I WAS 15 YEARS OLD when my grandmother had a stroke. She
was perfectly healthy until she needed a knee replacement. After having
total right knee arthroplasty. She was a little overweight and had high blood
pressure, but she was otherwise a very active individual. Raising nine children
almost single-handedly, she seemed like a superwoman
Cultivating over 40 years of experience, people started calling her
Dr. Huda, although she had not spent a single second in a medical school
classroom. I have to say she was indeed the most capable woman I have
ever met. As an individual, I was mesmerized by her, looked up to her as a
professional, and loved with all my heart as my grandmother. Always taking
care of everyone; children, grandchildren, family, neighbors, and friends. She
was Ms. Independent. Until that moment came. A left middle cerebral artery
stroke made superwoman utterly dependent on those that she took care of.
Within seconds, her life and the lives of everyone around her had changed
forever. Life was never the same after that, not for Dr. Huda and not for me.
Odds are, this story isn’t any different than any you’ve heard or
experienced. However, this story gave me the capability to write this article.
This story led me to choose a career in medicine, neurology, and vascular
neurology to be more specific.
Every 40 seconds, someone suffers from a stroke. Stroke is the most
common cause of disability in the United States and is the fifth leading
cause of death. A stroke can be an ischemic stroke or a hemorrhagic stroke.
An ischemic stroke is when an artery in the brain becomes blocked, causing
ischemia or lack of oxygen to that particular part of the brain. The signs and
symptoms depend on the part of the brain being affected. The larger the
blocked artery, the more devastating the symptoms.
For this reason, signs and symptoms of stroke can differ and vary from
one person to another. A hemorrhagic stroke is when a blood vessel in the
brain ruptures, causing decreased oxygenation to that particular part of the
brain. This causes symptoms—toxic byproducts of the deoxygenated blood
to the tissue cause further damage. As mentioned above, signs and symptoms
depend on the location of the ruptured vessel. It is impossible to distinguish
an ischemic stroke versus a hemorrhagic stroke based on symptoms alone.
A computed tomography scan (CT scan) is needed to separate between the
two and steer the direction of treatment. Ischemic stroke is by far much more
common and will be the bulk of this article. Superwoman
As mentioned earlier, can vary from person to person. It can range
anywhere from simple numbness to the face, arm, and or leg to complete
debilitating weakness of one half of the body, loss of ability to speak,
understand, and even death. Stroke is a serious condition. Advances in
medicine have allowed us to become more aggressive in the treatment of
STROKE RISK FACTORS
Stroke risk factors are well known and are no different
from cardiac disease and peripheral vascular disease. For
example, hypertension, diabetes, tobacco use, and elevated
cholesterol. Aside from these prevalent diseases, atrial
fibrillation is also a significant risk factor for ischemic stroke.
Even non-sustained atrial fibrillation can carry a high
stroke risk. Identifying the etiology of the stroke is critical in
reducing the risk of a recurrent stroke in the future. Another
FAMILY IS EVERYTHING
Being in the Rio Grande Valley over the past several months, I’ve learned a lot about this region. Some good, some bad. The weather is hot, except for when it snowed for an hour. The food is fantastic. People are genuine and sincerely appreciative. Also, people will also do whatever it is
you need, but tomorrow. One amazing quality, is the amount of respect they show towards physicians and healthcare providers. Again, coming from New York, you can see why it’s a culture shock for many different reasons. One of the biggest things I’ve learned while here in the
Valley is the value placed on family.
Family is everything.Ithas helped me constantly remember the keys to happiness. God, family, and health. With change come growing pains. But I can assure you this; I’ve come to the Valley as the only stroke neurologist to provide a service that wasn’t provided to my grandmother. I see my Dr. Huda in every stroke patient I encounter. I wish I never had to meet anyone in the hospital.
Still, when in the unfortunate circumstance, I guarantee that you will be our priority, and we will do everything in our power, knowledge, and skill-set as physicians and health care providers. We will always do our part; we need our patients to allow us to do so.
These strokes are termed cryptogenic strokes. As physicians we investigate every potential etiology to determine the source of stroke. It is also essential for every patient, family member, and loved one to ask and understand the diagnosis to address the underlying cause to prevent a
“How and why?”
When my grandmother had a stroke, I remember asking my aunts who were taking care of her, “how and why?” The response was, “she just had surgery a few weeks before, so she had a stroke.” I accepted the answer as much as it confused me and didn’t bring it up until seven years
later, when things made more sense to me. No one had investigated why this mildly overweight hypertensive right handed female developed what appeared to be an embolic ischemic stroke causing severe long-term disability. It was upon further questioning, about seven years after the stroke, that it was revealed that my grandmother had paroxysmal atrial fibrillation and was placed on oral anticoagulation for further stroke risk reduction.
BY HAMZAH M. SAEI, MD