Armchair Doctors

letter-447577_1280

It seems unfortunate that Sharon’s doctors feel compelled to defend their decision to prescribe blood thinners after his mild stroke. A stroke is caused by a blood clot, thinners prevent clotting, and they had planned corrective surgery for an undiscovered heart defect — which would have occurred just a few hours after his hemorrhage.

It is understandable that a great deal of attention will focus in upon the Prime Minister’s condition, but not that others should second-guess the medical decisions. As one of the doctors told the Jerusalem Post, “were the doctors not to have given the prime minister the anti-coagulants and he still suffered from hemorrhaging, the same deriders would have shouted at them for not medicating.”

The next layer away are those predicting the news — and those, it seems, are universally making things out to be (even) worse than they actually are. My own post of Friday morning may, of course, have been true, but was after hearing multiple “inside sources” say that all brain function had ceased, and that they were keeping Sharon alive long enough to prepare a state funeral. [HaAretz, as mentioned, anticipated the demise of Kadima, Sharon’s new party. It is apparently more popular than ever.]

Now that it seems likely he will survive, we have everything from those who claim he is in a vegetative state, to those floating the idea of putting him at the head of the Kadima list. The latter is derided by the other parties for the obvious reason — he will indeed garner huge numbers of sympathy votes (should he recover sufficiently to sign the paperwork placing himself in the running).

As for those who claim he is in a vegetative state, we already know this not to be true. In emergency medicine there are four levels of alertness, a scale called AVPU:

  1. Alert
  2. Responds to Verbal Stimuli
  3. Responds to Painful Stimuli
  4. Unresponsive

On Monday he was already responding to painful stimuli, so while it is extremely unlikely that he will fully recover, he is by no means in a vegetative state, much less permanently attached to a respirator. Maybe the armchair prognosticators should change the channel, and go back to watching sports?

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5 Responses

  1. Yaakov Menken says:

    Anne, agreed — the December one was an ischemic stroke, then he had the hemorrhage. I didn’t know until “Lumpy” prompted some further research that a brain hemorrhage is classified as a stroke, though it makes sense.

    I’m looking forward; in preparing GPC I pondered II.D.3.b)(2), which reads “Who is manifesting a rapidly decreasing GCS,” before remembering that we briefly mentioned it as a box on the MAIS form (used instead of AVPU). Now I know what the acronym stands for.

    Few readers will understand the above…

  2. Anne says:

    Mr. Sharon had both an ischemic stroke (the first one) and a hemmorhagic stroke. the second was why they did the surgeries, to reduce the pressure on the brain. Just wait, Yaakov, in 4B we’ll learn the Glasgow Coma Scale, and then you’ll really be able to assess Mr. Sharon’s mental status.

  3. yvonne pennink says:

    It is impossible to diagnose any case, without professional knowledge and analytical data. However, I also thought that Mr. Sharon might have had a hemorrhagic stroke. Reason? I had one myself, in 1981, and had similar symptoms, especially nausea, before and after the stroke. The eventual outcome can not now be predicted. After he regains conciousness there will be rehab, and both may be very lengthy, or may be not so much. If possible, it will take a lot of hard work and a strong will. If he gives up, there is not much chance. I blogged my “opinion” right after the first event on Arutz7, because I know from experience that it is easy not to get the right diagnosis right away. It is irritating that people give their “diagnoses” without data, especially for the patient and family, however, sometimes, if you have had a similar experience, you would want the real professionals to consider an alternative.

  4. Yaakov Menken says:

    True — but the other types of stroke are hemorrhages themselves. The garden-variety stroke is ischemic, and I read over Shabbos confirmation that this is what Sharon had in December.

  5. Lumpy Rutherford says:

    >A stroke is caused by a blood clot

    That would be an ischemic stroke. You can also have a stroke due to an aneurysm, in which the wall of an artery can weaken.