Movie stars aren't immune...

The day after Oscar night, perhaps it's fitting to check a recent WebMD story about how stroke takes a toll on Hollywood stars:

Pop quiz: What do Bette Davis, Cary Grant, and Sharon Stone have in common, besides being Hollywood stars of course?

Answer: All are Oscar nominees or winners who suffered a stroke, an event that took a tremendous toll on their and other stars' careers.

 Strokes are equal opportunity events that ... kill, maim and destroy lives. Know stroke signs. Even moderate lifestyle changes can reduce your own risk. Do it even if you're not a movie star.

Time is key for stroke recovery success

Some news in my town - quick response times for a local hospital. Columbia, Mo.'s University Hospital was named to the American Heart Association's stroke honor roll:

University Hospital has been named to the American Heart Association/American Stroke Association's 2011 Target: Stroke Honor Roll, which recognizes hospitals with "clot-busting medication" treatment times of fewer than 60 minutes for ischemic stroke patients, according to an MU Health Care news release.

University Hospital was one of 74 hospitals in the nation that were named to the list, and one of four in Missouri, according to the release. The other three hospitals in the state named to the Target: Stroke Honor Roll are Barnes-Jewish Hospital and Saint Louis University Hospital in St. Louis, and CoxHealth in Springfield, according to the American Heart Association website.

Niranjan Singh, a neurologist and co-director of University Hospital's stroke program, said this recognition is very important for stroke victims coming to the hospital for treatment.

"Time is a key feature of this stroke treatment," Singh said. "Patients coming to the University Hospital will have the same time metrics as the other hospitals in Missouri and the U.S. on this list."

 The clot-busting medication mentioned is tissue plasminogen activator, or tPA. There's a total time window of 4.5 hours in most cases, and a single hour can increase changes of better recovery. Not every stroke patient is a candidate for tPA, so the challenge is for the patients to arrive quickly, assessed accurately and without delay, then, as appropriate, treated.

More strokes are striking the young

A frightening story from The New York Times - strokes rising Among children and young adults:

More young people and adults in their 30s and 40s are being hospitalized for stroke, even as stroke rates are dropping in older people, new data show.

The findings, reported ... at the American Stroke Association conference in Dallas, may be a sign that that rising rates of obesity, diabetes and high blood pressure among teenagers and young adults are taking a toll.

Or it may simply be that physicians have improved their diagnosis and reporting of stroke in young people during the past decade.

 While the reasons are still up in the air, it is clear that  the young and old need to know the stroke signs and symptoms, and we all need to improve stroke prevention.

Live TV lesson about stroke signs

The chilling video of  Los Angeles TV reporter Serene Branson was played over and over the last few days. She began stumbling over slurred words on live television. Her face appeared not quite symmetric - class stroke signs.

Turns out, as U.S. News and World Report reported, her severe migraine mimicked a stroke:

Doctors at the University of California, Los Angeles, who performed a brain scan and blood work on Branson, said she suffered a type of migraine - often called a complex or complicated migraine - that can mimic symptoms of a stroke, the Associated Press reported Friday.

Dr. Ralph L. Sacco, president of the American Heart Association and chairman of neurology at the University of Miami Miller School of Medicine, explained that "a complicated migraine can often masquerade as a stroke or TIA (transient ischemic attack, sometimes called a mini-stroke)."

The symptoms can look just like a stroke, Sacco said, including loss of vision, blurry vision, paralysis on one side of the body, trouble speaking and trouble walking. "All kinds of things we associate with a TIA or stroke can be part of a complicated migraine," he said.

For people whose first experience with a migraine is a complex migraine, Sacco advises that they assume it is a stroke, however.

"If people have these classic symptoms, we should treat them as the emergency we think they are, which is a possible stroke," he said.

Branson did the right thing: Even though her symptoms subsided, she sought follow-up care. Too often, people don't see a doctor after a mini-stroke, setting themselves up for full-blown strokes. The lesson we can all take away: When you detect these signs, get help right away. It might just save a life.

From ABC News, a video of a good discussion of stroke signs:

Too often, delay threatens stroke recovery

Time, as many entries of this blog have noted, is vital.

For stroke patients who need the clot-buster tissue plasminogen activator, or tPA, it's especially important. While there is a 4.5-hour window, it's generally agreed that even quicker - if applied correctly - is ideal.

So how are the hospitals doing? According to one story, few stroke patients given clot-buster quickly enough:

Few eligible stroke patients get an injectable clot-busting drug within the recommended 60-minute window after their hospital arrival, new research finds.

