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CVA vs TIA: WHEN THE WORD ‘STROKE’ NOT A VERB
At work last week, a co-worker stopped in the middle of our day and looked at his right hand in amazement after it politely dropped the pen he was using. He picked the pen back up with his left hand, placed it back into his right hand and watched in disbelief as it refused to stay put.
He tried again. Plop…clatter. Onto the desk it dropped. Again.
Yep, right in the middle of notating a call log for MD247 quality control, his hand started twitching and shaking, dropping the pen right out onto the desk and pretty much gave notice that it would no longer be working for him after a 6 decade career as his primary helper.
Then he looked at me and said, “Did you see that? My hand’s not working!” A slight chill hit me as I stopped and really thought about what he was telling me. It sounded all too familiar.
Eleven years ago I became primary care-giver for my parents. I’ll never forget: I arrived on June 30th and 4 days later, on Independence Day, my mother collapsed in my arms. She never came out of the hospital. She passed away 4 days after her 70th birthday. For the first time in my life, I experienced high blood pressure.
A short year later, I was attending my father’s funeral as well. The morning of the funeral I woke up with no real use of my right hand. It wouldn’t hold a washcloth or button my blouse. Within an hour, one whole side of my body refused to function. My husband recognized the problem right away; a visit to the doctor confirmed I’d suffered several TIA’s (Transient Ischemic Attack) in a row.
Common term for TIA: Mini-stroke. And now my friend SEEMED to be in the middle of one.
Now I’m happy to report that my friend did NOT have a mini-stroke (though WE all thought he did…which is why you’re supposed to go to the emergency room and talk to a doctor instead of your friends!), which we were all happy to hear. But the whole incident caused many of us to wonder: am I at risk for stroke?
A stroke occurs when blood flow to any part of the brain stops, and lack of oxygen rich blood to brain cells during a stroke can cause some of them to die. That’s the “permanent damage” that is alluded to with the “go to the emergency room immediately” advice you get when you think you might be having a stroke. At the very least, you should call and talk to a doctor to verify your concern for yourself or someone you think might be having one, because even a “mini-stroke” can cause permanent damage if not treated within a few minutes. Permanent damage is just that: Permanent.
We always refer to things like breathing, heart-beat, blinking and swallowing as “automatic reflexes”. Other reactions like protecting your children, waking up to go to the bathroom when you “get the urge” or becoming sexually aroused whether by visual or physical stimulus, are also normally viewed as “auto response”. But if we ponder the miracle of the human body, we realize that EVERTHING is connected to the brain!
Think about it; what do you think would happen if brain cells were damaged or destroyed that regulate:
- Remaining conscious
- Feeling heat, cold or pain
- Maintaining your balance or equilibrium
- Controlling your bladder (or other)
Someone who works in construction or is a professional or recreational athlete might be inclined to think, “I wouldn’t mind my back not hurting so bad when I get home”. Really? Because pain is the first indication that there is either an injury, or a weakness that could potentially result in injury. Even a headache could signal the presence of aneurysm, high blood pressure or, yes…stroke.
Although memories of heartache, mistakes or things we’ve done that caused us embarrassment might seem to be memories you’d be happy to lose, remember that we learn from our mistakes. Without those memories we’d just continue making the same ones, over and over again. And you don’t get to pick and choose the ones you can keep, like that Appalachian thru-hike you took all by yourself, the cross country trip with a college friend, a beautiful sunrise with someone you loved or the life you had with your soul-mate.
So pay attention, because now comes the crucial part; as my granddad used to say, “the whereto’s and why for’s” of stroke.
There are two types of stroke: Ischemic and Hemorrhagic, and each has its own peculiarities. Yeah, scientific stuff…but important to understand.
Ischemic (from the word “ischemia” - a restriction in blood supply)
- Embolic: when a clot occurs outside of the brain and travels from that part of the body, through the bloodstream, to the brain, blocking blood supply to the brain
- Thrombotic: when a clot form in an artery (whether a large or small artery) supplying blood to the brain, blocking blood supply to the brain (these types of blockages are generally linked to high cholesterol and/or high blood pressure)
A mini-stroke is properly called a Transient Ischemic Attack; according to the Merriam-Webster dictionary, the word “transient” means, “lasting a short time; temporary”. Hence, the symptoms of a TIA usually only last for a few hours to, perhaps, a day.
Hemorrhagic Stroke (from the word “hemorrhage” – heavy bleeding)
- Intracerebral: caused by a sudden rupture of an artery or blood vessel within the brain; the sudden buildup of pressure can cause unconsciousness…or death
- Subarachnoid (no, not spiders!): caused when a damaged artery bleeds into the space between the skull and the brain, which can damage or destroy surrounding brain cells; this can affect the flow of spinal fluid, which can cause hydoencephalus
- oAneurysm: develop when walls of arteries become weak; instead of blood flowing through it smoothly, the pressure from the flow causes a bulge, or balloon affect; if the wall ruptures, it bleeds into the spaces between the brain and skull.
Recognizing signs of stroke can be learned by nearly anyone of any reasonable age. Even children, who may spend much time with elderly family members, can be taught to be aware of the symptoms. Who hasn’t heard stories on the news about the 6-12 year old children who saved a parent’s, grandparent’s or older member of the neighbourhood by knowing enough about heart attacks, seizures or other life threatening conditions, and calling 911? Take the time to learn…and teach…them.
Consider the ways that stroke affects your body, and be aware of these symptoms:
- nausea, neck pain, weakness of any part of your body
- sudden numbness of the face, arm, or leg, especially on one side of the body;
- sudden confusion, trouble speaking or understanding speech;
- sudden trouble seeing in one or both eyes, including a “window shade” affect;
- sudden trouble walking, dizziness, loss of balance or coordination; and/or
- sudden severe headache (“thunderclap headache”) with no known cause (most common with hemorrhagic stroke) and/or sudden intense pressure in your skull.
The good news, if you will, is that by controlling those risks that you CAN control, you stand a good chance of being able to prevent most strokes ( www.mayoclinic.com/health/mini-stroke/AN01432 ) by just following all the good advice you get about health care. The controllable risks include your alcohol, drug and tobacco use habits, your weight and eating habits, taking the medications necessary to control issues like diabetes and blood pressure and for women, following your personal physician’s guidelines when it comes to using birth control.
Submitted by Peggy Pearl-Kirkby
Posted by: Michelle Germann
Created on: Thu 12 July 2012 23:21
Last modified: Tue 09 October 2012 15:34