put such non-efficient tasks off as long as I can while trying to fit increasingly infinite "daily objectives" into the finite constraints of time (time is an asshole). I have more to do than is possible. I realize this, so even in the off-hours, I am thinking about it, planning it, adding tasks, and planning output. From boil to simmer to boil, never off. I would do more if I could.

----------------------

On Monday, I had a neurological episode.


After rush-writing an essay draft for the book (easy because it was already written in my head), chugging coffee, and listening to the radio, I raced down to a meeting. After the meeting I was sitting down for the second helping of a late lunch and....bftztzzzzzzfft!

----------------------

After 24 hours in the hospital for observation, CT Scan, echo cardiograph, jugular sonogram, and MRI, it was hypothesized that I had and episode of something called Transient Global Amnesia (TGA). TGA, in short, is the inability to process new information and utilize short term memory functions. But, I knew I was Ty and I found my car and I drove in my car. But something was terribly wrong. Broken, in fact.

One moment I'm happily eating Tandoori chicken when, quite suddenly and without warning, the words on a page of text that I wrote make no sense. Gibberish....bftztzzzzzzfft!

I do not believe that I was literally frightened of dying. We all die one way or another eventually. I'm resolved to that fact (even though I did very specific actions to prevent cardiac death - 81mg aspirin, much oxygen, cooler temps, notes on index card, etc.). But I was terrified that I had reached a new and permanent state of being. Was this how I was going to be now? Forever? Reflecting back, I do believe that I could never have lived that way, not being able to think. I feared that I wouldn't be useful to my friends and family and that I wouldn't be able to produce what I produce; to think as I've come to think. You see, I've reflected on this before, art for me is a race against time to do as much as I can while I can. Of all the "is this the end?" moments I've had, this week's episode was the most profound.

But naval gazing isn't the point of this piece, believe me, save that bullshit for daytime TeeVee talkshows and deathbed confessions. This piece will be all the reflection I plan to present.

The main point is this: I only know one way to live. Everybody is all telling me to "take it easy" and "rest" and "watch TeeVee" and "nap" and shit. No! Don't people read all the shit I tell them? Don't they know who they're asking to rest? This is what I do. This is my thing. Without my thing I'm just a dude in Dockers and a sweater vest drinking shitty office coffee and talking about 30 Rock while trying too hard not to say swear words in an office somewhere. Fearing layoffs and shit. Drifting into Walter Mitty fantasy worlds while in meetings.

I look around and I am so grateful that that wasn't it this time (and, yes, I am also so grateful to everyone for being so concerned and supportive - I really am). So, take it easy? Sit back and reflect on what has been accomplished? Past tense? No! Pedal to the fucking metal, fools! I've got work to do. The good stuff is to come. What has been done to date is just the honing of chops. Doesn't anyone get it?

So to assuage those with fear that I'm "doing too much," I'm gong to make some cutbacks in some areas (dropping the bullshitty things that only waste time and cognitive processing) so I can keep working in what I deem the important areas of my life. So I can keeeeep produuuuucing , man. I promise to "take good care" of myself and live healthy and all that shit. But, I am going to do my thing as hard as I can for as long as I can. What did you fucking think?

So, Transient Global Amnesia? Goodnight, John Boy. The tuck-in. It's not that I don't want to discuss it further because of denial or some shit. I fully accept and will do things to try to prevent health concerns from interfering with the master domination plan again (meds, "rest," and better efficiency techniques). But I'm not going to keep explaining something that isn't explainable. My neurologist said, "You've lost five hours of your life. That's it."

What, you expected me to curl up all fetal and whimper? The fuck outta here, I've got stuff to do. You're either with me or you're with the terrorists.

"Narm!"

The end.

TGA "Memento" - Found in Pocket

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Giving Totally Gay AIDS to Vegas Vegans -- UPDATE

Okay. I was hospitalized. Of course I posted iPhone pics and txt'd and emailed and shit because that's what I do. I thank you all for your notes and concern but it looks like I'll survive this. Hence:

"Don't die yet...I'm making you an album. If you die before my album kills you, I'm going to be very pissed off. I estimate an early March release. Then you can die."

