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Gabriel Suarez
03-09-2006, 11:53 AM
Sent by an EMT friend -

STROKE IDENTIFICATION:

During a BBQ a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) and just tripped over a brick because of her new shoes. They got her cleaned up and got her a new plate of food - while she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening. Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00pm, Ingrid passed away.) She had suffered a stroke at the BBQ - had they known how to identify the signs of a stroke perhaps Ingrid would be with us today.

It only takes a minute to read this-

Recognizing a Stroke


----- A neurologist says that if he can get to a stroke victim within
3 hours he can totally reverse the effects of a stroke...totally. He said the trick was getting a stroke recognized, diagnosed an getting to the patient within 3 hours which is tough.

RECOGNIZING A STROKE

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

1. *Ask the individual to SMILE.

2. *Ask him or her to RAISE BOTH ARMS.

3. *Ask the person to SPEAK A SIMPLE SENTENCE (Coherently) (i.e. . . It is sunny out today) If he or she has trouble with any of these tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher.

After discovering that a group of non-medical volunteers could identify facial weakness, arm weakness and speech problems, researchers urged the general public to learn the three questions. They presented their conclusions at the American Stroke Association's annual meeting last February. Widespread use of this test could result in prompt diagnosis and treatment of the stroke and prevent brain damage.

Steve Holden
03-09-2006, 12:20 PM
Sr... Con muchas gracias.

I can not go further. Long Range Rifle class in ethiopia is on.

Vaya Con Dios

Steve

SUAREZ CORPORATE
03-09-2006, 12:57 PM
Good advice, although sadly there is little we can do to treat most strokes. A few types can be helped significantly, most not. Not nearly the dramatic results we can effect on so many other injuries/illnesses (such as heart attacks and trauma).

Bruce Piffel
03-09-2006, 01:09 PM
Great info.....I had to deal with this last year with my Mother. Luckily she stopped by the doctors office before heading to the summer cabin. She was feeling out of it and always tired. She said she could not pass up the couch without laying down. Well the Dr. checked her out and sent her directly to the hospital via ambulance and she had a five way by-pass the next day....Wow! She is a different person now.The point is the symptoms ARE there. :)

SUAREZ CORPORATE
03-09-2006, 01:16 PM
she had a five way by-pass the next day....Wow! She is a different person now.The point is the symptoms ARE there. :)You are referring to coronary artery disease (which is a problem with blood supply to the heart muscle tissue), not stroke (which is a problem with blood supply to the brain tissue). Still important advice you are giving, but mixing two subjects. :)

Bruce Piffel
03-09-2006, 01:49 PM
Well .....see you learn something new every day.:) I suppose you could have a stroke from a poor pumper couldn't you ?

michael
03-09-2006, 01:58 PM
Good, simple advice that we need. Thanks for posting.

Cold War Scout
03-09-2006, 04:30 PM
My ex-wife's stepfather had a stroke in a taxi in NYC going from a restaurant to a Broadway show. His wife, my ex's mother, noticed he seemed suddenly weird and his speech was a little slurred (as I recall she specifically said slurred). She was one of the most well read persons I have ever known. She immediately told the cab driver to drive to the nearest hosptial emergency room. Which he did.

Because of the speed with which he was in receipt of medical attention, he recovered almost completely from this stroke. Doctors said if they had gone to the show, which he was protesting they should do, he would have suffered much more severe consequences.

Waldo
03-09-2006, 06:05 PM
Good info..thanks for posting...

Unfortunately, my Dad lived by himself when he suffered a stroke last December. His phone was not working. By the time I found him, he had been down for two days. We had to make a tough decision to terminate life support after a few weeks

Had he had some better info on stroke recognition, he might have been able to help himself by going to a neighbor's or driving to the E.R. Who knows?

Food for thought, especially if there is family history.

duncan_bayne
03-09-2006, 11:36 PM
Thank you for this information.

As I just told my wife: what I like about WarriorTalk is that the focus is on staying alive - mentally, physically, and spiritually - and that all information pertaining to that goal is posted here and, where it's called for, rigourously but courteously debated.

WT rocks! :D

Al Lipscomb
03-10-2006, 05:33 AM
Important information. The key is almost always knowing that something is wrong. I remember the scare we had when my mom had a TIA a few years ago.

