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Changing Behavior
to Prevent Tragedy

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 30 in the May 19, 2010 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

Stroke is a subject that leaves few families untouched. There are two basic types of stroke. Hemorrhagic stroke causes brain death when a blood vessel bursts and no longer supplies a portion of the brain. Ischemic stroke is the result of a small clot which lodges in a vessel and prevents the flow of oxygen rich blood to an area of the brain. In both cases, catastrophy depends on the amount of swelling that results, and how large an area is cut off from receiving blood flow. These should be differentiated from a TIA (transient ischemic attack) which essentially is a mini or warning stroke.

A complete assessment of all your risk factors and your health should be done to determine which strategy could help reduce your chances of suffering a stroke. There are risk factors which you can modify. Two-thirds of strokes occur in hypertensive individuals. Controlling your blood pressure lowers your risk. Smoking is a major modifiable risk factor. The evil weed increases your chances by 40-60%. Combining smoking with the birth control pill makes it worse. Excessive alcohol consumption, defined as more than two drinks daily, can cause weight gain, hypertension, and cholesterol elevation all leading to elevation of stroke risk. Elevated blood lipids and cholesterol harden the arteries by forming plaques on the inner surfaces. Fragments of these plaques can break off and cause ischemic strokes. Some street drugs such as cocaine and speed can cause strokes and so can some herbs and over the counter cold medications. Lack of regular exercise can also double your risk. Long plane rides in cramped quarters and neck manipulations have now entered the risk factor debate arena. These are all things that can be modified before you need to start thinking about taking medication.

My advice is to get your health checked out and discuss the potential benefits of aspirin with your doctor. In the mean time, learn to recognize the early signs of stroke. They can be confusing and often not clear-cut. Things happen suddenly: loss of speech, severe headache, vision changes, dizziness, numbness, tingling or loss of use of an arm or leg. There may be an inability to understand people, confusion or change in consciousness. The key is quick action. In the short span of my career, I have seen almost miracle like cures in some cases where the conditions were right. Trillium Health Centre was the first local institution to start using clot-bursting drugs in ischemic stroke victims to produce complete resolution in some people. But success lies in early recognition and seeking help within the first few hours before the brain is irreversibly damaged. Prevention is a difficult concept. It is not born of pain or clinic problems. Prevention is only for those who have the faith to believe that changing behavior may prevent tragedy. It can start right now.

The Heart & Stroke Ride for Heart takes place June 6, 2010. I will be taking my feet out of my mouth and putting them on a bike for a 50 K romp to raise research funds. Please sponsor this worthy cause at Ride for Heart Toronto 2010. www.heartandstroke.ca - "Dr. Pete Kujtan." I will personally match your support. Make a difference today!

(Go to Ride for Heart, click Sponsor Now, Enter Participant's First Name: dr pete. Scroll down and click on "Dr Pete Kujtan" to donate. Instant Heart and Stroke Foundation of Ontario official donation receipt printable).

Related resources:

Know Stroke. Know the Signs. Act in Time. - from National Institute of Neurological Disorders and Stroke.

Stroke from Heart and Stroke Foundation of Canada.

Stroke Warning Signs. The 5 Signs from Heart and Stroke Foundation of Canada.

Types of Strokes from Ohio State University Wexner Medical Center.

Stroke (Hemorrhagic).

Hemorrhagic Stroke from Merck.

Stroke (Ischemic, Thrombotic, Embolic, and Transient Ischemic Attack) from Life Extension Foundation.

Transient Ischemic Attack from MedlinePlus.

Aspirin and stroke from Bandolier, an independent journal about evidence-based healthcare in UK.

Aspirin for Reducing Your Risk of Heart Attack and Stroke: Know the Facts from U.S. Food and Drug Administration (FDA).

Low doses of aspirin may help some prevent stroke from CNN.com.

Aspirin to Prevent Blood Clots from Clinical Guidance, PRODIGY, UK.

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