Where's Kim?
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wrote on 25 Apr 2020, 16:51 last edited by
Putting in a stent is not a trivial affair, by any means. It involves getting a wire into a coronary artery from a remote location (groin, wrist or arm artery). Then a balloon with the stent is placed over the wire. The balloon is inflated, unclogging the artery, and the stent is then deployed to keep the artery open.
There are many dangerous parts of the procedure: inserting the wire through an obstruction can send debris down the artery causing ischemia farther down. The artery can be ruptured by the inflation of the balloon, or the inflation can send debris distally as well. Putting a wire into the heart can cause all kinds of heart arrythmias, some potentially lethal. The patient is sedated, potentially causing all kinds of anesthesia issues (airway, inadequate breathing, etc). The last thing I'd want to do is have to intubate that fat little guy.
So, it's not simple, doesn't take "a minute," etc. Certainly, if the anatomy is favorable, it's a far better thing than open heart surgery, but that's a judgment call by the cardiologist as to whether to stent or refer to a surgeon. If you recall, Jolly's anatomy dictated a CABG, not a stent.
Lots of things can go south, and when they do, it's a disaster. I hated catastrophes in the cath lab. Under best of circumstances, when that happens, you rush the patient to the OR for CABG. However, just transporting, getting an OR ready, etc takes time - precious time.
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wrote on 25 Apr 2020, 20:55 last edited by
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Putting in a stent is not a trivial affair, by any means. It involves getting a wire into a coronary artery from a remote location (groin, wrist or arm artery). Then a balloon with the stent is placed over the wire. The balloon is inflated, unclogging the artery, and the stent is then deployed to keep the artery open.
There are many dangerous parts of the procedure: inserting the wire through an obstruction can send debris down the artery causing ischemia farther down. The artery can be ruptured by the inflation of the balloon, or the inflation can send debris distally as well. Putting a wire into the heart can cause all kinds of heart arrythmias, some potentially lethal. The patient is sedated, potentially causing all kinds of anesthesia issues (airway, inadequate breathing, etc). The last thing I'd want to do is have to intubate that fat little guy.
So, it's not simple, doesn't take "a minute," etc. Certainly, if the anatomy is favorable, it's a far better thing than open heart surgery, but that's a judgment call by the cardiologist as to whether to stent or refer to a surgeon. If you recall, Jolly's anatomy dictated a CABG, not a stent.
Lots of things can go south, and when they do, it's a disaster. I hated catastrophes in the cath lab. Under best of circumstances, when that happens, you rush the patient to the OR for CABG. However, just transporting, getting an OR ready, etc takes time - precious time.
wrote on 25 Apr 2020, 20:59 last edited by@George-K said in Where's Kim?:
Putting in a stent is not a trivial affair, by any means. It involves getting a wire into a coronary artery from a remote location (groin, wrist or arm artery). Then a balloon with the stent is placed over the wire. The balloon is inflated, unclogging the artery, and the stent is then deployed to keep the artery open.
There are many dangerous parts of the procedure: inserting the wire through an obstruction can send debris down the artery causing ischemia farther down. The artery can be ruptured by the inflation of the balloon, or the inflation can send debris distally as well. Putting a wire into the heart can cause all kinds of heart arrythmias, some potentially lethal. The patient is sedated, potentially causing all kinds of anesthesia issues (airway, inadequate breathing, etc). The last thing I'd want to do is have to intubate that fat little guy.
So, it's not simple, doesn't take "a minute," etc. Certainly, if the anatomy is favorable, it's a far better thing than open heart surgery, but that's a judgment call by the cardiologist as to whether to stent or refer to a surgeon. If you recall, Jolly's anatomy dictated a CABG, not a stent.
Lots of things can go south, and when they do, it's a disaster. I hated catastrophes in the cath lab. Under best of circumstances, when that happens, you rush the patient to the OR for CABG. However, just transporting, getting an OR ready, etc takes time - precious time.
So you are saying you can create a credible rumor by merely saying he had a stent put in?
