Sawbones: A Marital Tour of Misguided Medicine - Sawbones: Stroke

Episode Date: March 8, 2019

Today, we're honoring the memory of Luke Perry who passed away this week after a stroke. We'll be talking about the history of strokes, but more importantly teach you how to help prevent them and how to spot them when they happen. Music: "Medicines" by The Taxpayers

Saubones is a show about medical history, and nothing the hosts say should be taken as medical advice or opinion. It's for fun. Can't you just have fun for an hour and not try to diagnose your mystery boil? We think you've earned it. Just sit back, relax, and enjoy a moment of distraction from that weird growth. You're worth it. from that weird growth. You're worth it. TAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAPTAP Hello everybody and welcome to Sobo. It's a metal tour of Miscite and Medicine. I'm your co-host Justin MacGrow. And I'm Sydney MacGrow.

Uh, kind of somber start for this episode, but we normally try to go real high energy. No, put a little pep in the EPP. That's not good. That was a good twist on that. Thanks, just a little twist. Yeah, did you just come up with that? Just write the app. That was a good twist on that. Thanks. It's a little twist. Yeah. Did you just come up with that? Just right the second.

Well, if you've been paying attention to the news lately, you may have heard the sad news that Luke Perry passed away. If you are a person of about my age, you probably remember him best from Beverly Hills 90210. I was a big fan of that back in the day. I had the doll. I had all the dolls. I had his doll and all the dolls.

Did you remember my Barbie's preferred to date? My Luke Perry doll and my, it's a bad boy. And my Jason Prisly doll instead of, remember that he was Pike in Buffy the Vampire Slayer? The movie? Yes. Yep. And now, and he has been most recently on Riverdale. That's true.

But sadly, he passed away from a stroke. And we thought this, well for one, it was odd that we'd never covered strokes before, because it's a major thing. I mean, it's a, it's a, unfortunately very common health concern. It's the fifth leading cause of death in the United States. And it is also something that if you know more about, one, you can prevent strokes

if you know what risk factors to work on to modify what to do. You can help prevent strokes maybe you can't not completely prevent them right. I mean yeah I mean if you you can modify your risk factor so that you won't have a stroke. Oh okay. Yeah there are things you can do one example quits quits smoking if you're smoking. So great way to help avoid a stroke. Obviously I don't mean they're all 100% preventable. I was going to give this stat later, but about 80% probably are preventable. So there are things you can do. So that's number one and two, recognizing the signs and symptoms

of a stroke quickly is very, very important. And I'll get into why towards the end, as we talk about the treatment and the management and what we do about a stroke, but knowing more about it so that if you or a family member, a friend is experiencing signs or symptoms of stroke and you can recognize that quickly and get help immediately, your outcomes are way better. So it's a really worthwhile thing to talk about

for multiple reasons. First of all, do you know what a stroke is just like? Okay, so I was just sitting here thinking about that because you always asked me that. But I think I have it confused with an aneurysm, so I need some help. Well, that's okay because there's a relationship between those two problems. So that's not, you're not totally off base. A stroke though is like an interruption of blood flow to the brain. I saw in several articles they referred to a stroke as a brain attack in the same way.

Well, to liken it to a heart attack. So a heart attack is when you have, for some reason, lack of blood flow to part of the heart muscle. Lack of blood flow to part of your brain. Okay, got it. It's a stroke. We also call it a cerebral vascular accident or CVA. You'll see it abbreviated that way a lot. And then you can kind of divide that up into a schematic or hemorrhagic. And what that means is either there was some sort of blockage so the blood couldn't get through.

Kind of like you would have in the heart. Yeah, because you could have a plaque like stuff build up in the lining of an artery, and then it can get disrupted and block off the artery. Or you can have a clot thrown from somewhere else in the body, a clot forms like in the heart. There's some conditions where clots can form the heart, and then they break off and can go to blood vessels in the brain.

Those would be examples of a schemic strokes, or lack of blood flow strokes. And then there are hemorrhagic strokes, which means you have a bleed in the brain. And that would be related to an aneurysm. If an aneurysm, which is a dilation of a blood vessel, a place where it's dilated, and it's weaker as a result, if that ruptures. And you can have a bleed. There are other reasons you can have bleeds in the brain, but that is one example.

