STROKE IDENTIFICATION:

During a BBQ, a friend stumbled and took a little fall - she assured everyone that she was fine (they offered to call paramedics) and just tripped over a brick because of her new shoes. They got her cleaned up and got her a new plate of food - while she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening. Ingrid's husband called later telling everyone that his wife had been taken to the hospital - (at 6:00pm, Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don't die. They end up in a helpless, hopeless condition instead.

 It only takes a minute to read this...

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke...totally! y. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

RECOGNIZING A STROKE

to remember the "3" steps, STR . Read and Learn!

Sometimes symptoms of a! stroke are difficult to identify Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.

T *Ask the person to TALK! . to SPEAK A SIMPLE SENTENCE
(Coherently) (i.e. . . It is sunny out today)

R *Ask him or her to RAISE BOTH ARMS.

NOTE: Another 'sign' of a stroke is this: Ask the person to 'stick' out their tongue... if the tongue is 'crooked', if it goes to one side or the other that is also an indication of a stroke}

If he or she has trouble with ANY ONE of these tasks, call 9-1-1 immediately and describe the symptoms to the dispatcher.

A cardiologist says if everyone who gets this e-mail sends it to 10 people; you can bet that at least one life will be saved.


Robin Lamar

Hi Robin,

Let me apologize in advance for the sermon that follows. After reading it
you will probably realize why I feel the way I do.

Your neurologist and cardiologist are right that the first few minutes are
critical. In the Korean war the phrase was the "golden half hour." (If a war
trauma patient got to the hospital within that half hour, the result was
usually much more satisfactory than that for those who arrived later.) And
recognition of the stroke symptoms is critical to getting the prompt, proper
care, and to maximizing the recovery of the victim. Promptness is the key,
as is proper care.

Good to get the recognition of symptoms distributed as widely as possible.
That leads to promptness.

But I don't want this email to unreasonably raise expectations. "totally
reverse the effects of a stroke" is, in my opinion, unwarranted, dangerous
and damaging. Let me explain why I hold this opinion.

And before I go any further I need to inform everyone that my signature
"Doc" does not imply a medical degree of any kind. (I use Doc because our
EAA chapter has several Davids, including my grandson, David A. Custer, and
the President of the Chapter, David Cross. Notice the initials: DC, DC and
DC. Very confusing.) I have an earned Ph.D. in Computer Science and
Audiology (double major). Audiology is a paramedical profession that studies
the ear and hearing, and so I received some medical knowledge and some
training at the University of Colorado Medical School, including spending
many hours in Clinical Audiology in the Otolaryngology Clinic (ear, nose &
throat). I spent the bulk of my career as a software engineer, including the
last 18 years at Bell Labs. I claim no medical knowledge other than as it
applies to the hearing mechanism, and that is no doubt seriously out of
date. One of the things that damages the hearing mechanism is stroke. I do
know how to recognize the symptoms of stroke.

When my wife had a stroke many years ago, I got her to the ER within 15
minutes (I heard her fall in the kitchen), told the ER intake nurse she (I
introduced her as Dr. Custer, <another Ph.D, but I didn't tell the nurse
that>) was having a stroke and got immediate attention. This was at one of
the Denver Area's leading hospitals. They put her on O2 immediately (a
virtual swarm of medical personnel around her) and called the board
certified neurologist. I believe she is alive today, and doing as well as
she is, because of the excellent care she received that first half hour
after the stroke. A subsequent angiogram confirmed a brain blood vessel had
malfunctioned. (Even though I asked I never found out exactly which kind of
malfunction.) Incidentally, I got her to the ER in 15 minutes by speeding,
flashing my headlights, honking the horn, and breaking any number of traffic
laws, including running red lights. This was before 911. I can't say I
recommend this procedure, but it worked for us. Didn't even have to explain
to a cop. Bet the cop would have understood.

After she got out of the hospital, she could not talk (and for along time
afterward had difficultly speaking), became confused and alarmed to the
point of nausea with more than three people in the room, and could no longer
teach at the college level (she was a teacher of teachers). She was retired
for medical reasons.

