Medical opinions

[Rogue]

Okay,

To start with... to all of you that are about to post "That sucks!", I know and please don't post or PM it... I do better with out it.

I know you love me and I love you too............ No not that way, back off TWN! But I really do better with out all the "That sucks" posts and PMs. I"m looking for real world experiences. Doctors and lawyers love to give ambiguous answers and I'm 3,000 miles away.

I KNOW internet advice is worth what you pay for it but I also know we have EMTs and Nurses here who may have real life experiences with similar situations.

My wife has high blood pressure.

My wife is in Florida on business and Monday her blood pressure hit 280 over 100 (No thats not a typo.... 280 over 100) by the time she was gotten to the hospital it was down to 234 over 104.

She had a "small" stroke She lost some mobility on her left arm and her left foot "feels like a block of concrete".

She is staying with her sister until she is feeling up to flying home.

Some history on my wife, she is a survivor!

When she was 3 she was playing with matches and lit a couch on fire... while she was on it.

At 4 1/2 she dropped the doll that she had all through burn therapy and ran down the hill to get it... and when the bus took off she was under the wheels.

About 15 years ago she almost died from a brain aneurysm, and later the doctors could find no sign of it.

She has had high blood pressure since she was 21 (she is now 56).

Her blood pressure has been over 200 more than once.

My question (knowing all cases are different) is what are the chances of another stroke (10%, 90%), with therapy haw much can she recover? And any other info you want to pass on.

 

[huk finn]

no medical diagnosis, Your docs will give you that. But I believe you should drive her home,,, NO plane trip for a while.Just something I read yrs ago about the pressurizing of plane and such.

 

[twowheelnut]

I've had one friend make a miraculous comeback from a major stroke - near death, almost complete paralysis. Today, she's left with just a droopy left cheek and lips and a somewhat labored walk. Recovery to that point took a while (around two years) and that was 25 years ago. She's been healthy as a horse since. Feisty, too and very health conscious, which I thinks made a big difference.

I wish your better half a speedy recovery!

Oh, yeah, not to nag (well, yeah, it is to nag), but now might be a good time for you to put down the Marlboros... just a though, my friend. Let me know if I can be of any help.

 

[Rogue]

... But I believe you should drive her home,,, NO plane trip for a while.Just something I read yrs ago about the pressurizing of plane and such.

I had the same concerns, The MD gave her an okay to fly.

I've had one friend make a miraculous comeback from a major stroke - near death, almost complete paralysis. Today, she's left with just a droopy left cheek and lips and a somewhat labored walk. Recovery to that point took a while (around two years) and that was 25 years ago. She's been healthy as a horse since. Feisty, too and very health conscious, which I thinks made a big difference.
I wish your better half a speedy recovery!

Thanks for the positive experiance.

Oh, yeah, not to nag (well, yeah, it is to nag), but now might be a good time for you to put down the Marlboros... just a though, my friend. Let me know if I can be of any help.

If it werent so PC to quit........................

And thank you to all for not postimg the "That sucks" posts.

This has been very theraputic to me posting this, thank you all.

 

[03HiYoSilver]

Rogue,

My grandmother had a stroke and she has totally recovered. Her key to recovery was actively and consistently working the areas affected with therapy.

She is 92 this year and other than general weakness associated with this age, she is doing well.

My heart goes out to you and your wife...may she have a quick recovery.

 

[painman]

Rogue, sorry I can't offer up any medical help but I know the big physican upstairs and my prayers are for your wife and you and the rest of the family. Take care my friend and don't give up hope. PM. <><

 

[Low Level FJR Pilot]

Rogue,

I won't say it, but I will keep her in my thoughts and prayers. That said, My dad had a major stroke at the age of 68. Doctors prognosis was very bad and they gave him six months. My dad on the other hand has always been a fighter and though paralyzed on the left side, unable to speak and pretty well messed up, he had ideas of his own. I talked to a friend of mine that worked as a night nurse at the hospital in my hometown and he told me how amazed he was at my dad's recovery during the weeks after the stroke. My dad would be up at 2am working the strength ball in his left hand.

He went to a VA hospital in Albuquerque and by the time I got home on my humanitarian transfer because I thought I was going to be burying him, he was 95% recovered and ended up 100% recovered. We had some great bonding time while I was stationed as a recruiter for 7 months at home. He lived 8 more years, long enough to see his grandson born, then went to sleep July 5th never to wake again.

