Wednesday, October 11, 2017

TIAs: Don't call them ministrokes

I've called them ministrokes before, but this article from U.S. News makes me re-think that phrase. It contends that you shouldn't call transient ischemic attacks ministrokes:
Yet, while 35 percent of adults in the U.S. have had symptoms suggestive of a TIA, only 3 percent of them called 911 for help, according to a recent online survey of more than 2,000 people by the American Heart Association and American Stroke Association. That’s a mistake, experts say. If you have symptoms of a stroke or TIA, “don't wait it out,” advises Dr. Dion F. Graybeal, medical director of stroke at the Baylor University Medical Center in Dallas. “Take these symptoms seriously and call 911.” If it’s a real stroke, every minute counts in terms of getting treatment and reducing the risk of permanent disability. And if it’s a TIA, “it’s an opportunity to intervene and hopefully stop a process or condition that could cause a stroke with disability in the future,” Graybeal says.
It’s better to be safe than sorry because if you have stroke-like symptoms, it’s difficult to tell immediately if you’re having a TIA or a full-blown stroke, says Dr. Nieca Goldberg, a cardiologist and medical director of the Joan H. Tisch Center for Women’s Health at the NYU Langone Medical Center in New York City. So it’s important to get to the hospital as soon as possible, There, you will most likely have a CT scan, a CT angiogram, an MRI or an MR angiogram of your brain and the blood vessels in your head to look for a blood clot and evidence of damage to the brain. If damage isn’t apparent and the symptoms have resolved, the episode will be deemed a TIA. But if there is evidence of damage to areas of the brain, the event will be diagnosed as a stroke, even if the symptoms have gone away, Goldstein says.

Wednesday, October 04, 2017

Stopping aspirin therapy may raise heart attack, stroke risk

Aspirin - cheap and perhaps lifesaving. So read how stopping aspirin therapy may raise heart attack, stroke risk:
Stopping low-dose aspirin therapy without good reason raises the likelihood of heart attack or stroke by nearly 40 percent, a large Swedish study suggests.
Doctors commonly prescribe daily low-dose aspirin after a heart attack to reduce the risk of having a second cardiovascular event. But about one in six patients stop taking their aspirin within three years, the study authors note in Circulation.

Wednesday, September 27, 2017

Closure of hole in the heart reduces stroke recurrence

A still from the video of my PFO being closed.
Click here to view the video.
If you've read this blog before, you might know that my hole-in-the-heart was closed 10 years ago. Click here to read details.

The hole is called a patent foramen ovale, or PFO. It's an opening between the upper chambers of the heart. We're all born with one, but it's normally closed shortly after birth. For some, though, it remains. For some people, blood clots can pass from one side to the other, getting pumped out to the arteries and eventually in the brain, causing a stroke.

Wednesday, September 20, 2017

Drug prices hit especially hard in rural America

Which is more valuable - the life of someone who lives in Mountain View, Ark., (population 2,860) or someone who lives just one county over?

That's the question from a good NPR piece about how high drug prices hit rural hospitals extra hard, a story beginning with the story of a stroke patient coming in to a small, rural hospital needing an expensive drug:
For example, Langston's 25-bed hospital pays $8,010 for a single dose of Activase — up nearly 200 percent from $2,708 a decade ago. Yet, just 36 miles down the road, a bigger regional hospital gets an 80 percent discount on the same drug. White River Medical Center, a 235-bed facility in Batesville, Ark., buys Activase for about $1,600 per dose.
White River participates in a federal drug discount program Congress approved in the early 1990s. The program offers significant price breaks on thousands of drugs to hospitals that primarily serve low-income patients. One federal report found the average discount ranged from 20 to 50 percent, though as illustrated with Activase, it can be much higher.