Because you don't get blood flow to the brain, where there is no blood flow, there is no oxygen and cells die. And you get damage to that part of the brain. What happens as a result of a stroke depends on where the stroke occurs, what area of the brain, how far down the path of the artery it is, meaning that it's, you know, less blood flow, less area that's receiving blood flow, or how close it is to like the root, so to speak of the artery. So how much of the brain is affected, all of that will depend on what you see and someone who's having a stroke. Yeah, it's never been interesting to me that, and I think part of what makes them confusing to the layman like myself is that you,

people seem to be affected so differently by them. Like you see some people who are obviously pass away as a result, some people who have a big loss of motor function, like I remember a Dick dick clerk was it was years before he was able to return to New Year's Rockney even it was still very difficult for him to speak and some people who do okay, like don't seem to be affected. Or even have some effects and then they actually completely resolve over time. We can see that generally speaking a stroke on the left part of the brain will cause problems on the right side of the body,

right side of the brain, left side of the body, generally speaking, that's the way the circulation works. You can get symptoms like weakness. That's the thing a lot of people will talk about weakness on one side of the body, you know, like your arm or leg, or one of the other, both can be weak. You can be numb, you can have dizziness, you can have difficulty speaking.

You can see the facial droop is a very classic sign of a stroke. So like one side of the mouth, one corner of the mouth will turn down. And then there can be some less typical symptoms like confusion or hallucinations or nausea and vomiting or passing out, even hiccups. Really? So there can be some unusual symptoms of terrifying. Why would you include hiccups? That's miserable of you.

Well, because if you're having hiccups in conjunction with other odd signs or symptoms, it would, you almost certainly would not have isolated hiccups. Fair. OK. I'm not going to say it's in pop. You said almost certainly over the pits. How could you do this?

I would not worry every time you have hiccups. I would worry if you're having a facial group and hiccups. The long-term outcomes from the stroke are based on again where the stroke occurs and the extent of brain tissue that is damaged as a result. Sometimes the effects improve greatly with time. Sometimes they don't. And part of that, we can predict based on where the stroke happened, based on like the pictures we take of your brain and look at the effects. Part of that just takes time to figure out. Now, as you may have guessed, we've known about strokes since ancient

times, because they've been happening since then. So, Hippocrates first recognized a stroke over 2,400 years ago, and back then, we would call a stroke apoplexy. And actually, through most of medical history, apoplexy is what you would see written in a text. So, if you see that somewhere in an old medical text, they're probably talking about a stroke. I have a feeling that that name is more scientifically accurate.

Affair? Well, I mean, it comes from the Greek for struck down by violence. So. There's a bit of a fight of fancy then. Not necessarily, but it does. It was because it happened so suddenly and the person almost seemed to have been a victim of some sort of violent act, even though, obviously, they weren't.

Hepocrates did not know that it was happening in the brain. You wouldn't have known at this time how everything, you know, the nervous system was still a mystery to us. So, we didn't know that. He thought it had something to do with a stagnation of the blood whereby all the motion and action of the spirits is taken away. So your blood stopped. Your blood stopped. Your blood stopped. And it could have been stopped by sharp humors. I thought the humors would get mixed up in here. Yeah, definitely the original concept of stroke was a variety of different humoral medicine, humoral medicine based theories and cold humorsh maybe like slowed everything down until it stopped, which is why you can't

move half your body, that kind of thing. Obviously. Galen also kind of and often did build on the theories of hypocrite is kind of accepting that a lot of it is true. Now, he did say though that he thought apoplexy could be caused by if anything that would interfere with the flow of what he referred to his vital spirits to the brain. So that is that does it at least involve the brain.

Yeah, he's in the right, the right hemisphere as it were. The right, the right, a third of the body right third of the body. He's on the top of the body. He's on the top of the body. You don't see the word stroke enter the medical lexicon until 1599. And there was a treatment protocol.

That was actually the place where it was first written. It was a doctor writing about a certain treatment that was recommended for stroke, which, by the way, was cinnamon, in case you're interested, which is not a treatment. Not a full knot, right, is nothing. Stroke, yeah, that's not. Except half of your heart. I was about to say a treatment for stroke, but it's not a treatment.

