Vascular Insights Issue #3

MAY 2011

www.ArteryandVeins.com

ISSUE 0003

VASCULAR INSIGHTS A QUARTERLY NEWSLETTER OF VASCULAR ASSOCIATES, LLC

MAY IS STROKE AND TRANSIENT ISCHEMIC ATTACK (TIA) AWARENESS MONTH

“Another serious stroke is a possibility, so if you have any sudden drooling, dizziness, or if you ever laugh out loud at a Garfield cartoon, call 911 immediately.”

DID YOU KNOW

that 5,000 Americans suffer from a Transient Ischemic Attack? To find out more information on this condition, read the article by PA Clark on page 4.

IN THIS ISSUE Stroke Prevention................pg.2 Lessons Learned..................pg.3 Transient Ischemic Attack..pg.4 TIA Continued....................pg.5 Stroke Awareness................pg.6

1836 Florida Avenue, Panama City, FL 32405 Phone: 850-872-8510 • Fax: 850-872-7412 www.ArteryandVeins.com

Famous Faces who have suffered from a stroke.

STROKE

Prevention Article from the National Stroke Association http://www stroke org/site/PageServer?pagename=prevent

Up to 80 percent of all strokes can be prevented —start reducing the risk now.

Late actress Elizabeth Taylor

Although stroke can happen to anyone, certain risk factors can increase chances of a stroke.

However, studies show that up to 80 percent of strokes can be prevented by working with a health care professional to reduce personal risk.. It is important to manage personal risk and know how to recognize and respond to stroke signs and symptoms.

•

Know Cholesterol Levels Cholesterol is a fatty substance in blood that is made by the body. It also comes in food. High cholesterol levels can clog arteries and cause a stroke. See a doctor if your total cholesterol level is more than 200.

•

Control Diabetes Many people with diabetes have health problems that are also stroke risk factors.

A doctor and dietician can help manage diabetes.

•

Manage Exercise / Diet Excess weight strains the circulatory system. Exercise five times a week.

Maintain a diet low in calories, salt, saturated and trans fats and cholesterol.

Eat five servings of fruits and vegetables daily.

•

Treat Circulation Problems Fatty deposits can block arteries carrying blood to the brain and lead to a stroke. Other problems such as sickle cell disease or severe anemia should be treated.

•

Transient Ischemic Attack (TIA) A TIA is a temporary episode of strokelike symptoms that can last a few minutes to 24 hours but usually causes no permanent damage or disability.

TIA and stroke symptoms are the same.

Recognizing and treating a TIA can reduce stroke risk. Up to 40 percent of people who experience a TIA may have a stroke.

Stroke Prevention Guidelines The following Stroke Prevention Guidelines will help you learn how you may be able to lower your risk for a first stroke.

•

Singer Bret Michaels

•

•

•

Actress Zsa Zsa Gabor

2

Know Blood Pressure (hypertension) High blood pressure is a major stroke risk factor if left untreated. Have blood pressure checked yearly by a doctor or at health fairs, a local pharmacy or supermarket or with an automatic blood pressure machine.

Identify atrial fibrillation (Afib) Afib is an abnormal heartbeat that can increase stroke risk by 500%. Afib can cause blood to pool in the heart and may form a clot and cause a stroke. A doctor must diagnose and treat Afib.

Stop Smoking Smoking doubles the risk of stroke. It damages blood vessel walls, speeds up artery clogging, raises blood pressure and makes the heart work harder.

Control Alcohol Use Alcohol use has been linked to stroke in many studies. Most doctors recommend not drinking or drinking only in moderation - no more than two drinks each day.

VASCULAR INSIGHTS | www.ArteryandVeins.com

Lessons Learned

“He couldn’t move his right arm, couldn’t speak, and lost control of his bladder function.”

Article by Bud Shuler, MD., FACS

My father-in-law is a great man, and not just because he is the father of my awesomely talented wife. He is however a stubborn “old fart.” Raised in central Colombia, he is the epitome of an ungracefully aging Hispanic senior. He doesn’t, like many of us, want to give in to Father Time and the limitations each additional day bring. He also is “rather” set in his ways. Until six years ago, he was active, enjoying the newly found freedom of retirement, and doting on his three grandchildren. He had planned well for retirement, sacrificing as Dave Ramsey says, “living like no one else, so that he could live like no one else” during retirement. He did have a darker side. He refused to stop smoking, despite the pleas of his children to do so. His rather macabre opinion that he planned to “just die of a massive heart attack and be gone,” epitomizes the misunderstanding of many smokers. That is until March 23rd, 2005, when he arose from bed, only to collapse in a heap on the floor. He had just suffered a stroke.

