Elderly parent had a major stroke just weeks after cardio said all looked good

[Anonymous]

Anonymous wrote:I’m confused why you’re saying it could be because of plaque build up. That’s my entire point. She just had a full cardio work up. Anyway, I just don’t understand what caused the stroke. And yes, I know, old age, etc. But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

Because you can have perfectly normal numbers during your appointment, and bloodwork within the normal range, and still, a clot might form that creates serious harm. It's statistical. Every day, you have little clumps of fat and cells that threaten to block some of your arteries, OP. But they all manage to pass in the end, so you are not aware of the danger you evaded. But with age, arteries become more fragile and one of those little clumps, which might have gone on their merry way safely before, happens to stay there and wreck that part of the brain (or pulmonary artery, etc). You cannot know in advance who will be hit at what time with a unfortunately-placed clot!

Medical check-ups are designed to catch the worst, but if the patient has never been a high-risk patient, sometimes the exams stay pretty basic, because despite great technological progress, standard of care can be quite low in certain populations in certain locations. Did your parent ever have a coronary calcium scan? It's one way to measure plaque build-up. However, we have no tool to accurately predict when a random clot might turn out to be a deadly stroke-inducer.

In patients who suffer from the medical check-up itself, ie, patients in pain, the elderly with limited mobility and stamina, the very young, or anyone with limited understanding, there is always a medical calculus to be made of how far to explore before the burden of testing outweighs the benefits of said tests.

And that's before you get to questions of insurance reimbursement and what is allowed by patients' healthcare plans. Sometimes doctors, consciously or unconsciously, make assumptions about patients' willingness to pay for expensive exams.

And then there are doctors like my husband, who will order every test that pertains to your condition so as to get the most complete picture, regardless of how expensive or dammed uncomfortable it might be for you. His mother had to insist that no, at her age she did not want a colonoscopy...

I'm sorry, OP.

[Anonymous]

Strokes are caused by two things: a blockage that impedes blood flow (e.g., a blood clot) and bleeding in the brain (e.g., a ruptured aneurysm in the brain). Both can happen spontaneously, so heart health can be fine in either case.

I'm sorry OP.

[Anonymous]

Anonymous wrote: But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

Indeed. I am not sure that intensive engagement with the medical profession does much to improve your quality-or even quantity- of life after a certain point.

[Anonymous]

Anonymous wrote:I’m confused why you’re saying it could be because of plaque build up. That’s my entire point. She just had a full cardio work up. Anyway, I just don’t understand what caused the stroke. And yes, I know, old age, etc. But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

You may never know. Perfectly healthy people in their 20s and 30s have strokes. Could have been a clot. Could have been something that burst. It's tough not to have answers. Your parent could have gotten a clean bill of health weeks ago and it just so happened that they were coming down with something, over expected themselves, or any number of things and their blood pressure spiked jussstttt enough to burst the fragile vessel in their brain.

As for the dragging them to appts, yeah in some cases it's not worth it. My grandmother, at 82, decided it wasn't worth it to start up with the annoyance of all the appts when Covid restrictions were lifted. Her feeling was a new diagnosis wasn't going to matter. If she got diagnosed with heart failure, she wasn't going to restrict her fluids and sodium intake to maybe extend her life for a couple years. If she had cancer, she wasn't going to put herself through chemo or surgery or radiation. N

[Anonymous]

Anonymous wrote:

Anonymous wrote: But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

Indeed. I am not sure that intensive engagement with the medical profession does much to improve your quality-or even quantity- of life after a certain point.

Agree with this. And if her existence is miserable perhaps it is simply time to let nature take its course. In general, I don’t really understand the drive to try to keep the elderly going once their quality of life really deteriorates.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I’m confused why you’re saying it could be because of plaque build up. That’s my entire point. She just had a full cardio work up. Anyway, I just don’t understand what caused the stroke. And yes, I know, old age, etc. But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

Because you can have perfectly normal numbers during your appointment, and bloodwork within the normal range, and still, a clot might form that creates serious harm. It's statistical. Every day, you have little clumps of fat and cells that threaten to block some of your arteries, OP. But they all manage to pass in the end, so you are not aware of the danger you evaded. But with age, arteries become more fragile and one of those little clumps, which might have gone on their merry way safely before, happens to stay there and wreck that part of the brain (or pulmonary artery, etc). You cannot know in advance who will be hit at what time with a unfortunately-placed clot!

Medical check-ups are designed to catch the worst, but if the patient has never been a high-risk patient, sometimes the exams stay pretty basic, because despite great technological progress, standard of care can be quite low in certain populations in certain locations. Did your parent ever have a coronary calcium scan? It's one way to measure plaque build-up. However, we have no tool to accurately predict when a random clot might turn out to be a deadly stroke-inducer.

In patients who suffer from the medical check-up itself, ie, patients in pain, the elderly with limited mobility and stamina, the very young, or anyone with limited understanding, there is always a medical calculus to be made of how far to explore before the burden of testing outweighs the benefits of said tests.

And that's before you get to questions of insurance reimbursement and what is allowed by patients' healthcare plans. Sometimes doctors, consciously or unconsciously, make assumptions about patients' willingness to pay for expensive exams.

And then there are doctors like my husband, who will order every test that pertains to your condition so as to get the most complete picture, regardless of how expensive or dammed uncomfortable it might be for you. His mother had to insist that no, at her age she did not want a colonoscopy...

I'm sorry, OP.

Thank you to the above PP for the detailed explanation with context. - NP

[Anonymous]

Anonymous wrote:

Anonymous wrote: But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

Indeed. I am not sure that intensive engagement with the medical profession does much to improve your quality-or even quantity- of life after a certain point.

I agree. They are guessing as much as we are.

[Anonymous]

I had a friend in college who had a stroke out of nowhere. Scared the crap out of us. It turned out he had something wrong with one of the vessels in his brain, probably since he was born, and it just went off. They were able to repair it and he recovered fine.

Point is, lots of things cause strokes.

[Anonymous]

Anonymous wrote:Any doctors on? Help me understand this…

How old is your parent?

[Anonymous]

Hemorrhage stroke often BP related.
Blood clot stroke often not cardio related

[Anonymous]

Anonymous wrote:

Anonymous wrote:Stroke and cardio are not necessarily linked.

Ok, that’s what I don’t understand. I thought there was a connection. Blood pressure issues etc contribute to strokes, no?

Also thicker blood, a fall, lots of things.

[Anonymous]

Anonymous wrote:I’m confused why you’re saying it could be because of plaque build up. That’s my entire point. She just had a full cardio work up. Anyway, I just don’t understand what caused the stroke. And yes, I know, old age, etc. But it makes me wonder why we bothered dragging her to these stressful appointments when they don’t seem to mean much anyway

It's not like they have imagine of every single artery, right?

[Anonymous]

The elderly are as fragile as newborns.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Clots comes from all sorts of causes. It could have nothing to do with the heart.

Like what?

A bruise/bump into something can cause a clot. A random blood vessel bleed. I have a malformation in blood vessels in my brain that makes clots more likely for me, unrelated to anything I do and would never be found without a specific MRI. You don’t know.

[Anonymous]

Neck strain or injury can also cause strokes. That's why visiting a chiropractor can be a stroke risk.