No, it's half of your choice, I guess. But he said that it was a prescription for, quote, the stroke of God's hand. Oh, like you've been, well, to use a different tense, like, struck down by God. That is exactly where the word stroke comes from, the concept that you've been struck, as if by some sort of supernatural or religious or higher power being God, God's,

something some force has struck you. And that is why you can certainly symptoms you can certainly see like In the paris case for example, like I don't of course, I don't know anything about his his health or what have you but It certainly seemed to come out of absolutely nowhere. Mm-hmm. They do strokes can often Often seem to come out of nowhere now. It's one of those things younger too and like a younger person Now that's a common myth that it only happens in older people Often seem to come out of nowhere. Now, it's one of the same. And younger too, and like a younger person. That's a common myth that it only happens to older people. Depending on, especially with various risk factors,

they can obviously, they can happen to younger people. But they can often seem to come out of nowhere. Now, again, I'm going to give you a lot of things that you can do to empower you to tell you how you might. Right, so don't freak out. Look into the future and see it coming. So you don't feel like you're struck by a higher power. This also reflected this idea that a lot of people started to have that a stroke was some sort of divine act,

a punishment, like a final judgment. And this idea that a person who had a stroke was somehow responsible for it or you saw it coming. Like that concept was very popular among lay people and a lot of physicians for a long time. That there was even the idea of an apoplectic habitus, meaning a certain type like body appearance that made one likely to have strokes Make I want to you know, you can understand it though like that's human Nature to want to ascribe patterns to something that terrible that seems random Nobody wants to think that it's like you want to think that there's some reason it happened, right sure Oh, he was a he was a a douchebagchebag. That's where it all went wrong, but that's just our nature. And they blamed it on things that, I mean, stroke is not unique in this way. A lot of stuff

would get blamed on behaviors that were kind of frowned upon at different times in society anyway. Yeah, right. So stroke was seen as like a physical and a moral judgment. So if you live too luxurious a lifestyle, a stroke could be your final judgment. And they would point to things like someone who was overweight and they would say, well, obviously you over and old. And so I am not saying that this is true of overweight people, but this was the concept at the time. And so that is why you have had a stroke is because you're being punished for this, you know, looks lifestyle that you lead. They would also point to

other things though, like not just something that is that clearly connected. Like I think that you have a lot of money and so you must have more food than me and so you weigh more than me. It was also specifically people who had a short neck, a large head, a flat chest, pale skin, and then a hitch in your breathing. A hitch in your breathing. Hitch in your breathing. And that these are people who are more likely to have strokes.

And so that's not necessarily, I think, is clearly connected to luxury. No, it just seems like people that get on God's nerves. Like for some reason, God's really irritated by people like, for me, it's people who chew their mouth open for God. It's these people with short necks. Why don't you even make them? Oh, how embarrassing. Honey, I hope that God is not annoyed with people with large heads because Go on the Macroi family go on You all have very large heads. You know where I'm going. I'm not gonna. I wasn't there was no nuance here You have given our children you've passed you've passed down this gene for large heads to our large-headed daughters

They're beautiful perfect heads, but they are large. Some of this was related to the idea that if you had a big head, you need more blood up there. So it made sense that you're more prone to having a shortage of blood up there because you need so much. Because you need so much. And so it was just hard to keep up. Yeah, it makes perfect sense.

In the, by the 1600s, we had some concept of like circulation, like the blood circulated in the body, that it wasn't just like constantly generating and then disappearing and sitting in our head and all that. And Jacob Weppher found that patients, that some of his patients who was examining who had apoplexy had bleeding in the brain. So he actually was doing disctions and found that there was bleeding and connected these two ideas. He also found that there were patients that had blockages.