He couldn’t move his right side, couldn’t speak, and lost control of his bladder function. Oh, he knew what he wanted to say, but he could only grunt. His leg and shoulder he fell on hurt badly, but he couldn’t tell anyone. If it wasn’t for the dull thud as he crumpled onto the floor, my mother-in-law would have found him the next morning. To a stoic, self sufficient, confident gentleman, he had entered hell on earth, completely coherent, feeling pain, and unable to move or communicate to those in this world. But he could pray, and he got to know his Maker well over the next few hours. Fortunately the blood flow was restored to his brain and his symptoms resolved, but not before he realized the error of a lifetime. There was nothing he could go back in his life and change, but there was something he could do from that day forward. Stop smoking. He didn’t do it for his family per say. He didn’t think about his wife, children, and grandchildren visiting him

in a nursing home, or the extensive care that would be needed to sustain his life. He didn’t think about the sacrifice of time and energy, or the mourning his family would endure.

No, at that moment, lying in a hospital bed staring at the ceiling, he was coming to terms with his future. The immediate driving force to stop smoking was selfishly motivated. He didn’t want to “live” the rest of his life on earth, in the “hell” he had just experienced.

So imagine yourself, smoking your cigarette one moment, the next, helpless but aware of all that it around you. My father-in-law described the event as the most vulnerable he had ever felt in his life… pain, fear, humiliation, uncontrollable helplessness with nowhere to flee. There was no escape, but by God’s mercy.

You have a choice. You alone can change your future, and your family’s. Stop smoking today and avoid a stroke tomorrow.

www.ArteryandVeins.com

| VASCULAR INSIGHTS

3

Transient Ischemic Attack

TIA Article by: Jennifer Clark, PA-C, MPAS

Symptoms •

Muscle weakness of the face, arm, or leg (usually only on one side of the body)

•

Numbness or tingling on one side of the body

•

Trouble speaking or understanding others who are speaking

•

Problems with eyesight (double vision, loss of all or part of vision)

•

Changes in sensation, involving touch, pain, temperature, pressure, hearing, and taste

•

Change in alertness (sleepiness, less responsive, unconscious, or coma)

•

Personality, mood, or emotional changes

• • • •

Confusion or loss of memory

•

Abnormal sensation of movement (vertigo) or dizziness

•

Lack of control over the bladder or bowels

•

Inability to recognize or identify sensory stimuli (agnosia)

Difficulty swallowing Difficulty writing or reading Lack of coordination and balance, clumsiness, or trouble walking

4

50,000 Americans suffer from TIAs as a curtain closing over the eye, difficulty (Transient Ischemic Attack) every year; with speech, weakness or inability to and of those 50,000 people, approximately move one side of the body, or facial one third will unfortunately progress to drooping. . A stroke (CVA) differs from have a stroke, also known as a Cerebral a TIA in that it is a neurological deficit Vascular Accident (CVA). Most of us that is often permanent and occurs as a are aware of the detrimental effects of result of tissue death due to lack of blood flow to a region of a stroke, but we the brain due to are not as familiar “Most of us are aware of the either a hemorrhage with the signs and symptoms of a TIA detrimental effects of a stroke, but or a blockage of an or what we can we are not familiar with the signs artery. do to prevent one and symptoms of a TIA” from occurring.

Certain risk By understanding factors predispose what exactly a TIA is, as well as the risk us to developing TIAs. Uncontrolled factors for developing one, we can enable hypertension or high blood pressure is ourselves to take proactive measures in certainly the most important. This can preventing it from happening all together! be a silent risk factor since hypertension is often asymptomatic. It is important A transient ischemic attack is defined to check your blood pressure regularly, as a sudden focal loss of neurological whether with your family physician or function that completely resolves within when you are at the store or the gym and 24 hours. This is caused by a brief period a blood pressure monitor is available. of inadequate blood flow from either the Any blood pressure reading greater than carotid or vertebral arteries to the brain. 140/90 is considered high blood pressure The symptoms of a TIA happen suddenly and needs to be evaluated and treated. and can include vision loss often described If you have a diagnosis of hypertension,

VASCULAR INSIGHTS | www.ArteryandVeins.com

make sure you are taking your medications as directed and are following up frequently with your doctor to ensure it is controlled appropriately. High blood pressure can also be affected by our diet; therefore it may be recommended that you start a low sodium diet.

Atrial fibrillation is another risk factor for TIAs. This is a diagnosis of an irregular heartbeat. If you check your pulse and notice that it is irregular, make sure you make an appointment for further evaluation.

