Welcome to May!
- June 01, 2022
Welcome to May!
May is national Stroke Awareness Month. It is as good a time as any to talk about this very common health crisis that happens to individuals every day. According to the CDC, about 795,000 Americans will experience a stroke this year. Of that, more than 600,000 will experience a stroke for the first time. So, this is a relevant topic to gain an understanding of and be aware of the long and short-term aspects of the crisis. There are immediate interventions that can be done if the timing is right as well as intermediate and long-term interventions. There is also a discussion on prevention to be had. In this article, I would like to address some of these concepts as it relates to the management and prevention of stroke.
WHAT IS A STROKE?
Put plainly, it is a heart attack that happens in the brain. When blood flow to the heart is compromised, you have a heart attack. Often, the same disease process can cause a compromise in blood flow to the brain and the result is a stroke. Same process, different location.
F. A. S. T.
The key thing to know about strokes is to recognize the signs and act immediately. There are common signs that can indicate that a person might be having a stroke. Professional organizations like the American Heart Association recommend following the FAST test to identify and respond to a person having a potential stroke. The acronym stands for Face, Arms, Speech, Time. Notice if somebody’s face is drooping or if their smile is lopsided. They may be unable to raise their arm or might be dragging their leg. Their speech may be slurred, and they may have difficulty speaking. Another acronym is BE FAST which also signifies balance and eyes. The person may be off-balance and stumbling. Their vision could be blurred, feeling as if a curtain is pulled over part of their sight. And finally, time refers to calling for help immediately once you establish these signs.
Any or all these symptoms can indicate that there might be a stroke in progress. It is imperative that you act immediately and call 911. The quicker you recognize the signs and seek help, the more likely it is that an intervention can be done to reverse the deficit. Calling 911 and seeking emergency care services is essential to improve the outcome and minimize lasting damage.
The interventions are available based on the type of stroke a person is having. If it is a clotting stroke, the goal is to restore blood flow and medications such as clot busters might be appropriate. If it is a hemorrhagic (bleeding) stroke the goal is to stop the bleeding and relieve pressure on the brain in which case surgical intervention might be needed. The quicker the health care team can determine what is going on, the quicker an intervention can be decided upon. This is especially true for clot busters because there is a window of opportunity beyond which the use of these medications may not be safe or appropriate.
As with all things, there are certain factors associates with stroke that elevate the risk of having one. High blood pressure, diabetes, high cholesterol, smoking, excessive drinking, and physical inactivity are the big ones. It is very important to control your blood pressure so that it is less than 120/80, control your blood glucose so that your hba1c is less than 8, and lower your bad cholesterol to the recommended levels. Remove any bad habits that promote plaque formation and blockage of blood vessels leading to a decrease in blood flow to the brain. I want to reiterate that these are all modifiable risk factors. We can work on each of these and control it to the best of our ability. A stroke does not have to be inevitable in your life just because of family history. We can reduce the chances of such an event by working on reducing the risk factors.
Let’s take a moment to talk about physical inactivity. It is now called the new smoking. In essence, that lack of mobility has the same negative effects on our bodies as smoking. People are increasingly sedentary, and it has been especially true during this COVID season in our lives. We are working more out of our homes and travelling less. So, our daily steps have diminished significantly. We need to offset that with scheduled exercise in our lives. In fact, it has been interesting to see that people’s cholesterol went up even though they were exercising but it was not enough to offset the less movement they were doing outside of exercise.
So, please be mindful of the importance of physical activity and build it into your daily lives. Take more steps when you have the opportunity. If you are working remotely, get up every hour stretch and walk around, and you will find that your efficiency will go up. I also want to remind you that exercise helps us to be mentally and emotionally healthy and helps us to age well. I want to encourage all of you to work on these risk factors so that we can continue to work on reducing the incidence of strokes in this country.
Lastly, I want to spend a few moments to speak about vascular dementia. Dementia has a variety of causes and next month I will be writing about Alzheimer’s dementia. It is important for us to understand that while some people may never have a stroke, these same risk factors still clog up our blood flow to the brain and, slowly and insidiously, cause a decline in mental function. Others will have tiny strokes unknown to them that seemingly had no impact except for damage to the brain that is pinhole size. However, if many such events happen repeatedly, brain function gets compromised, and we have a form of vascular dementia. There is no need to do anything different other than what I have already discussed. So, if dementia is in your family history realize it does not have to be inevitable and the same actions that you take for stroke prevention can help you to preserve your brain function. For a lot of people, stroke or dementia are some of the biggest fears they have. Don’t live in fear. Be proactive. Take steps to improve your overall health.
If any of you have questions regarding this or feel like you would like to take some positive steps towards your better health, please come see us and we can help you in your health journey. In fact, that is the type of visit that gives me the greatest pleasure.
Geni Abraham, Board Certified, American Board of Internal Medicine. Our Internal Medicine Practice is an integrated medical practice with a focus on Lifestyle Medicine. We offer health coaching sessions to help you reach your personal goals. Dr. Geni Abraham, Medical Specialists of the Palm Beaches, Inc., 205 JFK Drive, Atlantis FL 33462. Phone: (561) 432-8935, Visit DrGeniAbraham.com and Follow us on Facebook: @DrGeniAbraham