DaveJames
03-10-2006, 07:06 AM
Group,, this is the one thing that the Doc has told me, is the reason behind them telling folks to take one baby asprin a day,, every thing I have read seems to point to, it helping more , just short of a massive life style change.

michael
03-10-2006, 02:04 PM
Group,, this is the one thing that the Doc has told me, is the reason behind them telling folks to take one baby asprin a day,, every thing I have read seems to point to, it helping more , just short of a massive life style change.

Yes. I begin this when I turned 40 on recommendation of my doc.

cwood
03-10-2006, 04:18 PM
Mr. Suarez, I would like to thank you for bringing this up. My mother's stroke was devastating to her as well as the rest of our family.
In addition to the advice offered above, it is also important to screen for diabetes. Undiagnosed diabetes and the resulting high blood pressure causes many strokes. Preventive health care (diet and exercise) is the best course of action.
The three hour window of treatment may be important to limiting or reversing the damage. I learned after it was too late for us that Plavix given shortly after the onset of a stroke may be an effective treatment. Perhaps someone more learned in medicine than I could confirm this?

marcclarke
03-11-2006, 11:04 AM
You are referring to coronary artery disease (which is a problem with blood supply to the heart muscle tissue), not stroke (which is a problem with blood supply to the brain tissue). Still important advice you are giving, but mixing two subjects. :)

True, they are different as to the tissues where they occur being in different places. However, a stroke is technically a "brain attack"; an interruption in the supply of blood and oxygen to the tissues of the brain, just as a "heart attack" is an interruption to the supply of blood and oxygen to the tissues of the heart.

SUAREZ CORPORATE
03-11-2006, 11:30 AM
True, they are different as to the tissues where they occur being in different places. However, a stroke is technically a "brain attack"; an interruption in the supply of blood and oxygen to the tissues of the brain, just as a "heart attack" is an interruption to the supply of blood and oxygen to the tissues of the heart.Thank you for confirming my understanding of the pathophysiology.

marcclarke
03-11-2006, 11:50 AM
Thank you for confirming my understanding of the pathophysiology.

Most welcome. The mechanisms are the same (depositions of calcified plaques in the arteries narrowing the arteries, plaques breaking off the arterial walls and clogging an artery, etc.) and the methods of prevention are the same (diet, exercise, lots of good anti-oxidants, etc.).

I really liked Gabe's kick-off post and have copied the stroke identification techniques to my PDA to always have them with me. Thanks, Gabe!

marcclarke
03-11-2006, 01:55 PM
I should also note that I found Gabe's opening post highly thought provoking as I had not previously known these simple stroke recognition techniques.

I very strongly suspect that some years ago I was sitting next to my uncle at dinner when he underwent what I now suspect was a minor stroke. He lost orientation and while he could speak reasonably clearly, what he was saying suddenly seemed utterly random and unassociated either with what he had just said or with the conversation at the table. When I read Gabe's post I found myself really wishing I had then known these simple diagnostic techniques, as perhaps we could have gotten my uncle some helpful and timely medical intervention. :(

Thanks again for the post, Gabe. :)

Jeff22
03-11-2006, 10:01 PM
In 1998 one of my co-workers at the PD had a stroke when on duty. He was 54, strong as a bull and had great aerobic capacity BUT had not seen a doctor for a physical exam in 10 or 12 years. He had undiagnosed high blood pressure and had been having increasingly severe headaches for a month, but was too stubborn to admit there was anything wrong.

He still walks with a cane and his verbal skills are significantly impaired.

In January of 2006 another co-worker had a stroke the day after he turned 53. In this case, he had been declining physically for about 5 years. He is part native american (Chippewa nation) and his pre-diabetic high glycemia turned into adult onset diabetes. He didn't take care of the diabetes at all. He also had sporadic episodes of gout and migranes for years, and had high blood pressure and headaches that put him off work for a week in the fall of '05 (BP of 200/120 or something like that). His kidney function was also failing, and he was in total denial about everything. About three times a week we'd get on him about going to the doctor and taking his medication, and he'd get all stubborn and ignorant about everything. Then at bar time when there were disturbances at the downtown clubs, he'd be the first on scene and go running into the crowd without adequately telling dispatch what he was or where he was doing. We told him he had a death wish and just wanted to get killed on duty so his name could go up on the state law enforcement memorial. In truth, it was probably part of his denial. He wanted to show he was still a "feet first & guns a-blazin'" kind of cop.

In this case, after the stroke his mental state was unaffected (okay, he always was wacked and a little edgy and he still is) and he had slight motor impairment on his left side, which seems to be responding to physical therapy. Still, I don't expect he'll ever be coming back to work. He's on lots of medication for various things, his BP is back to high within the normal range, but he still has the kidney function problem.