Thursday, September 14, 2017

After years of decline, South sees rise in stroke deaths

Even though the South is also know as the Stroke Belt, we've seen a decline in stroke deaths - until now. In the most recent numbers, stroke deaths are rising in the South:
In its monthly Vital Signs report, the Centers for Disease Control and Prevention reported that stroke deaths are on the rise in the South in recent years after decades of decline, and rates are stagnant in other states. While stroke deaths have declined more than 76 percent since 1968 among adults 35 and older, and 38 percent since 2000, that decline has roughly leveled off or even increased in most states since 2013, according to the report. That includes an overall 4 percent increase in the South, with a 3 percent increase in Georgia and a whopping 10.8 percent increase in Florida.
“This is an important wake-up call,” said Dr. Brenda Fitzgerald, director of the CDC and a former Commissioner of the Georgia Department of Public Health. It is particularly alarming among those ages 35-64, which made up a third of the more than 32,000 “excess stroke deaths,” those who died from stroke who might not have had the death rates continued their decline.

Wednesday, September 06, 2017

Meth could up stroke risk in younger users

Methamphetamine's dangers are well known - and now, it looks like that the drug could up stroke risk in younger users:
With use of the stimulant increasing, particularly in more potent forms, doctors in many countries are seeing more meth-related disease and harms, the Australian study authors said. This is especially true among younger people, who are the major users of the drug.
"It is likely that methamphetamine abuse is making a disproportionate contribution to the increased incidence of stroke among young people observed over recent years," said researchers led by Julia Lappin. She's with the National Drug and Alcohol Research Center at the University of New South Wales in Sydney.
These strokes can lead to disabilities or death, she and her colleagues pointed out.
(Photo from MedlinePlus)

Wednesday, August 23, 2017

Men are seeing a decline in stroke risk - but women?

You might have seen postings about the disturbing numbers about younger people having strokes. Now, while stroke risk is declining among some groups, a recent study suggests that stroke risk is declining in men but not women:
The incidence of stroke has declined in recent years, but only in men.
Researchers studied stroke incidence in four periods from 1993 to 2010 in five counties in Ohio and Kentucky. There were 7,710 strokes all together, 57.2 percent of them in women. ...
No one knows why there has been no improvement in women, but the lead author, Dr. Tracy E. Madsen, an assistant professor of emergency medicine at Brown, said that some risk factors have a stronger effect in women than in men. Risk factors for stroke include high blood pressure, heart disease, diabetes and smoking.

Wednesday, August 09, 2017

Where did your stroke happen? Geography might impact treatment

Photo from David Kessler via Flickr
Last week, the posting was about people born in the "stroke belt" region.

So for a related item, a look at cholesterol-treating drugs seem less likely to be prescribed in the stroke belt, with no statin prescribed for half of stroke survivors:
But inside the so-called Stroke Belt region, seniors were 47% less likely to be discharged on a statin, and men were 31% less likely to get a prescription for the lipid-lowering drugs than women. Neither association was seen outside the Stroke Belt.
"All survivors of ischemic stroke should be evaluated to determine whether they could benefit from a statin, regardless of the patient's age, race, sex, or geographic residence," lead author Karen Albright, PhD, DO, MPH, of the Birmingham VA Medical Center, said in a press release.

Wednesday, August 02, 2017

Where were you born? If you're from the 'stroke belt,' you might be in danger

Geography if often a key health indicator. Now, a recent study shows that being born in the U.S. "stroke belt" is tied to higher risk of dementia:
For the current study, researchers examined data on 7,423 adults living in Northern California, including 1,166 people born in high stroke-mortality states - all but one in the South: Alabama, Alaska, Arkansas, Louisiana, Mississippi, Oklahoma, Tennessee, South Carolina and West Virginia.
At age 65, the risk of developing dementia in the next 20 years was 30 percent for people born in these states, compared to 21 percent for those born elsewhere, the study found.

Thursday, July 20, 2017

How heart health is linked to brain health

You've seen this theme before - exercise is linked to decreased stroke risk. This study looked at heart health, brain size, and what it means - how heart health is linked to brain health later in life:
Those who scored high at the start were more likely to have higher brain volume when they reached middle age. The study authors say that every point lower a person scored on the Life's Simple 7 corresponded with about one year of age-related brain shrinkage.
"Larger brain volume, relative to head size, is associated with better health," explains study author Michael Bancks, a postdoctoral fellow in preventive medicine at Northwestern University Feinberg School of Medicine, in an email to TIME. "Brain atrophy — smaller brain volume — is associated with death and disability." Prior studies have linked smaller brain size to lower cognitive function scores and an increased risk for health events like stroke in middle age and beyond.

