Tag Archives: Stroke

Straight, No Chaser: Stroke Recognition

General Health and Wellness, , , , , , , , , ,

strokerecog

This content of this post is so simple yet important that it really warrants taking up space in a few of your brain’s cells. Most of us know someone who has suffered from a stroke. With recent improvements in treatment, it’s really unfortunate when debilitating consequences occur simply because signs and symptoms weren’t recognized and/or brought in for treatment soon enough.
Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mnemonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”

Think FAST, Act Faster

Here’s how the layperson can recognize a possible stroke:

  • Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
  • Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
  • Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
  • Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.

It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset. Important treatment options are available within the first several hours of symptom onset that are otherwise unavailable.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: When Your Headache is Life-Threatening

Neurology, Health Prevention, , , , , , , , , , , , ,

Brain-Aneurysm-Prognosis-Factors

All headaches are not created equal. Earlier we discussed migraines, but there’s a lot more to headaches than those. In fact, when you come to an emergency room with a history of migraines and tell us you’re having a migraine, we aren’t thinking about migraines first. The ER is all about the life-threats.

The lead picture suggests items to avoid if you’d like to improve your prognosis for headaches in general and especially certain ones like brain aneurysms. In other words, alcohol, cocaine and cigarettes increase  your risk for life-threatening causes of headaches.

Secondary headaches are those related to some other illness or condition that produces headaches as a symptom. These are much more common causes of headaches than migraines. They’re even more important because they could represent life-threatening conditions. So we’ll put aside the headaches caused by things like panic attacks and hyperventilation, influenza, dental pain, sinusitis, ear infections, eye strain, dehydration, hangovers, hunger and “brain-freeze.” (Yes, “ice-cream headaches” are a real thing!) Today we’ll point you to some conditions about which you should be concerned. (I’m intentionally leaving out especially uncommon ones and otherwise esoteric conditions. I wouldn’t want to encourage any hypochondriacs out there.)

  • AVM (arteriovenous malformation): an abnormal formation of blood vessels inside your brain
  • Concussions and post-concussive syndrome
  • Brain aneurysm: a ballooning of one of your brain’s arteries that can steal blood away from needed areas

unruptured-aneurysm

  • Brain tumor
  • Carbon monoxide poisoning: from breathing exhaust fumes
  • Encephalitis/Meningitis: inflammation and/or infection of different components of your brain
  • Subarachnoid and other intracranial hemorrhage: bleeding inside various parts of the brain

Aneurysmal_Subarachnoid_Hemorrhage-1

  • Stroke
  • Temporal arteritis: inflammation of an important forehead artery with potentially devastating consequences to your sight

Given that I’ve blogged on several of these already (you can always enter the term in the search box on the right for more details), I’m going to focus on the symptoms that may suggest your headache is different enough to get evaluated for a possible life-threat.
Consider this a “headache plus this symptom = go to the emergency room” list.

  • Altered mental status
  • Confusion
  • Difficulty standing or walking (different from baseline)
  • Fainting after a headache
  • High fever, greater than 102 F to 104 F (39 C to 40 C)
  • Nausea or vomiting that’s not hangover related
  • Numbness, weakness or paralysis on one side of your body
  • Slurred speech
  • Stiff neck
  • Vision disturbances (blurred or inability to see)
  • Worse headache of your life

Unfortunately, defenses go down in (and when evaluating) those with a history of headaches. This places you at additional risk. Even if you have had headaches before, if you have new symptoms or something seems different about a new episode, the decision to get evaluated could save your life.

Thanks for liking and following Straight, No Chaser! This public service provides a sample of 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA). Enjoy some of our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.

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Straight, No Chaser: Public Health Has Saved More Lives Than Medical Care

General Health and Wellness, Public Health, Health Prevention, , , , , , , , , , , , , , , , , , , , , , , , , , ,

public health

When I tell most people I have a degree in public health, the typical response involves an assumption that public health involves caring exclusively for the indigent. I guess if you watched the news you could get that impression as well. Public health is the discipline dedicated to optimizing care for populations. Over the course of my career, I’ve cared for a lot of patients as a physicians, and I’ve actually saved a few lives. However, the work I’ve done as a public health professional has affected millions. The opportunity to work in public health is extremely gratifying.
In fact, according to the Centers for Disease Control and Prevention (CDC), the field of public health has been responsible for adding 25 years to the life expectancy of U.S. citizens over the 20th century. In this post I’d like to share the “Ten Great Public Health Achievements in the 20th Century.” Hopefully, this will cause you to reflect on how these discoveries, innovations and habit promotion affect your life and provide you opportunities to live a healthier life. These are being presented in no particular order.

