BajaNomad

Ischemic versus hemorrhagic stroke: know the difference and respond accordingly.

Whale-ista - 8-12-2014 at 08:29 PM

One of the values of this sort of communication forum became clear to me a few days ago when a friend of mine posted a notice on Facebook that had us all worried. She's in good health, relatively young, but woke up feeling a little off. Her husband was out of town on business so she was alone in the house.

It quickly became clear to those of us reading her posts that she had likely experienced a minor stroke. I was still in the middle of the ocean, but others quickly drove to her home and got her to urgent care then the emergency department at the nearest hospital. She was kept for observation and a multitude of tests.

It appears she did have a minor ischemic stroke. Fortunately she is doing well. But if it had been a more serious hemorrhagic stroke it's hard to know what the outcome might have been.

She was discharged from the hospital and referred to her primary care doctor for follow-up care. She reports she's doing well but is now moved into a high risk category for future strokes.

Today she was prescribed a daily aspirin, and given a book describing the symptoms, early warning signs, prevention, and follow-up care for strokes. It occurs to me it would be good information to have BEFORE you have, or someone close to you has, a stroke.

if you're not up to date on these things either, do some research. It may save your life or that of someone close to you.

bajabuddha - 8-12-2014 at 11:19 PM

I fully agree with you, W-I.... but you didn't state any difference of symptoms, or how to 'deal with them'.

There's no such thing as "a more serious'' stroke though. They both manifest the same symptoms, and need IMMEDIATE medical intervention. A passing 'ischemic' stroke is called a T.I.A., or Trans-Ischemic Attack. Luckily, the clot passed, or during intervention they have 'clot-buster' drugs that can unblock the flow; yes, hemorrhagic strokes are more serious to fix. They usually don't 'fix themselves' like an ischemic stroke can, but same symptoms usually.

"... it would be good information to have BEFORE you have, or someone close to you has, a stroke.

if you're not up to date on these things either, do some research. It may save your life or that of someone close to you."

Amen and amen, a pound of prevention is worth a pound of cure. KNOW the symptoms; slurred speech, numbness on one side of face or body, inability to speak plainly or at all, one pupil dilated more than the other, even have the person you're concerned about stick out their tongue... sometimes it will drift to the side without them knowing it....

FIND OUT AND LEARN, SAVE A LIFE, MAYBE YOUR OWN.

bacquito - 8-14-2014 at 11:57 AM

Good information, thanks

Whale-ista - 8-14-2014 at 12:03 PM

thank you for additional Information.

Many times people have small strokes and don't realize what has happened. The brain can often compensate if the stroke is not too severe, so it is important to notice changes in the ways you describe and get checked out ASAP.

bajabuddha - 8-15-2014 at 02:02 AM

Just remembered a few more warning signs; severe headache, also 'tunnel' vision or partial or full loss of vision in one eye. Strokes can also drop a person like a sack of flour.

A friend 10 years younger than I had a crushing headache followed by a slow-creeping numbness up one side of his body; hemorrhagic stroke; he survived. Found out it was genetic; a small group of people have one little spot on the brain where a vessel is naturally weak and just ruptures.

Another Baja bud was on the pot and constipated, and was just straining too hard, and bingo, same thing. He survived, with minimal effects also.

An older gal with a history of it in her family had several T.I.A.'s, and she'd just have short 'black-out' periods she couldn't remember the last few minutes or what she was doing... or she'd just pause in a conversation and a minute or so later resume talking; it eventually took her.

I hope these things help someone catch it early; the key is immediate medical intervention. The new drugs on the market are wonderful, but not foolproof. The first thing I look at if at all concerned is pupil dilation with a flashlight, checking if they're equally responsive, and have the person talk to me too. Y'all be well now, ya hear?
:coolup:

Alm - 8-15-2014 at 07:24 PM

Buddha, to get an "immediate intervention" you need to live close enough to a hospital capable of such intervention. "Clinica" on the hill in St. Rosalia didn't impress me much from the outside - thanks God, didn't have to go inside. And it's quite some miles away, unless you live right in town. And places like BOLA? With a small hospital of Guerrero Negro 140 miles away? Sheesh...

bajabuddha - 8-15-2014 at 09:23 PM

Quote:
Originally posted by Alm
Buddha, to get an "immediate intervention" you need to live close enough to a hospital capable of such intervention. "Clinica" on the hill in St. Rosalia didn't impress me much from the outside - thanks God, didn't have to go inside. And it's quite some miles away, unless you live right in town. And places like BOLA? With a small hospital of Guerrero Negro 140 miles away? Sheesh...

Too true, Alm. That's where living in Baja comes down to, "ya spends yer money and ya takes yer chances...". The tiny town I'm living in NM has a hospital, but it's a 'stabilize and ship'em' situation. Before here, a town of 300 in southeastern Utah, the nearest SMALL hospital (smaller than here) was 48 miles. You have to make your choice where to make a life, and then deal with the parameters of that choice. All the big-money life-flight insurance and pre-planning doesn't do a tinker's damn to the 'golden hour' and the 'platinum 10 minutes' referred to in EMS. That's what being Out There is all about. I think older Ex-Pats realized that, and now the Baby Boomer Baja-eņos have to cope with.

Baja-eņos??? WTF is that? What should it be? Thoughts?

Alm - 8-16-2014 at 12:22 AM

Don't know about "golden hour". With stroke I've read about 3-4 hours as a critical period to get help, before you kick the bucket or brain damage becomes permanent. The best - or the only? - FDA approved medication for acute ischemic stroke is IV called Alteplase, it dissolves the clots. It's pretty old, since mid-90s, and should be given within 3 hours. I wonder if Baja towns with population under 50K even have any, not to mention a working ECG machine.

When you are past 3-hours window, NOB they can try a few mechanical procedures to remove the clots. In Baja I doubt they do this anywhere other than Tijuana, Ensenada, or Cabo.

Other things like old-school blood thinners and aspirin you may get in most "clinicas", but it won't dissolve any clots, only prevent new clots from forming.

Yes, evac plans aren't much help, with these time-frames. When it takes 8 or 10 hours, you might as well get to NOB hospital a week later.