Carotid artery disease is also linked to TIAs. This is often discovered by physical exam, if your practitioner hears any abnormal sound in the neck then an ultrasound can be obtained for further evaluation. A screening ultrasound may also be ordered based on age and risk factors. Taking a daily baby aspirin and maintaining control of cholesterol helps prevent progression of carotid artery disease.

Diabetes Mellitus that is uncontrolled is also a condition that can predispose you to TIAs as well as heart disease.

Maintaining an ideal body weight and following the American Diabetic Association recommendations for diet as well as frequent visits to your family medicine clinic or endocrinologist and ophthalmologist is essential for management of this disease.

Obesity and sedentary lifestyle are both risk factors that we can reverse. Eating a sensible diet and cardiovascular exercise are very important lifestyle changes we all need to incorporate! The American Heart Association recommends 150 minutes of cardiovascular exercise a week, or five 30 minute sessions.

If you are completely inactive this may seem like a lot, but if you gradually change your lifestyle to incorporate physical activity, this is a highly attainable goal. Limit the use of alcohol consumption to more than two drinks a day for men and one drink a day for women.

Cigarette smoking not only increases the risk for TIAs, but it increases the risk for having a stroke by 2.5 times!

By stopping smoking not only do you decrease chances for stroke and TIAs, but you help reduce risk of disease throughout the entire body. Smoking is linked to numerous types of cancer and disease, therefore quitting is one of the most important things you can do for your health.

Prevention consists of understanding risk factors and making necessary lifestyle changes helps decrease the chances of developing a transient ischemic attack in the future. While we can’t change our genetics, we do have the ability to change how we live our lives and our health, and making simple changes to the way we do things can help improve our quality of life for many years to come.

Elevated cholesterol, also known as hyperlipidemia, can lead to atherosclerosis, or development of plaque in the arteries. We should be screened for hyperlipidemia every five years, and if diagnosed should be on medications to help lower cholesterol, which in turn will help stop the progression of atherosclerosis. If diagnosed with hyperlipidemia, it is imperative to follow up frequently to monitor effects of treatment with medication and lifestyle modification.

An ultrasound of a patient who has suffered a “mini stroke� or TIA.

www.ArteryandVeins.com

| VASCULAR INSIGHTS

5

Stroke Awareness Article by Krystal Alcott, DMS

E

very year, approximately 700,000 Americans suffer a stroke. Strokes happen when there is an interruption in blood flow to the brain, usually due to a blood clot. The moment blood fails to reach brain tissue, brain cells rapidly die. The death of these cells causes symptoms ranging from temporary and subtle, to permanent and severe. Mild strokes can cause short periods of confusion and weakness, often affecting only one side of the body. Severe strokes can cause symptoms such as permanent paralysis and loss of the ability to speak. The majority of stroke sufferers will experience some type of permanent disability.

There are many risk factors that predispose a person to stroke susceptibility. Among these include:

• • • • • •

Diabetes Arterial Diseases (such as atherosclerosis, PAD, and coronary artery disease) High cholesterol Smoking Heart attack or heart defects Blood clotting disorders

The symptoms of stroke are broad and can range in severity, but usually come on suddenly. These symptoms, even when mild, should never be ignored and require immediate medical attention. Things to look for include:

• • • • • •

One-sided weakness, tingling, or numbness Vision disturbances, such as loss of partial vision in one eye Inability to speak clearly or understand speech Confusion, disorientation, memory loss Trouble keeping balance Severe headache

When symptoms are mild, people often ignore them and attribute them to aging or other known medical conditions.

This is why stroke has been named “the silent killer.” These symptoms are not to be taken lightly.

Although this devastating condition can affect anyone, any age, at any time, stroke is largely preventable. A healthy lifestyle can greatly reduce ones chances of stroke, along with regular medical care. Ask your health care provider what steps you can take to make sure you do not develop the above mentioned risk factors. Or, if you are already at-risk, find out if your conditions are controlled and properly medicated. You can help protect those you care about, as well, by not allowing symptoms to go ignored and insisting on immediate action. The faster a stroke has been diagnosed, the better the chances of limiting the damage and recovering from it.

Here at Vascular Associates, if you think you or someone you know may have had a stroke or is at-risk for one, ask about carotid ultrasound and how it may be able to help. This noninvasive test is routinely used to determine if the path of blood to the brain is free from obstructive plaque build-up. The test usually takes about thirty minutes and requires no preparation on the part of the patient. Ask your provider if he or she recommends this step for you and start preventing stroke today.