If I ever suffer a stroke
Or any condition associated with acute circulation loss, including a heart attack...
(Let me be clear: What follows is not medical advice)
Someone called me a few days ago, concerned about her friend who had suffered blood clots in her brain some months following the "you-know-which-one injection". Her friend was now complaining of severe headaches. My advice was immediate and urgent: "She must get medical help immediately!"
She should cause a fuss about these headaches rather than be sorry later because she may have the first signs of a stroke. A stroke is devastating. I was reminded of this while visiting a close friend in the hospital after he had a stroke. These and other incidents got me thinking about how prepared I am for myself and my family should any of us suffer a stroke (NZ is in the midst of an utter epidemic of stroke and other cardiovascular events). One typical pattern with almost every case of blood clots, including stroke, which I've had anything to do with lately, is the unacceptable delays in getting treatment and the inadequacy of the treatment itself. These could have been much better.
So, if I had a stroke, what do I want my family to do for me: what treatment do I want for myself? I realised if I didn't speak for myself now, leaving it until I was lying unconscious and helpless in a hospital bed would be leaving things far too late. So here, for the record, are my wishes should I ever suffer a stroke. But, first, a brief history of my experience treating and rehabilitating stroke and other causes of traumatic brain injury (TBI), such as a concussion from falling off a bike or being punched in the head.
Please read this article about my experience with stroke and other brain injuries:
When it comes to stroke: First things first:
Act now - Do not delay!
The first and most immediate action is to do everything possible and practical to minimise tissue death due to oxygen starvation which begins within minutes, and secondary tissue death, which begins after a few hours of the incident due to the toxins associated with tissue death. If what follows is done quickly, within the first "Golden Hour", and much longer following the injury, tissue death will be minimal, recovery time shortened, and long-term disability will be minimised.
The early warning signs someone may be having a stroke:
Effective early treatment reduces disability
The 60 minutes after the onset of stroke symptoms are known as “the golden hour.” The outcome for me will likely improve if treatment can be initiated within this brief window. Here is advice from a doctor friend, beginning with the important stages, ideally to be completed within three hours of the first signs of stroke:
a) Recognise what's happening
b) Get to the hospital
c) Be assessed
d) Have a CT scan to exclude a haemorrhagic CVA
e) Get the CT reported on
f) Receive thrombolysis
"Practically speaking, this is very hard to achieve in many places in the required three-hour window from onset of symptoms to thrombolysis, except in a major city with a functioning ambulance service (good luck in most places now, thanks to you-know-what) and a specialised acute stroke service with fast access to radiology."
So, where you live is important for survival and minimising harm following a stroke.
Clot-busting drugs save lives and reduce harm
If they get me into treatment within one to three hours of the first symptoms of an ischemic stroke, I may get a type of medicine called a thrombolytic (a “clot-busting” drug) to break up blood clots, improving the chances of fully recovering from a stroke. If applicable, attempts may be made to aspirate or alleviate any blood clots or other causes of obstruction of circulation. I'm not an expert in this area of acute emergency care, so I'll leave it at that, assuming the doctors know what to do.
However, this is only the beginning of treatment to prevent what often amounts to catastrophic brain cell death, leading to many months and even years of rehabilitation and almost inevitable permanent disabilities. There is much more that can and should be done, which I insist on having should I ever suffer something like a stroke. They are HBOT and antioxidant therapy, which I will now outline.
The miracle of HBOT
Hyperbaric Oxygen Therapy (HBOT) is an overlooked therapy in New Zealand for the emergency treatment of ischaemic events such as stroke and heart attack. In brief, HBOT involves placing the patient in a chamber pressurised to 2-3 atmospheres. The patient then breathes oxygen through a mask while supervised by a doctor. The saturation of the tissues with oxygen while under pressure means life-giving oxygen can be delivered to stressed tissue despite the compromised circulation, thus sustaining the viability of the tissue. At the same time, while the HBOT acts to minimise tissue death, other treatments are instituted and have time to take effect.
HBOT, following the acute stages of ischaemia, then has a role in enhancing the healing process and does so for many months following the event, thus assisting the goal of making the closest to a complete recovery as is possible.
So, I'd like HBOT to commence at the earliest practical time and frequently continue the therapy for as long as there is a benefit.
The miracle of antioxidants
Antioxidants delay cell death following a stroke or heart attack by helping protect undamaged, but stressed cells from the increasingly toxic environment associated with ischaemia, bleeding and cell death.
Many studies show that the infusion of antioxidants immediately following a stroke, and even hours later, may reduce brain damage by as much as 40%.
So, I'd like infusions of antioxidants to begin immediately, if not a little later, once my condition has been properly assessed and reasonably stabilised.
So, this is what I want my family to do for me should I ever suffer a stroke or heart attack:
To minimise tissue damage, I want the following within the first 1-3 hours and ongoing:
Get me into a hyperbaric chamber asap, and give me
Aspiration or other surgery as deemed necessary to remove any obstructions (1-3 may reduce or remove the need for surgical intervention).
And, once stabilised, continue 1-3 for as long as there is a benefit from each one.