Top10AchievementsPH

  1. Control of infectious diseases: The combination of hand washing, improved sanitation and appropriate use of antibiotics has saved untold millions. Examples of once prominent diseases being much better controlled include cholera, tuberculosis and even sexually transmitted infections.
  2. Decrease in deaths from heart disease and stroke: The combination of risk modification, symptoms recognition and early treatment has contributed to a reduction in death rates by over 50% in the last four decades.
  3. Family planning and contraceptive services: Innovations include barrier contraception to prevent pregnancy and transmission of HIV and other STDs, pre-pregnancy screening and counseling, promotion of smaller family size, longer intervals between children and the development of prenatal assessment.
  4. Food safety and healthier food production: Food safety has involved reduction in contaminated food sources, better portion control, improvement of nutrition and appropriate components of meals. Fortification of foods has nearly eliminated once prominent diseases such as rickets, goiters and pellagra.
  5. Fluoridation of drinking water: Multiple benefits exists including better infectious control and prevention of tooth decay. It’s estimated to have reduced tooth decay and loss by 40-70% since its inception in the 1940s.
  6. Healthy mothers and babies: It is astounding that infant mortality rates dropped 90% and maternal mortality rates dropped 99% during the last century. The combination of better prenatal care, technological advances and better hygiene and nutrition all have played an important role.
  7. Motor vehicle safety: Seat belts, child safety seats, motorcycle helmets, speed limits, air bags, safer highways and reduction in drinking and driving have all led to substantial reductions in deaths from motor vehicle crashes.
  8. Recognition of tobacco as a health hazard: Today there are more former smokers than current smokers and untold million of lives have been saved since the 1964 Surgeon General’s report on the health risks of smoking.
  9. Vaccinations: It wasn’t long ago in history when epidemics of measles, polio and influenza were killing tens of thousands of people annually. Rubella, tetanus, diphtheria, Hemophilus and other diseases have been brought under control. Smallpox has been eradicated as a disease due to immunizations.
  10. Workplace safety: Elimination of workplace health hazards such as black lung (coal workers’ pneumoconiosis), silicosis, asbestos poisoning and reductions in injuries related to occupational hazards have reduced fatal occupational injuries by approximately 40% in the last 30 years.

These efforts don’t occur by accident and shouldn’t be taken for granted. Public health is a clear example of important, appropriate and effective societal collaboration for the betterment of us all. Next time you see a public health professional, give her or him a pat on the back. More importantly, take the time to review the above listing and be sure you’ve incorporated the items into your life.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

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Straight, No Chaser: Tips to Limit Your Risk of Contracting The Most Deadly Diseases

General Health and Wellness, Health Prevention, , , , , , , , , , , , , , ,

early-death-pair

It is interesting and, even more, curious to hear everyone obsess over how esoteric and rare conditions can potentially kill you. Word to the wise: Common things happen commonly.  I’m going to make this a very simple post (with links to previous Straight, No Chaser posts covering the individual topics in greater detail). Let’s help you extend your life expectancy by offering very simple tips (three to five for each) to prevent and combat the five most common causes of death. This list is by no means comprehensive, but if you follow the achievable steps mentioned, you’ll be much better off than if you don’t.
According to the Center for Disease Control and Prevention (CDC), here are the five most common causes of death in the United States for the year ending 2010. (It takes awhile to compile data, but these are basically the leading causes year after year.) I’ve also included the number of annual deaths per condition.

  • Heart disease (e.g., heart attack): 597,689
  • Cancer (all cases): 574,743
  • Chronic lower respiratory diseases (e.g., asthma, COPD, emphysema, chronic bronchitis): 138,080
  • Stroke (cerebrovascular diseases): 129,476
  • Accidents (unintentional injuries): 120,859

 agingheart

Heart disease – Click here to learn early recognition of heart attacks.

  • Stop smoking and exposing yourself to second-hand smoke.
  • Exercise daily. Walk at least two miles each day. It’s a final common denomination of other problems and is a major contributor to cardiovascular disease. You want your LDL (“bad cholesterol” levels) low and your HDL (“good cholesterol” levels) high. If your LDL and/or overall levels are high, it’s an immediate prompt to reduce your belly, change your diet and exercise more.
  • Limit your calories. Never supersize anything. Eat only until you’re full. Learn about healthy plate sizes.

cancer

Cancer – Cancer warrants a special comment to get screened! Early detection is the key to survival!

  • Don’t use tobacco in any form.
  • Eat more fruits and vegetables and less red meat.
  • Become physically active: strive for at least 30 minutes of moderate to vigorous activity at least five days a week.
  • Limit sun exposure and avoid tanning. (Skin cancer is the most common of all cancers.)
  • Limit alcohol intake to one to two drinks/day (women and men, respectively).

asthmarisk

Chronic lower respiratory diseases

  • Stop smoking and exposing yourself to second-hand smoke.
  • Get your home tested for radon.
  • Follow workplace guidelines for workplace exposures to particles known to cause cancer.

strokerecog
Stroke – Learn early detection.

  • Control your blood pressure. This is the most important risk factor in stroke prevention. High blood pressure increases your risk for a stroke four-fold.
  • Control your blood sugar levels. Diabetics have a 1.5 times higher risk of stroke.
  • Control your cholesterol.
  • Stop smoking. Smoking increases your risk for a stroke between 1.5-2.5 times above the risk of non-smokers.
  • Control your weight through diet and exercise, which is bundled in each of the first three considerations.

mvc

Accidents

  • Learn CPR.
  • Wear safety belts (shoulder and lap) every trip. Seat belts reduce auto crashes by approximately 50%.
  • Stop all distracted driving (drinking, cell phone use, eating, etc.).
  • If you’re going to swim, and even if you know how to swim, take a formal lesson that focuses on life-saving maneuvers.
  • Install smoke and carbon monoxide detectors in your home.