So he could actually open up arteries and see that they were clotted off or blocked off or whatever and connect this to what we call apoplexy or stroke at the time. I don't wanna, I'm sorry, can I sidebar you for a second? Yeah. What year did you say that we discovered about like

regenerating blood? 16 hundreds. It's 16 hundreds. It's wild to think about. There were 16 hundreds, you know, you take for granted this stuff, especially with doing the show as much as we have, but like, there were 16 600 years more, I mean, like, 600 years at an adominee, but like, at that before, thousands of years in human history,

where when someone would get cut really bad and blood would start coming out of the wound, they would look at the blood and be like, Oh, man, oh, no, I need that. Oh, no, what am I going do? That would talk about it forever. If my dad got cut deeply in the like 1500s and lost like a little bit of blood, he would be talking about it 10 years later. My arms still doesn't have enough blood. I love to help you move, but half the arms out, half the blood's out in the dang arm. It can't help.

Well, and it's interesting because you always like to find that note that we figured out that the blood circulated in the 1600s, but we continued to use bleeding a person as a treatment for many things with the idea that like, well, there's too much blood here, we need to let some out. Knowing that it circulated by then, so even after the idea had sort of permeated is like well, we think that's true We're gonna ignore that it's true as we continue to do this treatment that does not work Let us put you this way. We bought leeches in bulk Okay, that's that's the long journey and that's the interesting thing is that he he still Recommended even with all this he said like well I saw that there

was some bleeding in this one brain and this person had a stroke and so it must have been too much blood so I think the next time somebody has a stroke you should bleed them. So some next time somebody is bleeding in the brain you should bleed their arm. There you go he also did he thought that the blockages the reason that those cause strikes is that they blocked animal spirits. And he's but the and it blocked animal spirits. I thought you'd enjoy that. Our family.

In some cases, again, he blamed it on flim. It was fligmatic. It was a cold humor that blocked off the blood. And in those cases, he did say don't't bleed the patient, because then they'll die. Well, there's that at least. It's positive. And this distinction between different kinds of strokes that they started to make at this point, the 1600s, started to lead to different variations

and what the treatment would be. Instead of everybody comes in with a stroke and you bleed them, well, no, this person doesn't need me to bleed, this person needs some sort of like, a very common thought was that if it's a blockage stroke, it was probably caused by eating a large meal that you didn't digest all the way. And so some of the treatments.

I'm gonna chunk a chunk of roast beef up there blocking blood tubes. So the treatment will be, these are quotes, a proper stimulating vomit. A proper. Not to one of these wimpy vomit. Get a real tough guy vomit going a warm cordial purge. Okay. Perfect.

Or if you prefer the other end, a stimulating animal should be thrown up the rectum. I love that they throw them up. They're they always say that throw them up there. I mean, they don't throw them, but I love they say, throw them up the rectum. Throw them up there. Like a grandma tossing her Christmas ornaments into the attic.

Just toss them. Throw them up the rectum. Throw them up the rectum. How did we get better at stroke, Sid? Not quite yet, but before I tell you, we're back up everywhere. Let's go to the billing department. Let's go.

The medicines, the medicines that ask you let my car before the mouth. So I understood we're about to still be bad at strokes. Is that correct? We're moving forward. That this connection between diet and strokes, the idea that you could somehow, because we still didn't have great treatments for stroke.

So there was a lot of focus on, these seem to come out of nowhere, we have no idea why. A lot of the lay community was still seeing it as like some sort of magical supernatural divine event. Physicians did not feel that way, but they didn't have any better ideas. So I just like this one specific, here's some things to avoid. A diet of high seasoned meats, poignant sauces.

Poignant sauces. Poignant sauces. Love that, it's like green zaggots. And plenty of rich wines. The finest wines, no to humanity, you might say. The finest wines, no to humanity. And if you eat that way, that they will heighten the contractions of the vital organs

and flame the blood, fire the passions, and render the nerves extremely elastic. And when the nerves of the vital organs are wound up to the highest stretch they can bear, then the least higher impulse for me, their sudden change, are setting into a thorough debotch. A thorough debotch. May crank those noble springs of life, extremely

disconcert their action and put an everlasting stop to other motions. None of this is accurate, but man, it's beautiful, isn't it? A thorough debauch is so good. That's an album title waiting to happen. Next time when you're going to see that, you're wedding invites. Just say it'll be a thorough thorough debauch. Can you see that? Here's I wish our wedding invites had said Please join us for a diet of high season meats poignant sauces plenty of rich wines followed by a thorough debauch You're welcome. By the way, if you're whoever I know somebody's stealing that you're welcome So they thought a temperate life was the way to go. So they would tell people, don't eat rich foods, don't have sex, don't get too excited,

