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Stay ahead of Stroke
5 things to know about the medical emergency
Dr. Prashant Natteru
Mayo Foundation for Medical Education and Research
A stroke can happen at any time and to anyone. You might be talking to your loved one and notice they’re suddenly slurring their words. Or, while grocery shopping, you realize you can’t move your hand to pick up a jar from the shelf. You can go from feeling as usual to feeling sick within a matter of seconds to minutes. Here are five key things to know about stroke.
1 Strokes affect the oxygen and nutrients supplied to your brain. Strokes occur when nutrients and oxygen are not delivered to the brain through blood vessels, leading to the death of brain cells. This lack of delivery can be caused by a clot in a blood vessel obstructing the blood flow to the brain, known as an ischemic stroke, or when a blood vessel ruptures and prevents blood flow to the brain, known as a hemorrhagic stroke.
Sometimes, the obstruction to the blood flow and the resulting symptoms are caused by a temporary clot and are transient, resulting in a transient ischemic attack, often called a ministroke.
2 Strokes can happen to anyone.
Strokes can happen to anyone regardless of age, gender or race. Certain risk factors — both controllable and uncontrollable — can put you at a higher risk.
Common controllable risk factors include:
- Atrial fibrillation, which increases stroke risk by five times.
- Diabetes.
- Excessive alcohol intake — an average of more than one drink per day for women or more than two drinks a day for men.
- High blood pressure.
- High cholesterol.
- Obesity.
- Obstructive sleep apnea.
- Physical inactivity.
- Smoking or vaping.
Uncontrollable risk factors include:
- Gender.
- Heredity.
- Increasing age.
- Race.
3 Be prepared to spot the signs of a stroke.
Learn to recognize the signs of stroke quickly.
The American Stroke Association lists these symptoms to help you know when to seek medical care:
F = Face drooping: Ask the person to smile and see if the smile is uneven.
A = Arm weakness: Ask the person to raise both arms and see if one arm drifts down.
S = Speech difficulty: Ask the person to speak, and see if the speech is slurred.
T = Time to call 911: Stroke is an emergency. Call 911 at once. Note the time when any of the symptoms first appear.
Other stroke symptoms to watch for include:
- Numbness of the face, arm or leg, especially on one side of the body.
- Sudden confusion, trouble speaking or difficulty understanding speech.
- Sudden-onset, severe headache with no known cause.
- Sudden vision issues, such as trouble seeing in one or both eyes.
- Trouble walking, loss of balance, dizziness or coordination.
If you or someone you are with has any stroke-like symptoms, seek immediate medical care.
4 A stroke is a medical emergency.
Every second counts when someone is experiencing a stroke. Once a stroke starts, the brain loses about 1.9 million neurons each minute. For every hour without treatment, the brain loses as many neurons as it typically does in nearly 3.6 years of regular aging.
While waiting for paramedics, do these things if possible:
- If the person is conscious, lay them down on their side with their head slightly raised and supported to prevent falls.
- Loosen any restrictive clothing that could cause breathing difficulties.
- If weakness is obvious in any limb, support it and avoid pulling on it when moving the person.
- If the person is unconscious, check their breathing and pulse, and put them on their side.
- If they do not have a pulse or are not breathing, start CPR right away.
5 Women have an increased risk of stroke.
According to the American Stroke Association, stroke is the third-most common cause of death in women. More than 90,000 women die from a stroke in the U.S. each year. Every 1 in 5 women will have a stroke, and about 55,000 more women than men have a stroke each year, with Black women having the highest prevalence of stroke.
The risk of stroke increases in women who smoke, have atrial fibrillation or migraines with aura, take birth control pills, use hormonal replacement therapy, are pregnant or have preeclampsia.
Talk to your health care team about your stroke risk and ways to lower your risk by addressing controllable factors.
Study documents lost chances to treat overdose survivors
Carla K. Johnson
Associated Press
A new study documents lost opportunities to treat drug overdose survivors covered by the Medicare program — and illustrates the difficulty of managing chronic pain.
Overdose survivors “should be at the front of the line for the full range of medications and counseling and support,” said Dr. Brian Hurley, president of the American Society of Addiction Medicine, who was not involved in the study, published Monday in JAMA Internal Medicine.
Instead, those on Medicare who survived a drug overdose in 2020 were much more likely to later receive opioid painkillers than any medication to treat addiction — and some went on to die of an overdose.
U.S. government researchers found 53% of overdose survivors received opioid painkillers while 4% received treatments such as buprenorphine. Only 6% filled prescriptions for the overdose antidote naloxone. Within a year of their overdose, 17% experienced a second nonfatal overdose and 1% died of an overdose.
The researchers looked at nearly 137,000 Medicare beneficiaries who survived an overdose in 2020, when the emergence of COVID-19 scrambled drug treatment eff orts.
The group included about 30% who qualified for Medicare because of a disability rather than their age. About 80% of them had been treated for acute or chronic pain, and nearly half had prescriptions for opioids before the overdose.
In some situations, it might be appropriate to continue to prescribe opioids after an overdose, but “these patients should be closely monitored, provided naloxone” and have plans in place to reduce overdose risk, said lead author Capt. Christopher Jones of the Substance Abuse and Mental Health Services Administration.
Gaps in treatment for overdose survivors exist throughout the U.S. health care system and predate the pandemic, said Dr. Michael Barnett of the Harvard T.H. Chan School of Public Health, who was not involved in the new study, but found similar results among Medicare patients from 2016-2019.
“The health system is very poor at connecting people to life-saving medication after they overdose,” Barnett said. “It’s a health system problem. And it’s also a problem of stigma and public education that many people may not be interested or may not trust medications for opioid use disorder.”
In 2020, Medicare expanded coverage to include methadone to address a longstanding treatment gap. Methadone is the oldest, and experts say, the most effective of the three approved medications used to treat opioid addiction. It eases cravings without an intense high, allowing patients to rebuild their lives.
Medicare still does not cover residential addiction treatment, another gap that should be closed, Hurley said.
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Southwest Montana Health Care Directory
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