Hospitals That Specialize In Stroke Treatment

[egeefay]

Does anyone know the names of some hospitals in Thailand that specialize in the prevention and treatment of strokes.

My sister in law had a stroke when she lived in the US

Now she is living in Hua Hin and thinks she may be having the same symptoms again.

[Sheryl]

Bumrungrad has a special stroke center

Bangkok Hospital also specializes in stroke

Both have websites

There are actually 2 different types of stroke, one is caused by the blood vessels in the brain bursting, and is best prevented by controlling the blood pressure. Once a stroke of this type happens, supportive care can help avoid death but there is little that can be done to minimize the brain damage.

The other kind is caused by a blood clot. This is best prevented through anticoagulation (thinning the blood), either with aspirin or a drug like coumadin, the latter must be done under a doctor's supervision. If a stroke occurs due to a blood clot and the patient reaches a properly equipped hospital in time, it is possible to dissolve the clot and prevent permanent brain damage. Both Bumrungrad and Bangkok Hospitals can do this, but the patient must reach the hospital within hours of the attack.

[PeaceBlondie]

I sufferred a stroke on May 23, the same day this was posted! It was confined only to my right arm, and we immediately jumped on my boyfriend's motorcycle and went to the best govt. hospital in CMai, to the special clinic rather than to the ER. My cardio specialist scheduled me for an immediate CAT scan and a consult with the neurosurgeon. The blood clot dissolving was not attempted. Within half an hour after the neurorologist confirmed I had had a stroke, my feeling returned to my right arm (but not my coordination, which is still poor at typing). Two days later, he released me and I went on my long trip to Ireland.

On my return through Amsterdam, I sat next to an Oxford-trained trauma physician who said the clot dissolving method is very dangerous, and could cause another stroke (or other damage) and is only popular in the USA.

Then there were the 3.5 days in Ireland without my medications, when the stupid and worthless AerLingus could not find my luggage! I survived fine.

So, what words do I Google to find how to prevent another stroke? I intend to lower my BP, lose 20 ugly pounds, exercise like crazy, watch my diet, etc. I can't wait to get back on my own motorcycle. Thank God I didn't have a stroke while riding!

[endure]

I sufferred a stroke on May 23, the same day this was posted! It was confined only to my right arm, and we immediately jumped on my boyfriend's motorcycle and went to the best govt. hospital in CMai, to the special clinic rather than to the ER. My cardio specialist scheduled me for an immediate CAT scan and a consult with the neurosurgeon. The blood clot dissolving was not attempted. Within half an hour after the neurorologist confirmed I had had a stroke, my feeling returned to my right arm (but not my coordination, which is still poor at typing). Two days later, he released me and I went on my long trip to Ireland.

On my return through Amsterdam, I sat next to an Oxford-trained trauma physician who said the clot dissolving method is very dangerous, and could cause another stroke (or other damage) and is only popular in the USA.

Then there were the 3.5 days in Ireland without my medications, when the stupid and worthless AerLingus could not find my luggage! I survived fine.

Rule number 1. Always carry your meds in your pocket or your carry-on!

[PeaceBlondie]

I sufferred a stroke on May 23, the same day this was posted! It was confined only to my right arm, and we immediately jumped on my boyfriend's motorcycle and went to the best govt. hospital in CMai, to the special clinic rather than to the ER. My cardio specialist scheduled me for an immediate CAT scan and a consult with the neurosurgeon. The blood clot dissolving was not attempted. Within half an hour after the neurorologist confirmed I had had a stroke, my feeling returned to my right arm (but not my coordination, which is still poor at typing). Two days later, he released me and I went on my long trip to Ireland.

On my return through Amsterdam, I sat next to an Oxford-trained trauma physician who said the clot dissolving method is very dangerous, and could cause another stroke (or other damage) and is only popular in the USA.

Then there were the 3.5 days in Ireland without my medications, when the stupid and worthless AerLingus could not find my luggage! I survived fine.

Rule number 1. Always carry your meds in your pocket or your carry-on!

But the new rule about carrying LIQUIDS fooled me. Later I realized I could have managed, since the limit is 100 ml, and I only had 90 ml on me. I thought, "Hey, it's only from Heathrow to Shannon; what can go wrong?" I forgot that AerLingus also lost my bag for 3.5 days on a flight from Edinburgh, 3 years ago. Next time I need to go to Shannon, maybe I'll just swim over.

[Sheryl]

Blondie,

If I understand correctly your stroke was the thrombotic type (clot). For prevention, you should be on either aspirin or something else to "thin" the blood. Also, did they have any idea where the clot came from? For example, do you have atrial fibrillation? (A type of abnormal heart rhythm associated with a high incidence of clots).