Wednesday, July 12, 2017

'Aphasia Choir' uses music for help in recovery

I've posted before about my own story about stroke recovery, aphasia and singing. Here's a recent story about an "Aphasia Choir" in Vermont:
How is it that survivors of stroke and certain brain injury are often unable to speak but they still can sing? The answer lies in the brain's physiology. By tapping into the undamaged right hemisphere, the stroke survivor can recall familiar melodies and express them through song. Enter, the Aphasia Choir.

Wednesday, July 05, 2017

More millennials are having strokes

Is a stroke tsunami heading this way? That's one thought expressed in this piece on how more millennials are having strokes:
Although many of the details are murky, the potential impact is clear: In the short term severe strokes among younger adults are a big problem because disability in people in their peak earning years can severely impact their families and future lives, Elkind says. Longer-term, more strokes — even relatively mild ones — among younger adults are worrying because they portend an upcoming epidemic of worse attacks in another 30 years (since survivors’ second strokes are more likely to be stronger and potentially fatal). “We are just seeing those little waves hitting the beach now but that tsunami will come in the future,” says Elkind, who notes that risk factors such as obesity and smoking are cumulative over time.

Wednesday, June 28, 2017

Another hole-in-the-heart story about an unexpected stroke

A story similar to mine - a stroke that came out of nowhere. One woman's story about the undiscovered hole in the heart can lead to a stroke:
A still shot of the repair of my hole in the heart.
Click here to read more about it.
“I had four strokes,” Dean said. “A clot ran up from my leg, broke off a piece into my lung and the other half went into a hole in my heart that I didn't know I had and it went into my head and sprayed into four strokes.”
It’s called patent foramen ovale (PFO), Latin for “open oval window.” It is a small hole located in the upper chamber of the heart, which makes it possible for a baby in utero to get blood from the placenta through the umbilical cord to the heart, but it typically closes a few months after birth.

Wednesday, June 21, 2017

Stroke patients can keep recovering, even after a year

One takeaway from a recent story about stroke recovery shows something to remember - "it's highly unethical to say nothing can be done after 12 months" in recovery. Personally, it took me years to get back to my almost-100 percent recovery. Stroke recovery can be incremental.

Now, will horses and music definitely help? One small study doesn't prove that it does, but it's worth studying further. Read how long-term stroke survivors believe they do better with horse, music therapy:
A small Swedish study of stroke patients finds that activities such as horseback riding and rhythm-and-music therapy can help them feel like they're recovering faster, even if their stroke occurred years earlier.

Wednesday, June 14, 2017

Finding the right words - the challenge of aphasia

June is Aphasia Awareness Month. And until 19 years ago, I had no idea what the word meant.

But I know now. It's a language disorder, leaving some people unable to speak. Others can speak but struggle to find the right words.

That was me. I still have the list of words I said to my wife after my 1998 stroke: towrith, rice, torithe. And I was trying to say the name of a city I'd visited not long before -- Jonesboro. Through time and with the help of a speech therapist, family and friends, I'm almost 100 percent back.

I can still remember frequently swapping pronouns -- referring to a male as "she" or a female as "he," a common occurrence. Or leaving out small words. Or using the wrong tense -- such as saying "worked" instead of "working."

Wednesday, May 31, 2017

Helicopters delivering doctors for stroke patients

Most of us have likely seen helicopters carrying patients to hospitals. Now, there's the idea that flying doctors to stroke victims may improve outcomes:
Transporting doctors to stroke victims could be one viable way of bringing the procedure to more patients, Hui believes. He has been flown to Suburban Hospital to treat three patients this year. Early indications are that it is less expensive and faster than transporting a patient to the doctor.
In a case study of one those incidents printed in the Journal of Neurointerventional Surgery earlier this month, it took Hui 77 minutes to fly to the hospital and complete the procedure. The helicopter took off for the 19-minute flight from Hopkins to Montgomery County at 12:24 p.m. At 1:07 p.m. Hui inserted the catheter into the patient and he completed the surgery by 1:47 p.m.
The full process took about the same amount of time as it would have if Hui had performed the procedure on a patient at Johns Hopkins because doctors at Suburban prepped the patient before Hui arrived to the hospital. It likely would have taken longer to prepare the patient to be transported to Hopkins, let alone travel time and preparation and surgery once there, he said.
Although the study wasn't designed to look at the health outcome of the patient, studies have shown that timing is crucial when treating stroke patients because patients lose brain capacity with each minute they are not treated. Stroke victims do best when they are treated as quickly as possible — ideally in 100 minutes or less.

