{"id":23745,"date":"2018-12-16T08:18:00","date_gmt":"2018-12-16T07:18:00","guid":{"rendered":"https:\/\/4000mil.se\/?p=23745"},"modified":"2020-07-06T10:05:10","modified_gmt":"2020-07-06T08:05:10","slug":"om-framtiden-och-vara-odds","status":"publish","type":"post","link":"https:\/\/4000mil.se\/index.php\/om-framtiden-och-vara-odds\/","title":{"rendered":"Om framtiden och v\u00e5ra odds – vi fick till slut v\u00e5rt samtal"},"content":{"rendered":"

Inf\u00f6r utskrivningen fr\u00e5n sjukhuset<\/a> i fredags f\u00f6rde vi fram att vi v\u00e4ldigt g\u00e4rna ville ha ett sammanfattande samtal med n\u00e5gon av l\u00e4karna. Vi hade ju ett anh\u00f6rigsamtal redan f\u00f6rsta veckan men d\u00e5 hade unders\u00f6kningarna av Christofer inte slutf\u00f6rts och inga av de saker som framkom d\u00e4r hade hittats \u00e4n<\/a>. S\u00e5 vi k\u00e4nde d\u00e4rf\u00f6r att informationen vi fick p\u00e5 det samtalet inte l\u00e4ngre var relevant.<\/p>\n

Var st\u00e5r vi nu? Vilken \u00e4r risken f\u00f6r att Christofer ska f\u00e5 ytterligare en stroke och hur b\u00f6r vi leva v\u00e5ra liv fr\u00e5n och med nu?<\/em><\/strong><\/p>\n

Viktiga fr\u00e5gor f\u00f6r oss som vi g\u00e4rna ville f\u00e5 svar p\u00e5. Eller i alla fall f\u00e5 f\u00f6ra ett intelligent resonemang runt med n\u00e5gon med mer kunskaper i \u00e4mnet \u00e4n vi sj\u00e4lva.<\/p>\n

Samma l\u00e4kare som f\u00f6r tre veckor sedan behandlade Christofer p\u00e5 NIVA i det akuta skedet bokade in ett avslutade samtal med oss f\u00f6r att f\u00f6rs\u00f6ka svara p\u00e5 v\u00e5ra fr\u00e5gor. Det k\u00e4ndes bra f\u00f6r oss b\u00e5da att det var samma l\u00e4kare, som liksom hade en r\u00f6d tr\u00e5d i Christofers fall.<\/p>\n

Tv\u00e5 r\u00f6ntgenl\u00e4kare har nu studerat pl\u00e5tarna p\u00e5 Christofers huvud och de avvikelser man hittat g\u00e4llande hans blodk\u00e4rl d\u00e4r<\/a>. Och gemensamt har de nu kunnat avf\u00e4rda denna avvikelse som en orsak till stroken. Avvikelsen ligger inom gr\u00e4nsen f\u00f6r det normala.<\/p>\n

Man har ocks\u00e5 kommit fram till att en operation f\u00f6r att st\u00e4nga h\u00e5let i hj\u00e4rtat \u00e4r att rekommendera. Vissa risker finns dock med ingreppet, ca 5% f\u00e5r hj\u00e4rtflimmer som varar i upp till n\u00e5gra m\u00e5nader efter operationen. L\u00e4karen ville d\u00e4rf\u00f6r inte att Christofer skulle ta st\u00e4llning i fr\u00e5gan nu, utan i st\u00e4llet fundera \u00f6ver helgerna. Men som vi f\u00f6rstod det kan operationen komma till st\u00e5nd hyfsat snart in p\u00e5 det nya \u00e5ret. Vi kan heller inte i nul\u00e4get se n\u00e5gra orsaker till att vi skulle tack nej till denna operation.<\/p>\n

L\u00e4karlaget k\u00e4nner sig gemensamt ca 90% s\u00e4kra p\u00e5 att det var h\u00e5let i hj\u00e4rtat som orsakade stroken. 10% risk kvarst\u00e5r att det i st\u00e4llet finns en helt annan orsak som man helt enkelt inte lyckats hitta. Om man sluter h\u00e5let och det var orsaken, s\u00e5 har man allts\u00e5 sedan v\u00e4ldigt mycket eliminerat risken f\u00f6r ytterligare stroker. Christofer hamnar d\u00e5, som vi f\u00f6rst\u00e5r det, p\u00e5 ungef\u00e4r samma risk som genomsnittsm\u00e4nniskan i hans \u00e5lder.<\/p>\n

Men 10% risk allts\u00e5 att det var n\u00e5gon annat och d\u00e5 har man allts\u00e5 inte eliminerat risken med detta ingrepp.<\/p>\n