I still give it less than a coin toss odds. Parlor game right now...or he’s dead and there is lots of planning around what’s next before it’s announced. China would have a huge mess on its hands and could use the time. On the other hand Kim might be enjoying a sequel to his first head fake.
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@George-K said in Where's Kim?:
Putting in a stent is not a trivial affair, by any means. It involves getting a wire into a coronary artery from a remote location (groin, wrist or arm artery). Then a balloon with the stent is placed over the wire. The balloon is inflated, unclogging the artery, and the stent is then deployed to keep the artery open.
There are many dangerous parts of the procedure: inserting the wire through an obstruction can send debris down the artery causing ischemia farther down. The artery can be ruptured by the inflation of the balloon, or the inflation can send debris distally as well. Putting a wire into the heart can cause all kinds of heart arrythmias, some potentially lethal. The patient is sedated, potentially causing all kinds of anesthesia issues (airway, inadequate breathing, etc). The last thing I'd want to do is have to intubate that fat little guy.
So, it's not simple, doesn't take "a minute," etc. Certainly, if the anatomy is favorable, it's a far better thing than open heart surgery, but that's a judgment call by the cardiologist as to whether to stent or refer to a surgeon. If you recall, Jolly's anatomy dictated a CABG, not a stent.
Lots of things can go south, and when they do, it's a disaster. I hated catastrophes in the cath lab. Under best of circumstances, when that happens, you rush the patient to the OR for CABG. However, just transporting, getting an OR ready, etc takes time - precious time.
So you are saying you can create a credible rumor by merely saying he had a stent put in?
I still give it less than a coin toss odds. Parlor game right now...or he’s dead and there is lots of planning around what’s next before it’s announced. China would have a huge mess on its hands and could use the time. On the other hand Kim might be enjoying a sequel to his first head fake.
wrote on 25 Apr 2020, 21:25 last edited by George K@Loki said in Where's Kim?:
So you are saying you can create a credible rumor by merely saying he had a stent put in?
No, I'm saying that I've seen more than a handful of patients have catastrophes while on the cath table during a stent placement. Not many, but more than a handful in 35 years of being on the heart surgery team. If Kim had a stent put in, it is within the realms of possibility that things didn't go well. I have no idea how talented the cardiologists in North Korea are, but I would not go there for my procedure.
It happens, and when you add complicating factors, like obesity, smoking, etc., the risks escalate.
In the early days of doing this (I'm talking late 1980s to early 1990s, every time the cath lab was going to place a stent, or do an angioplasty, everyone on the heart surgery team was required to be in-house during the procedure, lest things go pear-shaped. As the cardiologists got better at it, that requirement was dropped. What do you think the skills of North Korean cardiologists are? How commonly do they place stents/do angioplasty. My guess is rare. With experience comes expertise. With expertise, complications go down.
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wrote on 25 Apr 2020, 22:02 last edited by
https://www.tmz.com/2020/04/25/north-korea-dictator-kim-jong-un-dead-dies-heart-surgery-reports/
North Korea's Supreme Leader/dictator Kim Jong-un has reportedly died, or is on his death bed with no hope for recuperation -- according to media outlets in China and Japan.
Amid reports China has sent a medical team to their communist neighbors this week to check in/advise on Kim, a Hong Kong-backed news channel's vice director -- who's apparently the niece of a Chinese foreign minister -- blasted out the news herself ... he's dead. TMZ has not confirmed that.
The woman put the report on a social media app called Weibo for her nearly 15 million followers to read, citing a "very solid source" about the claim Kim had, in fact, perished. A Japanese magazine reports he's in a "vegetative state" after a heart surgery gone wrong.
The outlet reports -- citing a Chinese medical expert privy to the situation -- that Kim had clutched his chest in early April and fell down while visiting the countryside there. He needed a stent procedure done, but apparently ... it either wasn't done rapidly enough, or it was botched completely by the surgeon -- with some reports saying he had shaky hands.
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wrote on 25 Apr 2020, 22:11 last edited by
Maybe he's with dad.