watch your physical exertion, don't smoke. Violent passions of the mind, cold weather, tight clothing around the neck, constipation, and everything in the least bit flacculent should be avoided. Things really turned around for us in the late 1800s with the development of the fig momenometer. Yes, that is the blood pressure cuff. Very good, Justin. That's right. We could begin to measure blood pressure, which was a big deal, because we'd always had

this concept of high blood, but we didn't really know what that meant. We could diagnose hypertension, and then we started to notice an association between hypertension and strokes that a lot of patients who had strokes had high blood pressure. And this fit with this kind of already idea that you have too much blood or too much impulse or excitement, that wasn't quite correct, but they liked that. That was embraced because it seemed to fit that concept. The treatment was still just to bleed the patient and relieve the pressure, but at least we

were on the right track. There were a lot more dissections being performed in the 18 and 1900s, and that also helped with the concept of what caused a stroke, because then they started to see what we now know was cerebral vascular disease. So plaque building up in the arteries in the brain, you know, blockages in the arteries in the brain. Just like we saw on the heart, cardiovascular disease, same idea. We saw this in the brain and that term, CVD, cerebral vascular disease, started to be used. So we knew that this was the kind of condition

that led to a lot of strokes, not all strokes, but we knew that this was responsible for a lot of strokes. In the late 1800s, surgeons began, actually not in the late 1800s and early 1800s, surgeons began performing a surgery on the carotid arteries to try to clean out a lot of the blockages that they thought were responsible for strokes, which are, I should say, responsible for some strokes.

They thought that there were like plaques and clots and things building up and that they're the major arteries in your neck, the supply blood here brain. And so they started doing something that was called a carotid endard erectomy, where they kind of went in and scraped down and cleaned out those blood vessels to try to prevent strokes. But we still didn't have a lot of treatments on the back end once strokes occurred.

It was actually, by the way, 1935 before bloodletting was formally removed as a treatment for strokes. 1935. That was when it was taken out of like the manuals as a treatment for stroke. I don't know how many people were still doing it at that point, but it was still in the books. In the 1900s, we really started to focus on the causes of strokes, the treatment, what can we do, because people still felt pretty helpless. They had some ideas, high blood pressure seemed to be connected, that smoking people were still kind of putting that together, even though nobody knew why.

It was more of a, one of those like moral things before, like don't live a wild life, a smoking and drinking and dancing with the ladies, but some of those things were actually accurate. In 1928, Apoplexy was formally divided into the categories that we kind of already alluded to, the ischemic stroke and the hemorrhagic stroke, and they started to figure out like, what could cause one and the other.

And we started calling things CVAs or cerebrovascular accidents at this point instead of apoplexy. Acidins actually, like, is not a word that you all use a lot. Acid? You know, it's not- We say CVA all the time though. It's wild though, like you don't say accent, you just don't seem like a very medical, but a medical term, right? I can see that.

Well, but it sounds better than apoplexy, and it sounds better than stroke. Yeah, but it's weird because if it's medical, it's not an accident, is it? I mean, it's like, it's an inaccurate term, I think it's what bothers me, because it didn't happen by accident, it happened because of the specific conditions

in the body that created that situation. I mean, your brain didn't mean to lose blood flow. Yeah, but like, that's like saying, like, that's like saying 2D is like a gas accident because your body didn't mean to make 2D. It's like, well, no, you just, that's how it works. It's what happens. Well, but that's, okay, you're also talking about physiology

versus pathology. Okay. I'm making out. Still, I get that it's a weird, it is a weird name. And I saw that term use in a lot of, even like medical journals brain attack to like get people to call it that instead of surface EVA.

Straight attack is another great, that's too great. I don't title it, I'm gonna surface of the loan, y'all. Throughout the 1900s, we developed angiography, so we can kind of inject dye into a system of blood vessels and then look at them, you know, using radiology equipment. We can look at all the blood vessels and see where the blockages are. And that was a huge advancement in stroke, Because once you, then you can actually see that a stroke has occurred. That's available through like CT angiogram, so a CT machine, a CAT scan machine with angiography or you can do it with an MRI.

