We recently received an update from the Medical City Iloilo hospital announcing that the hospital has a dedicated stroke unit available 24/7. This is good news. You can read the full Medical City Iloilo post “TMCI Acute Stroke Unit Brings rtPA Closer to Ilonggos” at http://www.themedicalcityiloilo.com/tmci-acsu-rtpa/
The fact that Medical City Iloilo offers recombinant tissue plasminogen activator (rtPA) treatment is positive, although we don’t know if other Iloilo hospitals also stock rtPA. RtPA is a protein which can breakdown of blood clots in strokes, pulmonary embolism, and myocardial infarction, in a medical treatment called thrombolysis. The most common use is for ischemic stroke. While the use of this drug has mixed reviews in medical trials (see http://www.dcn.ed.ac.uk/ist3/) it is generally view as the best available treatment for ischemic stroke. It should be administered within three hours of the beginning of symptoms, although it may have some benefits up to 4.5 hours. After 4.5 hours, the risks are thought to outweigh the benefits. Of course it is critical to know the symptoms of stroke and to get treatment as soon as possible. Don’t wait to see if you “feel better”.
RtPA is a very expensive drug. While we don’t know how much Medical City charges, it is good that they stock it. RtPA is unavailable in many developing countries: see http://www.hindawi.com/journals/srt/2011/686797/. We are thankful that the Philippine authorities have approved it for use in the Philippines, that The Medical City Iloilo stocks and knows how to use it. Worldwide the cost of the drug itself is about $3,000.
One question is what happens when you arrive at Medical City Iloilo and need rtPA treatment? It seems unlikely that the drug would be provided to those unable to show that they can pay for it. Readers should give advance consideration to this issue and make sure that they have immediate access to the necessary financial resources. We are guessing that most patients would not have P130,000 pesos in their pockets. We feel it would be wise to have a credit or ATM card with a sufficient balance to ensure that there is no delay in emergency medical treatment, whether at the Medical City or elsewhere.