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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

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Stroke, Unable To Swallow, No Speech, Breathing Difficulty, Weak Lungs, Pneumonia. Had Bypass Surgery. How Long Will It Last?

My husband had a 4 bypass surgery last week, 3days later on telemetry floor, MD concerned about pneumonia, he is Bach in ICU with a left sided frontal stroke no swallowing, speech, dificulity with right sided negket, was on CPAP unit for a with breathing , unable to tolerate and too weak to clear lungs him self , he was re intubated NGT inserted to give meds, if 40-50 % on frontal lobe infart ,in present , ocurred last thur fri am, what changes if any, for regaining any functional mobility, they have started to wean down vent , Is it too early to be starting semi agressive PT services, with ROM ex, poss sitting on edge of bed while still on vent , Talk about poss of trach if he breathing on his own, would trach be ONLY for his swallowing deficits and speech. I am looking down the road and it may be too soon, for my answers to be answered, but is there a% of salvageable recovery with aggressive LTC facility , Thanks so much what am I looking for, CABG is doing great, his left carotid artery was already blocked and no stens placed, right side was stenting Nov.. last yr, Is there a time limit on when brain had first stroke last thurs to know how long does a brain take after swelling in brain slowly resolves and pt able to participate in therapy
Sat, 19 Oct 2013
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Neurologist 's  Response
Hi,

Thank you for posting your query.

It is unfortunate that your husband suffered a stroke of left frontal lobe (the dominant side of brain), resulting in right sided weakness of arm and leg, swallowing and speaking difficulty. In addition, he has pneumonia, for which he is on mechanical ventilation.

The recovery is best when the patient is thrombolysed with tissue plasminogen activator, which is the treatment of choice in the first few hours after stroke. When someone is not thrombolysed, as in your husband's case, recovery is delayed and often incomplete.

The first priority here is to wean him off the ventilator. For this tracheostomy may be required.

Physiotherapy can be started now, while he is in ICU and on mechanical ventilator. This would ensure faster recovery. Along with this, speech therapy can also be started once he is off ventilator.

If his swallowing remains inadequate, then, NG tube feeds may be continued.

The most crucial phase for development of brain edema is the first four days,after that the brain swelling starts to decrease.

I hope it helps.

Wishing you good health,

Dr Sudhir Kumar MD DM (Neurology)
Senior Consultant Neurologist
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Stroke, Unable To Swallow, No Speech, Breathing Difficulty, Weak Lungs, Pneumonia. Had Bypass Surgery. How Long Will It Last?

Hi, Thank you for posting your query. It is unfortunate that your husband suffered a stroke of left frontal lobe (the dominant side of brain), resulting in right sided weakness of arm and leg, swallowing and speaking difficulty. In addition, he has pneumonia, for which he is on mechanical ventilation. The recovery is best when the patient is thrombolysed with tissue plasminogen activator, which is the treatment of choice in the first few hours after stroke. When someone is not thrombolysed, as in your husband s case, recovery is delayed and often incomplete. The first priority here is to wean him off the ventilator. For this tracheostomy may be required. Physiotherapy can be started now, while he is in ICU and on mechanical ventilator. This would ensure faster recovery. Along with this, speech therapy can also be started once he is off ventilator. If his swallowing remains inadequate, then, NG tube feeds may be continued. The most crucial phase for development of brain edema is the first four days,after that the brain swelling starts to decrease. I hope it helps. Wishing you good health, Dr Sudhir Kumar MD DM (Neurology) Senior Consultant Neurologist