Can you identify a Stroke?

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October 28, 2008

First I want to apologize to my readers, we have been working on finding and buying a house and have had several close calls but came up short on each of them for one reason or another. We do have to be out of our apartment very soon or suffer a major rent increase, so much so that we have stepped up looking to a fevered pitch and even started packing, and this has caused me to miss several weeks of articles. I do want to report that we have found a nice place (old farm house that has been remodeled) out in the country with 10 acres and once again (cross your fingers!), barring any unforeseen problems, we should have our Own place shortly! And it even has a garage big enough to store the camper in it; we just have to put another door in it! Now back to our regularly scheduled articles on health and safety!

Today I want to talk about a problem that is becoming more common as we start to have an older population, that is of strokes. In the medical profession, we call them CVA or Cerebral Vascular Accidents. Most of us fear being left with the crippling after-effects, or maybe I am speaking only for myself. But know this, in today’s world, there are more treatments than were possible even just a few years ago.

But what is a stroke or CVA? Well, there are two types.

First, let us begin with the most dangerous type which is the least treatable; it is called the Hemorrhagic Stroke. This occurs when a blood vessel in the brain breaks and begins bleeding (or hemorrhaging )into the space around the brain. The reason this is so serious is that the brain does not tolerate pressure very well and, unless the bleed is very small or clots off quickly or you have a brain surgeon very handy, the damage can be wide spread and quickly progressing. This type usually begins as a very sudden and very severe headache (Patients will often say it is the worst headache I have ever had!) and often quickly progresses to unconsciousness. This can happen in a very short time depending on the size of the bleed. The best treatment if the bleed is small is surgery, otherwise this condition is often not treatable. Thankfully this type of CVA is not the most common. If you think anyone is having a hemorrhagic stroke immediately call for a ambulance, make the patient comfortable and do not give food or liquids.

The second type of a stroke is the most common and the most treatable. This is the Occlusion stroke, which is when a blood vessel in the brain becomes blocked. This is often sudden but painless in most cases. Sometimes the patient doesn’t even know it is happening, especially if it only effects a small area of the brain. The larger the vessel the more brain tissue is effected. This is the stroke that, if the area effected is part of the motor control portion of the brain, can cause paralysis. Symptoms are often one-sided weakness (or paralysis), facial droop, slurred speech and trouble communicating; sometimes it can only be a small part of the body affected or not being able to say certain words. To test ask the patient to repeat a sentence like "You can’t teach a old dog new tricks"; if they miss words or can’t remember it, start to worry. If the patient has any of these symptoms, please call 911immediately. The paramedics will often test these and other symptoms and use what is called the Cincinnati Stroke scale or the LA Stroke scale to evaluate the patient.

The important thing is to get the patient treatment as fast as possible. The drugs that a few years ago were used to open clotted heart arteries are now used to open vessels in the brain. The key is not to delay treatment as the window that these drugs can make a difference is measured in hours, not days. Do not let the patient try to deny the symptoms and delay treatment as this can make the damage permanent. Please note the time the patient was last seen "normal" and record it as this can make a difference in the method of administration of the drug. And, for all of you that say "My camping friends aren’t Ever Normal", I have to agree that most of mine are the same way, but I want to keep them around for a few more years to harass me! Keep the patient calm and comfortable and don’t give food or liquids.

Strokes or CVA’s today aren’t the permanent damage or disfiguring strokes of the past. The key is to recognize the symptoms and get the patient to help quickly!

Your Obedient Servant,

Gary Smith, Jr.

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