Wednesday, May 24, 2017

Here's another story of 'A Stroke of Faith'

Wait for the Lord; be strong and take heart and wait for the Lord.
-Psalm 27:14
Mark Moore learned this lesson the hard way. Ten years ago he was hit by back-to-back strokes that could have taken his life. He spent a month in a coma and wake up to find his life forever changed. He re-learned how to walk.

His biggest challenges? One was impatience - recovery doesn’t happen overnight. “It’s incremental … you have to be patient,” he said in an interview earlier this week, coinciding with the release of his new book, “A Stroke of Faith: A Stroke Survivor’s Story of a Second Chance of Living a Life of Significance.” Just to be clear, the book isn’t directly related to this blog with a similar name.

Then again, it’s semi-related because like me, Mark had a stroke at a relatively young age, nearly died and struggled to recover. Also like me, he's finished races during his recovery. A year after his stroke, he finished a 5K (that's 3.1 miles) and went on to run a 10K.

Wednesday, May 17, 2017

Up to 1 out of 3 of you have had a stroke - perhaps without knowing

Have you ever had a stroke? Perhaps you had one but didn't recognize it. Read this link how 1 in 3 Americans may have had warning stroke without knowing it:
 ... [A]bout 35 percent of Americans experience symptoms of a warning stroke. Yet only about 3 percent get immediate medical attention.
Most adults who had at least one sign of a "mini" stroke - a temporary blockage also known as a transient ischemic attack (TIA) - waited or rested until symptoms had faded instead of calling 911 right away, according to the research from the American Heart Association/American Stroke Association (AHA/ASA).
"Ignoring any stroke sign could be a deadly mistake," said ASA chair Dr. Mitch Elkind, in a news release from the organization.

Wednesday, May 10, 2017

May is Stroke Awareness Month: How aware are you?

May is Stroke Awareness Month. It's important to be aware of stroke signs, what to do and how to prevent strokes - and not only in a single month.

Why? A stroke can strike anyone. Strokes do not respect age, social status or wealth. My own stroke happened in May 1998. Outwardly, I was healthy - a longtime distance runner - and under 40.

I received a chart showing basic information about strokes, signs and prevention from Crouse Hospital of Syracuse, N.Y., and wanted to share its good information for this month. It's not an ad as far as I'm concerned, but rather information for you to retain and share.

Click on the chart and check it out.

Wednesday, May 03, 2017

Emoji app - can it help aphasia patients?

Back in the pre-emoji era, one of the tools I used to get my language skills back was an educational toy called GeoSafari. The company still makes more modern versions of this toy.

Fast forward almost 19 years, and here's some new technology to help people with aphasia, a common result of a stroke. Read how Samsung’s new app uses emojis to help people with language disorders communicate:
Created by Samsung Electronics Italia (the company’s Italian subsidiary) and speech therapist Francesca Polini, Wemogee replaces text phrases with emoji combinations and can be used as a messaging app or in face-to-face interactions. It supports English and Italian and will be available for Android on April 28, with an iOS version slated for future release.

Wednesday, April 26, 2017

Unsettling numbers: Stroke rates and young people

This topic really hits home for me. I was under 40 when mine happened. Despite that, there's a general assumption that strokes happen only to the elderly.

But yet another study shows stroke rates appear to be rising steadily in young adults:
"Most people think that having a stroke is something that only happens to older people, but the impact of stroke is significant — it is uniquely complex in younger adults, in midst of careers, serving as wage earners and caregivers, who may suffer disability that can impact their lives and the lives of family members and loved ones," George said.

Wednesday, April 12, 2017

'We are renewed day by day'

Therefore we do not lose heart. Though outwardly we are wasting away, yet inwardly we are being renewed day by day.
Every so often, my body reminds me that I'm no longer in my 20s. Or 30s. Or 40s. You get the picture.

