Hi all. I am looking for some advice. My mum had a major stroke last wednesday 3rd Jan. She lives in Spain and is in a spanish hospital. I live in the UK but flew over on the earliest flight. She can say yes, no and ok but thats about it. Does anyone have any experience in terms of when rehab starts? Obviously the spanish language barrier is difficult, and I really need to get my mum back to the UK asap (she doesnt speak spanish except very very basic). I am meeting with the Neurologist today and fortunately I can get into mums phone and found someone who lives locally who will come with me to the hospital to help translate. She also has blood clots, one of which has blocked her Carotid artery and blocked entirely. The doctor said they’d look to put her on meds to try and disperse this, but the needed to wait a few days.
Its a very worrying time and incredibly stressful since she is here in spain and English is barely spoken. I dont believe she has UK health insurance and so would not qualify for any repatriation flights. She has spanish healthcare but this is public similar to the NHS. So logistally I am trying to see what I can do/when mum may be fit to fly commercially, though I dont know whether airlines expect someone medical to fly with or who decides this? I will be with her on the same flight. I have spoken to the British Consulate here in spain today and theyve suggested she may also not qualify for health ‘treatment’ such as rehab until 3 months post-arrival back to the UK but that I can query this with Social Services. Also, does anyone know timelines in terms of when patience may begin to understand whats happened to them. Its incredibly sad and I am trying to reassure her as much as I can that she will be ok. If anyone has been though similar or any advice on any of the above I’d gratefully appreciate any info. many thanks
Hi @Sma1512 and welcome. So sorry your mum has had a stroke and so far away from you too 
I doubt she would be fit to travel any time soon if she’s still got blood clots and blocked arteries. She may yet need surgery to unblock the artery. Expect or plan for the worst and hope for the best.
This is what the Stroke Association says:
Can I fly after a stroke?
People often ask when it is safe to fly after a
stroke. It is probably best to avoid flying for
the first two weeks. This is the time when
your problems are likely to be most severe
and other conditions related to your stroke
may come up. After that there may not seem
to be any reason why you should not fly, but
it is always advisable to check with your
doctor before flying. https://www.stroke.org.uk/sites/default/files/holidays_after_stroke.pdf
I’d say the bare minimum would be 6wks before she can fly but I doubt that. Plan for anything from 4-6mths to a year before she can fly.
As for physio, some form of physio usually starts within days of being admitted to hospital over here (providing the patient hasn’t had major surgery), for me it was the following day but every health authority is different. And Spain may be different again. But they do try to get you mobile as soon as to avoid any fluid build ups anyway.
@Sma1512 hi & welcome to the forum. Sorry your mum has had a stroke & the extra difficulties that brings.
I agree with @EmeraldEyes in that it doesn’t sound like she will be fit to fly right now. Flying increases risk of clots so if she already has some they will need to be dispersed first. I suspect she’ll need to be signed as fit to fly by a Dr before any flight. Perhaps other travel methods could be considered, trains, ferries maybe but again she’ll need to be fitter as it will be exhausting.
In the UK an element ofcrehab starts straight away that could be different in Spain. It also depends on the severity of the stroke as the individual needs to be able to participate.
It is difficult to say when your mum may be able to understand what has happened as it is different for everyone.
Try ringing the Stroke Association helpline for some advice as they might have some options that you can consider.
03033033100 - this is their uk no.
Wishing you & your mum all the best.
Ann x
Hi both and many thanks for your reply.
I met with the consultant today and she instilled a lot more hope than I’ve had so far. She was fluent English too so communication wasn’t an issue.
Oh yes I would expect mum to be able to come home just yet, the consultant said maybe a month or so, depending on progress. She also said that it is highly unlikely to suffer another stroke, since they’re starting her on meds to disperse the clots.
She said she’d do a fit to fly note when mum was ready. Spain don’t offer speech therapy, only physio, so they’re going lend me a speech picture book and I’ll look online for anything else that can help - unless you’ve got any recommendations?
They seem pretty good here, in two weeks mum will be going to a specialized rehab hospital where she’ll have dedicated practitioners often; helping with rehab, before she’s ready to be discharged.