Don't smoke and keep your lipids (cholestrol, triglycerides) in normal range; if you are diabetic be sure your blood sugar is well controlled. These are all risk factors for thrombosis.

And of course need to keep BP well controlled to prevent a stroke of the hemorraghic type. This becomes even more important if you need to take anticoagulants. Ironically, the very treatment that reduces the risk of thromobosis can increase the risk of cerebral hemorrhage.

BTW, the mortality rate for patients treated with clot-dissolvers is the same as those not (but the neurologic outcome is better) so it is not correct to say it is "dangerous" if done properly. Done properly means careful application of almost 20 exclusion criteria, i.e. not everyone with a clot is a suitable candidate. Also, in cases showing signs of spontaneous improvement or thought to have only partial occlusion it may not be considered necessary, I suspect this was true in your case.

[PeaceBlondie]

Sheryl, the neurosurgeon-neurologist did not name my condition, but my cardio doctor called it a ¨lacoon.¨ I can only equate that to the old Greek word lacuna, which refers to a tear in an ancient manuscrit, or to a fragment of the manuscript. The remission has been so swift, and the localization of the stroke so limited, that I can only be thankful it wasn´t worse.

I need to get a list of my meds, but I doubt there´s an anti-coagulant among them. Folic acid, a combination of B vitamins, a half dosage of the usual felopidine that I´ve been on since January, and maybe 2 or 3 more meds.

So far as I recall, I've never been diagnosed with arteial fibrilation, but I've been known to fib.

I have never smoked (cigarettes, that is ) and my lipid results pleased the neurologist. I thought my blood tests would show nothing but chocolate and diet cola. I think you advised me to cut down on the Pepsi Max, and I went from 2.5 to 1.9 liters a day. I've never been diabetic and I passed a glucose tolerance last year.But I do eat lots of sweets. I'll try to cut down.

As always, thanks for your excellent advice. Now, to get back to Chiang Mai from Moscow, after the nice, tall, cute, sweet, young hotel clerk located my airline tickets that I left at the front desk.....

Blondie,

If I understand correctly your stroke was the thrombotic type (clot). For prevention, you should be on either aspirin or something else to "thin" the blood. Also, did they have any idea where the clot came from? For example, do you have atrial fibrillation? (A type of abnormal heart rhythm associated with a high incidence of clots).

Don't smoke and keep your lipids (cholestrol, triglycerides) in normal range; if you are diabetic be sure your blood sugar is well controlled. These are all risk factors for thrombosis.

And of course need to keep BP well controlled to prevent a stroke of the hemorraghic type. This becomes even more important if you need to take anticoagulants. Ironically, the very treatment that reduces the risk of thromobosis can increase the risk of cerebral hemorrhage.

BTW, the mortality rate for patients treated with clot-dissolvers is the same as those not (but the neurologic outcome is better) so it is not correct to say it is "dangerous" if done properly. Done properly means careful application of almost 20 exclusion criteria, i.e. not everyone with a clot is a suitable candidate. Also, in cases showing signs of spontaneous improvement or thought to have only partial occlusion it may not be considered necessary, I suspect this was true in your case.

[bkkmei]

Hi

sorry to hear about your stroke - it's a really scary situation. Lucky you reacted immediately to the mini-stroke and hopefully the meds now will prevent anything worse happening.

My dad had a stroke last year due to a blood clot. In the morning he takes 75mg aspirin, an anti-clotting drug, and something to line his stomach against the aspirin. In the evening, he takes the anti-clotting drug again, and 40mg of simavastatin (for cholesterol lowering).

His blood pressure was very high. It's now pretty normal. As one side of my dad's carotid artery is now fully blocked the doc actually told him that he shouldn't lower his blood pressure any further!

BTW, this website is a great source of information

http://www.stroke.org.uk/information/index.html

[Sheryl]

Blondie,

That would probably be lacunar infarction, which is a type of stroke which is usually due to small hemorrage (often in people with high BP) occurring in the lower part of the brain. This would explain both why no use of clot-dissolvers and no blood thinners: you had a bleed due to rupture of a (fortunately) very small artery in the brain.

Sounds like your life style and medical regimen are already on the right track. Only thing I would add is, really work on keeping your BP down.

Good luck!

[PeaceBlondie]

Sheryl,

Thanks, as always. Lacunar infarction sounds like an impressive phrase to throw around at my next expatriate's meeting. The neurologist did not put me on any blood thinners, so I won't start using baby aspirin unless he okays it when we see him this Friday.

I've been swimming at least 20 minutes almost every day, watching my diet.