- RPW

I get weird shit when I get sick, I guess. I have been diagnosed by a prominent neurologist, and after much high-tech testing, it appears that I had an episode of TGA (not Totally Gay AIDS and before you get pissed or something the "AIDS to Vegas Vegans" thing is just something my brain concocted in the CT Scan tube, so lay off - see bottom).

I had the following diagnostics to see if I had a stroke, TIA, heart attack, aneurysm, or something life-threatening:

• CT Scan
• Ultrasound of neck region
• Echo cardiogram
• MRI of brain

So what happened? I was sitting in a restaurant when....

Since the Mayo Clinic explains it so well and since the Clinic's explanation very closely syncs with what I experienced, and since I'm tired as hell, I present the following directly copied from the Mayo Clinic's website (don't sue me the Mayo Clinic, I'll claim I had a TGA).

Transient Global Amnesia

Transient global amnesia is a sudden, temporary episode of memory loss that can't be attributed to a more common neurological condition, such as epilepsy, transient ischemic attack, stroke or head injury. During an episode of transient global amnesia, your recall of recent events simply vanishes, so you can't remember where you are or how you got there. You may also draw a blank when asked to remember things that happened a day, a month or even a year ago. You do remember who you are, and you recognize family members and others you have known for a long time, but that knowledge doesn't make your memory loss any less disturbing.

Transient global amnesia would be even more distressing if it recurred more often or lasted longer than it does. The condition is rare to start with, and among the few who do have one episode, a second episode is uncommon. Also, episodes of transient global amnesia last only six hours, on average — although an episode of any length is frightening to witness or experience.

When an episode of transient global amnesia is over, you remember nothing that happened while your memory was impaired, and you might not recall the hours beforehand. Otherwise, though, your memory is fine.

Symptoms

Transient global amnesia is identified by its main symptom, which is the inability to recall the recent past. Once that symptom is confirmed, ruling out other possible causes of amnesia is important.

Diagnostic criteria
The criteria for a diagnosis of transient global amnesia are:

• Sudden onset of memory loss, verified by a witness
• Retention of personal identity despite memory loss
• Normal cognition (ability to recognize and name familiar objects and follow simple directions, for example)
• Absence of signs indicating damage to a particular area of the brain (limb paralysis, involuntary movement or impaired word recognition, for example)
• Duration of no more than 24 hours
• Gradual return of memory
• No evidence of seizures during the period of amnesia
• No history of active epilepsy or recent head injury

Additional signs and symptoms
These signs and symptoms sometimes accompany the chief symptom, memory loss.

• Headache
• Nausea
• Vomiting
• Dizziness
• Chills or flushing
• Fear of dying
• Pins-and-needles sensation
• Cold hands and feet
• Powerful expression of emotion
• Trembling
• Sweating
• Chest or neck pain
• Visual disturbance
• Racing heartbeat

Causes

About half of all transient global amnesia episodes start just after a physically or emotionally stressful incident. Among the triggering events commonly reported are:

• Sudden immersion in cold or hot water
• Strenuous physical activity
• Sexual intercourse
• Medical procedures, such as angiography or endoscopy
• Acute emotional distress, as might be provoked by bad news, conflict or overwork

The underlying cause of transient global amnesia is unknown. The incidence of migraine may be higher than can be explained by chance among those affected by transient global amnesia, suggesting that similar processes may be involved in both conditions. Compression of the large veins that empty oxygen-depleted blood from the brain and arms back into the heart may play a role as well. Many of the physical stresses experienced just before an episode of transient global amnesia result in compression of these veins.

Risk factors

Interestingly, high blood pressure and high cholesterol — which are closely linked to strokes — are not risk factors for transient global amnesia. Your sex doesn't seem to affect your risk, either. Transient global amnesia affects about as many men as it does women.

The clearest risk factors are:

• Age. People between the ages of 56 and 75 have a higher risk of transient global amnesia than do younger or older adults, and the condition very rarely occurs in children.
• History of migraines. If you have migraines, your risk of transient global amnesia is significantly higher than that of someone without migraines. The link appears to be strongest before age 56.

When to seek medical advice

Transient global amnesia may be frightening, but it isn't dangerous. Because your sense of social propriety and instinct for self-preservation aren't impaired, you're not likely to get into a dangerous situation.

