Stroke… A Different Perspective
by John L. Stump D.C., Ph.D., Ed.D.
In May 1999, upon returning Sunday evening from one of his many trips, John Stump and his wife went out for dinner. Arriving home they decided to begin packing for the upcoming lecture he was scheduled to do in New Zealand. He glanced at the clock; it was five minutes before midnight when a strange feeling went to his right arm and a few seconds later his right leg went weak. He fell over on the bed; he tried to call for his wife but nothing would come out of his mouth but gibberish.
By the time they got him to the hospital, he was unconscious. They rushed him into the ER. "When I saw the doctor’s face, it didn’t look good. In the waiting room, he looked at me and said he would do all that he could, "but your husband has had a massive stroke and is hemorrhaging in the brain. We’re trying to get the blood pressure under control. I’ll get back to you when I can," Diane Stump recalls.
"They confirmed my worst suspicion; he had suffered a stroke. But why? He’s not a smoker, or over weight, and has been an avid athlete all of his life…. What would cause this sudden brain attack? It was not until later that I realized the doctor on duty was trying to tell me there was not much hope. The ER physician told me he had called the neurosurgeon and the cardiologist but not to expect anyone very quickly. It was midnight Sunday."
What Every Doctor of Chiropractic Needs to Know
What you have just read was an account pulled from the book A Stroke of Midnight. Alternative Concepts publishing, 2007. This book strives to enlighten not only chiropractors but also the general public about the epidemic of stroke in America.
Stroke is now the number two-killer in the west, behind heart disease, and replaces cancer. Every 43 seconds someone suffers a stroke. One out of three of those people is lucky and has only mild symptoms from the episode; yet a second dies and the third suffers permanent physical disability. Stroke is the number one cause of physical disability, at a cost of 6 billion dollars each year to the taxpayer. Disability accumulates year-after-year due to this ever-increasing condition. It is estimated by the World Health Organization that stroke will become our number one cause of death in the modernized world by 2020. The worst thing about these awful statistics is 80 percent of these strokes are preventable!
Today we find ourselves defending the profession and our procedures regarding stroke and stroke information. Let us turn the tables and issue statements from the profession supporting Stroke Awareness. We should not have to continually take a defensive posture about our position. Let us begin to show we are interested in the total health and wellness of each of our patients.
During a stroke, a blood vessel carrying oxygen and nutrients to the brain either burst or is blocked by a clot. This prevents brain cells from getting the blood (and oxygen) they need, and can result in a possible death. A stroke usually doesn’t just happen; it comes on gradually over a period of years. Signs and symptoms are seen well in advance of the incident, if you know what to look for.
This is why blood pressure should be checked at the time of an examination. If there is an increase in BP over a period of months or years, another risk factor should be noted. The main problem is the fact that, by the time the stroke signs and symptoms appear and present themselves, it is almost too late. Not too late to save the person’s life, but too late to use preventive health care methods like diet, exercise and lifestyle changes.
Our practice is very different from a medical practice. We are seeing patients more often and usually on a wellness basis first and an acute basis second. In as much, we keep better records of weight, cholesterol, blood pressure, neurological signs, arm numbness, tingling and differences in speech and articulation.
We are not asking the DC to become anything but a little more observant, especially with the over 40 patient. A few years ago it was felt that only the 60-year-old was at risk for a stroke; now the 40-year-olds have begun to suffer heart attacks and strokes. The American Heart Association (AHA) has recently issued advisories for all doctors to begin screening twenty-year-olds. (AHA, 2009)
Types of Strokes
Ischemic Stroke: This type accounts for about 83 percent of all cases. They occur as a result of an obstruction within a blood vessel supplying blood to the brain. The underlying condition for this type of obstruction is the development of fatty deposits lining the vessel walls.
Hemorrhagic Stroke: This type accounts for about 17 percent of stroke cases. It results from a weakened vessel that ruptures and bleeds into the tissue of the brain. The blood accumulates and compresses the surrounding brain tissue.
Transient Ischemic Attacks: (TIA’s) are minor or pre-strokes. In a TIA, conditions indicative of an ischemic stroke are present, and the typical stroke warning signs develop. However, the obstruction (blood clot) occurs for a short time and tends to resolve itself through normal mechanisms. Even though the symptoms disappear after a short time, TIA’s are strong indicators of a possible major stroke, and preventive steps should be taken immediately. (American Stroke Association. (www.strokeassociation.org)
Teach a Preventive Lifestyle
Diet: Chiropractors know diet is probably the most important of all the lifestyle modifications patients have to make. Growing up in the South as we did, nearly everything was deep fried all the way to the tomatoes! Patients must avoid and limit fried foods that contribute to clogged vessels. Red meat is another red flag food, as well as sugar and junk food. We ask all of our patients to limit their consumption of processed foods from a can, bottle or box, due to the excessive amount of additives like sugar, salt and other chemicals. We are not asking you to change your practice; just be a little more aggressive in your advice on diet, exercise and lifestyle.
Physical Activity: We know not everyone can spend as much time in the gym as we would like, but daily physical activity is a must for overall good health. Make simple choices for more activity, take the stairs, park a little further away and walk an extra block or two, stop using remotes and begin being more physical. Everybody needs 30-45 minutes of daily physical activity—walking, bicycling, swimming, volleyball or golf—to keep the body, mind and spirit functioning properly.
Sleep and Rest: Just as they need physical activity, they also need rest and relaxation. Sleep depravation has become a big health issue within the last three decades. Sleep medications are a top pharmaceutical draw. A few years ago, it was a miniscule seller for the pharmaceutical industry. Tension, stress and fatigue are all by-products of lack of enough sleep. Today, sleep, rest and relaxation are being robbed by society’s demands. We recommend more activities like Tai Chi, Yoga, Qigong and Meditation each day, something that will both relax and refresh the mind and body. These can be done in a class or on an individual basis, depending on the patient. That’s why these ancient exercise and meditation systems are very old and still popular. Plus, they require no equipment and they can be done at anytime with no expense.
Let us point out one thing further. In February 2007, at an International Stroke Conference held in New Orleans, it was learned that the rate of strokes among middle-aged women has tripled in the last six years. Nearly 2 percent of women ages 35-54 reported a stroke in the most recent federal survey, from 1999 to 2005, while only 0.63 percent did in the previous survey, from 1988 to 1994.
Health officials think that women may be less attentive when it comes to acknowledging their own signs and symptoms. Women tend to ignore signs and symptoms in themselves, because they don’t want to upset their ability to take care of their family.
While statistics show women and men suffer strokes at about the same rate and time during their lives, this latest study gives us reason to believe the statistics are about to change toward the female suffering strokes at a younger age and at a faster rate.
We want to emphasize, chiropractors are in the prime position to recognize, teach and follow up with patients about the devastating effects of stroke. This was the primary reason why the book A Stroke of Midnight was written. Once John knew he was going to live and could write again, he decided everyone should be more aware of stroke and its consequences. It seems everyone knows about heart attacks but few know stroke is now the number two killer and will soon become number one. People must wake up and begin to change their habits and lifestyles. Chiropractors are "Wellness Oriented" and in prime position to help curb this tragic epidemic.
This is where the DC can project an entire new image of the profession as being on the cutting edge of the American "Stroke Awareness" movement.