May You Not Have a Stroke

We are finishing “May”, also known as National Stroke Awareness Month.  There are ample sources of information about how to recognize stroke signs and symptoms.  If they are present, getting to a stroke center can save your life or prevent serious long term disability.

But wouldn’t it be better to prevent stroke from happening in the first place?

One of my most memorable experiences with misinformation came at a fundraising dinner where the featured speaker was an elderly gentleman who recounted his experience of having an ischemic stroke due to a blood clot blocking an artery to his brain.  The good news for him?  His family recognized the signs and symptoms and the quick response of the health care system to dissolve the clot restored the blood flow to his dying brain.

“Just in the nick of time” rescues make for exciting after-dinner speeches and heroic movie endings.  But his story was newsworthy because it wasn’t typical.  More often than not, highly technical care cannot be administered in time and disability or death are the common outcome.

The end of his talk almost had me standing on my chair shouting “NOOOOO!!!!”  He described how, at his 3 month follow up, his doctor patted him on the shoulder, pronounced him recovered, and not in need of any further treatment.  “WHAT?!!” I was thinking to myself.

Didn’t he and his doctors know that the patients at highest risk to have a stroke in the future are those who have had a stroke in the past?!  Did they not know that there are measures, most of which are not expensive, invasive or toxic, that can significantly improve the chances of avoiding a stroke?  Did they not know, or did they not care?  Or did they not care to know?

About 18 months ago, I learned about the Bale-Doneen Method for heart attack and stroke prevention.  It changed my practice dramatically and gave new hope for saving lives not by rescue, but by prevention.  Both heart attack and ischemic stroke are the result of atherosclerotic plaque that ruptures, setting in motion a cascade of events that form a blood clot that obstructs flow to heart muscle or brain.

A stroke is actually not an accident.  It is likely a missed opportunity for prevention.  Instead of sending in firefighters to battle the blaze, we should engage Smokey Bear or the building inspector to prevent the fire in the first place.  Not as dramatic as “nick of time” rescue but a lot more effective if applied to those at risk.

Step one is to know if you have disease.  Find out if you have plaque.  The Carotid Intima Media Thickness scan is noninvasive, quick and inexpensive.  If you have plaque, find out how to form less plaque and stabilize the plaque you have.  If you or your doctors don’t know how to do that, we should talk about evidence based proactive individualized opportunities to prevent stroke (and heart attack and diabetes and other chronic diseases).

Don’t miss that opportunity to prevent.  “May” you not have a stroke.