Stroke-Know the Signs

Lisa Niday - Saturday, February 18, 2012

 Stroke-It Can Happen Any Time to Anyone

It started as any other day, we were having a little backyard cookout for my husband's son. It was his birthday and we thought it would be nice to enjoy a little outdoor cooking and time together. It turned out to be a today that forever changed our lives. My husband was chopping some vegetables in the kitchen and he just slid down the wall. It was as if it was in slow motion. When I went over to him, he could talk and move, nothing externally seemed wrong. We did go over to the kitchen table and take his blood pressure and found it to be very high. Although he only exhibited this "fainting" nothing else but the higher than normal blood pressure seemed awry. I convinced him we needed to go to the hospital and have it checked out. He walked into the ER under his own power and while they were taking his history, it seemed as though nothing were wrong.

In the ER, they had taken blood and even done a simple test and were thinking perhaps he had a seizure. While they were getting a list of his medicines the nurse looked over when he didn't answer the question. It was as though he had died in the bed. He was unable to speak or move. They rushed him to get a CAT scan to find out he had a blocked carotid artery and had a blood clot.  It had been almost 4 hours since the initial onset of his symptoms. When he arrived back from the CAT scan he was speaking (albeit slowly) and they wanted permission to administer TPA (a clot busting drug). No sooner than permission was given, Airlife was in the hallway to take him to the stroke center for a 5-state region.

After a procedure to remove the blocked carotid artery and open it up with a stent and then some neurological maneuvering to remove pieces of the clot from his brain, he is well on a path to recovery.

So why share all these details? For a couple of reasons. One, everyone should be familiar with the warning signs of stroke (even though he barely showed one of them). Two, to tell you to act quickly when you think something is wrong. Three to discuss preventative versus symptomatic treatment for illnesses.

Stroke Warning Signs

• Sudden numbness or weakness of the 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, or loss of balance or coordination

• Sudden severe headache with no known cause.

For us the loss of balance or coordination would have been the largest warning sign because he kind of slid down the wall. Once he got up he didn't exhibit any other symptoms. Had he shown other signs, I think we would have reacted differently and called 911. My recommendation would be to err on the side of caution, just make the call to 911 and let them diagnose. He did experience something that was unusual and not his normal pattern and did have a spike in blood pressure.

Most people either have a stroke in their sleep or do not recognize the symptoms soon enough to take advantage of TPA (provided they have an ischemic stroke (clot) versus hemorrhagic (bleeding) stroke. We have been attending a stroke group for about a month now and out of this group, my husband is the only one who received TPA. His recovery appears to be much more faster as a result of the TPA.

Results are Devastating

It doesn't appear to matter, whether you are younger or older, the results of a stroke can be very challenging to the victim and the caregiver. Many lose feeling in their legs or arms, are aphasic (can't speak), experience apraxia (not using normal tools like silverware appropriately), short term memory loss, and understanding to name a few.

The good news is the mind is very resilient. It appears to rewire to compensate for damaged areas.  These are very similar to the same things that people with traumatic brain injuries experience (think Gabby Gifford). Many times they must learn to walk and talk and do basic functions again. A positive is that you do see people recover, but there is a cost to the victim, caregiver and families lives as well. Why do I mention this?

Prevention Versus Treatment

I recently watched an episode on ABC's Nightline and Good Morning America, where correspondent Bill Weir underwent a battery of tests at the bequest of Dr. David Agus who authored, The End of Illness. In these tests they uncovered an already blocked artery in a young, otherwise healthy man. Weir indicated these tests wouldn't have been recommended by the American Heart Association.

In the book, Agus advocates the testing to prevent illness versus treating the illness after the fact. I thought immediately to the fact, that if these tests had been performed for my husband, they most likely would have uncovered the blocked carotid artery in time so that a stroke would never have occurred. I understand these tests are expensive and for most people they won't find anything so they can be seen as needless and costly. However if they are used in the context to help people make lifestyle changes to prevent more detrimental affects later and to find a problem before it becomes a full blown illness, I have to wonder if Dr. Agus is really on to a better system for healthcare.

The costs of treating after the fact, can be 4-5 times the amounts of preventative treatment and those are conservative numbers. I think more of us have to have dialog with our doctors and be more proactive in our health care in order to make the changes. I think we are all aware that changes in health care are being thrust upon us. Wouldn't it be nice if we let our voices be heard around what we would like health care to become.

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