Another reason to take depression seriously

Even to this day, depression is too often not taken seriously. Now, a recent study shows another reason to take depression seriously and seek solutions. The study showed that depression may be stroke trigger in women:

Depression appears to be a risk factor for stroke among middle-age women, even after accounting for other variables, an Australian study showed.

Among women in their late 40s and early 50s who were followed for up to 12 years, meeting criteria for depression was associated with more than double the likelihood of having a stroke ..., according to Caroline Jackson, PhD, and Gita Mishra, PhD, of the University of Queensland in Australia. ...

"Our findings contribute to the currently limited evidence on potential age differences in the association between depression and stroke, and suggest that the effect of depression may be even stronger in younger women," they wrote

Diabetes and stroke risk

As if we didn't have enough evidence that watching our personal health no matter our age is important, a recent article brings in more.

Diabetes increases stroke risk, particularly in under-65s:

"Our results suggest that diabetics aged under 65 have up to a 12-fold increased risk of stroke compared with people of a similar age who do not have diabetes," lead investigator Dr Jane Khoury (Cincinnati Children's Hospital Medical Center, OH) commented in an interview. "In the over-65s, there was still an increase in stroke of about two- to threefold in diabetic patients."

'Our salvation in time of distress'

Lord, be gracious to us;
    we long for you.
Be our strength every morning,
    our salvation in time of distress.

-Isaiah 33:2

We've all had distress, stroke-related or not.

Last week, I marked my 15th "anniversary" of my stroke, and remarked how God gave me strength in my recovery.

That strength is available to you, every day, especially in time of distress, as the above quote from Isaiah notes.

These days, I exercise most mornings. When I run this morning, I will thank God for the strength of that morning. No matter your schedule, even when your "morning" is everybody else's afternoon, you, too can reach out for that strength and salvation.

(Photo from NASA; text added by author)

Stroke prevention reminder for Stroke Belt folks

I spent my youth (and many adult) years in the Stroke Belt (Arkansas), and mine came a little over 15 years ago, also in Arkansas.

Does living in Arkansas (or other Stroke Belt states) guarantee a stroke? Of course not. But during Stroke Awareness Month, a reminder that taking stroke prevention measures can't start too soon.

Click here to read how teen years put the "Stroke" in "Stroke Belt":

Overall, the strongest predictor of stroke risk was the proportion of one's entire life spent in the so-called stroke belt, which encompasses much of the Southeast. After adjustment for other stroke risk factors, though, the proportion of adolescent years in the stroke belt remained the only significant predictor, increasing stroke risk by 17%.

"Our data suggest that living in the stroke belt during adolescence may contribute to the higher stroke mortality in the stroke belt, and the harmful effects associated with living in the stroke belt may be greater for black than white subjects," Virginia J. Howard, PhD, of the University of Alabama at Birmingham, and co-authors concluded in the April 30 issue of Neurology.

"Improvement in childhood health circumstances should be considered as part of long-term health improvement strategies.""

Fifteen years ago today...

Fifteen years ago, this was a bad day. But the day could have been far worse.

May 8, 1998, started as a busy work day for a reporter, starting with two-hour drive from Little Rock, Ark., to Batesville, Ark. Fellow reporter Sandy Davis and I were sitting in a government office, sifting through boxes of documents.

About noon, my right arm and right leg fell useless. I could not speak. I was in the grip of a stroke. Sandy got help. An ambulance crew took me to White River Medical Center.

For this 15th "anniversary" of my stroke, I spoke with Dr. John O. Collins, the neurologist who treated me with the clot-busting drug tissue plasminogen activator, or tPA. At the time, he was practicing in Batesville, the small town where I grew up. Not long before, he'd finished a medical residency at the University of Maryland School of Medicine in Baltimore.

I was the first patient he administered tPA to on his own.

"You were a classic case," he said. Within an hour of my symptoms, a CT scan showed a blood clot, in the left side of my brain. About two hours after my stroke, the tPA started flowing. Shortly afterward, I showed clear signs of recovery. My arm and leg could move once again. I struggled with speech but that, too, came back.

The drug tPA was rarely used in 1998 - especially at small town hospitals. It's still used only 5-10 percent of the time, often because people don't get to a hospital in time for the treatment, Collins said.

He stayed in Batesville for four years and now practices in Fort Wayne, Ind., where he  frequently works with stroke survivors in their recovery.

He was one of a series of health professionals, along with colleagues, friends and my wife, Laura, who helped me recover physically and regain my abilities to speak coherently and eventually to write again.

I thank God for all those people. He gave me their help and the strength to get through some struggling recovery times.

But as the first blog posting here back in 2005 states, it's really not about me. The purpose of today's posting is to remind people to know the stroke signs and symptoms and don't delay getting help. You can save or change a life.

