Need ALS/Para Help W/ Family Member

[uglyEMT]

Hey guys and gals. I need real world advice for my Father. My father is a 67 year old partial quadraplegic for the past 7 years.

He was with my Mother when he had a (as DRs descibe it) mild heart attack.

I need your advanced diagnosis and thoughts on this.

I will give an exact description of the discharge paperwork that I understand but can wrap my head around right now.

NSTEMI

Non Q Wave

Peak Cardiac Triponin .86

Marked Hyperlipodemia

Marked Hypertension A-symptomatic

Severe Cardiomiopothy

Ejection Fraction 25%

Akanisis of posterial wall

Severe Hypokenisis of anterior lateral wall

Mitroregurgitation 1+

and is now on Mononitrate 30mg Imador (sp)

Please help me understand whats going on beyond my EMT-B knowledge. My folks are out of the hospital and flying home this Wednesday June 23. Is this advised? Dad did not go for the angioplasty due to his condition but still wants to come home. Please help me, in lay term s, whats going on and if travel is advised.

Thanks everyone.

UGLy

PS I do not have ECG to upload. Only the hospital discharge sheet

PSS they are in Florida and I am in New Jersey,  I diagnosed the NSTEMI over a phone and had MOM call 911

Edited June 22, 2010 by UGLyEMT

[Timmy]

Hi UglyEMT,

While we understand your concern your questions are best not answered on an online forum, you need to discuss your concerns with the treating doctor.

Take care and best of luck

[uglyEMT]

Just wanted some basic info thats all. I tried talking with the Doc but he brushed me off on the phone.

Like I said they are in Florida and I am here in NJ so face to face isnt possible right now.

I basically just need to know whats going on, kinda like a scenario question just with an actual case thats close to home thats all. I kinda know what most of it means but some of it is just above my head right now.

I also just reread my post, cant edit it for some reason, I mispoke when I said I diagnosed the NSTEMI, what i should have said was based on what my father described to me I felt it was an MI in progressed and had Mom call 911. My appologies.

Thanks everyone for anything you can shed light on

Edited June 22, 2010 by UGLyEMT

[Just Plain Ruff]

Hey guys and gals. I need real world advice for my Father. My father is a 67 year old partial quadraplegic for the past 7 years.

He was with my Mother when he had a (as DRs descibe it) mild heart attack.

I need your advanced diagnosis and thoughts on this.

I will give an exact description of the discharge paperwork that I understand but can wrap my head around right now.

NSTEMI He had an non-st segment elevation MI

Non Q Wave -

Peak Cardiac Triponin .86 His Troponin was elevated which made the NSTEMI diagnosis possible

Marked Hyperlipodemia His cholesterol and triglycerides are quite elevated

Marked Hypertension A-symptomatic - he has high blood pressure which does not produce symptoms right now

Severe Cardiomiopothy - His heart is tired

Ejection Fraction 25% - He has decreased heart function

Akanisis of posterial wall - NO CLUE what this is

Severe Hypokenisis of anterior lateral wall - same as above

Mitroregurgitation 1+ - His mitral valve is faulty

and is now on Mononitrate 30mg Imador (sp) I believe the med might be Imdur which I'm not sure what it does

Please help me understand whats going on beyond my EMT-B knowledge. My folks are out of the hospital and flying home this Wednesday June 23. Is this advised? Dad did not go for the angioplasty due to his condition but still wants to come home. Please help me, in lay term s, whats going on and if travel is advised.

His condition did not allow angioplasty so I would be concerned about what he and his doctor can do to fix this or at least make life more livable. He's a sick guy but you know that. You are your dad's best advocate so keep on him and make sure he keeps all his appointments.

Thanks everyone.

UGLy

PS I do not have ECG to upload. Only the hospital discharge sheet

PSS they are in Florida and I am in New Jersey,  I diagnosed the NSTEMI over a phone and had MOM call 911

My responses are in red above.

Ruffems

[Timmy]

My comments are not to be taken into consideration in your circumstance, this is just based around a scenario that you have presented. Again, you need to speak with the treating MD.

To be very brief and in layman’s terms:

NSTEMI is a Non ST Segment Myocardial Infarction. Non occlusive, small blockage of the coronary artery. I haven’t examined the patient so I can’t comment on the appropriate treatment.

Non Q Wave clot is usually non occlusive or is only temporary so some damage to the heart muscle occurs.

Troponin is a cardiac enzyme, it elevates when there’s damage to the heart muscle. 0.86 is only slightly elevated.

Hyperlipidemia indicates a high level of lipids (fats) in the blood stream.

Hypertension A-symptomatic – high blood pressure with no symptoms.

Cardiomyopathy is a cardiac disease which causes deterioration to the myocardium (middle layer of the heart)

Ejection Fraction is the amount of blood pumped from the ventricle with each heart beat.

Not familiar with Akinesis or Hypokenisis so I won’t comment.

Mononitrate is a vasodilator. Can be used for angina and hypertension. Is this the only medications the patient is on?

The above is quiet a substantial cardiac history and leaves quiet and number of co morbidity’s which can place the patient at high risk of further cardiac events, flying can be stressful especially for older people, it may raise blood pressure or cause a DVT… But I won’t comment on whether or not I recommend flying because it’s not my job, just making you aware of the risk factors…

Ruff beat me to it

[uglyEMT]

Thanks guys thats what I was looking for. I knew some of the terms just not everything. I guess it more scared me because I am not right around the corner to lend a hand. I will be tomorrow but until then

I will make sure he keeps up with his cardiologist, thats the reason they are flying up here to NJ. His cardio is up here so instead of having the Florida doc work on him he's going to go to his doc.

Thanks for the explinations.

[Timmy]

Could you just narrow down what you mean by partial quadriplegic?

[uglyEMT]

Their term not mine LOL

Basically he has very limited movement of all extremities. He has control of everything internally as well. Some sensations of hot and cold, no pain though. Legally classified as a quadraplegic according to the Doctors. I say partial because he has some limited movement and sensation.

He needs a wheelchair but is not bound to it. If helped to his feet he can use a walker with arm craddles and take a few steps. Cant do long walks but at least Mom doesnt have to lift him to get stuff done.

Does that make any sense?

[rat115]

Their term not mine LOL

Basically he has very limited movement of all extremities. He has control of everything internally as well. Some sensations of hot and cold, no pain though. Legally classified as a quadraplegic according to the Doctors. I say partial because he has some limited movement and sensation.

He needs a wheelchair but is not bound to it. If helped to his feet he can use a walker with arm craddles and take a few steps. Cant do long walks but at least Mom doesnt have to lift him to get stuff done.

Does that make any sense?

I've always heard this as "incomplete quadraplegic". I know a gal who was injured last October in a hockey game and is in similar condition.

Hope you dad's cardiologist is able to help him.

[maverick56]

Could you just narrow down what you mean by partial quadriplegic?

It means that the cord is not fully severed, but the lesion is at a level that effects all four limbs. He may have various combinations of sensation and motor control, most often there is limited ROM in the upper extremities, usually controlled by the chest muscles and very diminished sensation. Most people don't realize that the majority of "quads" aren't anything like Christopher Reeve, rather they push themselves around in wheelchairs.

Akinesia is a loss of normal motor function resulting in impaired muscle movement. ER doc last night described it as freezing in place.

Hypokinesis is just diminished or slow movement.