General News about Joachim, Marie and Family Part 5: September 2019 - December 2020

[Nordic]

I believe it would be considered odd if a member of the DRF was a burden to a hospital system in foreign country - not least in the middle of an epidemic.

Don't understand...? The family lives in France. They intend to live there for several years, maybe even for the rest of his life. Why would it be odd to be treated where he lives? He lives in Paris and it would be only natural to move him to a hospital there, if necessary.

It would be more odd to be treated in a completely foreign country, like, say Greece or the US after something had happened during a holiday or something.

 

[Muhler]

Why would he be considered a burden to the French health system? Isn’t one of the points of being a EU citizen to have equal access to the healthcare system of all member countries? Although we are in the middle of a Covid pandemic, people still have other conditions too and should not be considered a burden for taking hospital beds because of their conditions.

Right now, the most important consideration should be the best interest of the patient. It is probably unadvisable if not outright impossible to remove him from France to Denmark given how recent his event and his operation were. I don’t think the medical team would agree to do that.

Furthermore,, given in this case the Covid pandemic, it may be recommended that the Queen stay in Denmark and do not go to France to visit Joachim, which might be a risk for her.

The EU-argument wont sell in DK.
Apart from that Joachim is not an average citizen. So being a man of means it would be more acceptable to transfer him to a private hospital in order not to be seen to burden the French taxpayers unnecessarily - should it be decided that at least a part of the treatment should take place in France.
It would also be seen a snub of the DK hospital system that a member of the first family in DK does not wish to be treated in DK. Especially as DK doctors are just as capable of treating Joachim.

Had it been me, who was a temporary resident of France it would be natural to continue my treatment in France. But I'm not a member of the DRF.

After all, I doubt a younger son of the US president would remain in DK, being treated at Danish hospitals - even if DK and USA had an agreement about mutual treatment of citizens.

Anyway, Danish doctors will take over.
There have been contacts between the hospital in Toulouse and Rigshospitalet, so I believe he will be transferred to Rigshospitalet as soon as possible.

This is stunning news because he is so young. I hope he does not smoke and that Second-Hand Smoke is very bad for people.

Indeed!

I understand he gave up smoking in December - about time, since he has a son who is having severe allergy attacks.


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The procedure Joachim underwent is only fifteen years old.
Prior to that a major bloodcloth, like the one Joachim in all likelihood had, would have meant curtains. I.e. death or permanent severe disability.

 

[Somebody]

It is good to know that Prince Joachim is doing as well as possible under these circumstances.

What is the reason that it is being taken for granted that he will be repatriated to Denmark as soon as feasible? Seeing as, as others pointed out, first-class medical treatment is accessible to him in France also, and he has established a home in that country.

Given that the reason for the longer stay in France officially was Joachim's new job, I guess it will depend on the seriousness of the situation. If it is expected that he we recover soon and fully, I expect him to still take up this post; and it would make some sense to stay in France (although there would be little reason not to go to Denmark instead - the main one against it being Henrik and Athena's schooling - the main one in favor being his elder sons living in Denmark and most likely wanting to visit their father a bit more regularly in these circumstances).

If they expectation is that he won't fully recover, it would make little sense to stay in France as Marie could still carry out engagements in Denmark and doesn't have a job in France - and again, all Joachim's children would be closer to him.

Nonetheless, there is precedent of a royal prince being treated in a different country, so I don't necessarily see that as a problem. After the first treatment in Austria prince Friso of the Newas treated for over a year in a London hospital - close to where his family lived (and still is living) - until he was brought to his mother's palace grounds when apparently it was clear that he wouldn't recover - where he spent his final weeks. However, a big difference is that they had been living in London for several years for both of their jobs and not recently moved for his job unlike Joachim and Marie.

 

[Muhler]

AFAIR that was a private hospital in London.

 

[Somebody]

AFAIR that was a private hospital in London.

It was Wellington Hospital, which is indeed an independent hospital. However, I don't know the system in France but in the Netherlands we don't make a distinction between public and private hospitals, so it didn't really occur to me that could be relevant. The relevant distinction would be university hospital / non-university hospital or whether it was some kind of specialized hospital (for example for cancer patients or patients that were severely burned).