A year later she had improved greatly. She could talk reasonably well,
although had great difficulty finding nouns, but had reasonably good speech
otherwise. One of her favorite words was <thing>, because she could not
think of the noun. Her speech continued to improve for several more years.
Today many people don't realize she is a stroke victim.

It took about three years before she could tolerate more than a few people
in the room at the same time. Today she navigates Denver International
Airport with its crowds, noise and bustle without pause. She regularly
travels by herself on commercial airlines to Washington DC, Phoenix and
other places. This morning I dropped her off at DIA to go to Seattle in
order to visit her first granddaughter (we have six grandsons, aged 15 to
22). The granddaughter is only a few weeks old. And she needs a break from
her other duties. See Below.

She is currently the Republican candidate for County Commissioner in Custer
County, CO after she won the primary election. One of her primary opponents
was the Mayor of Siver Cliff, a fine gentleman. That is one measure of the
degree to which she has recovered.

She is now, and always was, an excellent writer. As an example, she has
written, and served as primary evaluator, many peer reviewed federal grants
with funding totaling in the millions of dollars, a currently executing one
for $600,000.

She has been appointed to state level policy making or regulatory boards by
all of the last three Colorado Governors, over a period of about 18 years,
serving without interruption to the present, regardless of political
affiliation of the Governor.

Obviously her intellectual capacity is undiminished.

But even today she has trouble finding nouns, which frustrates her greatly.
Everybody experiences disfluency (halts in speech while seeking a word) in
their speech or idea. In her case, it is more pronounced, but usually in
what I would call the normal range. This is probably why some persons do not
recognize that she is a stroke victim.

Is this "totally reverse the effects of a stroke?" I am sure she would not
agree. Nor do I. Could she have received better care? I doubt it. Sooner?
Perhaps, if it had happened in the hospital or some other place where
medical personnel and equipment were immediately available. Neurons die
without oxygen. No blood flow, no oxygen. Dead nerves almost never
regenerate. Those in the hearing mechanism certainly don't. (Loud prolonged
noise kills nerve. Take care of your hearing folks. But I won't start that
sermon.)

My feeling is that it borders on criminal behavior to raise false hopes for
the victims and families of injured and sick persons. As an Audiologist I
have had to deal with parents of deaf or hard of hearing children who have
been told by some well meaning person, sometimes a professional who should
know better, that their child "will grow out of it" or some other platitude
(lie, really) when the fact is that persons with a damaged hearing nerve
almost never recover a normal hearing threshold. Try telling a loving set of
parents and grandparents that their child will probably never hear; that
his/her education will be severely impacted, and s/he will probably never
develop "normal" speech if s/he has not already done so. Especially when an
"expert," sometimes their pediatrician, has told them that the child will
make a full recovery, or "will grow out of it."

For the Audiologists or Otologists who might be reading this, I hasten to
point out that I have deliberately not used technical words, and minutia, so
the message would not be lost in the jargon or unnecessary detail.

Again, sorry for the length of this sermon, but I feel it is extremely
important to recognize that dead nerves almost never regenerate. (Never say
never!) The improvement of stroke victims over several years has many
theoretical causes, probably mostly from recovery of the surrounding brain
tissue from secondary trauma. Not directly impacted by the vascular event,
i.e., did not have the blood supply completely stopped, impacted by brain
swelling, etc. Sorry, slipped into the jargon. Almost none fully recover all
their function. My wife is an example, despite her "excellent" recovery and
prompt expert care.

Please be careful of what you tell the families. And victims.

Cheers,

David D. (Doc) Custer, Ph.D.
Retired Software Engineer and sometime Audiologist
Completing RV-9A fuselage. Wings and tail feathers 98% complete. Time to
take up allot of room; about to start erection of a 42' X 40' hangar at
Silverwest Airport (C08). Come visit! 100LL available $3.999 per gallon.
Volunteer (me) to fetch mogas, currently under $3.00.



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