Full recovery is possible, but few arrive at the hospital in time.
by Rick A. Richards
One of the major contributing factors in strokes is stress. For business owners worried about their bottom line, they need to take a step back and consider the impact that has on their health, according to the National Stroke Association.
Jim Baranski, CEO of the association, says that while stroke remains one of the leading causes of death in the United States, data from the Centers for Disease Control and Prevention shows it is no longer among the top three. After decades of being the third-leading cause of death, Baranski says 2008 statistics just made available by the CDC show strokes have fallen to fourth.
“National Stroke Association is encouraged by these new preliminary data,” says Baranski. “Stroke has governed the third-place ranking for cause of death in this country for much too long. This development is representative of many factors, including increased awareness, better stroke care, more use of available treatments such as clot-buster thrombolytic drugs and other medications, improved risk factor management and more people getting to the hospital immediately upon recognizing a warning sign or symptom.”
Dr. Virgil DiBiase, a neurologist with Porter Hospital in Valparaiso, describes stroke as “a brain attack.” DiBiase says up to 80 percent of strokes are preventable, adding, “Not only can we save lives, but we can restore people to their full and active lives after a stroke if we see them in time.”
He explains that stroke victims who receive clot-busting medication within three hours of the first symptoms can make a complete recovery. “Yet nationwide, just 2 percent of stroke patients arrive in time for optimal treatment.”
DiBiase says people need to be aware of any sudden change in their physical condition. “The key is sudden. If one moment you're fine and then there's an abrupt change, think stroke. Even if the symptoms go away, you need emergency care, as it could be a warning sign that something big is going to happen. Don't wait. Don't call a doctor. Call 911.”
Kip Adrian, medical director of Porter's Emergency Department, says, “Strokes are one of the most common serious diagnoses we see in the ER, yet many people aren't familiar with the signs. Time can make all the difference. We treat stroke with the same intensity and level of concern as someone having a heart attack. Expect immediate attention and expedited testing so we can quickly learn if you're having a stroke and what kind.”
Adrian says if someone is having a stroke, those nearby should act “FAST.” He says that stands for Face (ask the person to smile and look to see if one side of the face droops); Arms (does one arm drift downward?); Speech (are the words slurred?); and Time (if the person shows any of these symptoms, time is of the essence).
Sherry Mosier, stroke coordinator at Methodist Hospitals in Gary and Merrillville, says that one of the things she emphasizes when she talks to community groups is that time matters. “With strokes we have a small window of opportunity to reverse the effect of stroke. Optimally, it's within three hours, but we can stretch that to 4 hours under the right circumstances,” says Mosier.
She says stroke victims often don't realize they've had a stroke. “Heart attacks are painful,” she says. “Strokes don't hurt. A stroke is a bit of weakness on one side or you have trouble talking or you have blurred vision. People may think they're tired and go to bed. That's the worst thing you can do. These all seem minor but it could be a stroke.” Other symptoms include dizziness, loss of balance or coordination, a severe headache with no known cause, or confusion.
Laurel Valentino, director of neuroscience services at Methodist Hospitals, says there are factors people can control to prevent strokes. For instance, she says diet and exercise are two factors that play a big role in a person's susceptibility to stroke.
“Keep moving. You need at least 30 minutes of exercise a day,” says Valentino. “Limit the amount of salt and fat in your diet. Make sure you maintain a healthy weight.”
Valentino says it's also important to keep your blood pressure under control, and if someone has diabetes, he or she needs to closely monitor it and keep it under control.
She adds that controlling stress is also important. “The nice thing about stress is that it's controllable. If you feel stressed, get up and walk. Take a 10-minute break. You can get so much more done if you move and if you eat something healthy when you do. Think about what you're doing.”
Mosier says strokes happen when the brain's blood flow stops or leaks into the wrong place. When that happens, brain cells die. Among the major risk factors for stroke that can be prevented or controlled are hypertension, smoking, sleep apnea and heart disease.
She says the major risk factors that cannot be controlled are age, sex, race and family history. The risk for stroke doubles every decade after age 55; African-Americans have a higher incidence of stroke than the general population; the risk for men is higher before age 55, but for women, the risk increases with age, and in fact, stroke kills twice as many women as breast cancer.
Dr. David Rozenfeld, director of neurology and neurodiagnostic services at Community Hospital in Munster and St. Catherine Hospital in East Chicago, also is on staff at Northwest Indiana Neurological Associates. While Rozenfeld echoes the advice of other stroke experts in Northwest Indiana, he recognizes that not everyone is going to be successful in controlling or eliminating the risks associated with stroke.
“We're all human,” says Rozenfeld. “Losing weight is so hard and putting it back on is so easy. Not everyone can exercise because of physical limitations or age. In an ideal world, we all would exercise three times a week and get to our ideal weight. Frankly, it's easier to stop smoking than it is to lose weight.”
Rozenfeld says being aware of the risks that lead to stroke is the first step toward doing something about correcting those issues. “If you have hypertension, for instance, get your blood pressure down. If you have sleep apnea, get it treated because you'll die sooner with it than if you didn't have it.”
Rozenfeld says that fully addressing stroke risks could take years for some people, but the sooner people get started, the better they will be in the long run.
That is the position of the National Stroke Association. “There remains work for all of us,” says Baranski. “The first treatment for stroke became available 24 years ago, and today, research shows that less than 5 percent of eligible patients receive it. Imagine the public outcry if this were the case with, say, heart attacks. It is imperative that we continue raising awareness of stroke and addressing the needs of stroke survivors as they recover.
“We're going to … push even harder for more public awareness and education that will eventually drop stroke further down the list of leading causes of death in this country,” says Baranski. “And, we are always happy to have people join us.”
Know the Signs of Stroke
These are common signs of stroke in both men and women:
* Sudden numbness or weakness of face, arm or leg, especially on one side of the body.
* Sudden confusion, trouble speaking or understanding.
* Sudden trouble seeing in one or both eyes.
* Sudden trouble walking, dizziness, loss of balance or coordination.
* Sudden severe headache with no known cause.
Women may report unique stroke symptoms:
* Sudden face and limb pain.
* Sudden hiccups.
* Sudden nausea.
* Sudden general weakness.
* Sudden chest pain.
* Sudden shortness of breath.
* Sudden palpitations.
Call 911 immediately if you have any of these symptoms. Every minute counts for stroke patients and acting FAST can lead patients to the stroke treatments they desperately need. The most effective stroke treatments are only available if the stroke is recognized and diagnosed within the first three hours of the first symptoms. Actually, many Americans are not aware that stroke patients may not be eligible for stroke treatments if they arrive at the hospital after the three-hour window.
Source: National Stroke Association. For more information on stroke awareness and prevention, visit www.stroke.org.