Now we do this as well. And then things like blood thinners became part of the equation too because we figured out that clots are responsible for some of these and then finally in 1996 what a lot of people refer to as the clot buster have you heard of that before I've heard you say yeah clot buster so this is TPA tissue plasminogen activator it's a medication that breaks up blood clots and it was a big breakthrough for the treatment of strokes. Because again, up to this point, we didn't have a ton of stuff to do on the back end. We had some ideas about how to prevent them, but how to treat them. We still were kind of clueless. TPA was a big advancement, but TPA is not used in all cases of stroke.

In fact, I don't see it used very often in my clinical experience because you have to get there pretty quickly for the benefits of it to outweigh the risk. In a lot of cases, if you're not there within four hours of when the symptoms began, you're outside the window, you're not even a candidate for TPA.

And it's just because of the risk. It's not like a mean thing. It's just, you're not even a candidate for TPA. And it's just because of the risk. It's not like a mean thing. It's just, they're very specific. So when you administer TPA, you risk that it's gonna break up a bunch of clots and cause a bunch of bleeding. And bleeding is bad in the brain, which you could guess, bleeding is very bad. So you're going to take that risk,

so you wanna make sure that the benefits are all there. And in a lot of patients, the risks far away, the benefits, you can't use it. So it is a good advancement and it has saved a lot of probably lives and function, but it's not for everybody. Sure. There's also what we call thrombectomy where you can go in and remove the clot, like actually mechanically remove it, which again, as you can imagine, is a high-risk procedure. You have to have specialists of specialists to do this.

And so you got to be at a stroke center where they can perform this. But it is, again, can be life-saving and function-saving, you know, quality of life-saving if it is the right patient in the right place at the right time. But all of this, again, depends on being at the hospital quickly, which is why one of the best things you can do is know the signs and symptoms of a stroke so that if they're occurring, you can get somebody hopefully to a stroke center as fast as possible,

but at the very least to a hospital as fast as possible. So what are those signs and symptoms in in fast is the easiest thing to remember. Do you know what that stands for? I may I was going to tell you fast because I knew fast. Well, you tell me fast then facial drooping. Mm hmm. So look for the person's face to be asymmetrical like the corner of their mouth drooping. Acting weird.

No. Arming. Arming. Arming. Arm numbness. Well, I mean, that would be concerning. I'm just kidding, if you feel, just tell people what it is.

Have them hold their arms up. Okay. Can they not, like, does one drift or drop? Okay, so what's that? Just arm. Arm. Okay. Yeah. So facial drooping. No. Facial drooping arm. What's the S? You got the next one? Come on. Wait, stroke. Just. Facial drooping arm. Speech. Speech. Is there speech, Lord? Ask them to talk to you and tea is talking time time to remind you that I mean, it's just like you know with heart attacks. They always say time is muscle everybody always remembers that right time is muscle time is muscle You got to get them in there because the longer you wait the more muscle. They're losing it's the same idea with the stroke

The longer that those brain cells are deprived of blood flow and therefore oxygen, the more damage it's being done. So the faster you get somebody to the hospital, the better and the more function they have the chance to regain. So the big thing is, as soon as you recognize any of these signs of symptoms in yourself or somebody else, get these to a hospital. And again, those are like the big things to look for But that you can have other kind of strange symptoms particularly in women women just like with heart attacks can present differently Women with strokes are likely to present a little differently. So somebody just passes out out of the blue or

Becomes violently ill out of nowhere and is confused and maybe hallucinating. Anything like that, anything out of the normal, out of the normal like that, it's best to go get checked out as quickly as possible. And to know when the symptoms started, keeping track of that exact time, if you see somebody and you think they're having a stroke, look at the clock as you call 911. Don't hesitate from calling 911. But look at the clock while you're doing it so that you can tell that EMT, the symptoms started at this time because the doctor at the stroke center needs to know that exact time. That was a T stands for maybe time. That's what I said, like check the time. Check the time. Like, remind you. Oh, maybe it is. Maybe.

I guess it could go either way. Yeah, I bet you're right. It does. It's all the time. It's important, okay? In all fairness, like, I don't really use the fast thing a lot. We're just like a doctor. You just like doctor.

