Concerned0427 Asked December 14, 2017

What do I do if my 58 year old fiance refuses to go to ER after experiencing a a possible stroke about 4 days ago?

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After feeling something pop in his head and feeling numbness on his right side from head to toe. At first he could barely walk that has gotten better but still dizziness and numbness are lingering. I wanted to call ambulance asap but he told me don't I dare. Can he refuse ambulance if I call anyway and if he does nothing what do you think is in-store for him maybe I could give him some facts. Thank you

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Veronica91 Dec 15, 2017
CM I beg to differ. I think this is still an emergency even if he is improving. The definition of a stroke is that symptoms have lasted for more than 24 hours which is the case here. He needs blood work, a neurological examination, MRI, cardiac consultation or whatever other tests are necessary. It is also possible they will keep him over night at least but I wouldn't tell him that.
As others have said this is a warning sign that something worse could happen at any time. This is not the time to wait a week for an appointment with a PCP and then be reffered on to specialists.
What he or you do is entirely up to the both of you but now you have the facts. You certainly do get seen faster if you arrive on a stretcher but in this case the triage nurse will push him to the top of the line so if he will only go by car then do it that way. But get him there or pack your bags. You could easily become a caregiver for the next 20 years and living in poverty.
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Countrymouse Dec 15, 2017
Hold your horses. What are you expecting ER to do for him?

He had the symptoms of a possible stroke four days ago. There has since been a gradual improvement. You're FAR too late for clot-busting therapy, even assuming there was a clot and not a bleed. And there isn't much else ER can do for him that can't be done more methodically - which is important for continuity of care - by his own GP.

If he has one. Does he have one?

He shouldn't ignore what has happened, he must get himself examined at the earliest opportunity (today would be good) by a competent doctor who will then request appropriate investigations. So if he doesn't have a GP or PCP then he must get registered with one pdq, and meanwhile go to the nearest walk-in centre to get himself checked out. And if he's reluctant to do that then he really is being an idiot and you can ask him if he likes the idea of being paraplegic.

But this isn't an emergency. Don't call an ambulance. Look up some phone numbers instead and dial them for him if necessary.
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BarbBrooklyn Dec 15, 2017
Concered; is this his typical reaction to being sick? Or is this out of character for him? I guess what I'm asking is, is he always a jerk?

My husband and I had been married for about two years (second time around for both of us; we were in our early 50s). To make a very long story short, he started acting REALLY dumb one day; wore the wrong clothes to a family party, asked directions and was told "three miles down the road" and then drove a block and parked. Very much not himself. He had a crick in his neck and went to the doctor the next day. Doc sent him to a cardiologist, who discovered a leaking aortic valve and an about to burst aortic aneurysm.

Acting "out of character" can be a symptom of bit enough oxygen getting to the brain, which can be caused by cardiac/stroke or other serious issues. 
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Lymie61 Dec 14, 2017
Yes he can refuse transport in most cases but they will make that very difficult with these symptoms and may have better luck convincing him to get checked out especially with some vitals and probably rhythm readings to confront him with along with facts about what they could indicate. There are circumstances that enable them to transport without his consent of course but it doesn't sound to me like the route they will go, I expect more of the assumptive close here and then strong arm convincing if that doesn't work. One strong argument for calling an ambulance of course is the fact it brings trained providers to him who can take all those vitals and make assessments and then a strong argument for going to the hospital by ambulance, in case he reverts to "I'd rather drive myself" is that when you arrive by ambulance you get in the back door, head of the line so no long waiting room time. We used that often to help patients make up their minds.

As far as his symptoms and the amount of time that's passed. It's true, if he had a stroke 4 days ago the window for clot busting, damage minimizing stoke medications has long closed but strokes are often preceded by smaller strokes or TIA's, some that cause noticeable symptoms as this has if indeed that's the issue and some that don't cause symptoms that patients or the people around them notice, those symptoms can be widely varied so no opinion as to whether or not that's what this is but should what happened 4 days ago be a TIA or should he be having several little ones over the last few days they are typically warnings about a bigger more severe attack to come. Much like little tremors leading up to the big earthquake. But unlike earthquakes when you heed the stroke warnings you can not only prepare and minimize damage you can prevent the big event all together and that all by it's self is hands down a reason to go get these symptoms checked out. If you can prevent a stroke, even the slight possibility of one, you want to do that. This coming from the daughter of a stroke patient. If that's not enough to get him to the hospital, I strongly suggest a hospital where they have the needed specialists unless he already has a neurologist and or cardiologist (in which case call them and they will tell him to go get checked out), then simply the symptoms he's having should. Nothing you are describing even if it's getting better and doesn't "hurt" are normal and should be checked out but especially given that they have been going on now for multiple days. He isn't just sick with a cold and it might just be that he needs fluids or something, big deal they give him an IV bag and he feels much better. It may not be a stroke or cardiac issue at all and that's great, wouldn't knowing that be nice and alleviate a lot of stress (probably not helping the symptoms)? As would knowing what else is or isn't causing his symptoms. Denial of course is a classic symptom of cardiac distress too, in fact the very comments/behavior people are expressing basic relationship concern about could be symptoms, indications of cardiac or neurological issues if they aren't normal for his personality. Your instincts are right on either way and he needs to get on board one way or the other so up to you whether you take the force him with an ambulance (and maybe police) route or convince him with facts and guilt to cooperate route. Good luck and please keep us posted and or reach out if you need more support along the way.
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Tothill Dec 14, 2017
First concern, if he is saying 'Don't you Dare' call an ambulance, there is a threat there and I am worried for your safety.

Two a stroke is not necessarily a one and done event. My Dad had been having an ongoing stroke for a couple days before he called for help. He had two more over the next couple days and was near death. Now Dad is 30 years older than your fellow.

Dad had a series of MRIs to determine if it was a stroke, plus blood work.

Depending in the type of stroke, clot or bleed, blood thinners may be needed as well as other medications. Rehab may be needed as well.
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GardenArtist Dec 14, 2017
My thoughts echo Jjariz's - if he refuses to take care of himself now, what's in store for you as a potential wife?

There are additional issues beyond potentially having a stroke:

1. Has he had any before (I was told my MRI showed several but I had no symptoms whatsoever).

2. There might be changes he could make to prevent future strokes, but he won't know if he doesn't get help.

3. The next stroke could be significantly worse, if not incapacitating.

I think you have some thinking to do about whether or not you want to commit to caring for someone who refuses to get medical help for something as dangerous as a stroke.
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JoAnn29 Dec 14, 2017
Yes, h can refuse an ambulance. Four days is a long time. The sooner u get to the hospital the sooner meds can be given to stop any damage. He may be passed that point. Call his primary.
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MACinCT Dec 14, 2017
Look up F.A.S.T. assessment for stroke and see if he show signs
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MACinCT Dec 14, 2017
If he is alert he can refuse until he us unable to consent. Yes it sounds like a stroke which may get worse. Does he drink or use drugs that may cloud his judgement?
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jjariz Dec 14, 2017
This isn't the question that you asked, but I wouldn't be planning a new life with someone who won't take care of their own health.
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