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What is the chance of recovery for an 84 year old diabetic stroke patient?

My 84 year old grandmother had a stroke last Tuesday morning on 1/31/17. My grandfather discovered her in the morning lying unresponsive in bed and called my mother who immediately rushed over. My mom tried to wake her up and my grandmother did respond but with slurred speech and she was unable to move her right side. My mother recognized that this was symptoms of a stroke and immediately called 911. At the hospital, the doctors took an MRI and discovered she had had an ischemic stroke on the left side of her brain, however it was not too severe. My mother, who is a doctor, requested a tPA or thrombolysis but the neurologist refused due to my grandma's age and health conditions. (She is obese and has type 2 diabetes) He believed that the tPA would cause more bleeding and may lead to a hemorrhagic stroke. He gave my grandmother aspirin and she later woke up on Tuesday. I called her around 4 pm in the afternoon and she responded to me and talked to me like normal. She was alert, could eat, could talk but she could not move the right side of her body. Because the stroke was not severe and the MRI showed that it was quite small, we thought she would be able to recover with PT. However, that night, my grandmother went into a deep sleep and has not waken up since. (Today is Thursday, 2/9/17, 9 days after the stroke) The doctors then took a chest scan and discovered a round mass in her chest surrounded by lymph nodes. They believed this may be cancer because of the lymph nodes but she had not shown any symptoms of lung cancer so my mother was unsure of the accuracy of that diagnosis (she is a pulmonologist) Now, we believe it may be round pneumonia. However, the doctors chose not to treat her because of her conditions and when my mother requested another MRI because my grandmother was getting worse, the doctors refused because they thought it would be futile. Instead they sent us information about hospice care because they had basically given up on my grandmother. They also took CT scans that were useless because they did not see clearly into the extent of the brain damage/swelling. On the 3rd day after the stroke, my grandmother began to show signs of recovery and from then until the 5th day, she was able to communicate with us (sometimes with words, sometimes with grunts and sounds), move her left hand, and open her eyes. She was still unable to swallow though, which worried us because she needed the nutrients for energy. On Sunday, we put in an NG tube (feeding tube through the nose) because we thought if she gained strength she would wake up. However, on Monday she was in a deeper sleep than before and her condition seemed to had worsened. She did not pee or poo (which she had been the days before, although not consciously), she did not communicate with us or open her eyes. She was very unresponsive and she had a fever, which we believe was from the pneumonia that she may have had as a result of lying immobile and not being able to swallow (aspirating). The doctors gave her antibiotics and the next day she seemed to have improved. She was able to move her left arm as a response to discomfort or pain, pee and poo, make facial expressions and respond to pain. She still could not speak, eat or open her eyes. We had hope that she may recover however, the next day (yesterday) she was back to a deep sleep state, with a fever. Then, today she seemed to improve again and was able to make some sounds (although it may just be a reflex), move in response to discomfort or pain and she seemed to hear me when I spoke. However, my mother insisted on having another MRI done and we discovered that her condition had worsened and that the brain swelling had expanded to other areas of the brain which could leave her very impaired should she wake up. We believe that she may have had another more severe stroke while in the hospital and we didn't know until now because the doctors had refused to do an MRI. Now, the doctors are planning to discharge her on Sunday, which means she will not have the feeding tube since this hospital does not send patients home with an NG tube. This basically means she will die within a few days as she cannot eat or drink by herself. What I want to ask is, is there any hope for my grandmother? While I feel she is making slight progress based on her actions, her MRI says otherwise and I do not know if this slight improvement is a signal for a recovery. I do not want my grandmother to suffer nor do I want her to wake up but have dementia or other severe brain damage that may severely affect her memory or thinking abilities. My grandmother was fully mentally aware until the stroke and was a strong willed, full of life, smart woman. She was not physically healthy but she was mentally 100% there. If she were to have physical impairments such as a paralyzed right side, I would still hang on. But, my grandmother would not want to live a life where she cannot even recognize her own children and grandchildren. Should I let go? Should I hang on?
1 Responses
Avatar universal
I hate this for you.  I am in your shoes with having a loved one with a stroke (my father's happened on  12/23/2016).  As far as the stroke - the doctors where my father (53 year old male) went to the hospital, told us that the swelling would be the worst 3-5 days after the stroke, and it was.  He had a stroke on his left side, it was a massive ischemic stroke (blockage in his left carotid).  they said that the whole left side of his brain was without sufficient blood flow.  Somehow, my dad survived the brain swelling and my dad was able to go to rehab and walked out of there.  (the doctors said he never would).  He is still unable to speak or use his right hand, but he's doing well otherwise and can communicated with yes and no.  He was able to progress - meaning wake up, respond, move limbs and all that within 2 weeks of having the stroke.  I believe this is because of his age though.  A younger body will be able to bounce back a lot better than an older one.  I also went through this same thing several years back with my husbands grandmother.  She had a stroke and never really woke up - doctors said there was nothing they could do and she passed away.  The crappy thing about stroke is - there is no crystal ball.  No one can tell you exactly what to expect or what will happen, because they quite simply do not know.  As far as letting go or hanging on - The doctors are smart.  They went to medical school and passed boards that say they can practice medically.  It's hard to trust them because you don't want to give up on your family member, but if the doctors say there really isn't anything they can do - and your family member isn't progressing - I would say to just wait and see what happens.  Doctors don't know everything, but for now - only time will tell.  I would spend time with your grandmother, and speak to her like you know she can hear, tell her she's safe and how much you love her.  You won't regret that ever.  Again, I'm so sorry.
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