It's like, look, I hear I have any stroke. I'm a one. But like, let's go. Yeah, actually time. Note the time. Let's go over it. Let's go over it again. Could you go over it again?

Because I was in a hurry. Face. Facial drooping. Uh huh. face face face face. Do you see asymmetry or is there drooping? Arm have them hold their arms up. Can they not lift one arm? Is one arm drifting? Is one more arm drooping? It does it appear there's weakness and an arm? Speech ask them to talk to you. Does it sound slurred and time? Note the time. What time is it that these symptoms started and then move quickly? Call 911 and then convey that time to the EMT. Yeah, call 911, don't, I mean, don't drive them, certainly don't drive yourself. No, what? No. Well, hey, listen. I'm sure some things have happened.

And some things you can do outside of recognizing the signs and symptoms and getting somebody the hospital as fast as possible so they have every opportunity for treatment that is available to them, which again depends on your medical conditions and your history and your background and all that. So it's not that clear cut, but get them to the hospital. As I said, 80% of strokes can be preventable, so there is a lot you can do. Stuff that we know, as I mentioned, smoking is a big risk factor for stroke. You shouldn't smoke. It's bad for you. You shouldn't drink to excess. That's a risk factor for strokes. You, a healthier diet, one, a balanced diet, plenty of fruits and vegetables, leaner meats. That is an important, more and more,

a plant-based diet is really what a lot of medical people will tell you to lean towards. I'm not willing to give up my proteins, but I will stick with lean proteins a lot of the time. Exercise, regular cardiovascular exercise is important physical activity every day. It's good for your heart, it's good for your brain, it's good for your body, it's good for your lungs, it's good for your sleep, it's good for your brain, it's good for your body, it's good for your lungs, it's good for your sleep, it's good for your mood, it's good for your cognition, all that stuff. Also if you see a doctor regularly, so you can be diagnosed and managed for conditions like diabetes, which is a risk factor for stroke, high blood pressure, high blood pressure,

which is a risk factor for stroke, and something called atrial fibrillation, which is when your heart beats abnormally, the top part of your heart, the atrium kind of flutters or fibrillates, I shouldn't say flutter, that's whole other thing, fibrillates it kind of quivers, that's a good word. And it can, you can get blood clots forming there because it's sort of quivers and the blood clots and just kind of hangs out and those little clots can shoot up to your brain and cause strokes. So, if you're having chest pain or palpitations where you feel your heart pounding and fluttering and it feels weird and you don't know why, anything like that, go get checked out.

I'll give a history of that. Tell your doctor. These are all things that you can have managed to avoid the outcome of a stroke, hopefully. And again, women, it is women's history months. So I'd like to mention this, women have a higher rate of stroke because of some extra risk factors that can occur. People who can become pregnant, people who take hormone replacement therapy, people who take oral contraceptives, and people who have migraines with aura. All of these things are extra risk factors for stroke. And stroke kills twice as many women as breast cancer each year.

And I think it's important to say something like that because I think we all are a little more aware and cognizant if we are people who are at risk for breast cancer that we need certain screening and testing and that's kind of in our minds. But stroke isn't always necessarily there at that same level. But these are things that you can be preventing, you can have managed, you can do things to help avoid a stroke in many, not all, but many cases. So do those things, get to your doctor,

know the signs and symptoms, and if you see them occurring, get somebody help as fast as possible and know that time so you can tell that EMT ER doctor emergency room nurse whoever you talk to What that time is well take care of yourselves take care of yourselves folks and take care of each other Thank you so much for listening to our program. Thanks to the taxpayers for the use of our song medicines

Their song, I guess you could even say Yeah, it's not our song in song. It's not our song. There's on But it's called medicines and we use it as the entry and natural of our song medicines, their song, I guess, you could even say. Yeah, it's not our song. It's not our song, it's their song. But it's called Madison's, and we use it as the entry and natural of our program. And thanks to Max, I'm a fun network for having us on. Max, fun drive, just try the corner. Get there.

It's gonna be fun. And that's gonna do it for us for this week. So until next time, my name is Justin McRoy. I'm Sydney McRoy. And as always, don't drill. Hold in your head. Alright! Maximumfund.org Comedy and Culture, Artistone

Listener Supported