Welcome back to the program.
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I'm Charles Mills
here with Dr. James Marcum
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and we're talking
about the causes of death
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in this world and
one of the major causes,
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of course, is heart disease.
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And we're talking
about stroke here.
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Make the
connection for us, Dr. Marcum,
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between heart
disease and stroke.
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How are they connected?
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Well, you know,
they're connected
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'cause the heart
pumps blood and oxygen
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and nutrients to
everything. Right.
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So if the heart
doesn't work good,
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of course, the brain
is not gonna work good
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but the same process
is having in the arteries
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of the heart can also happen
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and the arteries of
brain requires cholesterol.
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In addition, blood clots
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which can
originate in the heart.
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It can be pumped to the brain
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which causes these
tubes to be clogged up.
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And, really, I want
to let our audience know
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the stroke is a
medical emergency
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just like heart attack.
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I mean, if you're
not moving your arms,
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if you're not thinking right,
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if you're not speaking right,
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severe headache,
if you can't see,
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this is a medical emergency
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and you want to
get help right away
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'cause if we don't get
help you could be devastated.
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It could be something
that damages your body.
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You might not ever get it back.
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So stroke is a
medical emergency.
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Get help right away
and it's just so scary
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that people are out
there that have had stroke
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and what they've had just
live through and suffer through.
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And unfortunately,
our treatments for stroke
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aren't as advanced as
they are for the heart.
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The blood vessels are smaller.
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The brain's a little
bit trickier to navigate.
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So it's so
important that if you have
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a family history of stroke
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or if you have
risk factors of stroke
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that you address it early
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before you run into the
problem with these symptoms.
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All right, well,
let's get to some questions
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from the
Heartwiseminstries.org website.
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Here is the first
one on this subject.
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Can atrial
fibrillation cause a stroke?
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Yes, it can.
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And we talked a little bit about
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how the blood
circulates the body.
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Let's talk about that.
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If the top part of the
heart is not squeezing well
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it could get a blood clot.
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And we see that in
atrial fibrillation.
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That blood clot can be pumped
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to other places
including the head. Okay.
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So it's been estimated
that almost 15% of all strokes
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come from atrial fibrillation.
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Atrial fibrillation is
a very common abnormality.
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Some people don't
even know they have it.
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That's why we always
talk about blood thinners
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and people that
have atrial fibrillation
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to lower the risk of
getting a blood clot.
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Also people that
have weak hearts, Charles.
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If you're heart's weak sometimes
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the bottom
doesn't squeeze very good.
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If the blood doesn't move
sometimes you can get a clot
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from a weak heart that
can pump into the brain.
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Now there's another condition.
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Sometimes you have
blood clots in your legs.
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And if you have
blood clots in your legs
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usually those
clots go to the lungs.
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We called that a
pulmonary embolism.
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But in some
instances there could be
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a hole in the heart.
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And a blood clot
could cross to that hole
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and then pump up
to the brain, too.
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So, you know, there
is a condition called
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an atrial septal
defect where there is a hole
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in one of the
chambers of the heart
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where actually clot
from leg could pass to that.
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So blood clots
could pump into the brain.
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That could cause a stroke
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because once it gets to a
small blood vessel, guess what?
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No blood can get
through that part of the brain
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that that blood
vessel nourishes dies.
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If it's your talking part,
all of a sudden you can't talk.
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If it's your seeing part,
all of a sudden you can't see.
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If it's your moving part,
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you might have the left
or the right side go numb.
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Then all of a sudden you
have a medical emergency.
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All right, this
really underlines
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the fact that we
should be moving.
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That we should
have an exercise program
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because you're saying
that when we are lazy,
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when we are
sedentary and our heart
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is just slowly pumping
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and everything that
this pulling of the blood,
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this clotting could happen?
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Well, mainly if the
heart's damaged, Charles.
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Now if the
heart's damaged and weak
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but, you know, if
you're laying on a couch
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and your heart's strong,
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you're not that
that big of a risk.
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If you lay there
for weeks and weeks
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and months and
months? Right, right.
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But what we want to do,
though, is if you lay around
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and don't do
anything what happens is
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you might have
high blood pressure
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'cause you're gaining
weight. You might get diabetes.
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You might have high cholesterol.
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Those are the
things-- those risk factors
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that can raise a
chance of you having a stroke.
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And since our treatment
for stroke is not very good
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and since it's a
leading cause of death
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we've got to do
everything we can right now
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wherever you're
at everything you can
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to lower the risk of stroke.
