Saturday, January 07, 2006

Sharon

I'm a bit shocked about this. Overall, Sharon is VIP casualty. Here's the story that I can put together. This is my speculation only. I actually have less facts at my disposal than usual because I don't watch TV.

He's a 77 year old obese man who probably at least has one of the vascular risk factors that give rise to strokes, heart attacks, and dead black toes: high blood pressure, impaired glucose, and high cholesterol. He has a distant history of smoking (I'm actually not sure of that). As is no surprise to anyone who's staffed an ER for more than a day, such a person had a stroke. He was lucky. Although the stroke stole his language and right side motor function, the embolism no doubt dissolved nearly immediatly, leaving dysfunctional neurons, not dead ones. He recovered within the next few hours.

Stroke. It occurs when a blood vessel gets filled with something that doesn't let blood flow to the brain. The problem is either in that vessel, a feeding blood vessel, or the source of all blood vessels: the heart.

By the age of 77, being obese, one would expect an above average amount of plaque within Sharon's blood vessels. We don't have the information about this. We only know that he had a PFO, or a hole in the heart.

WOW! That's pretty scary. Having a hole in your heart. That's something that really sick babies get surgery for! It's scary, until someone tells you that 1/4 of all people have one. And that most people go through their entire lives without it being a problem at all. And that they have to be huge to be a significant problem. And that if Sharon made it 77 years with no problem, or even 40 years with no problem, then his hole probably wasn't a problem.

But Sharon is a VIP. So VIPs need to get problems fixed. Thus he was fully anti-coagulated (blood thinned) to prepare for a surgery to fix the 'problem' that would be utterly and rightly ignored were anyone else to go to that hospital. This has actually been studied. About 3 years ago a study came out that showed that full anti-coagulation is no better than aspirin in preventing strokes that are associated (note the word choice) with PFOs. So placing him on anti-coagulation was done so with no good data, and with some contrary data. Also, there is no data on getting a PFO closed for stroke prevention. The studies are underway.

And he suffered a brain hemorrhage while on the blood thinners. This is pretty horrible. But Sharon's story gets worse.

The OR. The story of hemorrhage and surgery is appealing. Blood in brain, take it out, brain gets better. Except it doesn't work that way. Blood in the brain is bad, but surgery in the brain is probably worse. The trials have been negative unless there is so much blood that the brain starts to get pushed out of the holes in the head.

So Sharon goes under the knife. Three times.

Uggh.

Well, there's still some hope. Not much, but perhaps the hemorrhage was small.

6 Comments:

Blogger acumamakiki said...

Ugh. I hate hearing this about brain surgery because we have a friend (late 60's?) who randomly had his doctor to a CAT scan (history of brain tumors in his family) and the doctor found a tumor (they think benign) in his brain, not sure of the location. So he's going to have an operation to remove it and I sort of wasn't worried. Hoping that brain surgeries when not urgent are like most other surgeries, with risks but not scary.

This is interesting though, seeing that because Sharon is VIP his treatment.

4:24 AM  
Blogger marybishop said...

A perfect example of VIP treatment turning into SNAFU.

Makes me very happy to be Everyman and have no special treatment.

6:55 AM  
Blogger laurenbove said...

Thanks for the physician's insider view of what's going on with that. Very interesting because w/o your info. I would not have realized his troubles were caused by too much medical care.

Blood on the brain is "toxic" to the brain and kills it, NO? Did I hear that wrong?

10:26 AM  
Blogger Doc NOS said...

The blood is bad: it kills neurons and the mass effect probably robs them of blood flow, which kills them as well.

Sharon will have some recovery, but he'll never return to politics, unless the hemorrhage was in a clinically silent area.

1:53 PM  
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6:28 PM  

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