Delays to stroke treatment can be costly

I was fortunate enough to get help quickly on the day my stroke happened. Now, recently published research casts this in a different way - stroke patients lose a month for each 15-minute delay:

Diane Barbeler had a stroke on Monday last week. The next day, she walked out of the hospital with only minor sensory changes in her right hand and foot.

Barbeler owes her quick recovery to the tissue plasminogen activator, or tPA, that she received within 3 hours of losing strength and control in her lower limb, says Atte Meretoja, a neurologist who helped diagnose her stroke at Australia’s Royal Melbourne Hospital. Patients like Barbeler, 66, gain a month of disability-free life for every 15 minutes saved in getting the clot-busting drug, according to research by Meretoja and colleagues published today in the journal Stroke. ...

“The main delay in stroke is due to people not calling for help,” said Meretoja, the lead author of the study and an associate professor of medicine at the University of Melbourne. “We have now demonstrated that this is very harmful, and people lose on average a month of life for every 15 minutes they wait at home hoping that the symptoms will go away.”

That's a sobering number. Wait 15 more minutes, and you lose a month. Know the signs of a stroke and get help - for yourself or someone you care about - quickly.

From the American Stroke Association

Watch your blood pressure - now more than ever

Hypertension - high blood pressure - is the leading cause of strokes in the United States. So it makes sense to keep up with your own numbers and, if directed by a physician, do something about them.

Now, the latest news is that even slightly higher blood pressure may raise stroke risk:

The sweeping review analyzed data from 760,000 study participants who were followed for up to 36 years. The researchers found that people with "prehypertension" - higher-than-optimal blood pressure not officially defined as high blood pressure - were 66 percent more likely to experience a stroke than those with normal blood pressure.

"This meta-analysis confirms evidence from many studies, and I think it continues to warn physicians and the public that more vigorous control of blood pressure is important for reducing stroke risk," said Dr. Ralph Sacco, chairman of neurology at the University of Miami Miller School of Medicine, who was not involved in the research. "The findings confirm that even mild to moderate levels of elevated blood pressure are important for determining stroke risk."

App might help with aphasia

My speech stopped then garbled on the day I had my stroke. It took me quite some time to get back close to normal,  thanks to speech therapists, family and friends.

Now, there's something that might help supplement speech therapy - a new app that puts speech therapy in patients' pockets:

Patients can use the app to practice matching pictures and associated words, according to Dr. Stephen Hughes, who helped build the app.

“So we’re looking at the kinds of things that they’re doing already with paper and pencil and saying, ‘Can we use the technology to help them manage that experience better?’” Hughes said.

The Name That! app isn’t meant to take the place of traditional treatment. Rather, the creators hope that it will supplement what speech therapists already do in sessions. Hughes and Burda are currently working on expanding the app’s simplistic design in order to fit more needs of aphasia patients.

I used some educational "toys" myself - really more suited to children learning English for the first time. But an app specifically tailored to people struggling with aphasia would be better. It's important to note that aphasia does not affect intelligence. The thoughts are there - aphasia causes difficulty in getting thoughts out.

Perhaps another reason for a flu shot

I have no desire to get the flu, so flu shots are a matter of course for me every fall.

Now, another possible reason, too. Flu shots may lower stroke risk, too:

Photo from the National
Library of Medicine

The researchers analyzed data from more than 47,000 people in the United Kingdom who suffered a stroke or mini-stroke (transient ischemic attack) between 2001 and 2009. The investigators found that having a flu shot was associated with a 24 percent lower risk of stroke. However, this association does not prove a cause-and-effect relationship.

The stroke risk reduction was strongest if a person received a shot early in the flu season, the study authors noted.

Note that, as the story notes, association does not mean cause. Still, not a bad move to make.

Too many drugs for older patients?

Last blog post was about young people. Now, news about the older set.

A thought-provoking article asking the question Are oldest patients getting too many drugs?:

Photo from National
Institutes of Health

"The data strongly suggest that we are overtreating many healthy patients aged 80+ regarding stroke prevention," he wrote.

"We need actively to rethink our priorities and beliefs about stroke prevention, actively informing and involving the views of the key person, the patient," he wrote. "Most of the patients will probably eschew the modest potential benefit, preferring the reduced burden of polypharmacy and side effects judged as 'minor' by the prescriber."

In the last few years of my mother's life, a wise physician told us that there's quite a balancing act about prescribing medicines for older people. Drugs can interact and interfere with each other. This is definitely a topic to have a serious conversation at the right time.

Young does not mean invincible

Young doesn't mean you're stroke-proof.

I was a young 39 when mine happened. While most strokes happen to older people, a growing number of young people are having strokes, and this recent article shows that young doesn't mean invincible when it comes to strokes:

Strokes sounds like an old folks' problem, but they hit young people, too. And they don't all shake it off. One-third of people who had a stroke before age 50 are struggling with disability and loss of function nine years later.

Many of those people aren't able to live independently or need help with everyday tasks, such as managing their finances or personal care, a study of young stroke survivors finds. About 1 in 8 wasn't able to live independently.

The last sentence of that excerpt (you should read the whole article) is sobering. A stroke can rob a young person of his or her independence.

It's vital to know the stroke signs or symptoms and get help quickly. For the young, old and in between.

'Run and not grow weary'

[B]ut those who hope in the Lord will renew their strength. They will soar on wings like eagles; they will run and not grow weary, they will walk and not be faint.

-Isaiah 40:31

I never get tired of that particular verse. And I certainly need it now.

A few weeks ago, I mentioned on this blog a knee injury. Initially, it seemed to resolve itself but not long ago, it came back with a vengeance. An MRI later, I was told I have a torn meniscus (cartilage between the femur and tibia).

And bad timing for this injury: Due to travel plans, I can't get it fixed (a relatively simple arthroscopic procedure) until April 1. So for the next several weeks, I can't run. That's quite a shock for someone who's been running for 26 years.

But like the Isaiah verse above mentions, hope is present. Like in my stroke recovery days and now, the key was - and is - to place hope and trust in God.

Here's hope that in warmer days ahead, I'll run and not grow weary. Again.

On the road - with stroke treatment

It's known that the quicker the treatment, the better chances for better outcome for a stroke patient.

Now, one hospital is taking this one step further, taking stroke treatment on the road:

The unit -- a standard ambulance equipped with a CT scanner and stocked with clot-busting tissue plasminogen activator (tPA) -- overcomes the limitation of having to wait until a patient arrives at the hospital to confirm that the stroke is ischemic, which can drastically delay administration of the proven treatment.

The hope is that bringing the imaging and the tPA to the point of first medical contact out in the field will restore blood flow to the brain faster, save neurons, and ultimately improve patient outcomes, according to James Grotta, MD, director of stroke research for the Clinical Institute for Research & Innovation at Memorial Hermann-Texas Medical Center.