New info on stroke

Parent Cafe
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<p>The Dad - it sounds like your father had a chronic or subacute subdural hematoma. Very small veins btwn the surface of the brain and its fibrous covering stretch as our brains shrink with aging (or at fairly young ages in alcoholics). They can leak with little or no trauma, especially with high blood pressure and blood thinners. There is a very slow, vague onset of symptoms because the blood accumulates slowly. (Reagan had this from falling off a horse and it took about a month before enough blood accumulated for it to be diagnosed). If your dad was on a ventilator, his was very severe. The accumulated blood can be drained off, but the damage to the brain from having the blood pressing against it for days or weeks is already done. None of the new stroke treatments are useful for this. The only treatment that does exist is to basically make a hole and drain the blood out, something that was known to ancient Egyptians. Even when that is done successfully and the patient initially survives, permanent seizures or serious disability are common. Rebleeding is common. I would have made the same choice you and your siblings did. It sounds like what your dad would have wanted if he had been able to decide for himself. </p>

<p>All of which just underscores the importance of having written advanced directives, and having conversations with our family members about what we or they would want done in various medical circumstances. It is not just to respect the wishes of the patient, it is also to save the family unnecessary guilt or anguish if they are forced to make end of life decisions for a loved one. People who are getting together with their families over the holidays might want to take take advantage of the non-crisis setting to bring these issues up and find out everyone’s feelings and preferences.</p>

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<p>Very good advice, texas137. I am going to find a time to do exactly that, asking my dad about his own wishes and what he would want for my invalid mother, should my brother and I be the ones needing to make that decision. Thank you for the suggestion.</p>

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<p>I agree it’s a good idea to call EMS. But it’s also a good idea to call your family doctor too if you can.</p>

<p>I was dealing with EMS in a situation where a family member had collapsed and EMS wanted to take her to a hospital that was 10 minutes away. Knowing her doctor had privileges at that hospital (and that it was the most convenient one for her doctor to get to, I said, “Okay.”)</p>

<p>While they were stabilizing her and preparing her for transport, my husband reached her doctor’s office and told them what was up. The staff alerted the doctor who told her receptionist to call us back and told us we should get her to a different hospital, at least a 30-minute drive (possibly worse because of rush hour traffic.) At this point, she was all strapped in and we were just about ready to take off. The ambulance driver looked doubtful when I said the doc wants us to take her to XYZ (the regional medical center for our area) and he said, “I don’t know if we can take her there.” I was still on the phone with the office and he heard me tell them “The ambulance driver isn’t sure he can take her there. Should I just drive her there myself?” When he overheard that I was actually considering that option, he immediately said, “Oh, alright, we can take her to XYZ.”</p>

<p>(It should be noted that the EMS transport in our area are private concerns that compete with each other to answer 911 calls. I guess they make more money on multiple short trips than one long one or something. Not sure why he was initially reluctant to follow the doc’s instructions about where to take her.) The doc, after all, was familiar with her history and he wasn’t.</p>

<p>Anyway, the irony of it all was that as we were approaching the more distant XYZ, the ambulance driver gets a call that his own dad had sustained a head injury in a traffic accident near XYZ and was himself on his way to XYZ. So he was quite relieved to be already practically at XYZ at the time.</p>

<p>I’d say, in retrospect, the moral of the story is…elderly people and people with conditions that place them at risk for ER trips should talk to their doctors in advance and find out where the best places to go are. In fact, it’s not a bad idea for everyone to have this kind of conversation with their family doctor at their next checkup.</p>

<p>And then, when something happens, call EMS first and the doctor next to double-check that you are headed to the best place under the circumstances!</p>

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<p>For all of us who have lost somebody, with the approaching holidays,
I offer my condolences and peace to all. Our family members and friends will be missed as we celebrate. I guess what we can give ourselves is forgiveness for all the “what if’s” we have in our mind, and realize everything happened the way it is supposed to. I’ll miss ya dad.</p>

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<p>AS in all things, timing and luck play into illness. When my FIL had a severe Hemorrhagic storke, he was in another city, 700 miles from anyone and 30 miles from one of the best medical centers in the world.</p>

<p>The EMS took him to a little suburban hospital which quickly transferred him to another little suburban hospital. It should have been curtain right then and there for him. However, as luck would have it, the little nothing hospital had a decent operating theatre and a couple of brilliant rogue neurosurgeons who had been booted out of the univeristy hospital program some months earlier. They preformed 4 hours of neurosurgery.</p>

<p>That was nearly six years ago. Yeah, his brain is scrambled eggs and he is completely paralyzed on one side–but ya know what? That bloody minded Fortune 500 CEO/marine learned to walk again. He’s kinda fallen back to a shuffle, but he still dresses himself and does a few other simple chores. He went to residential Speech Camp at UMich (fantabulous for stroke victims). If he’d go every year, the difference might even be more remarkable than it is.</p>

<p>He has a small repetoire of funny responses and his comic timing is still perfect. He can’t read or maintain focus for long periods but he is still with us and he enjoys himself–despite the difficulties. He had another chance to check out last year but he didn’t. He fought his way back to life one more time.</p>

<p>The dynamo guy isn’t there anymore, but we all love and admire the new guy too for a whole different set of reasons.</p>

<p>It’s an uncertain world, that world of strokes. Sorry your dad got the poor end of luck, amith. You must miss him.</p>

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<p>Until today, I had only read the first few posts here. I wish I had read them all. My Dad had a stroke last night. My Mom called 911, then called me. Don’t know anything yet, but hope to find out today. </p>

<p>There is some excellent advice here, especially the suggestion that for elderly parents (eek - we ourselves will be there in not too many more years), advance planning be done. When it happens, the plan can then be followed. I am going to suggest that my parents discuss this with their doctor and know exactly what to do if it happens again.</p>

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<p>Oh…so sorry to hear that, digs. Cyber prayers to you and yours…</p>

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<p>Digi, I’m so sorry. Good luck to you, your Mom, and your Dad. Prayers in your direction.</p>

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<p>Thanks to all who sent well-wishes. The news so far looks good. It appears that there is no significant brain damage and the improvement in my father in one day is incredible. If he improves at the same rate from day to day, he’d be back to normal very quickly. I think this will turn out to be a mild stroke. Now we CAN do some pre-planning in case this happens again. Thanks again.</p>