Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Monday, April 3, 2017

Patients can fly, go to high altitudes with precautions after MI

You'll have to ask your doctor if they know one damn thing about this travel after a stroke.
http://www.healio.com/cardiology/vascular-medicine/news/online/%7B2de3d4ee-d288-48e9-a5b3-4fb2d54d8377%7D/patients-can-fly-go-to-high-altitudes-with-precautions-after-mi?utm_source=selligent&utm_medium=email&utm_campaign=cardiology%20news&m_bt=592835816269
Most patients after an MI and other cardiac conditions can return to high altitudes, including air travel, after a few weeks, according to information presented at the American College of Cardiology Scientific Session.
Once high altitude, defined as over 2,500 meters (8,200 feet), is attained, a patient can experience “fairly significant” physiological changes. Most mountains are high altitude, and airplanes fly around 30,000 to 40,000 feet, but the cabins are pressurized to 2,400 meters.
John P. Higgins
Effect of high altitudes
“Altitude does require more work from the [CV] and respiratory systems,” John P. Higgins, MD, MPhil, MBA, FACC, FACP, FAHA, director of exercise physiology at Memorial Herman Sports Medicine Institute in Houston, chief of cardiology at Lyndon B. Johnson General Hospital in Houston and associate professor of cardiovascular medicine at the University of Texas Medical School in Houston, said in his presentation. “People with mild to moderate stable [CVD] can go with the right precautions and preparation to altitude. However, those that have [instability], high risk or a recent procedure should delay travel and be guided by their provider.”
Higgins said bodies work most efficiently at sea level, where the barometric pressure is around 760 mm Hg. At sea level, the partial pressure of inspired oxygen is 149 mm Hg and in-arterial saturation in blood is 98%. In higher altitudes, the partial pressure of the inspired oxygen decreases. At 8,000 feet, or where airplanes are pressurized, the barometric pressure is an estimated 564 mm Hg, the partial pressure of inspired oxygen is 108 mm Hg and in-arterial blood saturation is 60%.
“A healthy individual should have a saturation of 90% or more and be able to handle that without any problems,” Higgins said.
A short-term effect of going to a higher altitude is hypobaric hypoxia, where the body increases its minute ventilation and tidal volume, which causes hypoxic pulmonary vasoconstriction. The body’s cardiac output is increased to compensate for it, Higgins said.
Waiting periods
Higgins reviewed the recommended amount of time before patients can return to higher altitudes and air travel. Patients with CAD and prior MI who are stable experience angina symptoms at lower workloads. Those who had non–STEMI or STEMI should wait 2 weeks before flying or going to a location of high altitude, but if they had a complicated case of MI, 6 weeks is recommended. Patients with a recent diagnosis of ACS who were not revascularized are recommended to have a maximum stress test prior to air travel, but if they are revascularized with PCI and have no complications, they can wait a couple of days. Patients who recently underwent CABG should wait 10 days for gas to be reabsorbed, he said.

More at link.

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