"It has been widely recommended that the 'door-to-needle' time should be 60 minutes," said study author Dr. Gregg C. Fonarow, a professor of cardiovascular medicine at the University of California Los Angeles David Geffen School of Medicine. The phrase refers to the timeframe between when the patient arrives at the hospital and when that patient is given the clot-buster, known as tissue plasminogen activator (tPA).

In his analysis of stroke patients from 1,083 hospitals, he found the 60-minute window was not the typical reality. "That occurs only in 26.6 percent of patients," he said.

We can, and must, do better. Lives and the quality of those lives are at stake.

(Photo from Wikimedia Commons user Jorgebarrios)

'My God is my rock'

I love you, LORD, my strength.
The LORD is my rock, my fortress and my deliverer;
my God is my rock, in whom I take refuge,
my shield and the horn of my salvation, my stronghold.

-Psalm 18:1-2

A refuge. A fortress. A shield. A stronghold.

Haven't we all needed these things at least one time of our lives? When we struggle in stroke recovery, we need that rock, that deliverer. For all of us, God is all these things and more.

This Psalm is a good reminder that no matter what life throws at you, God is your strength. Always.

Strokes hit young people in rising numbers

A repeated message from this blog is that strokes can hit both young and old. While the stereotypical stroke patient is an elderly man, every group faces that risk.

It was especially brought home by recent research from the U.S. Centers for Disease Control and Prevention showing that ischemic strokes increased among teens and children:

"We cannot link anything in particular to the trend in younger patients, but I believe the role of obesity and hypertension will prompt a big discussion. Unfortunately, right now we can't speculate on the causes," said [Xin] Tong, a health statistician with the CDC's Division for Heart Disease and Stroke Prevention in Atlanta.

However, hospitals and physicians should be aware of the rising risk of stroke in young people, and the necessity to educate them about stroke symptoms, Tong said.

"Acute ischemic stroke is currently considered something that mostly happens to older people, but awareness of rising rates in the young is important or else tPA [tissue plasminogen activator] and other important stroke treatment may be unnecessarily delayed in younger patients," she said.

 For any age, everyone should take the stroke signs seriously and get help right away.

A story from Kansas - but could be almost anywhere

The story about how a Kansas county ranks high in stroke deaths shows the need of stroke awareness and the need for people to know that if stroke signs are present - even just ONE stroke sign - it's time to get to some help.

From the Morning Sun article:

With either type of stroke, immediate treatment is crucial.

“A surprising number of people wait not just hours but days before they seek treatment,” [Dr. Colleen] Lechtenberg said.

“I know people try to stay out of the ER, but they need to come and get checked out if they have stroke symptoms,” [Dr. Timothy] Stebbins said. “I would much rather tell somebody that they have a simple headache, or that we didn’t find anything wrong with them, than have to say, ‘I’m sorry, we can’t do anything now, but we could have several hours ago’. That is heartbreaking.”

He added that even younger people should get to the ER if they experience any stroke symptoms.

“It’s true that stroke is much more common in older people, but you can have a stroke at any time in your life,” Stebbins said. “The body is a complex machine that surprises us all.”

Sometimes, systems fail stroke patients

An exasperating story - to many times, in any country, stroke patients don't get the attention needed. This story came from England, where too many stroke patients are too often waiting too long.

It's critical, critical that stroke patients get to a hospital soon. In the United States, ideally, it should be a hospital designated as a stroke center. But as BBC reported,  post-hospital stroke care "needs to improve":

Patients often faced delays in being seen, while some areas were failing to provide services altogether, the official health regulator said.

Immediate improvement was needed, it added.

The findings comes after a major focus on hospital stroke services in recent years. This has led to improvements in testing and treatment in the immediate aftermath of a stroke.

This in turn has increased the numbers surviving and, as a result, there are now 50,000 people a year who are left with disabilities following a stroke.

Tracking stroke care can improvement care

What's best for stroke victims?

Important question. Most of us know someone who have suffered a stroke. Everyone knows who someone who is especially at risk. Not long ago, the American Heart Association released new guidelines for stroke care:

The updated standards include:

• Specifically tracking the percentage of ischemic stroke patients identified as eligible for tissue plasminogen activator (tPA) and appropriately treated within a 60-minute door-to-needle time. According to the guidelines, tPA is the only clot-busting drug approved for treating ischemic strokes and is effective only when given within a few hours after the onset of a stroke.

• Tracking the time from hospitalization to treatment to repair blood vessels for patients with a ruptured aneurysm.

• Performing 90-day follow-up of ischemic stroke patients to assess their outcomes after acute interventions, including treatment with tPA.

Standards like this will help find ways to make better decisions that will improve treatment for people who are often helpless when they arrive at a hospital.