Guys hate to go to the doctor. GO ANYWAY. I scheduled a (long overdue) physical exam the day after Stan had a stoke, and have a colonoscopy scheduled for the week after next. (I'm not looking forward to it, but colon cancer killed my mom in 1990, so I know it's necessary).

And just to be on the safe side, when they do your blood work, have them check your lead level, particularly if you shoot a lot on poorly ventilated indoor ranges or reload or handle lots of brass or cast your own bullets. (My level was 10 mg/dl, which is slightly elevated but not a big deal. During previous tests over a 15 year period, it was a 13 and then an 11, so the lead level is actually going down). The local commercial reloader had to go through chelation therapy for lead poisoning about 25 years ago (he was casting bullets then without proper ventilation) and about 17 years ago the Rangemaster for the Sheriff's Department had a dangerously elevated lead level in his blood, which he dealt with by better hygiene (DON'T chew tobacco when running the line on a poorly ventilated circa-1955 indoor range!!) and taking extra vitamin C and zinc. (I think he was taking some kind of mineral blend the doctor recommended as well, but I don't remember for sure).

Go to the doctor. If they prescribe something for high blood pressure or high cholesterol or something, TAKE IT. Take care of your health. You can't defend yourself or anybody else or enjoy the shooting sports or the martial arts if a stroke puts you in a wheel chair or a heart attack puts you in the grave.

fish78
03-13-2006, 02:38 PM
I had a stroke in 1996. Fortunately, mine was minor and the symptoms were sufficient to get me to a doctor fairly quickly. I was playing golf and noticed that my distance was poor...after the round, I went to the range and hit ball after ball with my driver, still not getting any distance, suddenly, there was a flash, just like a flashbulb on a camera and the after glow did not go away...the next morning I went to my eye doctor, who sent me to an opthamologist, who took one look and called a vascular surgeon...I was admited to the hospital and placed on heperin...the eye cleared up immediately, the next day they did an arteriogram and the following day carotid endarterectomy...home for ten days and had the edarterectomy on the other carotid...been 10 years and I consider myself very lucky.

danc676
03-21-2006, 05:51 PM
Great post from Gabe.
If you even think someone close to you may be having a stroke(Brain attack, CVA) get them to the ER; If it can be diagnosed and found that it is not from a bleed there is a drug avaliable to help. But it must be given within hrs of the onset of the symptoms. Now for the bad news the hospital must have a CT to prove the symptoms are not due to a bleed(really bad form to give this drug to someone who is bleeding it is one of the same "clot busters" we give to people having a heart attack) and now for the worse news even if it is a nonbleeding stroke you may not get the drug depends on the facility and how their doctors practice medicine. But when it works it really works I have seen it many times.

SUAREZ CORPORATE
03-21-2006, 07:14 PM
But when it works it really works I have seen it many times.Actually, the medical literature doesn't support that statement. It remains very controversial whether to even give it to the 3% of patients who meet the stringent qualifications for administration of the thrombolytic ("clot buster") drug. Let's just say it this way: my group of emergency physicians have all said, among ourselves, that if one of us has a stroke, we don't want it given to us. We honestly feel the risks far outweight the supposed benefits.

Condition Brown
03-21-2006, 09:34 PM
Gabe, I'm a volunteer firefighter/EMT. What you describe is the Cincinnati test. It's what we use in the field.

The three hour limit is the extreme. Anyone who demonstrates any one-sided droopiness of face, of arms or of grip, call 911 immediately and have them transported to the hospital immediately. The 'clot busting' cocktail called TPA is very dangerous, and the hospital will need to run at least 45 minutes of tests (assuming no delays) before giving the go-ahead. If it's outside of that 3 hour window by the time they are ready, they won't administer it.

huntermedic
03-22-2006, 05:04 PM
Good info, and good questions to ask. There is only one flaw. You have to recognise that there is a problem.
Look for these in any person that you think may be having a stroke; complaints of a severe headache, any type of altered mental status (acting different from usual) lack of coordination.
If any of these are showing positive, ask the above questions and most importantly, when in doubt call 911, even when the person is adament that they are fine.

Jeff

S3Project
03-22-2006, 11:09 PM
My father had a minor stroke last weekend.

From what I've heard, the only initial symptom for him was a headache - and he never gets headaches. He went to sleep one night, then woke up the next without vision in his right eye.

Fortunately, there was no memory/brain/motor damage...he lost some peripheral vision, but it's recovering.

- Derek