Brief Answer:
Consultation

Detailed Answer:
Hi XXXX, thanks for asking from HCM.


I can understand your concern. As your father had stroke on last saturday, it means 7 days has passed since than. He is out of major dangerous consequences of stroke.
It is good for him.

Now coming to his speech and language problem, it must be due to left side brain stroke. Area for speech is there in frontal and temporal lobe. I don't have his complete report. You can read it and match it. If it is so, chances of recovery is high if he is able to speak some words. Recovery can be fastened by

: Speech therapist help. It is usually started after 1 month. This much time is given for spontaneous recovery. After 1 month, depending upon status of speech, you can take help.
: Try to converse with him. Make him remember old good memories, ask names and things.
: If he is fully conscious, try to play mind games with him e.g. Chess/Sudoku/Puzzel.
: You can give him neuron recovery drugs like Citicoline/Edaravone/Cerebroprotein hydrosylate to enhance recovery after prescription. There role is not 100% effective, but they provide some relief in speech/memory/confusion/behaviour if started early.
: Take help of physiotherapist and occupational therapist to make him more independent.
: Do not create emotional stressful environment in front of him.

Spontaneous recovery also occurs in any neurological deficit for up to 18 months, maximum in first month.

Now coming to his 2nd problem of sudden shooting of BP. It can be treated by

: Low salt diet (<2gm in a day)
: Decrease intake of fatty/oily food
: Start morning walk
: You can give him Tablet labetalol which is safe on brain and reduces BP (you need to have proper prescription by your local physician to get all these medications).

: Consult cardiologist for heart, arteries evaluation and control of BP.
: Ask him to avoid any mental stress. As he is having speech problem, he might be taking too much stress. You can start anxiolytic drug like Alprazolam or mouth dissolving Clonazepam. It will reduce anxiety, helps in sleeping and thus reduces BP.

Also keep few points in mind
: Maintain hygiene
: Daily mobilisation is must
: Follow doctor advise strictly
: Ask doctor to find out the cause of stroke whether hypertension, Diabetes Mellitus, hyperlipidemia, stress, alcohol/smoking abuse.
: Keep patience. Recovery in stroke is a norm, so don't worry.

Hope it will help you and him. Thanks. take care. If still in doubt, do let me know.

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Brief Answer:
Consultation

Detailed Answer:
HI XXXXXXX XXXXXXX thanks for asking from HCM.


I have read the CT report/ECG and discharge paper.

The CT report is suggestive of left side bleed and right side infarct (poor blood supply area). Due to the left side bleed, your father had speech problem. It was small bleed. It will resolve on its own and no need of surgery. Just follow advise mentioned in previous answer. Poor blood supply area or Infarct is irreversible damage. But no need to worry, as it was small.

Discharge report - The doctor has prescribed antihypertensive medication Pinom-H, which is a very effective medication. But if still BP is high, you can ask him to add Labetalol.
Citicoline was already added which is a good neuro-protector. I have asked for it and your father is taking it.
Felicita-OD is a multivitamin. It helps in regenerating neurons.


His ECG report is normal.

There is no need to consult other doctor. However follow advise mentioned in previous answer like speech therapist/physiotherapist and occupational therapist. Have some patience and faith, your father will recover.

Hope it will help him. Thanks, take care.

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Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX XXXXXXX thanks for asking.


I got your point. He may travel to XXXXXXX in an ambulance setting (Ambulance equipped with Oxygen cylinder, AMBU bag, Small ventilator, Pulse/BP monitor, Defibrillator, life saving drugs like Atropine/Adrenaline/Dopamin/Hydrocortisone, a trained doctor and staff). It is because he is in acute stage of stroke. There is less than 1% chance of any complication like aspiration/rebleed/sudden BP shooting, but we should not take any risk.
One more thing, as your father is stabilised and have some improvement, you can wait for some more time. This stroke is going to be managed by medication only and the doctor has prescribed you correct medication. So you can again think. Rest is upto you and your family.

To overcome diet problem, you can follow few tips
: Give him small frequent meals like 5-6 times feeding daily.
: Give him energy and protein rich food like paneer/cheese/pea/legumes/pulses/fruit/dairy products/eggs/soyabean.
: You can give him syrup Cyproheptadine after proper prescription. It can cause some sedation.
: Make sure he empties his bowels regularly. Use syrup lactulose/Isabgol husk to overcome constipation.
: You can also give him appetite enhancing food like soup, orange, raw tomato, apple.

Hope it will help you. Thanks. Take care.

Still in doubt, do let me know.

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Brief Answer:
Consultation

Detailed Answer:
Hi XXXXXXX XXXXXXX It is good to hear from you.

I am happy that your father is recovering at good speed. Regarding regeneration of nerves, recovery of partially damaged nerves and some new nerve formation occurs for 18 months. Maximum recovery or regeneration of nerves occurs in first month and it completes in 12 months. After that in next 6 months, minimal recovery occurs.

In case of your father, he is showing good prognosis and I believe he will almost regain his functions in next 3-4 months. You must stress on physiotherapy, occupational therapy. Start speech therapy after passage of 1 month. It will help in getting maximum recovery.

Hope you will find it helpful. If still in doubt, do let me know.
Thanks. Take care.

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