I say all this because your wife is a big survivor. She has beaten the odds from the beginning and will beat them again. She will recover and she will probably live longer than all of us just because she is a fighter. Your job is to help her fight and encourage her every day. Take care of her when she gets home, work with her and get her some rehabilitation. A physical therapist really helped put my dad back together and a lot of prayer and trust. Also, her chances of another stroke are not something to dwell on. Help her maintain her blood pressure, figure out what her triggers are that set it off and insure that she doesn't have anything pull on those triggers. If there is anything you need let us know.

 

[ponyfool]

A stroke that doesn't cause extensive brain damage is nearly always recoverable.

My good friend's dad has had several, including a significant one about 10 years ago. His is caused by an inoperable aneurysm in the basilar artery. After each, his recovery has been considered 100% because the blood flow cut off wasn't prolonged. Worst one, he had limited mobility in his right side for nearly 4 months that progressively healed. He was back on the golf course 3x per week in 6 months. That was 10 years ago when he was 55. He's had two or three very minor ones since then.

In high school, my girlfriends father suffered a catastrophic stroke that pretty much devastated one side of his brain (don't remember if it was left or right side) during surgery. The docs said he wouldn't come out of the coma from the surgery and would likely be dead in days.

When he was released from the hospital about a month later, they said he'd never walk or talk again because half his brain was essentially dead, and he wouldn't make it through the year.

While he never fully recovered, he was able to walk very short distances (from wheelchair to car, etc) and was clearly able to communicate with a limited vocabulary and very definitively was able to articulate yes and no verbally. He finally passed away last summer, 28 years after the stroke.

I guess my point in this last case is, everything the doctors said he couldn't or wouldn't ever be able to do, he proved them wrong. As I'm sure you are aware, in medicine, there are some certainties, but more often than not, nothing is for sure.

 

[Thug]

No flying mate at least for 3 months just in case. Some people do remarkably well others not, It sounds like she may be ok from what you have said I take it she it getting her strength back and speech is good.. BP is a concern I don't need to tell you that, do what ever it takes to get it down. Half an aspirin a day would be good too for the rest of her life, if there are no bleeding complications or other meds or conditions that may contradict taking them. The power of the mind is a great tool as well I know its sound corny but I have witnessed some amazing things to people who have such a positive outlook.....and above all live everyday as best as you can. Your wife will always be at risk form another ABI so take the head and make some changes mate.

 

[madmike2]

Ooohhh Jii-iilll.......paging SilverPenguin......Er, Nancy Nurse to your computer, please.

Uhm, EvilMedic, are you out there, boy? Youse EMTs are close to the action and have a pretty good finger on the pulse of what's happenin'......

Rogue, if the MD has released her to fly it sounds like he thinks it was a mild, one time occurence. That is GOOD news! Thankfully she has family there for support and comfort.

Help her maintain her blood pressure, figure out what her triggers are that set it off and insure that she doesn't have anything pull on those triggers.

Low Level FJR Pilot gave some good advice, though finding the triggers might be difficult. It sounds as if her diet (and yours, big boy) is about to change drastically.

Keep us updated...we ARE in your corner, y'know.

 

[wpbfjr]

rouge,

i'm i south fla if you need forum support for your mrs...

it almost sounds like your mrs had a 'tia' transient ischemic attack...

as has been said, recovery from her signs and symptoms can easily be 97-100%

the danger is that a 'tia' is a major warning sign... without major med/diet/lifestyle changes, the 'big one', or more tia's until the big one, are just around the corner...

dana

20 year street medic (retired)

 

[Murph]

Rogue,

My mom had a stroke October and, when I spoke to her on the phone (since I live in a different state), I could not understand her at all. Her mobility was also inhibited. However, the use of her arms returned within days and her speech returned 100% within weeks thanks to the help of an in-home lingual therapist. I hate to say it but, since my mom's health is absolutely terrible, I did not have much hope of a recovery. However, while everybody's situation is different, my takeaway from the experience is that there is indeed much hope ... it sometimes just takes time and alot of therapy work on the patient's part as well as a lot of patience and assistance from family. I wish your wife and you the best.

