Stroke not great Christmas present

[Daniel Boon]

First off, I am not a doctor.

On December 17, my wife and I were traveling Naconchair bus from Pattaya to Surin; we just entered Burri Ram when a German bloke made some wheezing noises, to the best of my knowledge, he was having or just had a stroke.

I cannot speak German (he couldn't speak at all); however, people sitting 'next' to him (German man and his Thai wife), didn't know him, nobody did.

Anyway, as I had assisted a Thai lady of the bus (with steel rods in her leg, for some reason the Thai / German lady thought I knew something; she had losened his belt and asked me to unbutton his jeans (he had peed himself), so I did.

My Thai wife speaks a little English and translated into Thai and the Thai lady spoke some German, but the only thing active about this bloke was his eyes and with remnants of control he had, trying to get up. I looked at his imobile left arm and side and his dropping mouth on one side and deduced he had had a stroke, by this time - trying to communicate with the Thai stewards and her with the drive, they thought it best to proceed to Surin hospital.

Anyone aware of a stroke victim would know there is a small window of opportunity for remedial assistance, to the best of my knowledge, less than half an hour and it is possible, with significant physio, to regain most of your use of the affected limbs; however, the two things against him were a) he was very much overweight and we were more than a half hour from Surin and c) competent as Surin Hospital Staff might be, but the time the ambulance got him there, it was all over red rover. It took two Ambulance Officers (one each leg) and me carrying his torso to get up from his chair and carry him to the ambulance gurney.

My wife, coincidentally, knew his Thai wife (he lives / retired in Surin), my wife told me this morning that he had died.

So take and make of this what you will ... but if you're over-weight, over here and over 20 minutes from a doctor and nurses who Can help you, your days are numbered. Get a medical, look after yourself and enjoy life in moderation.

All the best

[rgs2001uk]

As callous as it may sound, and no doubt I will be slagged off here, best of luck to the guy.

He checked out of this mortal coil, wasnt a burden to his family and friends, and at least he didnt spend his final days hooked up to some machine that is nothing more than a money making scam and a burden on his or his wifes finances.

There but for the grace of etc etc, I can only pray I exit so swiftly and so pain free.

[Daniel Boon]

Can't argue with that rgs2001uk ...

[NancyL]

I hope Sheryl stops by to clarify, but I believe the window of opportunity for the clot-busting drug to be given is about four hours -- however minutes count. A quick internet search said the rule of thumb is "save a minute, save a day" of disability. It's imperative that someone get to the hospital as soon as stroke symptoms start.

This medication is not going to be in an ambulance -- the best course of action once stroke symptoms start is to get someone to a major hospital as quickly as possible -- often a tuk-tuk is the quickest way -- rather than waiting around for an "ambulance" to show up.

I wonder if this poor man had his blood pressure checked regularly?

Edited December 23, 2014 by NancyL

[Sheryl]

I hope Sheryl stops by to clarify, but I believe the window of opportunity for the clot-busting drug to be given is about four hours -- however minutes count. A quick internet search said the rule of thumb is "save a minute, save a day" of disability. It's imperative that someone get to the hospital as soon as stroke symptoms start.

This medication is not going to be in an ambulance -- the best course of action once stroke symptoms start is to get someone to a major hospital as quickly as possible -- often a tuk-tuk is the quickest way -- rather than waiting around for an "ambulance" to show up.

I wonder if this poor man had his blood pressure checked regularly?

Clot-busting drugs:

1. Are only given for thrombotic, as opposed to hemorrghagic, strokes. So before they can be given, patient must get CT or MRI scans at a facility able to perform them and with neurologists able to interpret the films, differentiate the two types of stroke, and experienced in the use of thrombolytic agents. I very,very much doubt Surin Hospital would fit this. Likely only KKU Hosp in Issan would.

2. Cannot be given, even in thrombotic stroke, if a number of contraindications are present. In cases where it is not possible to rule these out (they include being in anticoagulant medication), they will not be administered as they may do more harm than good. From what is described of this man and the communication problems,even had he gotten to a facility meeting the criteria described in #1, and been found to have a thrombotic as opposed to hemorrhagic stroke,it would still not have been possible to give them.

If it is any comfort, really massive strokes are more likely to be due to hemorrhage than thrombosis and no matter what is done, the prognosis is poor for hemorrhagic stroke since the areas of brain affected are quite diffuse,whereas thrombotic events have localized effects.

Uncontrolled (or poorly controlled) hypertension is a major risk factor for hemorrhagic stroke. Use of anticoagulants without proper monitoring is also a risk factor.

[Kitsune]

Well done in doing your bit and helping to take him out

I would also say,if you're overweight change your diet here.