Stroke Prevention Starts With You

An Op-Ed Column
by Jason Eberhart-Phillips, MD
Kansas State Health Officer

No two strokes are exactly alike.

Public radio’s Garrison Keillor described his experience of a stroke last year like this: “You're talking on the cell phone and suddenly your mouth goes berserk and your speech becomes very slurred and mushy, as if you had had four martinis. And it’s numb, as if you had been to the dentist and had four martinis.”

To Jill Bolte Taylor, a brain researcher who was stricken by a massive stroke at 37 years of age, it began with a pounding pain behind her left eye. Soon she lost her balance, and then her right arm became completely paralyzed.

While this was happening Taylor said to herself, “I can no longer define the boundaries of my body. I can’t define where I begin and where I end.”

For my mother, who had a “mini-stroke” more than 10 years ago, the event began with an unusual weakness in her left arm and leg. She felt dizzy and had difficulty standing up.

Each year about 795,000 people in the United States experience a new or recurrent stroke. Millions more have one or more “transient ischemic attacks” like my mother had, events that cause no permanent damage but serve as a warning for more serious strokes in the future.

Stroke is our state’s third leading cause of death – behind heart disease and cancer – accounting for 1 in 16 deaths in Kansas each year. It is one of the leading causes of long-term disability, and is thought to cost the U.S. economy more than $73 billion a year.

Strokes occur in two ways. Either there is a blockage in the flow of blood to the brain, or there is bleeding into brain tissue. In both cases the result is the death of innumerable brain cells, death which causes a sudden loss of movement, speech disturbance, vision problems or other serious impediments to everyday activities.

With help from experts in rehabilitation, full recovery of normal function after a stroke is sometimes possible. Often it is not.

Prevention of the damaging effects of stroke occurs at two levels. One is to get people to learn the signs of having a stroke and to take action immediately to reach a hospital. The other is to prevent strokes from occurring in the first place, by helping people eliminate the root causes of stroke in their lives.

Although the ways that strokes unfold can vary widely, there are some common signs and symptoms that should prompt an immediate call to 911. These include:

Sudden numbness or weakness of the face, arm or leg
Sudden confusion or trouble speaking or understanding others
Sudden trouble seeing in one or both eyes
Sudden dizziness, trouble walking, or loss of balance or coordination
Sudden severe headache with no known cause

Unfortunately, surveys show that less than a quarter of adults correctly recognize these tell-tale signs of a stroke.

In Kansas, more than half of stroke deaths occur before transport to a hospital, largely because time is wasted at home before an ambulance is called. Emergency treatments to dissolve blood clots in the brain can prevent long-term disability from many strokes, but they must be administered within three hours to be fully effective.

Here is the bottom line: After a stroke hits, every minute counts. Time lost is brain lost.

To reduce the chances of being hit by a stroke at all, everyone can take proven steps to lower their risk – starting today. These steps include:

Keeping your blood pressure under control. High blood pressure doubles a person’s chances of stroke compared to having normal blood pressure. Roughly a third of Kansas adults have high blood pressure, and many don’t even know it.

Watching your cholesterol level. About a third of Kansas adults have cholesterol levels that are too high. High cholesterol is associated with blocked arteries in the brain, just as it is linked to blockages in blood flow to the heart.

Being physically active. Moderate activity, like walking for half an hour most days of the week, can have a dramatic effect on lowering stroke risk.

Limiting alcohol consumption. More than one or two drinks a day increases the risk of a stroke, along with heart and liver disease.

Avoiding cigarette smoke. Smoking reduces the amount of oxygen in the blood, allowing clots to form more easily. You can get help to quit smoking by calling the 24-hour Kansas Tobacco Quitline at 1-800-QUIT-NOW (784-8669).

Every 40 seconds, someone in the United States has a stroke. Learn all you can now about the prevention of stroke, and chances are good that it won’t happen to you.

Dr. Eberhart-Phillips is the Kansas State Health Officer and Director of Health in the Kansas Department of Health and Environment.


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