American Medical Association Family Medical Guide - American Medical Association [414]
I couldn’t help thinking that I might have prevented this stroke if I had followed a healthier lifestyle.
The doctor wrote a couple of prescriptions and told me I needed to quit smoking. She also told me that losing weight and exercising would help lower my blood pressure. She gave me a couple of pamphlets about exercise, healthy eating, and losing weight. I took my medication every day, started eating healthier foods, like fresh fruits and vegetables and whole grains, and tried to cut back on salt, fat, and cholesterol. I started taking walks after dinner. After a couple of weeks, I started to feel pretty good and the weight started coming off—3 pounds that first week. After a couple of months, I had lost about 10 pounds and I was feeling really good. In fact, I felt so good that I stopped taking the medication. Eventually I stopped taking walks and fell back into my old eating habits. And I was still smoking.
One day when I woke up, the right side of my face was numb and I couldn’t see too well out of my right eye. I had a really bad headache and was dizzy. I tried to tell my wife, but the words came out slurred. She ran to the phone and called 911 for an ambulance.
In the emergency room, some doctors and nurses gathered around and asked me a few questions, but I couldn’t talk. My wife told them what had happened. A couple of the doctors examined me and hooked me up to a machine that showed my heartbeat on a monitor, which looked like little blips on a screen. Then a nurse gave me an injection and told me it was medication that would dissolve the blood clot that was causing my problem. One of the doctors told me that he was putting me in the intensive care unit for a few days so they could monitor my symptoms. A day or so later I started to get the feeling back in my face and could see OK, but I still couldn’t talk right. A speech therapist said that the stroke might have permanently damaged the part of my brain that controls speech. She said if my speech didn’t get better in a couple of days, she would start to work with me. I couldn’t help thinking that I might have prevented this stroke if I had followed a healthier lifestyle.
I now feel lucky. It’s been a couple of months since my stroke and I have totally recovered. I am talking normally again and I’m taking much better care of my health. My wife is very supportive and we both eat lots of fruits and vegetables and other healthy foods and take long walks together every day. My wife and I have both lost weight and we feel better than ever.
Diagnosis
The diagnosis of a stroke is based on the symptoms, a physical examination, and the results of tests. Your doctor will probably order a CT scan (see page 112) or MRI (see page 113) of your brain to determine the type of stroke and location and the extent of the damage. The doctor will also order blood tests to evaluate blood clotting. In addition to these tests, he or she may order a cerebral angiogram, an X-ray examination of the arteries in the brain. A cerebral angiogram enables the doctor to detect blocked or narrowed arteries and to evaluate blood flow in the arteries. Your doctor may also order an echocardiogram (an ultrasound examination of the heart; see page 561) to check for blood clots and to determine if your heart is pumping effectively.
Effects of a stroke
Each side of the brain controls the opposite side of the body. For this reason, damage to the left side of the brain may result in paralysis and loss of sensation in the right side of the body.
If the stroke was caused by a blood clot and treatment is early enough, the doctor will administer thrombolytic drugs to dissolve the clot and restore blood flow to the affected part of the brain. These drugs are safest and most effective when given within 3 hours of the onset of symptoms. The