Now we're in the middle of Holy Week, the week between Psalm Sunday - the celebration of Jesus' entry to Jerusalem - and Easter Sunday - the celebration of his resurrection and the ultimate promise of what Paul is saying in the verse above.

So consider this verse this week. Despite age, health issues, anything that troubles you, there's that promise of renewal.

Wednesday, March 29, 2017

This millionaire’s stroke led him to a life of philanthropy

Interesting thoughts from a stroke survivor, a millionaire whose stroke led him to a life of philanthropy:
The stroke changed you physically, but how did it change your outlook?
I was scared. A stroke is very difficult because it’s physical and mental. It’s an attack on the brain. But I had a lot of support: my wonderful wife and a lot of friends. But I also had to turn to my faith. When I was sitting there that night after I came out of the coma, I didn’t ask God to let me go back to work or play basketball again. All I said was: Give me the strength to deal with whatever you send my way. That was different for me.
Had you been very religious before that?
My view back then was that Sunday was God’s day, but the other six days I was in control. This was the first time that I realized that God was in control every day. I would not have recovered had I not relinquished control.
The point is not to imitate him in detail - we're not all millionaires - but to do what we can. I need that reminder.

Wednesday, March 22, 2017

Many at risk for stroke don’t get anti-clotting drugs

Stroke prevention can save a life. Yet, many at risk for stroke don’t get anti-clotting drugs:
More than four in five stroke patients with a history of heart rhythm problems didn’t get any blood thinners, or didn’t take enough to help prevent a stroke before they had one, a U.S. study suggests.
Most strokes occur when a clot blocks an artery carrying blood to the brain, known as an ischemic stroke. The study focused on more than 94,000 stroke patients with atrial fibrillation, an irregular rapid heartbeat that can lead to stroke, heart failure and chronic fatigue.

Wednesday, March 15, 2017

'Something else going on' in pot connection

You've likely seen similar news before. Click here for the most recent.  And while the research leaves many unanswered questions, it's worth considering how pot use is tied to higher odds for stroke:
New research analyzing millions of U.S. medical records suggests that marijuana use raises an adult's risk of stroke and heart failure.
The study couldn't prove cause-and-effect, but the researchers said they tried to account for other heart risk factors.
"Even when we corrected for known risk factors, we still found a higher rate of both stroke and heart failure in these patients," explained lead researcher Dr. Aditi Kalla, a cardiologist at Einstein Medical Center in Philadelphia.
"That leads us to believe that there is something else going on besides just obesity or diet-related cardiovascular side effects," Kalla said in a news release from the American College of Cardiology (ACC).

Wednesday, March 08, 2017

Exercise: It's good for your brain

Do what exercise you can - it's good for the brain.

If you've read this blog before, you likely know I'm a longtime distance runner. Not everyone can do that, I realize. But almost anyone can exercise at some level of motion. And recent research reiterates that for stroke survivors, exercise is good for the brain:
The findings bolster what experts have long believed: Exercise can aid stroke recovery in multiple ways.

Wednesday, March 01, 2017

Too often, too many people don't get the right treatment

The clot-busting drug tPA has been available now for more than 20 years. But still, too many stroke victims don't get the drug:
Every year, patients were 11 percent more likely to be treated by tPA, even though across the entire period of time only 3.8 percent of total patients got the clot-busting drug, researchers reported.
The team found certain types of patients were less likely to receive tPA:

Wednesday, February 22, 2017

Alexa - tell me how to save a life

Alexa has moved into our home.

That is, a couple of Amazon Echo Dots occupy the place where I live. So far, I've told Alexa (the name of the voice) to tell me jokes, give me news and weather information, play radio stations, play music and more.

Very handy devices, all voice-controlled.

And now, Alexa can tell you the steps for CPR and warning signs of heart attack and stroke:
Alexa, the friendly voice of the Amazon Echo, will for the first time offer CPR instructions and describe the warning signs of heart attack and stroke.

Wednesday, February 08, 2017

Snowstorms and strokes - strange association

The people in my town, Columbia, Missouri, can thank me for the lack of snow lately. A couple of years ago on Black Friday, I bought a snow blower online, from my recliner. That's my kind of Black Friday shopping.

