Tag Archives: Stroke

From the Health Library of SterlingMedicalAdvice.com: “If I stop smoking, what does this do to my risk for heart disease and stroke?”

January 6, 2016Cardiology/Heart, General Health and Wellness844-SMA-TALK, Behind the Curtain, cigarette smoking, coronary heart disease, heart attack, Heart disease, smoking, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, StrokeJeffrey Sterling, MD

There are immediate and longterm benefits to smoking cessation that extend beyond just lowering your risk for lung cancer. Consider the following regarding lowering your risk for heart disease and stroke, and make the change to make yourself healthier.

Within 1 year of smoking cessation, your excess risk of coronary heart disease, heart attack, and stroke has dropped to less than half that of a smoker.
Within 5–15 years after stopping, your risk of stroke has declined to that of a non-smoker.
At 15 years after stopping, your risk of coronary heart disease is that of a person who has never smoked.

You can do it. There are many great reasons to. You likely can them family and friends.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Straight, No Chaser: The Most Frequent Causes of Death and How to Avoid Them

December 3, 2015General Health and Wellness844-SMA-TALK, accidents, Asthma, Behind the Curtain, Cancer, COPD, Heart disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, StrokeJeffrey Sterling, MD

It is interesting and 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 Centers 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

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 – Please 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).

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.

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.

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 if you’re actually trying.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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

September 11, 2015General Health and Wellness, Neurology, Health Prevention844-SMA-TALK, Behind the Curtain, Blood vessel, Brain, Cerebrovascular disease, Conditions and Diseases, health, Neurological Disorders, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, Transient ischemic attackJeffrey Sterling, MD

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.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

Straight, No Chaser: Aspirin – It's Not Just for Heart Attacks Anymore

August 31, 2015Cardiology/Heart, General Health and Wellness, Health Prevention844-SMA-TALK, Aspirin, Behind the Curtain, Digestive Tract Cancer, heart attack, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, StrokeJeffrey Sterling, MD

…not that it ever was! Aspirin has been known to be a pain reliever for thousands of years. Let’s take a brief look at the additional qualities that should make aspirin one of the meds you’d want to have if stranded on a deserted island.
Heart attacks: Many doctors routinely prescribe a daily aspirin to help prevent heart attacks. In fact, the research was so good that a Nobel Prize in medicine was awarded to those discovering that aspirin prevents the clot formation that leads to heart attacks. It has been estimated by the American Heart Association that up to 10,000 American lives would be saved every year if an aspirin (325 mg) was taken at the first signs of a heart attack. However, it is important to note that the US Food and Drug Administration (FDA) updated its recommendations to state daily use of aspirin should only be in those instances in which individuals already have cardiovascular disease, due to aspirin’s side effect profile.
Strokes: Aspirin has the same preventive effects on stroke development as it does for heart attacks, and daily preventive medicine is now part of many lives for that reason.
Cancer prevention: Aspirin appears to have preventative benefits for certain digestive cancers. Just this week, research published in the Annals of Internal Medicine finds that daily aspirin use at recommended levels for at least five years was associated with a 27% less likelihood of developing colorectal cancer. Additional evidence is strong for presentation of esophageal and stomach cancers, but outside of the digestive tract, conclusive evidence hasn’t presented of yet.
So if you’ve been told to take a daily aspirin to reduce your risk of a heart attack because you likely fell into one a high-risk category, here are some logistical considerations about what to do.

1) Is there a better time of day to take an aspirin?
Recent data suggests that most heart attacks occur early in the morning. The best time to take an aspirin is relatively soon before you have that heart attack. However, since your heart doesn’t give you a heart attack alarm clock (and many of us aren’t especially mindful of heart attack recognition), the best move would seem to be to take an aspirin before going to bed, and recent research supports that an aspirin taken before going to bed offers the most protection from a heart attack. There are limitations to doing this (e.g. taking aspirin on an empty stomach if you have a history of ulcers may not prove to be the most pleasant thing), and you should discuss such timing with your physician.
2) Is there a better dose of aspirin to take?
That’s a question your physician will answer and is dependent on your personal situation. That said, doses as low as 75-81 mg have been shown to be effective. You may be placed on any dose up to 325 mg/day. It really is important to take an aspirin dose recommended by your physician for this consideration.
3) Is it better to chew or swallow an aspirin?
Chewing an aspirin is the quickest way to achieve effective blood levels. In case you were thinking about taking an Alka-Seltzer (which contains aspirin), that’s also good – but it’s just not as good as chewing an aspirin.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright, Sterling Initiatives, LLC. 2013-2015

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

April 14, 2015General Health and Wellness, Health Prevention844-SMA-TALK, Asthma, Cancer, Cardiovascular disease, Chronic bronchitis, Conditions and Diseases, Diabetes, emphysema, Heart attacks, MVA, MVC, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, StrokesJeffrey Sterling, MD

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

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 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).

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.

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.

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) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
Copyright © 2015 · Sterling Initiatives, LLC · Powered by WordPress

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

April 13, 2015General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, asbestosis, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

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 20^th century. In this post I’d like to review the “Ten Great Public Health Achievements in the 20^th 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.

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.
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.
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.
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.
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.
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.
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.
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.
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.
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.

Straight, No Chaser: The Most Frequent Causes of Death and How to Avoid Them

August 27, 2014Public Health844-SMA-TALK, accidents, Asthma, Cancer, COPD, Heart disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, StrokeJeffrey Sterling, MD

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

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 – Please 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).

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.

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.

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 if you’re actually trying.
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.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Stroke Recognition

May 29, 2014General Health and Wellness844-SMA-TALK, cerebrovascular accident, Conditions and Diseases, CVA, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, thrombolytics, TIA, Transient ischemic attackJeffrey Sterling, MD

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.
Copyright © 2014 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: When Your Headache is Life-Threatening

May 4, 2014Neurology, Health Prevention844-SMA-TALK, arteriovenous malformation, AV malformation, Carbon monoxide poisoning, Conditions and Diseases, encephalitis, meningitis, Migraine, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, Subarachnoid bleed, temporal arteritisJeffrey Sterling, MD

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

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

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.

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

April 8, 2014General Health and Wellness, Public Health, Health Prevention844-SMA-TALK, asbestosis, black lung disease, Centers for Disease Control and Prevention, Conditions and Diseases, coronary heart disease, diphtheria, family planning, goiters, homophiles, immunizations, infant mortality, Influenza, measles, motor vehicle collision, pellagra, polio, rickets, rubella, Sexually transmitted disease, silicosis, smallpox, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, tetanus, vaccinationsJeffrey Sterling, MD

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 20^th century. In this post I’d like to share the “Ten Great Public Health Achievements in the 20^th 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.

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.
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.
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.
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.
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.
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.
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.
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.
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.
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.

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

March 17, 2014General Health and Wellness, Health Prevention844-SMA-TALK, Asthma, Cancer, Cardiovascular disease, Chronic bronchitis, Conditions and Diseases, Diabetes, emphysema, Heart attacks, MVA, MVC, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, Stroke, StrokesJeffrey Sterling, MD

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

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 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).

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.

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.

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.
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Straight, No Chaser: Stroke Recognition

October 14, 2013Medical Treatment, NeurologyBrain, Circulatory system, FAST (stroke), health, Hypertension, Limited liability company, Stroke, Symptom, TIA, Transient ischemic attack, WordPressJeffrey Sterling, MD

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

September 13, 2013General Health and Wellness, Neurology, Health PreventionBlood vessel, Brain, Cerebrovascular disease, Conditions and Diseases, health, Neurological Disorders, Stroke, Transient ischemic attackJeffrey Sterling, MD

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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