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.
STROKE? THINK FAST!
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
- AEROBIC EXERCISE:
- 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
- WEIGHT TRAINING:
- 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: drpmackarey@msn.com
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.
Part I
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!
What is a Stroke?
A stroke occurs when the arteries of the brain are unable to bring necessary blood flow to a specific region of the brain. When blood flow carrying essential oxygen and nutrients is unable to reach brain tissue, the brain cells in that tissue die. The longer the blood flow is cut off, the greater and more permanent the residual damage. Two primary causes of loss of blood flow to the brain are ischemic stroke and hemorrhagic stroke. In an ischemic stroke a clot obstructs or blocks the flow of blood to the brain. In a hemorrhagic stroke, a blood vessel tears or ruptures which interrupts the flow of blood to the brain. Another term used when describing a stroke is a “mini stroke” which is a transient ischemic attack (TIA) which caused by a temporary clot.
The Effects:
The effects of a stroke depend on several factors such as the location and duration of the tissue damage. The brain is unique in that one side of the brain is responsible for the opposite side of the body. So, a stroke that damages the right side of the brain will result in damage to the left side of the body.
Symptoms Associated with Damage to the Right Side of the Brain
- Weakness on the left side of the face
- Paralysis on the left side of the body
- Quick and inquisitive behavior
- Memory loss
Symptoms Associated with Damage to the Left Side of the Brain
- Weakness on the right side of the face
- Paralysis on the right side of the body
- Speech and language difficulty
- Slow and cautious behavior
- Memory loss
Symptoms Associated with Damage to the Brain Stem
The brain stem is the central trunk of the brain which traverses downward to form the spinal cord. Symptoms include:
- Deficits on both sides of the body
- May lead to a “locked-in” state where the patient is unable to speak or move below the neck
Risk Factors For Stroke That CANNOT be Changed (NSA)
- Age – For every decade of life after age 55, the chance of having a stroke doubles. While common in the elderly, many people under 65 have strokes.
- Hereditary (Family History) – Both family history (parents, grandparents, siblings) and genetics can increase your risk for stroke.
- Race -The incidence of death from stroke is much higher in African-Americans than in Caucasians. This is partly related to the higher incidence of high blood pressure, diabetes and obesity in African-Americans.
- Gender – Women have a significantly more strokes and deaths by stroke than men in great part due to: use of birth control pills, pregnancy, and history of preeclampsia or gestational diabetes, smoking, post-menopausal hormone therapy.
- Prior Stroke, TIA OR Heart Attack – are strong predictors of stroke. In fact, those suffering a TIA are almost 10 times more likely to have a stroke.
Risk Factors For Stroke That CAN be Changed (NSA)
- High Blood Pressure - is the leading cause of stroke and therefore the most important controllable risk factor.
- Smoking – nicotine and carbon monoxide from cigarette smoking increases the risk of stroke. When combined with oral contraceptives, the risk increases significantly.
- Diabetes – this disease directly increases the risk of stroke. However, when combined with high blood pressure, high cholesterol and obesity, the risk increases exponentially.
- Carotid or Peripheral Artery Disease - When arteries become diseased and plaque builds up in the walls of the arteries, the risk of stroke increases.
- Atrial Fibrillation & Other Heart Diseases - a disorder in the rhythm of the heart or malformation of the heart tissues can lead to blood clots that may enter the blood stream and travel to the brain.
- Sickle Cell Disease & Other Blood Diseases - Blood diseases that lead to blood clotting can increase the risk for stroke
- High Cholesterol – Poor Diet – Obesity & Inactivity - all of these factors, individually or in any combination, increases the risk for stroke.
- Geographic Location, Socioeconomic Factors, Alcohol & Drug Abuse - are less documented but have strong associations with stroke risk.
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: drpmackarey@msn.com
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.
SOURCES: National Stroke Association, National Institutes of Health; www.strokeassociation.org; www.stroke.org