Avoiding an ambulance can be tragic

Too often, people wind up at a hospital too late for the best stroke treatment. Another story made the rounds, this time how a third of stroke victims delay action by avoiding ambulance:

When patients were taken by ambulance, 79 percent of them got to the hospital within two hours after they first started to notice symptoms. That’s crucial, said Wallace, who has specialized in stroke treatment since the mid-1990s. The most common form of stroke can be treated in most cases with a clot-busting drug. But it must be injected within a maximum of 4½ hours from the onset of symptoms, and it’s better if injected within three hours, she said.

“That means a person has to have symptoms, recognize it, get into the hospital, be seen by us, get a CAT scan of the brain, IV started and a decision made, all within 180 minutes,” Wallace said."

Look tomorrow for another - very personal - story showing the importance of getting to help in time.

Stroke awareness - a global issue

May is Stroke Awareness Month, but stroke awareness is a global issue. And as I've blogged many times, it's not just an senior citizen issue. Here's one more example why - Swedish stroke data has good news and bad:

Overall ischemic stroke rates have declined sharply in Sweden over the past 25 years, and one-year mortality rates after a first stroke have been halved across all age groups, according to new longitudinal research. But in a troubling new finding, rates of first stroke, as well as four-year mortality rates after an initial stroke, are on the rise among younger Swedes.

Dr Lena Björck (University of Gothenburg, Sweden) and colleagues presented the new data in a trio of posters here at EuroPrevent 2013. ...

But the rate of deaths over the years has been declining, she noted. "The mortality after stroke is decreasing in all age groups, over a long period—1987 through 2010. And that's a positive thing," she said. And of note, while the numbers are most striking in the older patients, where stroke is more common, the relative risk reduction was actually slightly greater in the youngest group (age 18-44) than in the 45-64- and 65-84-year-old groups."

Too many heart, stroke patients keeping bad habits

A bit of a sad note - too many heart, stroke patients keeping bad habits:

Many patients suffering from coronary heart disease or stroke are unlikely to adopt healthier lifestyles, says to a new study led by a McMaster University researcher.

In fact, the study found more than 14 per cent of patients failed to adopt any healthy habits at all.

“We know that people after a heart attack or stroke, if they exercise regularly or they eat a healthy diet and they quit smoking, the risk of having a second event is much reduced,” said McMaster cardiologist Dr. Koon Teo. “Therefore it is just as important to adopt lifestyle changes as it is to take medication.”

Post-stroke communication issues

My stroke happened on my left side, affecting speech and the right side of my body - couldn't talk, couldn't walk, couldn't use my right hand.

The physical effects went away relatively quickly. Speech - spoken, written and read - took a little longer and in my way of thinking, still not quite as good as it used to be. But that's just an opinion.

But those early days included some serious frustration as I tried re-learn coherent speech and re-learn how to write (critical skill for a reporter). So recent news about why some stroke survivors struggle with communication really hit home with me. About a third of stroke patients will be affected by aphasia:

A shift of language function to the right side of the brain hampers some stroke survivors from recovering their ability to read, write and to say what they mean, a new study indicates.

The inability to do these things is called aphasia, and is caused by damage to the parts of the brain that control language. ...

"Overall, approximately 30 percent of patients with stroke suffer from various types of aphasia, with this deficit most common in stroke with left middle cerebral artery territory damage," lead investigator Dr. Jerzy Szaflarski, of the departments of neurology at the University of Alabama and University of Cincinnati Academic Health Center, said in a journal news release.

As a previous post noted, aphasia does not mean intelligence is affected. It does not mean that the person is confused. Important - for the patient and those around him or her - to remember.

Remember stroke prevention - even for the young

One more reason to reduce stroke risks. The story is about as stroke risk rises among younger adults, so does early death:

New data show that younger stroke survivors are at great risk of premature death. Within two decades, 1 in 5 stroke survivors will die, according to a study in the March 20 issue of the Journal of the American Medical Association. The death rate is even higher among those with the most common kind of stroke, caused by a blood clot in the brain.

Dr. Frank-Erik de Leeuw of Nijmegen Medical Center in the Netherlands, who led the study, says the results surprised the research team.

"We had the impression that [younger stroke survivors] were doing quite well," de Leeuw tells Shots. "But now that we have followed all of them — and also the patients who didn't show up in our outpatient clinic anymore — it turns out that their prognosis was poor. To me, it was a true surprise."

This isn't intended to scare people needlessly. It is yet another wakeup call for stroke prevention by addressing stroke risk factors. I'm closing in on 15 years after my stroke at the "young" age of 39. This story adds more motivation to watch my own health.