I don't know how the French system works but without knowing all the complexities I would not automatically assume that having a patient that needs care in your hospital would be a burden to the French hospital system. Isn't that exactly what the hospital system is for?! And I assume there is a system that makes sure that the costs that go with it are paid somehow by the patient's insurance?! Why would it fall on the French taxpayers to pay for his bills?

 

[Muhler]

Well, because once the initial life-saving treatment is over. Joachim is basically a foreign citizen taking up a bed and resources instead of a French citizen - who may not have the means to be transferred to a private hospital.

It's not a question of state run French hospitals being not being able to treat Joachim to the highest standard - they can!

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Expense wise I imagine Joachim on vacation has firstly a private personal insurance. He may also be covered by the EU health insurance card - which would cover free treatment and transport home from all over EU. (I'd have to check the specific details to be 100 % certain though.)
And there is also the possibility that he is covered by his employer - also during holidays - being stationed in France. The employer being the military.
- So in theory Joachim's treatment shouldn't cost him or the DRF a single €. Except for some special arrangements the DRF make, like home transport in a private plane.

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Every stroke specialist in DK, not away on holiday, has been contacted by the press to give an assessment. They vary a lot! Simply because the effect vary so much from patient to patient.
All agree though, that it's serious!
And all agree that within a couple of days the doctors will be able to gauge what after effects the patients will suffer from, and to what extent.
And small scale rehabilitation starts, well, about now.
There is also a general agreement that it will be unlikely that Joachim will not suffer from some sort of aftereffect (*) the question is what, to what extent and whether it will be permanent.

(*) I need to ask the English speakers here: It's how to translate the word "mén" The word covers the condition after say a trauma. Like limping after injuring your leg. Reduced sight on one eye after an injury or stroke. A paralyzed hand. - Or another "mén" - What is the English word?

 

[Heavs]

(*) I need to ask the English speakers here: It's how to translate the word "mén" The word covers the condition after say a trauma. Like limping after injuring your leg. Reduced sight on one eye after an injury or stroke. A paralyzed hand. - Or another "mén" - What is the English word?

Perhaps side effect or disability.

 

[Prinsara]

Perhaps side effect or disability.

"Side effect" is more for expected and routine things, though it can be used like this. There's "consequence", if you want to be more formal.

I would say disability probably works best, in this case.

 

[Muhler]

Thank you. ?

Disability it is then.

 

[Countessmeout]

Disability is correct and not correct at the same time.

Loss of vision or a permanent limp are indeed physical disabilities. But in this case we are referring to them being caused by the illness/treatment. And in that context it would be proper to refer to them as a side effect of the illness.

If Joachim were to suffer from blindness in one eye, and you simply called it a disability, one would think it unrelated to this illness.

 

[Tatiana Maria]

I am not a medical professional, but in regard to ordinary conversation, I agree that "effect", or "complication", would be more readily understood in this context than "disability".

 

[Prinsara]

Disability is correct and not correct at the same time.

Loss of vision or a permanent limp are indeed physical disabilities. But in this case we are referring to them being caused by the illness/treatment. And in that context it would be proper to refer to them as a side effect of the illness.

If Joachim were to suffer from blindness in one eye, and you simply called it a disability, one would think it unrelated to this illness.

If that's the issue, then I would go with "consequence" over "side effect", since the latter has somewhat mundane connotations. The issue with TBI is the outcomes being tricky and variable. No one knows what the consequences for Joachim might be at this point.

 

[Muhler]

Let me clarify: "mén" is a long term or permanent after effect after a specific illness or injury.

It is also used to specify the level of injury or disability by the insurance companies, say 30 % "mén" after a traffic accident.

There has been a lot of talk about possible "mén" Joachim may have after this.

 

[Countessmeout]

Let me clarify: "mén" is a long term or permanent after effect after a specific illness or injury.

It is also used to specify the level of injury or disability by the insurance companies, say 30 % "mén" after a traffic accident.

There has been a lot of talk about possible "mén" Joachim may have after this.

It would still be proper to call it a complication/side effect in that case.

It can be a chronic/permanent complication. For insurance purposes you are saying this 'disability' was caused by the illness/procedure in question. You are going to your insurance company and saying 'I now suffer blindness in one eye due to the brain surgery I underwent'. The blindness there for was a complication/side effect of the procedure.