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wrote on 25 Apr 2020, 22:15 last edited by
If more outlets are citing the same two sources it doesn’t mean the odds have gone up that he is in fact dead. What we need to know is whether there are new and unique sources.
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wrote on 25 Apr 2020, 22:18 last edited by
He might just be miffed that COVID is getting all the attention.
'What if you fire off a ballistic missile and no one cared?'
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wrote on 26 Apr 2020, 00:13 last edited by
Maybe he injected bleach?
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wrote on 26 Apr 2020, 00:28 last edited by
Jackass, you don't inject bleach. You inhale it.
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wrote on 26 Apr 2020, 01:52 last edited by
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https://www.tmz.com/2020/04/25/north-korea-dictator-kim-jong-un-dead-dies-heart-surgery-reports/
North Korea's Supreme Leader/dictator Kim Jong-un has reportedly died, or is on his death bed with no hope for recuperation -- according to media outlets in China and Japan.
Amid reports China has sent a medical team to their communist neighbors this week to check in/advise on Kim, a Hong Kong-backed news channel's vice director -- who's apparently the niece of a Chinese foreign minister -- blasted out the news herself ... he's dead. TMZ has not confirmed that.
The woman put the report on a social media app called Weibo for her nearly 15 million followers to read, citing a "very solid source" about the claim Kim had, in fact, perished. A Japanese magazine reports he's in a "vegetative state" after a heart surgery gone wrong.
The outlet reports -- citing a Chinese medical expert privy to the situation -- that Kim had clutched his chest in early April and fell down while visiting the countryside there. He needed a stent procedure done, but apparently ... it either wasn't done rapidly enough, or it was botched completely by the surgeon -- with some reports saying he had shaky hands.
wrote on 26 Apr 2020, 08:56 last edited by@George-K said in Where's Kim?:
or it was botched completely by the surgeon -- with some reports saying he had shaky hands.
If as a surgeon, a patient said to me, "I die,you die", I'd have shaky hands too.
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wrote on 26 Apr 2020, 14:20 last edited by
Any closer to resolution, or is this still Schrödinger's dictator?
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@George-K said in Where's Kim?:
or it was botched completely by the surgeon -- with some reports saying he had shaky hands.
If as a surgeon, a patient said to me, "I die,you die", I'd have shaky hands too.
wrote on 26 Apr 2020, 14:26 last edited by@Improviso said in Where's Kim?:
@George-K said in Where's Kim?:
or it was botched completely by the surgeon -- with some reports saying he had shaky hands.
If as a surgeon, a patient said to me, "I die,you die", I'd have shaky hands too.
Kim was not in such a low position in the hierarchy that he'd need to say that. Making threats is for the little people.
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wrote on 26 Apr 2020, 14:37 last edited by
@jon-nyc said in Where's Kim?:
Any closer to resolution, or is this still Schrödinger's dictator?
He remains alive at least until people have some narrative (thought experiment) around what life looks like after he is not alive.
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wrote on 26 Apr 2020, 14:39 last edited by
@jon-nyc said in Where's Kim?:
Any closer to resolution, or is this still Schrödinger's dictator?
Love this!
Thanks, jon!
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wrote on 26 Apr 2020, 18:13 last edited by
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@jon-nyc said in Where's Kim?:
Any closer to resolution, or is this still Schrödinger's dictator?
Love this!
Thanks, jon!
wrote on 26 Apr 2020, 18:28 last edited by@brenda said in Where's Kim?:
@jon-nyc said in Where's Kim?:
Any closer to resolution, or is this still Schrödinger's dictator?
Love this!
Thanks, jon!
NYPost headline:
North Korean dictator Kim Jong Un rumored to be dead, brain dead or just fine
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wrote on 26 Apr 2020, 18:39 last edited by
FWIW South Korea is still asserting Kim is alive and well. Of course they could have political reasons for saying this but they are not one of the sources of his ill health.
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wrote on 26 Apr 2020, 19:14 last edited by
