Stroke

A very sad thing happened on the second day of Chinese New Year. First, a whole gang of my aunts, on my mum's side, and uncles and cousins came to my house. Many of them were back from other states/countries and most had never been to our condo, so it was nice to have everyone over and to catch up with those whom we had not met for quite some time.

When it came time to leave, everyone went to the corridor to put on their shoes and say goodbye. Then suddenly, one of my uncles passed out and collapsed onto the floor!

He has a long history of diabetes and had already suffered a few minor strokes. Initially, we thought it was a hypoglycemic episode, where a diabetic's blood sugar level goes down too low, whether due to medication or lack of food, etc..

We laid him down properly and tried to give him some sugar syrup, but he clamped his mouth shut. When we realized it was a stroke (he was moving his left leg and arm but not his right), we immediately called the ambulance. Thank goodness Aunty Rosa, who was a staff nurse like mum was around.

The ambulance came in about 15 minutes and promptly sent my uncle to the hospital. We initially did not think it was a serious stroke, but apparently there was a lot of damage done and to everyone's shock his condition deteriorated and he passed away a few days later.

I felt really useless, when the whole thing played out and I had no idea what to do, even though I am in the medical field. I decided to ask Big Sis (who is now a professor!!) what to do in such cases. She said that in cases like these, time is most important. Time lost is brain lost.

When a stroke happens, there is either a bleed or a clot in the brain, so parts of the brain is not getting enough blood, thus it is starved of oxygen and dying. Thus the more time elapses, more brain cells die.

Also, if a patient arrives at a hospital within 3 hours, an injection called tPA (tissue plasminogen activator) can be administered. It is a very potent clot-busting drug. In my uncle's case, the doctors said he was too weak to handle the strong drug, as they had given him milder drugs and those already made his stomach bleed.

We get a lot of emails regarding strokes and I wondered if they were true. I searched on the internet and it says this one is true and is a good and easy guide to remember:


How to Recognize a Stroke


This might be a lifesaver,  if you can remember the following advice, sent by a nurse, whose husband is a medical doctor.


Sometimes symptoms of a stroke a difficult to identify. A stroke victim may suffer permanent brain damage when people fail to recognize what's happening. Now, doctors say any bystander can recognize a stroke, simply by asking three questions:

• ask the individual to smile.
• ask him or her to raise both arms.
• ask the person to speak a simple sentence.

If he or she has trouble with any of these tasks, call 911 immediately and describe the symptoms to the dispatcher. Researchers are urging the general public to learn to ask these three questions quickly, to someone they suspect of having a stroke. Widespread use of this test could result in prompt diagnosis and treatment of a stroke, and prevent permanent brain damage.


There is another email however that recommends we use a needle to prick the patient's earlobes and fingertips and squeeze until a drop of blood emerges. Then it continues to tell us not to send a patient to the hospital in a car until he or she regains consciousness. This is because the bumpy car ride might cause blood vessels to burst.

Now the pricking part is not proven, though I suppose it's harmless to try while waiting for an ambulance or while in the car on the way to the hospital, but for the record, my cousin did do that for my uncle, before the ambulance came. Apparently such a small drop in peripheral pressure does nothing to the pressure in the brain.

The second part of the email is the dangerously misleading part. You should bring the patient to the hospital straight away, regardless of whether he or she is conscious or not. A bumpy car ride is the least of your worries and the worst has already happened anyway. Only in the case of spinal injuries should you not move a patient, for everything else, get to the hospital ASAP!

I think it is a good idea to learn first aid... Sis no2 and I talked about this before, after another sad incident involving a little girl drowning a while back. Well, I'll put it on my to-do list and hopefully will get around to it soon. You never know when it could mean the difference between life and death.