What are your odds of the right stroke treatment?

You can read my story here and an update here. But in a nutshell, I wound up in the right place and the right time when my stroke occurred back in 1998, two years after tissue plasminogen activator was approved for stroke patients - a Southern community hospital, of all places.

More than 18 years later, we still have problems getting this medication to stroke patients. Kaiser Health News noted geographic and racial disparities in stroke treatment tracked in a new study:

The findings come from a report published Wednesday in the journal Neurology. Researchers found stroke patients living in the Northeast states had more than twice the odds of receiving tPA — a powerful anti-coagulant that can break up the clot causing the stroke — than those living in the Midwest and the South.

Staying thirsty, my friends? You are one of most interesting people in the world

Therefore, since we are surrounded by such a great cloud of witnesses, let us throw off everything that hinders and the sin that so easily entangles. And let us run with perseverance the race marked out for us, ...

-Hebrews 12:1 NIV

If you haven't heard it yet, you'll hear about it soon: The most interesting man in the world will become the most interesting man in two worlds. He's heading to Mars on a one-way trip.

Check out the commercial, then re-read the verse from Hebrews:

Recent stroke stats show we've got a lot of work remaining

Men are more likely to die of a stoke than women. And black men are in danger the most. I'm signed up to receive reports from the U.S.Centers for Disease Control and Prevention, and these nuggets of information came through.

None of these numbers are shocking. Numbers seem to be in a slow downward trend, but still too high. Here's a link and excerpt to the report under the category of QuickStats:

During 2000–2013, age-adjusted death rates for stroke for all racial/ethnic groups decreased steadily. Non-Hispanic white males had the largest decline (41.7%), and Hispanic females had the smallest (35.8%). Throughout the period, the rate for non-Hispanic black was the highest among the racial/ethnic groups examined, followed by non-Hispanic white and Hispanic populations. The rate for males was higher than that for females in each racial/ethnic group.

Now, how do make these numbers better?

Stroke prevention, racial disparities and younger patients

Stroke prevention is important! If a stroke doesn't happen, then treatment is not necessary. Therapy for recovery is not necessary. And quality of life remains.

So a recent story highlighted not just one, but two issues - racial disparities and strokes for those under 65. The story is about how rising stroke rate for blacks in South Carolina, study finds:

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

They found that stroke hospitalizations among blacks younger than 65 jumped by more than 17 percent, but remained stable for whites younger than 65.

Blacks appeared more vulnerable to stroke at younger ages, too. According to the study, slightly more than half of the blacks hospitalized with stroke were younger than 65, compared with 30 percent of whites.

The study was published June 19 in the journal Stroke.

"Excess strokes among blacks, as well as the lingering racial disparity in the younger groups, represent a serious public health issue," lead author Dr. Wayne Feng, a stroke neurologist at the Medical University of South Carolina Stroke Center in Charleston, said in a journal news release.

Troubling age, race research results

I recently saw this troubling article from MedPage, from the annual meeting of the American Academy of Neurology. According to a study, age, race biases are seen in stroke transfers:

Blacks and the elderly were dramatically underrepresented among ischemic stroke patients in rural Alabama sent to a tertiary stroke center after initial thrombolysis, a researcher said here.

Compared with 212 patients presenting directly at the stroke center's emergency department, the 96 "drip-and-ship" patients were significantly younger (median age 63 versus 68, P=0.001) and less likely to be African American (21% versus 38%, P=0.012), said Amelia Boehme, MSPH, of the University of Alabama at Birmingham (UAB). ...

The drip-and-ship model is a method to deliver thrombolysis to acute stroke patients in facilities that lack onsite neurology coverage, the authors explained.

Again, these results are troubling. I realize that each case must be handled individually, but at the same time, every patient should expect quality care.

Concerns about the stroke care gaps

The American Heart Association recently highlighted a disturbing and continuing trend about racial, ethnic gap in stroke care:

In a scientific statement, the AHA notes that stroke is more common among African-Americans, Hispanics, American Indians, and Alaskan Natives than among whites.

The AHA calls for raising awareness of stroke factors and the need for urgent treatment, increasing access to insurance coverage in minority populations, and doing more research on the roots of racial and ethnic disparities in stroke care. ...

Stroke is more likely if you have risk factors including high blood pressure, diabetes, high cholesterol, smoking, obesity, and a history of peripheral artery disease (PAD), carotid artery disease, or certain types of heart disease.

Several of those risk factors are more common in minority groups than among whites.

'Lord is my strength'

The Sovereign LORD is my strength;
he makes my feet like the feet of a deer,
he enables me to go on the heights. ...

-Habakkuk 3:19

Well, I didn't exactly feel like a deer but was able to finish a race.

Almost a dozen years ago, I couldn't even walk. Last Saturday,  I ran 13.1 miles in a half marathon in Sedalia, Mo. No records set, but God enabled me to hit my own height that day.

Stroke survivors recover at various levels. All require strength. This verse reminds us the source of that strength.

Despite some progress, disparities remain

This article by Reuters Health illustrates how strokes can impact. Despite age or race, this problem impacts us all, and we're all better off if we all work to reduce stroke risks:

Strokes in young blacks drain South Carolina's pocket:

In South Carolina, African Americans suffer strokes at younger ages and have worse outcomes than Caucasians, Dr. Wayne Feng and colleagues report in the latest issue of the medical journal Stroke.

They point out that in their state, lifetime costs for strokes that occurred in 2006 alone, including lost earnings, are likely to total $1.92 billion.

The persistent racial disparities in stroke "result in significant economic consequences to the state, particularly among younger patients," the researchers conclude.

'A crown that will last forever'

Everyone who competes in the games goes into strict training. They do it to get a crown that will not last; but we do it to get a crown that will last forever.

-1 Corinthians 9:25

Not that I did "strict" training, but recently finished third in my age division in the Sedalia (Mo.) Half-Marathon. The award sits on a shelf in the same room I'm typing up this blog entry. I don't run to get awards, but it's pleasing to win one from time to time.

The verse from 1 Corinthians is a good lesson from Paul. Awards - like this one - received on earth will eventually turn to dust. God's awards are eternal.

Stroke survivors often struggle to do all they can. Sometimes, earthly prizes are appreciated. But remember that the true award awaits, promised and ready.