There is no fountain of youth. Your cure won’t be found in a bottle, a fad or any other quick fix. It really is about diet, exercise and risk management. The choices you make matter. Remember, although these tips were focused on prevention, early detection and treatment at the time of crisis give you the best chance to survive. Learn early detection of heart attacks and strokes, learn CPR, get screened for cancer and learn how to survive car crashes. It’s not that hard.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what  http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Stroke Recognition

Medical Treatment, Neurology, , , , , , , , , ,

strokerecog

Let’s talk about strokes, aka Cerebral Vascular Accidents (CVA) and Transient Ischemic Attacks (TIA), and specifically about recognition and treatment. If you don’t remember anything else here, commit the mneumonic FAST to memory. (Details follow.)
A stroke (CVA) is an insult to some part of your brain, usually due to an inability of the blood supply to deliver needed oxygen and nutrients to that part of the brain. The brain actually approximates a “body map,” so depending on what part of your brain is affected, different parts of your body will be predictably affected. Technically, a stroke isn’t a stroke until the symptoms have been there for more than 24 hours; until then and/or if the symptoms reverse within that timeframe, the same scenario is called a TIA or a “mini-stroke.”

Think FAST, Act Faster

Here’s how the layperson can recognize a possible stroke:

  • Face: Ask the affected person to show you his/her teeth (or gums). In a stroke the face often droops or is otherwise noticeably different.
  • Arms: Ask the person to lift and extend the arms so the elbows are at eye level. In a stroke one side will often be weak and drift downward.
  • Speech: Ask the person to say any sentence to you. In a stroke the speech will slur or otherwise be abnormal.
  • Time: If any of the above occur, it’s recommended that you call 911 immediately, but if it’s my family, I’m getting in a car and going to the nearest MAJOR medical center—not the nearest hospital, which is where the ambulance will take you. There are important differences in hospitals when it comes to stroke treatment (which you won’t know offhand), because some are designated stroke centers and others are not. Friends, this is not the situation where you should wait hours or overnight to see if things get better. Time is (brain) tissue.

It is VERY important that you act on any of the above symptoms (F-A-S) within three (3) hours of symptom onset. Important treatment options are available within the first four and a half (4 ½) hours that are otherwise unavailable.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what www.SterlingMedicalAdvice.com (SMA) will offer beginning November 1. Until then enjoy some our favorite posts and frequently asked questions as well as a daily note explaining the benefits of SMA membership. Please share our page with your Friends on WordPress, and we can be found on Facebook at SterlingMedicalAdvice.com and on Twitter at @asksterlingmd.
Copyright © 2013 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Life Begins (To End) at 40 (Unless It Doesn’t) – The Cerebrovascular System (Your Brain)

General Health and Wellness, Neurology, Health Prevention, , , , , , ,

brainaging

Last but not least, in the first part of this series, let’s talk about your brain. But first a summary comment. Life after 40 poses both opportunity and obstacles. 35 to 40 is either the age when your lifestyle begins to catch up with you, or the work you’ve put in begins to pay off. For those who’ve lived life smartly and healthily, 40 really is the new 30. For those who’ve lived life less diligently, 40 may as well be 60, and your health probably reflects that. It’s really not that difficult. Diet, exercise, don’t smoke and alcohol in moderation keeps a body strong. Now to your brain…

Changes: As you age, cholesterol based blockages (plaque formation) inside the arteries and hardening of the arteries in the blood vessels that supply the brain is called cerebrovascular disease, and it causes strokes. These changes begin in earnest at about age 35. Prior to the complete blockage of the blood vessels, the brain is deprived of adequate blood flow (and oxygen) resulting in less than optimal brain functioning, such as confusion, disorientation, memory loss and ‘mini-strokes’ (TIAs). Strokes may result in paralysis, speech disorder, and sensory deprivation in varying degrees.
Challenges: Unlike many of the other systems I’ve discussed, the effects of these changes on our brain health status can be drastic, ranging from slight discomfort to death, and they involve major physical as well as social components. The social implications of these effects can be just as severe as the physical, as those suffering become less functional both mentally and physically. Unfortunately, in varying degrees stroke survivors become or perceive themselves to be a burden to others. Social interactions are doubly inhibited: internally, the patient is less able to interact; and externally, family, friends, and others may be less interested in interacting with them. This is sad, but true (think about the lives of the stroke survivors you may know…).
Solutions: The alternatives are twofold: after the fact, education is essential by a loved one’s support group and community, otherwise a stroke becomes a different type of life sentence. Physical and occupational therapy save lives and the quality of lives. Continuing to value and show value to your loved ones can make all the difference in the world. Before the fact, again, it’s preventive measures such as diet and exercise that have been shown to decrease or even prevent strokes. I cannot overemphasize how vital diet, exercise and the avoidance of toxins are to your long-term health.
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