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Health & Exercise Forum


Dec 19, 2022

Part II of II

We all know someone who has been affected by a stroke. It can be a devastating and life-changing event. According to the National Stroke Association, (NSA) it is the 5th leading cause of death and number one cause of disability in the United States. Nearly 800,000 people in the USA have a stroke every year. Every 40 seconds someone has a stroke and every 4 minutes someone dies of a stroke in the USA. 897% of all strokes are ischemic from a clot or mass blocking a blood vessel in the brain. 

The Good News

According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. THE GOOD NEWS: According to a study in the Journal of the American Medical Association, there is almost a 50% reduction in strokes and 40% reduction in stroke deaths more than two decades from 1987 to 2011. Improved smoking cessation, management of high blood pressure and cholesterol are believed to be significant contributing factors. THE BAD NEWS: Progress has slowed in recent years! THE MESSAGE: Continued vigilance and lifestyle changes are essential!

Signs and Symptoms

While the signs and symptoms vary, most people experiencing a stroke have several if not all of these symptoms in various parts of the body.

  • Face: Facial muscle weakness and numbness
  • Visual: Blurred, double, or loss (temporary or permanent) of vision in one eye
  • Speech/Mouth: Facial droop on one side, difficulty: slurred or loss of speech.
  • Limbs: Numbness and/or weakness on one side of the body (arm/leg)
  • Body: loss of balance, dizziness, lightheadedness, difficulty walking, loss of coordination, with stiff or paralysis of the muscles on one side of the body. Also, headache, confusion, and rapid eye movement.


F – Face Drooping – ask for a smile to see if one side droops

A – Arm weakness or numbness

S – Speech – can the person repeat a simple sentence? Do they slur?

T – Time = Brain Damage! Time to Call 911

Diagnosis & Treatment

If the above signs or symptoms have been identified than there is a medical emergency - Immediately Call 911

Emergency Room Treatment

  • Exams and Tests - The first test after a stroke is typically a CT scan, a series of X-rays that can show whether there is bleeding in the brain.
  • Identifying and Treating Stroke - When a patient displays stroke-like symptoms, a doctor must not only confirm the symptoms but also identify the type of stroke, its location, and the extent of brain damage.
  • Thrombolysis - If the CT Scan determines that an ischemic stroke (the most common type) has occurred, then a clot busting drug, tissue plasminogen activator (T-PA) can be administered intravenously. T-PA to dissolve the clot must be given 3 hours of a stroke and it has been confirmed that there are no signs bleeding in the brain. This treatment to dissolve dangerous clots in blood vessels will improve blood flow, and prevent damage to tissues and organs.
  • Oxygen, Intravenous (IV) Fluids and blood tests may also be administered.
  • Stroke Rehabilitation - The best way to get better after a stroke is to start stroke rehabilitation ("rehab"). In stroke rehab, a team of health professionals works with you to regain skills you lost as the result of a stroke.

Prevention - How to Lower Your Risk

Strokes can happen at any age, even to babies in the womb. Still, the odds of a stroke climb quickly after middle age.

To cut your odds of having a stroke:

  • Get Regular Checkups – visit your primary care physician regularly to be screened for risk factors.
  • Keep your blood pressure healthy. If you have high blood pressure (consistently over 130/80), this is the single biggest thing you can do to lower your odds of a stroke.
  • Avoid tobacco/smoking. cigarettes and chewing tobacco -- even secondhand smoke -- cause physical changes in your body. They can thicken your blood and make it more likely to clot and cause fatty buildup in your arteries.
  • Control your cholesterol levels. High levels of LDL, or "bad" cholesterol, make it more likely that plaque will build up in your arteries, putting you at greater risk of a clot that causes a heart attack or stroke.
  • Manage diabetes, if you have it. If it’s not under control, it can lead to a stroke by damaging your blood vessels.
  • Manage Stress – find healthy ways to manage stress such as: aerobic exercise, yoga, meditation, and counseling.
  • Diet and Exercise - Check your weight and waist. Your doctor can let you know if these numbers are in a healthy range. if you have a belly that’s bigger than 40 inches around for men or more than 35 inches for women, that may be especially risky.

How to begin an exercise program:

  • Get your physicians approval
  • Consult with a physical therapist to set up a program for your needs
  • Buy good running sneakers – not walking shoes
  • Plan to exercise 3-5 times per week for 30-35 minutes
  • Walk for aerobic fitness
  • Begin 5-10 minutes and add 1-2 minutes each session
  • Walk in a mall if it is too hot or too cold
  • Use light dumbbells, sandbag weights and resisted bands
  • Begin with 5-10 repetitions and add 1-2 reps each session
  • Alternate weight training days with walking days

Visit your doctor regularly and listen to your body.     

Keep moving, eat healthy foods, and exercise regularly

NEXT MONDAY – Read Dr. Paul J. Mackarey “Health & Exercise Forum!”

This article is not intended as a substitute for medical treatment. If you have questions related to your medical condition, please contact your family physician. For further inquires related to this topic email:

Paul J. Mackarey PT, DHSc, OCS is a Doctor in Health Sciences specializing in orthopaedic and sports physical therapy. Dr. Mackarey is in private practice in downtown Scranton, PA and is an associate professor of clinical medicine at GCSOM.