A lot can happen in 40 seconds. A hummingbird will flap its wings 405 times; the world's fastest sprinter will cover 400 meters; a heart will beat about 50 times; and in the next 40 seconds, one more person in the United States will suffer a stroke.
May is American Stroke Month, a time dedicated to raising awareness about this nation's No. 3 killer. Stroke is also a leading cause of long-term disability. Every year, about 780,000 Americans suffer a stroke and 150,000 die. It is expected that stroke will cost the nation $65.5-billion in 2008. Stroke is not a disease of just the elderly or men. Stroke can occur at any age, including children. Each year, about 60,000 more women than men have a stroke in this country.
A stroke occurs when a portion of the brain suddenly is deprived of blood supply — oxygen and nutrients — because of a clot in one of the blood vessels going to the brain or because of rupture of a tiny blood vessel in the brain.
Warning symptoms and signs of a stroke are sudden: numbness or weakness of the face, arm or leg, especially on one side of the body; confusion, trouble speaking or understanding; trouble seeing in one or both eyes; trouble walking, dizziness, loss of balance or coordination; and sudden severe headache with no known cause.
Receiving a clot buster medication within three hours of a stroke caused by a clot may be able to stop the stroke completely or at least minimize the effects of the stroke. A person has to recognize the symptoms and get to the hospital emergency room, preferably by ambulance. Time is of the essence.
As in most cases, prevention is the most important element of the treatment strategy. Most of the common risk factors that lead to a stroke are the same as for heart disease: hypertension, smoking, high cholesterol, obesity, diabetes and inactivity. All of these are preventable or correctable. Some of these risk factors also promote Alzheimer's (dementia) and some cancers.
High blood pressure is the most common cause of strokes. Patients do not usually have any warning symptoms or signs until they sustain a full stroke with an exception of some lucky patients who develop a ministroke but the symptoms subside within 24 hours even without treatment. (In most cases, only to be followed soon by a sudden severe stroke). Smoking — by virtue of causing heart attacks, other circulatory problems, cancers, and emphysema in addition to stroke — remains the No. 1 cause of preventable death. Smoking is the most expensive and excruciating way of committing suicide.
I often hear patients say, "Everybody has to die someday and I am not going to live miserably sacrificing everything." One does not want to die of a stroke.
The majority of the people who sustain a stroke do not die from it. They live with it for a long time, not able to talk or walk. Life will truly be a living hell with little freedom and independence. One will be struck speechless in the middle of a sentence. One will fall to the ground trying to take the next step. One cannot even reach for the phone to call for help. But all this is mostly preventable.
A few years ago, with the help of the American Heart Association, the Florida Legislature took a lead in the nation (thanks to the members of the Pasco-Hernando delegation for sponsoring the bill) to pass a Florida Stroke Act which increased and mandated the preparedness of the hospitals to treat stroke victims in an efficient and emergent manner. The American Heart Association/American Stroke Association is also currently working with the U.S. Congress to pass the Stop Stroke Act in 2008.
Like most other things, the final and ultimate responsibility belongs to the individual. Action has to be taken before a stroke strikes a person dead or leaves him or her disabled. Reduce the risk factors, know the warning signs and respond quickly to receive appropriate treatment. Every second counts and you don't get a second chance.
Dr. Rao Musunuru is a cardiologist at Regional Medical Center in Hudson. He is a member of the national membership and communications committee of the American Heart Association/American Stroke Association.