There is a slight difference. Doctors will tell you when you have a procedure to expect this, this and this after (these are standardly referred to as side effects or less commonly consequence). But then there is 'there is a risk of.....' and that would more commonly be the 'complications'.

 

[Frelinghighness]

This is stunning news because he is so young. I hope he does not smoke and that Second-Hand Smoke is very bad for people.

Yes he has always been a smoker that wa the first thing I thought of though apparently quit six months ago. Most people don’t realize strokes are what smoking can cause

 

[Prinsara]

Yes he has always been a smoker that wa the first thing I thought of though apparently quit six months ago. Most people don’t realize strokes are what smoking can cause

Unfortunately when you have the history and rate of smoking Joachim does, six months is not enough to reverse what you've already done, though it's undoubtedly beneficial he stopped.

Does anybody think this will affect his mother's smoking? (Probably not, though I assume she'll stop around him.)

 

[Muhler]

Hmm, okay.

But if Joachim suffers say permanent reduced functionality in his right arm, that would in Danish be an unspecified "mén."
So what would you use in that specific case?

Because it's a word I fear I'm going to translate often.

Example: Doctor XX said that although nothing is yet certain, Prince Joachim will have "mén" to some extent due to the damage the blood cloth left in his brain.

What word would you put in here?

Thanks in advance.

 

[Prinsara]

Hmm, okay.

But if Joachim suffers say permanent reduced functionality in his right arm, that would in Danish be an unspecified "mén."
So what would you use in that specific case?

Because it's a word I fear I'm going to translate often.

Example: Doctor XX said that although nothing is yet certain, Prince Joachim will have "mén" to some extent due to the damage the blood cloth left in his brain.

What word would you put in here?

Thanks in advance.

Consequence.

 

[Mbruno]

Consequence.

I suggest “ sequelas” although it is not really an English word, but a borrowed one.

 

[Countessmeout]

Hmm, okay.

But if Joachim suffers say permanent reduced functionality in his right arm, that would in Danish be an unspecified "mén."
So what would you use in that specific case?

Because it's a word I fear I'm going to translate often.

Example: Doctor XX said that although nothing is yet certain, Prince Joachim will have "mén" to some extent due to the damage the blood cloth left in his brain.

What word would you put in here?

Thanks in advance.

Same thing: complication/side effect.

Even if its a permanent lifetime issue, as long as you can link it to the illness/treatment it would be a complication/side effect.

Complications can be temporary, they can be permanent, they can be permanent unless treated.


Its a disability in that you would be applying for 'long term disability'. But when filling out insurance you would be asked if it was something you were born with or the cause. The cause would be 'complication of'.

 

[kalnel]

I'd use "after-effects," "impairments," or "disabilities."

Sometimes people link these with time-frames or degrees of seriousness. Someone might suffer from the "immediate after-effects of a stroke," or have "temporary impairments," or "long-term disabilities." (You could combine any timeframe with any of those terms.)

Also, a tiny spelling tip: No "h" on "blood clot."

Hopefully, these are all words and problems no one will need to be using. It seems so premature to be talking about such outcomes when no one really knows what his condition is. As a relatively young man, he may bounce back very well and very quickly. The fact that reports say he was aware and alert when the clot first struck, would seem to be very encouraging.

I thought the palace's statement earlier today that he was doing well under the circumstances was a little odd, but it may have been another nuance lost in translation. I couldn't tell if it was implying that he was "as well as could be expected" or he was doing well except for the complications of the clot.

 

[ladongas]

Aftereffects would be the word I would choose.

 

[Sidacarri]

I think the word to describe the effects on someones life be it physical or cognitive from a brain injury is 'impairment'

 

[Lady Daly]

I don't know if this has been brought up but Prince Joachim very well could have suffered from a subdural hematoma which requires emergency surgery. There are several types of hematomas (bleeding/clotting in the brain) indicative of medical emergencies and scenarios – such as a subdural hematoma and/or intracranial (brain) hematoma. Various causes include head trauma, liver disease, clotting problems such as thrombocytopenia, cerebral aneurysm, AV malformation, tumors, and idiopathic or unknown. I think until further details have been shared we are all of course speculating including myself. I send my well wishes and hope Prince Joachim will have a speedy recovery without untoward effects or disability.