But it's been mostly idle since - not that much snow. Which is fine. I'm not a fan.

So how does this tie in with strokes? It seems that snowstorms may bring blizzards health troubles, including strokes:
Hospital admissions for heart-related ailments -- heart attack, chest pain and stroke -- were 23 percent higher two days after a storm.
The study authors believe their analysis is the first to examine hospital admissions over the course of several days after low, moderate and high snowfalls.

Wednesday, February 01, 2017

Story of a clinical trial provides serious food for thought

A still from the video of my PFO closure.
Click here to watch the video.
Something to think about: Clinical trials are necessary but can be thought-provoking.

The Houston Chronicle recently published a look at a clinical trial to find answers about closing a heart defect called a patent foramen ovale, or a PFO. It's potentially a stroke-causing defect. It was the probable cause of my stroke in 1998. It got patched up in 2007. You can click here to read about it.

But even though mine was fixed almost 10 years ago, it didn't end the controversy over whether the procedure - done in a cardiac catheterization lab - was really better than treating the defect with medication. One of my personal choices involved not taking blood-thinning warfarin - click here to read about it - for the rest of my life.

Wednesday, January 25, 2017

Undiagnosed and untreated - what's your blood pressure?

Last week, the focus was global hypertension problems. Now, in a North American study, we learn that high blood pressure is often undiagnosed, untreated:
For the study, the researchers measured the blood pressure of almost 1,100 volunteers. The measurements were taken at mobile clinics that the researchers had set up at shopping malls, workplaces, hospitals and community centers in a large city.
The study revealed that 50 percent of the participants were unaware they had high blood pressure. Of these people, 2 percent were at very high risk for health complications.
The findings were published online Jan. 5 in the American Journal of Hypertension.
"What is particularly significant about this study is that a surprisingly large number of participants exhibited some type of hypertensive urgency or emergency," study author Dr. Grant Pierce said in a journal news release. Pierce is executive director of research at St. Boniface Hospital in Winnipeg.
Most of the people with high blood pressure weren't being treated even if they had been diagnosed. The study authors suggested that either these people didn't fully understand their condition, or they didn't understand the health consequences associated with high blood pressure.
High blood pressure is the leading cause of strokes. Taking it seriously might save a life.

Wednesday, January 18, 2017

The world is experiencing a high blood pressure increase

High blood pressure - hypertension - is the leading risk factor for strokes.

So the news is a little frightening - high blood pressure is increasing worldwide:
"There are almost 900 million people in the world with hypertension, and there are almost 3.5 billion people with elevated blood pressure that doesn't quite meet the definition of hypertension," said study lead author Christopher Murray. He directs the University of Washington's Institute for Health Metrics and Evaluation in Seattle.
"Blood pressure is the leading cause of premature death and disability in the world," Murray said.
Blood pressure is made up of two numbers. The top number, called systolic pressure, measures the pressure in the arteries when blood is being pumped from the heart. The bottom number, the diastolic pressure, measures pressure between heartbeats. Blood pressure is expressed in millimeters of mercury (mm Hg).
The study authors said that even systolic blood pressure within what is considered a normal range -- less than 120/80 mm Hg, according to the American Heart Association -- can increase the risk of heart attack and stroke.
It's important to pay attention to your blood pressure and if needed, work with your health professionals to control it.

(Photo from U.S. Centers for Disease Control and Prevention)

Wednesday, January 04, 2017

Top posts visited in 2016

Stroke of Faith has been around since December 2005 - more than 11 years now.

I ran numbers recently for the top five most-read postings in 2016. Just one was actually posted that year - the rest are a collection of oldies but goodies starting with:

1. There's a hole in my heart 

2. Stroke signs: Remember the first three letters, S. T. R.

3. 'Do not be anxious about anything'

4. 'Be our strength every morning'

5. How I learned about aphasia and intelligence - the hard way

The top most-read posting is about the likely cause of my stroke - a patent foramen ovale, or a hole between the two upper chambers of my heart. The second is a quick read about stroke signs. Numbers 3 and 4 are Scripture-based postings, and No. 5, the only one posted in 2016, reminds us all that aphasia effects language - but doesn't reduce intelligence.