Positiva besked \u00e4nd\u00e5, tycker vi.<\/p>\n

Flyg m\u00e5ste vi ju fr\u00e5ga om ocks\u00e5. Och ja, l\u00e5ngflygningar \u00f6kar risken f\u00f6r proppar i benen. Som, om man har ett h\u00e5l i hj\u00e4rtat kan slinka upp i hj\u00e4rnan. Fast inte om man opererar igen h\u00e5let. Riken f\u00f6r stroke \u00f6kar inte alls vid l\u00e5ngflygningar f\u00f6r personer utan h\u00e5l i hj\u00e4rtat.<\/p>\n

Och sen m\u00e5ste jag ju s\u00e4ga det. Jag som \u00e4r lik Leif GW i just detta fall. F\u00f6r jag hatar slumpen.<\/p>\n

– Dykning d\u00e5? fr\u00e5gar jag. En \u00f6ppen fr\u00e5ga.<\/p>\n

L\u00e4karen tittar till. ”Vad\u00e5?”<\/p>\n

– F\u00f6r Christofer d\u00f6k f\u00f6r f\u00f6rsta g\u00e5ngen p\u00e5 19 \u00e5r 4 veckor innan stroken<\/a>, fyller jag i.<\/p>\n

\"\"<\/p>\n

Och nu blir v\u00e5r l\u00e4kare intresserad, det ser man.<\/p>\n

– Jag forskar p\u00e5 det, s\u00e4ger han. En hypotes om att h\u00e5let i hj\u00e4rtat kan g\u00f6ra att substanser fr\u00e5n venerna kan hamna i art\u00e4rerna i st\u00e4llet. Och d\u00e4rmed orsaka en stroke. Men inget \u00e4r bevisat \u00e4n. Men om den teorin st\u00e4mmer, skulle dykningen ha kunnat gjort att h\u00e5let \u00f6ppnades upp av tryckf\u00f6r\u00e4ndringen och att dessa substanser tog sig \u00f6ver d\u00e5. Men det finns som sagt ingen evidens.<\/p>\n

– Men om din forsknings-tes skulle visa sig st\u00e4mma, och dyket var den utl\u00f6sande faktorn, d\u00e5 betyder det att det faktiskt \u00e4r hj\u00e4rth\u00e5let som \u00e4r orsaken till stroken?<\/p>\n

– Ja det skulle st\u00f6dja det. Men jag kan inte h\u00f6ja de 90 procenten ytterligare f\u00f6r er. F\u00f6r det finns som sagt ingen evidens.<\/p>\n

Men jag beh\u00f6ver ingen evidens. Jag \u00e4r inte forskare. Jag \u00e4r en poet och en ber\u00e4ttare. Och jag gillar n\u00e4r det h\u00e4nger ihop. Ett gev\u00e4r som h\u00e4ngs upp p\u00e5 v\u00e4ggen i b\u00f6rjan av ber\u00e4ttelsen m\u00e5ste avfyras innan ber\u00e4ttelsen \u00e4r slut.<\/p>\n

Och jag hatar slumpen.<\/p>\n

\"\"
Vinter i Ume\u00e5. Inbjuder inte till dykning.<\/figcaption><\/figure>\n

 <\/p>\n

Disclaimer: Eftersom jag varken \u00e4r l\u00e4kare eller forskar inom \u00e4mnet medicin \u00e4r risken \u00f6verh\u00e4ngande\u00a0f\u00f6r att jag har missf\u00f6rst\u00e5tt ett antal saker i resonemangen. Citaten \u00e4r inte heller ordagrant \u00e5tergivna p\u00e5 n\u00e5got s\u00e4tt. Jag vet att m\u00e5nga l\u00e4ser bloggen, inklusive StrokeCenter p\u00e5 NUS. Detta inl\u00e4gg liksom alla \u00f6vriga ska ses som min personliga ber\u00e4ttelse om v\u00e5r resa efter Christofers stroke. Inte som inl\u00e4gg i den vetenskapliga debatten.<\/em><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Inf\u00f6r utskrivningen fr\u00e5n sjukhuset i fredags f\u00f6rde vi fram att vi v\u00e4ldigt g\u00e4rna ville ha ett sammanfattande samtal med n\u00e5gon av l\u00e4karna. Vi hade ju ett anh\u00f6rigsamtal redan f\u00f6rsta veckan men d\u00e5 hade unders\u00f6kningarna av Christofer inte slutf\u00f6rts och inga av de saker som framkom d\u00e4r hade hittats \u00e4n. S\u00e5 […]<\/p>\n","protected":false},"author":3,"featured_media":23746,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"footnotes":""},"categories":[1516],"tags":[1674],"class_list":["post-23745","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-personligt","tag-stroke"],"yoast_head":"\nOm framtiden och v\u00e5ra odds - vi fick till slut v\u00e5rt samtal<\/title>\n<meta name=\"description\" content=\"Inf\u00f6r utskrivningen fr\u00e5n sjukhuset i fredags f\u00f6rde vi fram att vi v\u00e4ldigt g\u00e4rna ville ha ett sammanfattande samtal med n\u00e5gon av l\u00e4karna. 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