DEAR DR. ROACH: In 2021, I drove to the hospital with chest and back pain. I was told that I needed an emergency surgery to remove my gallbladder. During the procedure, I suffered a heart rhythm disturbance, which they were able to stabilize. (Months later, a doctor indicated that they had to use electrodes to rectify my heartbeat during surgery.)

Post-op, however, I discovered that I could no longer drive because my driving leg was acutely weak and would spasm uncontrollably. It was a year until I drove again — and still, only locally. Everybody said these symptoms must have been preexisting, but the truth is that I drove fine prior to the surgery. What could account for this? — G.S.

ANSWER: A very good rule for physicians to live by is to believe the patient. The sudden onset of a new neurological symptom, especially weakness, suggests a stroke. Supporting this is that you had two risk factors for a stroke: Any surgery puts a person at a small increased risk for a stroke, but a new arrythmia makes this risk go much higher. Since they used electricity to stop the rhythm, this suggests a serious rhythm disturbance.

Muscle spasms are common after a stroke. They often get better over time, as does a person’s strength. However, I am disappointed that nobody apparently thought of a stroke since you should have had imaging of your head (such as a CT scan or an MRI scan).

If you did have a stroke, you should at least have had therapy after the stroke. Most people benefit from treatment to dissolve the blood clot that is the cause of most strokes, but this may not have been possible during the postoperative period.

At this point, I still think it would be helpful for you to know what the rhythm was. If it was atrial fibrillation, it would be prudent to monitor your heart to see if you are having any further episodes, as this would put you at risk for another stroke. Also, if you were my patient, I would still get an imaging study of your head to see whether my concern of a stroke is justified, or whether there is some other reason they can see for the sudden weakness.

There are other causes of leg weakness around the time of surgery. If they gave you spinal anesthesia, it’s possible that the nerve was damaged or a blood clot pressed on a nerve, but the long duration of weakness after surgery really has me concerned for a stroke.

DR. ROACH WRITES: A recent column on the inaccuracy of the A1C test in people with iron deficiency or conditions that cause red blood cells to turn over faster did not include one other option for testing, which is the fructosamine level.

Like the A1C, fructosamine looks at how much sugar gets attached over time, but for fructosamine, it is the sugar on blood proteins rather than on red blood cells. Conditions that cause the abnormal turnover of blood proteins, such as nephrotic syndrome (where albumin, the major blood protein, is lost in the urine) or protein-losing enteropathy (where protein is lost in the gut), can cause falsely low fructosamine levels.

I thank Dr. I.F. for writing in with the reminder.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2026 North America Syndicate Inc. All Rights Reserved