Dover, Del. —Strokes are the third leading cause of death in the United States. Regardless of how common strokes are, Bayhealth Stroke Care Coordinator Dawn Fowler said most of her patients say they had no idea they were at risk. Fowler and Bayhealth Neurologist Dr. Joel Rutenberg will discuss stroke prevention and treatment, and how strokes impact the entire family, at two seminars Wednesday, May 19, and Thursday, May 20. Fowler answered some common questions May 4 for the Dover Post.Q What are stroke risk factors?
A Risk factors are high blood pressure, high cholesterol, heart disease, smoking, heavy alcohol use, physical inactivity, history of irregular heartbeat and genetics. If you have a genetic predisposition to high cholesterol, you might have a family member with stroke.
Often times, stroke patients have been on blood pressure medication and they stop taking it for financial or other reasons, which prompts the stroke. Their blood pressure is lowered on medication and their body gets used to that, so when they go off the medication suddenly it’s like there was a kink in the hose that gets unkinked. That blood spurts forward and pushes plaque and other blockers with it. Always check with a doctor before changing medication.
Also, once you have a stroke, it’s more than likely that you’re going to have a second one. The disease that caused the first one usually hasn’t been corrected, so a second one is more likely. They usually are more damaging.
Q What preventive measures can people take?
A Preventive measures for strokes are pretty much the same ones we use for cardiovascular disease. High blood pressure can be prevented or controlled, watching obesity, watching eating habits and salt intake, physical activity, all of those things. People who have strokes also are often diabetics. When you have diabetes, your body can’t control insulin levels, so all of the vessels are bathed in sugar and can’t function like they’re supposed to.
A stroke is the same thing as a heart attack, it just happens in a different part of the body — recently they’ve been referred to as “brain attacks.” Your brain is not a muscle, it doesn’t really have any nerve endings, per se, so strokes are not associated with pain. But the heart is a muscle, and a strain on it hurts.
Q What are some warning signs?
A Any time you have a sudden — the key is sudden — change in vision, weakness or the inability to use one side of your body, dizziness, inability to be coordinated, slurring of speech, mouth droop or sudden severe headache. It could be any one of these things. Stroke affects everyone differently because it can happen in any part of the brain, the part that controls your vision, speech, coordination, etc.
Q What are mini strokes?
A Transient Ischemic Attack, or TIA, is your body’s warning sign saying something’s wrong. Those symptoms last less than an hour. The problem is that most people say, “Oh, I’ll lie down and feel better,” and when symptoms go away patients forget about it. Most people who have them will have a stroke in the first three months afterward.
Q What percentage of people recover fully?
A The damage is always present, but other parts of your brain can take over for what you’ve lost. These patients go through intensive rehab, and they put a lot of intensive effort into it. They have to retrain their brain.
Q What are the biggest misconceptions about strokes?
A No one thinks that it can happen to them. Then you hear about all the risk factors and all of those things scream, “You can have a stroke.” Stroke is kind of the redheaded stepchild of heart disease and it hasn’t really gotten a lot of attention in the past.
Q What did you learn from attending the AHA/ASA International Stroke Conference in February?
A The biggest thing I took away from it was the importance of patient education. It was estimated that 70% of stroke patients couldn’t say what the signs and symptoms of their stroke were. We’re hoping the seminar provides a lot of education.
We’re also educating staff, and working with Kent County paramedics so they alert us when they have a possible stroke coming in. Then we can get all the pieces in place, we’re ready.
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