Thursday, August 30, 2007

Stroke! Stroke! Stroke!

My mom me sent one of those emails stating, "Pass this on to ten friends and save lives." I have a personal policy to never pass on anything no matter what it is and I never vary from it. This one seemed pretty good though. It’s about how to identify the symptoms of a stroke. I didn't pass it on but I decided to investigate nonetheless.

Up until about ten years ago I rarely thought much about strokes or any medical problems. Most people in the military take care of themselves, especially in these rabidly health conscience times; and part of the job requirement anyway is staying in shape, so death by disease is rare for people on active duty.

Not only that, but most of us are forced out by "high year of tenure" rules before most of us are anywhere near old enough to get sick and die of conditions like heart attacks and strokes. When one does get sick like that to the point of no longer being qualified to be "a war-fighter," it's medical retirement time, whereupon it's time to go home as a civilian to either die or recover.

The email’s subject line was: New Signs of a stroke - Not a joke

The body of the email continued on thusly, about a woman named Ingrid at a BBQ who tripped and fell, seemed fine, ate her BBQ, had a good time, went home, and soon thereafter died in a hospital:

xxxxxxxxxxxxxxxxxxxxxxxx x**************************

STROKE: Remember The 1st Three Letters... S.T.R.




During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) and just tripped over a brick because of her new shoes They got her cleaned up and got her a new plate of food - while she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening. Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00 pm, Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don't die. They end up in a helpless, hopeless condition instead.

It only takes a minute to read this.

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.


Thank God for the sense to remember the '3' steps, STR. Read and Learn!
Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *
Ask the individual to SMILE.

T *
Ask the person to TALK to SPEAK A SIMPLE SENTENCE (Coherently) (I.e. It is sunny out today)

R *
Ask him or her to RAISE BOTH ARMS.

NOTE: Another 'sign' of a storke is this: Ask the person to 'stick' out their tongue. If its crooked, if it goes to one side or the other, that is also an indication of a stroke. If he or she has trouble with ANY ONE of these tasks, call 911 immediately and describe the symptoms to the dispatcher.


So that was the "stroke email." Before taking such a thing as gospel I thought I’d check it out on Snopes and send it to a doctor buddy of mine to scope out. Snopes addressed the exact email that my mom sent and it basically says that yes, its mostly good stuff. Read it here.

Snopes also addressed another BS "pass it on" email about strokes that instructs people to prick and bleed a stroke victim’s fingertips as well as to pull on their earlobes, all according to some ancient Chinese remedy. Snopes claims the supposed "Chinese stroke cure" is complete malarkey. No surprise there.

After checking out the above email, my doctor pal gave me a critique of the stroke email that I had received as well as a pretty good rundown on strokes, and even provided some great insights into heart attacks. All of it is good stuff, and combined with the excellent info from Snopes you’ve got everything you need to know about the whole range of cardio vascular episodes.

Check out what Doc Dick had to say:

Yes some of it is indeed true. Some of it is baloney.

If a person has a stroke, their smile is going to be different. The affected side of the face will generally droop downward to one side, something that would be abnormal for that person.

Getting them to talk and say a simple sentence will tell you a lot because usually the speech might be a little slurred or the person might have aphasia which is difficulty talking at all.

Asking them to raise their hands above their heads will tell you which side is affected. Generally speaking the person won't be able to raise the affected side as high.

I don't believe this lady had the stroke at the BBQ though. Once a stroke starts, it generally gets worse by the minute. She probably had a pre-stroke at the BBQ, which medically is called a transient ischemic attack (TIA). That's a warning. Sometimes people have TIA's and recover as if nothing happened. Sometimes the TIA is a warning that the big one is coming shortly - could be within hours or a few days.

Other tips:

If a person is having a stroke - he or she will normally have a very strong bounding pulse that is slower than normal.

There may be projectile vomiting.

The pupils will generally be uneven one dilated and one constricted if it is actually a stroke. This is not always the case in a TIA.

Have the person squeeze your fingers with both hands. The squeeze on the affected side will be much weaker.

A transient ischemic attack (TIA) is usually mild and may only last a minute or two but sometimes it might last a few days. However a transient ischemic attack (pre-stroke) will improve and the person may resume normal activities very soon. Not so long ago, a guy I knew here had a TIA. He dropped like a sack of potatoes in Garfield’s. He insisted on going to his doctor’s office instead of the hospital. I went with him and told the doctor I thought he had a TIA. The doctor gave him something sweet to drink saying it was just his blood sugar (which he did not check).

Two days later the guy died of a stroke.

What is baloney below is this. If it is a pre-stroke or transient ischemic attack, yes, usually within two or three hours a good neurologist can have the person out of danger and possibly even have the problem identified. If it is a thrombosis (blood clot) causing the TIA, then there are drugs to dissipate the blood clot. If it is a bleed, i.e. a burst blood vessel in the brain, then surgery at this point may take care of the problem IF it is in an area of the brain that is operable. Only about 25% of the brain is operable.

If it is a full blown stroke, not a TIA, even with a good ambulance service, the chances of saving the person's life are not so good. The reason is that the blood clot if that is what it is, has already damaged a large portion of the brain or if it is a bleed, then the intercranial pressure has already turned the brain into Jell-O. If the person lives, more than likely he or she is going to be severely debilitated due to brain damage and require quite a bit of rehab to be functional again - if being functional is possible.

Statistics for heart attacks and strokes are basically the same, since they are basically the same thing - except one is happening in the brain and the other is happening in the heart. About 50% of the people who have a first time stroke die from it within two hours. Most of them never get medical help until it is too late.

50% of the people who have heart attacks die with the first heart attack because most fatal heart attacks have NO symptoms at all. The person feels fine one minute and drops over dead the next minute. It's called "sudden cardiac death". When I was an ER doc, we used to tell people the fact that they are having chest pain is a good indicator that they are going to survive the heart attack.

And now you have had your medical class on strokes and heart attacks for the day. Regards bro.


KA said...

You know,i generally never read forwards, much less double check their facts. That's a pretty good lesson there.

PhilippinesPhil said...

If something gets my attention as being worthwhile I hate the idea that I might be accepting BS as fact. So, I always try to find out if its as good as it sounds. I'd say more often than not what comes to me in emails is false.