 

[BrunDog]

Dana hit the nail on the head: The range of strokes is quite broad, and that is why it is hard to pin down exactly what is going to happen. A TIA is the most mild form and are somewhat common, a larger infarct is a bigger problem. Ultimately the amount of brain tissue supplied by the blocked artery, and the length of time that the blockage occured are the determining factors.

Hypertension can cause stretching of cardiac fibers, inducing structural damage, which can lead to arryhthmias, including atrial fibrillation, a condition where the top chambers of the heart (where our natural pacemaker resides) have multiple concurrent "pacemaker" sites all firing erratically, causing the chambers to quiver rather then fully squeeze. One of the major causes of stroke is atrial fibrillation The pooling blood in the left atrium clots, and pieces of clots can then travel to the periphery, including the brain. A. fib also causes an erratic heart beat that drives people nuts when they first get it. It also decreases cardiac output, and that can lead to people being tired, or ultimately combined with other effects, heart failure. I am assuming she has had a full cardiovascular workup in the past, but if she hasn't, or done so recently, run, don't walk, to your nearest cardiologist.

Naturally, and you know this, they need to get her BP under control. That can be difficult given her history and the dramatic elevation. That will take larger dosing of meds and it will always be a concern.

If she isn't already, the docs will not want to take any chances and they will anticoagulate her. This is usually for life. Coumadin (warfarin) is the preferred prescription and has to be monitored monthly to make sure the clotting function isn't overly hindered, which could lead to organ and cranial bleeds. There are other medications on the horizon and she may become a candidate for those when they become available given her age. I will bet there are some gents on this board who are on the coumadin train and could tell you their experiences.

I'll add my nag, too: If she is smoking, she needs to stop right now. If you are smoking, you need to stop right now - even the second hand can cause ill effects. Time to give your brain the authority to rule over the addiction and overcome. Being killed by smoking is not a matter of if...

We wish you the best of luck. I am also in South Florida and am familiar with the local cardiology community, so if there is anything I can help you with, lemme know.

-BD

 

[evil_henchman]

My father in law never took his high blood pressure seriously. It took a series of strokes that left him an invalid to change his mind. I have high BP too and take medication for it. I would say from my own experience and talking to doctors that if your wife doesn't get a handle on her BP she's almost guaranteed another stroke. I never leave home without my meds. Someone mentioned smoking, surely she doesn't....

 

[Rogue]

Thanks for the advise, to address some of the comments and questions:

Medication-

She is and has been on medication.

Because her BP has a history of jumping around so much (it has also dropped very low) her doctors have modified her medication more times than I can remember.

She was taking 3 different drugs a day when she left, now she is on 5.

Diet-

Well she is allergic to dairy so is on a dairy free diet, she is allergic to all kinds of wheat so is on a wheat free diet, she has been off coffee for years, she does not drink alcohol ( she would have about one drink a year but hasn't had any for 3 years).

Smoking-

She does smoke and has tried to quit but has not been able to. She cut down to 5-6 cigarettes a day and has been told by her GP Doctor that if she won't quit then smoking less than 1/2 a pack a day is good.

We don't smoke in the house (a habit from when our Grand-daughter lived with us).

She is not overweight, She is 5'2" and her weight tends to be around 110#.

What causes the BP to be fine for months then go haywire????

IMO there are 2 major catalysts:

1- She does not handle heat well.

She is from Nova Scotia and has never gotten used to heat.

It is hot and humid in Clearwater FL where she is now.

2- Lack of sleep.

She has been going through menopause and the included hot flashes for 15 years! When the hot flashes are acting up (as I know they have been the last week) she is woken up by them multiple times at night and ends up getting very little sleep.

 

[evilmedic13]

SorryRogue, loooong day at work. HTN can cause a ton of stuff, not just a stroke. Stroke, either TIA or full on, is caused by a clot in the bloodvessels feeding the brain to stop giving an area of the brain the blood it needs. Similiar to a heart attack, if it it's treated quickly enough w/ (i believe) TPA/H it usually can be reversed, but there is a strict time frame in which the meds can be used by the hospital.

Honestly, a bp of 280/100 gets a full blown ALS tx for hypertensive crisis w/ baby aspirin(anticoagulant) NTG tablets(vasodilators to lower b/p by openeing the vesels wider) and ,possibly Morphine as the last vaso-dilator. Both #'s tell me there is extreme pressure on the heart in both pre-and after load. The heart will be damaged by pressures like this, as well as just about all the other systems that are in-line w/ it due to the amount of stress on them.

