A Stroke At 32? How Can This Happen? Strokes Can Occur In Young Men And Young Women!
A Stroke At 32! Almost Missed By The ER Docs!
Shortly after dinner on Thursday night, my son received a call from the new wife of his best friend. His best friend had suffered a stroke. Just married, expecting his first child, his life just beginning and this young man I have known for almost 17 years is in the hospital. I have always known that anyone at any age can suffer a stroke, but when it hits this close to home, it becomes real. Too real! I saw my son on the phone. His face turned almost green and I knew there was something wrong. When he got off the phone and told me, I was in shock. I felt like this had happened to one of my own. Growing up, this boy was in my house morning, noon and night. How did this happen? Why him? My first question was whether he had high blood pressure? My son's answer was yes, his friend had high blood pressure and had started taking medication. I had so many questions and knew I would get few answers.
I asked my son if I could go to the hospital with him and of course he said no. The boys, now men, didn't want me around anymore. Actually, there has been little change in that area. Now that I think about it, they never wanted me around. Sure, they tolerated my presence when I was making them countless meals and snacks, when they needed rides to a hockey game or someplace else, but other than that, I was just an unwelcome chaperone. My son was out the door in less than a minute. I told him to call me and keep me posted, that if they needed me, I would come. Like that was going to happen!
The last few days have been a blur. I have talked to my son, talked to his friend's wife and worried with them, just from home. I have the blood pressure numbers, the medication names, the list of symptoms, the names of the doctors, know that the hospital has a nationally accredited stroke center and also know that the first ER doc almost sent him home without even thinking he had suffered a stroke. Thank God a second doctor came in and asked the first, "What are you doing? You don't know what this is?"
Although I am not a doctor, I have a clinical background. The symptoms were clear cut to me. Extremely high blood pressure, unrelenting headache, dizziness, one-sided numbness, difficulty walking and talking. There was no facial drooping, but the other symptoms were right out of a stroke manual. To me, age was not a factor. I know that a stroke can occur even in babies. I also know what course the treatment will take. That is the only reason I have gotten the phone calls. Whenever they need medical information or insurance information, they call me. I am glad that I know a few things. It is the only reason I have been able to keep track of my almost son. Crazy sounding? Probably, but that is just the way it is. I love the kids that mine grew up with. They don't realize it, I am sure. I quite often still tell them I can't stand them and that they are a pain in my butt. They know that I mean none of it, but I don't know if any of them realize how much I love and care about them.
The MRA And What It Is
Because of the delay in diagnosis, it was probably too late for TPA, even if it might have been indicated. TPA is short for Tissue Plasminogen Activator. It is an anti-clotting agent that is best used within 3 hours of a stroke. It breaks up a clot quickly, but there are many reasons that it cannot or should not be used. When it is indicated, it many times prevents death and severe disability. In this case, it would probably not have been advised to begin with.
One of the calls came about the MRA that had been ordered early Friday morning. What was it? Why was it taking so long to send him for it? It was already almost 1 in the afternoon and they were impatient. I explained that an MRA is magnetic resonance angiography and that they would inject a dye and take pictures of blood vessels; that it was necessary and was a wonderful diagnostic tool. It would show any clots or aneurysms. I suggested that my son go to the nurse's station and simply ask what time the MRA was scheduled. It was done within the next couple of hours.
Saturday, the results came back. The stroke was caused by some sort of trauma. One of the blood vessels in the the neck had somehow been damaged and had caused a clotting of the blood to the brain. The doctors have hope that the vessel will heal, but until that happens, have placed my son's friend on a blood thinner. In a day or two, he will be moved out of the stroke unit and will start physical therapy.
The Insurance Issues And There Are Some
The hospital where my son's friend was taken by his wife is not their member hospital. Because it was a true emergency, the insurance company will cover the stay, but at this point, coverage may become an issue. When a patient is stable and able to be safely transferred, most insurance companies require that the patient be transferred to their own hospital because it costs them less money. I have already explained part of this to my son and his friend's wife. Actually, they called me regarding the insurance. The wife will need to get in touch with the insurance company and find out if they want him to be transferred or if they will authorize continued treatment in a non-par hospital. She must at least make the phone call. If they tell her the stay has been approved, she must take the name of the rep she speaks with, note the date and the time and try to get some sort of an authorization or case number. At least by making the call, she will have released herself and her husband from any responsibility, if for some reason there is difficulty at a later time with the bill.
If the hospital later provides paperwork and the insurance company, in its infinite wisdom, decides that the medical record does not support his stay and denies part of the bill, the hospital will be unable to come after them for it. They may try, but it won't work.
Then again, the non-member hospital may have made a deal with the insurance company, agreeing to accept the same amount of money that would have been paid to the member hospital. That is the smartest way for the hospital to go and in many instances, that is what happens. By signing paperwork agreeing to that, any other service providers will also be bound by the same agreement.
In a number of hospitals, the lab, Xray and pharmacy are not a part of the hospital; that is, they are not owned by the hospital, but they are leased to separate providers. Part of their lease contract with the hospital states that they will accept the insurance rates that the hospital accepts. When this sweet, young couple get home, they will most likely receive several bills. They will probably be from the radiology department, laboratory or the pharmacy. They will need to send the bills back and state that the hospital has agreed to accept a member payment from the insurance company and by contract, they must also. End of discussion.
The same will be true of any physicians, physical therapists, techs or other health care providers of any type.
This will be covered during the next phone call I receive.
The Long Road To Recovery
Depending on the final damage from the stroke, the road to recovery may be long and difficult. My son's best friend is strong. He has a beautiful wife who loves him and they are expecting a child in July. She will be with him as his recovery begins and together they will work through this. His best man, my son, will be there, too. This young man will come back, just as strong as before, if his friends and family are beside him. Soon, this incident will fade into a distant memory. He will probably continue with blood pressure medications and will take the meds faithfully. He will pay attention to his physical well-being, for sure. Soon, I will be able to again tell him that I can't stand him and that he is a pain in my butt! Most important, he will survive this and he will be alive...
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