Hi @Sma1512
Welcome
I see you have already received some good advice about
Speech is often more affected in the early days and recovers as time passes.
I recently suggested a few sources of resources in this post Reading/writing after a stroke - #5 by SimonInEdinburgh - Aphasia and communication - Stroke Association Online Community - they are mainly aimed at asphasia sufferers that includes things like apps such as LookToSpeak which aids people who can’t speak at all but our cognitively ok
Ciao
Simon
@Sma1512 that sounds very positive & like things are moving in the right direction which I’m really pleased to hear.
Hope your mums rehab goes well and you’re both soon on a flight back to the uk.
Hi @Sma1512 that is good to hear, so glad for you both that it’s so positive. As it’s only been 7 days since her stroke, I suspect her speech will improve more over the next few months, at enough to make herself understood. Energy levels come in short bursts throughout the day, and they affect our abelites. We become like the Every Ready battery Rabbits in those commercials, where they wind down as they run out of power.
We have the cheap battery in the beggining, the ones that run out within minutes to an hour. Everything slows, becomes clumsy and weak, maybe out of focus, speech is slurred or non-existent, even physio wipes you out; that’s the brain just wanting to shut down and rest a while…while it replaces its batteries. And that will go on for some months at least but her stamina will build up slowly, gradually!
Will you be able to stay over in Spain 'til you bring her back or will you have to come home?
Thank you both.
I am intending to stay until I can bring her back. She’s isolated as it is as no one speaks English here, so my priority is for as soon as she becomes fit to fly, she can come home. I don’t know whether she’ll need a medical escort, the doctor said probably not, as I’ve been quoted £14,500…! They’ve given me a picture book, but it’s in Spanish so I’m covering up the words. Though I’m struggling to get her to look at the book. She doesnt copy what I’m saying or doing, but I wonder if it’s too soon? The doctor did say though that she will shut her eyes if asked etc. The first day I got here (the morning after she arrived in hospital) she was much more engaged with me and responding quite confidently, but she seems to have gotten worse over the last few days and not very engaged at all, Is that normal? I think she understands some of what I am saying as she’s responded to things I’ve said to her eg I’ve said thinks like do you love me, can I have a hug, and she’ll say yes or nod, but if I say do you dislike me she’d say no. So I’m confident that with certain things she knows what she is answering to.
@Sma1512 hopefully you won’t need a medical escort particularly if they sign her as fit to fly. I flew about 5 months after my stroke & just got GP to write a letter to say i was fit to fly.
It may well be too soon for your mum to be interested in books to any degree. For weeks after my stroke all i did was turn the pages over in a magazine. I had no interest in reading it as it was too difficult & tiring. Pre stroke I read a book a week post stroke i’ve read one in 2 years.
You may find your mum is suffering from good old stroke fatigue & that’s why she appears to have gone backwards. Everything is exhausting in the early stages even things you’d never imagine. If she’s having difficulty undetstanding things even just nodding or shaking her head, saying yes or no will wipe her out. I remember in the first 10 days or so i tried talking to the lady in the bed next to me. I managed one sentence then felt so ill i couldn’t do anything but sleep for rest of day.
All these things do tend to improve in time so try not to worry too much.
Best wishes
Ann x
Thank you. And it’s reassuring to know how exhausting it is in terms of early stages and that that’s probably why mums very distant and disengaged.
She went almost 24 hours between the stroke and hospitalization, I hope and pray that the damage isn’t so bad that she won’t improve.
She’s so outgoing and personable normally.
I hope to see the doctor again on Friday when they’re back in doing the rounds, and I hope Kim goes to the rehab hospital soon.
What did they check in terms of your fit to fly note?
I hope the meeting with the dr goes well tomorrow & you find out a bit more.
I didn’t really have any specific tests for my fit to fly letter. She just asked me a few questions on how I was coping & the affects of my stroke. I was on all the right meds to disperse clots etc. I guess some of the questions she asked ensured there were no clots lurking I didn’t know about. She then advised me to keep moving my legs & feet etc to minimise risk of further clots. I only flew to Spain so was short flight.