What do her ankles look like when her b/p shoots up like this? What is her breathing like?

Seeing as she's a smoker she could be heading for CHF/COPD which I see a lot of. They also have b/p's in that range when I see them , but that is due to fluid filling up their lungs because the heart is no longer an efficient pumping system and tends to store the excess fluids in the extremeties first and then the lungs so it can maintain some rythym. Usually when I get them a b/p 280/140 isn't a suprise, but they are in serious trouble due to the amount of fluid that is not being pumped by the heart and is instead drowning them! An IV w/ 80mg of lasix and 2NTG tablets are usually given by me in less than 3mins, most times it works, but that is in the field by me, not in the house by family.

What meds does she take right now? How often does the b/p shoot like that? How many doctors does she have?

1) Meds can be of help to treat stuff, they are noy usually given to prvent something that hasn't happened already though. 2)This may give a clue as to what the triggers are, if any. 3)I see a lot of people w/ more than 3 doc's and the pt never tells them what the other is doing. Sometimes to the detriment of themselves because some of their meds act in a fashion that null each other out, making them as effective as water.

You said she smokes, from another smoker, she MUST quit. There are new meds that make this easier than we used to have but the #1 medicine to work w/ those is HER WILL, the best meds never work unless the pt wants them to. As much as I LOVED to smoke I love being able to breathe clean air and not be out of breath w/ any strenuous activities. This is a priority, if it was a heroin addiction would it be any more serious? No, it would just be illegal, think about that.

Iknow I really haven't given you the answer you wee looking for 90% for or against, unfortunately I don't have everything the doc has in front of him to even think about odds. But I do know there is more to it than just "avoiding" a stroke by odds. I've seen them in so many different shapes, sizes and personalities as well as b/p profiles the best I can say is, do everything to PREVENT it not AVOID it. Above all do it in a way she can enjoy doing it, if it's miserable for her, there's no way she'll want to change, would you?

Good luck to recovering from this and preventing a recurrence and here's to both of you finding a pleasant way for it to be effective :drinks:

 

[Scab]

If stopping smoking is considered I have a recommendation: Chantrix. It is a relatively new prescription that I just used to quit smoking. It works. It counteracts the effects of nicotine on the pleasure sensors. Anyway, it works. The only side effect that I experienced was a change in the way some things tasted. Mostly, it was drinks. My favorite diet Mt. Dew no longer tastes good. Oh, well.

Anyway, ask your medical professional about the stuff.

 

[Last Chance]

If stopping smoking is considered I have a recommendation: Chantrix. It is a relatively new prescription that I just used to quit smoking. It works. It counteracts the effects of nicotine on the pleasure sensors. Anyway, it works. The only side effect that I experienced was a change in the way some things tasted. Mostly, it was drinks. My favorite diet Mt. Dew no longer tastes good. Oh, well. Anyway, ask your medical professional about the stuff.

GUNNY!! On quitting smoking!

You can both quit as a team effort. I, a 40+ year smoker and a 2 pack a day'er, have now gone 135 days nicotine free using Chantrix (Veranicline). For me it COMPLETELY eliminated the physical withdrawal symptoms of quitting. The "triggers" and "stress" induced reasons people smoke are still present, but a lot easier to deal with if you are not running cold sweats and shaking! Included with your prescription is a years subscription to a Website that, although kinda primitive, IS a help and provides some support for the quitter. (I've saved over $900 on cigarettes to date.) My BP has dropped and my breathing has improved. I just feel better.

My doctor told me it was just a matter of time till a stroke or heart attack. I'm on all kinds of medication. I'm hoping that by quitting smoking, changing my diet and getting some exercise I might be able to avoid it for a few years. I'm 61 and it's never too late.

Good luck, it's not about PC. It's about you living and the quality of life!! If you quit they won't be able to tax the @#$% out of you!! That's the way I look at it.

LC

 

[rogdeb]

We wish your better half a speedy recovery!
Oh, yeah, not to nag (well, yeah, it is to nag), but now might be a good time for you to put down the Marlboros...

WE second that.

Rog n Debs