 

[Lady Daly]

https://www.barrons.com/articles/danish-prince-joachium-stable-after-brain-clot-surgery-01595766606

Article above reports contrary to earlier Danish media reports saying Prince Joachim had been taken by helicopter, he was driven by ambulance to the hospital in Toulouse 130 kilometres (90 miles) away. If it was suspected Prince Joachim had a subdural hematoma, flying by helicopter would be contraincidated due to the increase in intracranial pressure ICP "pressure build up in the brain" initially caused by the clotting and then by cabin pressure in the helicopter.

I worked as an RN in a trauma level one hospital and we were always the receiving hospital. I remember concerns with ICP (intracranial pressure) regarding air transports. I'm really hopeful with what appears initially to be prompt care he will make a full and complete recovery. Since the window for recovery can include days to weeks to months, I think this is why we are not hearing more details currently.

 

[Prinsara]

They keep saying "clot" and not "stroke".

https://www.everydayhealth.com/colu...ts-from-easily-treatable-to-life-threatening/

The link discusses different brain clots.

Whatever the diagnosis or the prognosis, my best wishes to the prince and his family for an effective recovery.

 

[csw]

I think the word to describe the effects on someones life be it physical or cognitive from a brain injury is 'impairment'

Very good word choice. It accommodates the concept of having a percentage of damage.

 

[caethi]

They keep saying "clot" and not "stroke".

https://www.everydayhealth.com/colu...ts-from-easily-treatable-to-life-threatening/

Apparently there is some difference.

Whatever the diagnosis or the prognosis, my best wishes to the prince and his family for an effective recovery.

There are two kinds of strokes--thrombotic (due to a clot) and hemorrhagic (due to bleeding, for example, from a leaking or ruptured aneurysm).

 

[Helen.CH]

He seems to be in a very unlucky situation.
he failed in almost any position he had before and now the government gave him another chance with the new position and what happens?
I hope he gets well soon and maybe finds peace afterwards whereevr that might be.
A brainsurgery is a massive thing and nothing will be like it was before
plus the fact that we do not know how this clot developped. maybe he is a strong smoker like his mother?
rumours saying the two brothers are not that close, maybe now things get better though the distance Danmark France seemed as an attempt to calm things for the crown prince and Joachim.
all the best.

 

[Lady Daly]

I've been trying to find a way to explain "a blood clot in the brain" which is not necessarily a stroke. An ischemic stroke is vascular which means blood clots impeding blood flow within the blood vessels that either lead to the brain or actually in the brain. Very similar to a "heart attack" only in the brain. The fact that they continue to specify this is a blood clot in the brain tells me this is exactly that, a blood clot within the spaces of the brain itself not a vascular ishemic event. Of course because of the language differences and practice of medicine they could mean stroke but I don't think so.

Specifically, the information below covers subdural hematomas, which is the most common type of blood clot found in the brain.

About Blood Clots in the Brain:
A blood clot in the brain is also called a hematoma, a particular type is called a subdural hematoma. A subdural hematoma occurs when there is initially bleeding between the brain and the thin membrane covering it, the dura, and then becomes a clot or several clots.

A blood clot in the brain is typically the result of trauma, which can be either a single significant episode or repeated minor injuries. The chance of a blood clot in the brain increases with age. This is because the brain shrinks over time, but the skull remains the same size. Think of this as creating a space around the brain, with room to jostle around. This can lead to tears in delicate blood vessels and bleeding, followed by clotting. The risk increases with age naturally, as well as factors that increase bleeding, such as anticoagulant medications and excessive alcohol intake.

This is a bit complicated but I think if Prince Joachim had had an ischemic brain event caused by a blood clot in a vessel they would have called it a cerebral ischemic vascular event or a stroke but they maintained this to be clots in the brain. Also, the fact he was not life flighted to Toulouse by helicopter indicates there were considerations with intercranial pressure increasing which occurs with blood clots in the brain not so much with a stroke. Had there been a medical evac fixed wing plane sitting around in the countryside of Cahors they probably would have flown him as you can adjust cabin pressures in fixed wing.

The intervention for a stroke vs subdural hematoma is very different, the outcome is also different depending on location, extent and severity. Different parts of the brain are involved but there are overlapping symptoms upon initial presentation.

What an unfortunate shock for this to have happened. We all certainly want the very best outcome and I am staying hopeful! Best wishes to Prince Joachim and his family.