But there's no easy way to distinguish transient global amnesia from the life-threatening conditions that can also cause sudden memory loss. In fact, sudden amnesia is much more likely to be caused by a stroke or a seizure than by transient global amnesia. For that reason, anyone who quickly goes from normal awareness of unfolding reality to confusion about what just happened requires immediate medical attention.

Someone experiencing memory loss may be too disoriented to call an ambulance. Don't hesitate to call one yourself if someone you know suddenly appears disoriented.

Tests and diagnosis

Diagnosis of transient global amnesia rests on excluding more serious conditions — stroke, seizure or head injury, for example — that can cause the same type of memory loss.

The process begins with a neurological exam, checking your reflexes, muscle tone, muscle strength, sensory function, gait, posture, coordination and balance. Your doctor may also ask questions to test your thinking, judgment and memory. By checking your knowledge of general information — such as the name of the current president — and assessing your ability to recall a random list of words, the doctor can determine the extent of memory loss.

Diagnostic tests
The workup for acute memory loss also includes tests to detect abnormalities in the brain's electrical activity and circulation. The most common of these tests are painless and take less than two hours each.

• Electroencephalogram (EEG). An EEG records the electrical activity of your brain via electrodes affixed to your scalp. People with epilepsy often have changes in their brain waves, even when they're not having a seizure.

  To prepare for an EEG, avoid elaborate hair styling, metallic hair spray or greasy hair dressing. Refrain from caffeine for six hours before the test. The procedure itself is painless and usually lasts about 30 minutes. However, it can take as long as an hour to place the electrodes on your scalp.

• Computerized tomography (CT) scan. Using special X-ray equipment, CT machines obtain images from many different angles and join them together to show cross-sectional images of your brain and skull. CT scans can reveal abnormalities in brain structure, including narrowed, overstretched or broken blood vessels and past strokes.

  To prepare for a CT scan of your head, you should remove such things as earrings, eyeglasses, dentures and hairpins. You may need to have an intravenous (IV) line inserted if your test requires the injection of a contrast material — which makes abnormalities easier to see. During the test, you will lie on a table that slides into the CT machine.

Complications

Transient global amnesia has no direct complications, but it can cause emotional distress. If you have an episode, the gap in your memory can be unsettling, and you're likely to worry about a recurrence. Also, a symptom as dramatic as memory loss often heralds a serious underlying disease. Transient global amnesia is an exception, but it can be hard to let go of the fear that you actually had a tumor or stroke. If you need reassurance, ask your doctor to go over the results of your neurological exam and diagnostic tests with you. A counselor or psychotherapist can help you deal with persistent anxiety. Importantly, transient global amnesia is not a risk factor for stroke.

Treatments and drugs

No treatment is needed for transient global amnesia. It's self-limited and has no confirmed after-effects.

Prevention

Since the cause of transient global amnesia is unknown and the rate of recurrence is low, the effectiveness of preventive measures has been difficult to demonstrate. Some doctors recommend daily aspirin, on the theory that reduced circulation is the cause.

If your episode of transient global amnesia followed a particular activity, such as a strenuous workout or a vigorous swim in a chilly lake, steer clear of that and similar activities.

All are everything is "Have you seen my penis? I left it on the table." Doy!™

Transient Global Amnesia

Discharged 'cuz that's how I roll. At least, I think that's how I roll.

Nine

Eight

Seven

Narm!

Six

Five

Oy Vey!

Doing OK. Admitted for tests.

Out of iPhone battery power now.

Four

Three

Two

One

It's Official: I'm Dying

Okay. Look up there. That's my ATM (automated teller machine) card. As you can see I've had it since 1996. That's 12 years. Longer than I've been married and longer than I've known most of my friends. Longer than my child's entire life by a factor of nearly two.

To use an ATM you insert your card and you type in your PIN (personal identification number). I was away from the house this weekend for Thanksgiving and I went to an ATM to get some cash. I didn't get any cash.

I have forgotten my PIN. Totally and completely. My card and account "frozen" because of too many attempts at typing a PIN.

It's been a great life and I suppose I'll miss you...'cept that I'll be dead and incapable of thoughts and feelings such as nostalgia. So it begins...I am dying. It's official.

Goodbye.