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And if you're having a
stroke get in right away.
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I can't tell you how many people
I've seen through the years.
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Oh, it's nothing
serious, you know? I can't move.
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It's gonna go away or
you know, it will go away.
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I don't wanna wake up my wife
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and then the next thing
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they can't even
move part of their body.
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It's just devastating.
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So atrial fibrillation
is a cause of stroke.
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All right. Question number two
from Heartwiseministries.org.
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What should be done for a
family history of strokes?
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Everyone in my family has
had a stroke at some point. Wow.
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Yeah, and it's just the
things we've talked about.
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You'd be concerned
if someone said that.
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I would be very concerned.
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And I would tell
them, you know, we got a--
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just like heart disease,
we've got to lower the stresses
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as we've got to lower the
stress of high blood pressure.
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If they carry extra
weight we got to loose weight.
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Control the diabetes.
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Some people need a
cholesterol medication.
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Get in an exercise program
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and then lower all
the other stressors
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that might have--sleep
apnea is a stressor on the body.
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So anything that
raises blood pressure
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and put stress is gonna raise
a chance of having a stroke.
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Very similar to what we
tell someone with heart disease.
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And we want to lower
that but if you've have
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a family history things
tend to run in families.
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And if these arteries are
getting blocked up in the brain
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you're gonna be at a
higher risk of having a stroke.
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You know, if everyone in
the family has had a stroke
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that can talk about genetics.
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We could also
talk about lifestyle.
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Yes. Maybe whole family
had bad lifestyle, you know?
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Maybe, everyone
smokes cigarettes
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and had high blood
pressure and weighed a lot
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but these are things that,
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you know, family history
can be changed, you know?
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We talked about bad genetics.
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You can change your genetics
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by the way you live sometimes.
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Absolutely. Okay, next question
from heartwiseministries.org.
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Is it possible
to regain function
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and I'm sure that this
person would like to know
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if we can regain full
function after a stroke?
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After the clot has gotten there
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and something has been
damaged can you get it back?
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Yeah, and that's
why it's so important
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to get treatment right away
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if you think
you've had a stroke.
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If you can get into the hospital
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and they can give a
blood thinner within the,
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you know, four or
four and a half hours
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or if they can go in
and pull out the clot,
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you're brain can be
totally, completely better.
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Now sometimes we have a stroke
and the strokes there at home
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and we can grow
collateral blood vessels, okay?
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What we can--you know, retrain
the brain that's been damaged.
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Sometimes that occurs and
that's why its very important
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especially the six months
after they've had a stroke
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to go through stroke
rehab where they try to retrain
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the brain to do things
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depending on what part
of brain has been damaged.
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You might see a
speech therapist.
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You might see an
occupational therapist,
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other people to
help retrain the brain.
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Sometimes you
have to start over.
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And we've seen
the greatest benefits
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in the first six months.
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However, some people, you know,
it's like after a heart attack
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I want people to
start exercising,
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doing things even if
they've never done it before
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to help the heart
regain its function.
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Some people after
stroke they don't go
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and get anything done.
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They just say, oh,
you've had a stroke.
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Go home, live with it.
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The doctor fixed it. You can go.
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Yes, or they haven't
done anything for it.
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They've just had the stroke.
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The part of the brain
hasn't been tried to retrain.
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So it's very
important to get stroke rehab.
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And they've shown
that up to six months
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you can retrain
parts of the brain.
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So even if you don't
get it on time sometimes,
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if you have the
appropriate therapy
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after the stroke
it could be retrained.
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Now unfortunately,
if the brain is damaged
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you have to learn
things over again.
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Like, what if you
can't swallow well and,
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you know, the food's
getting into your lungs?
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What if you can't move
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and you're
getting bedsores on you?
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What if you're having seizures?
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What if you can't do a
lot of the things you knew?
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What if you're eyes can't close
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and you need drops in your eyes
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just to keep them
moist and help your vision?
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So there is a lot of things
that go along with the stroke
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even if you can't
get to retrain the brain
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that must be done to care
for a person with the stroke.
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So it's very
important that the caregivers
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as well as the person themselves
learn everything they can
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not only to retrain
the brain but the brain
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can't retrain the
brain doing the things
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you do to function well.
00:08:00.92\00:08:02.62
One of the scariest
things after stroke, Charles,
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that I see is people
can't swallow. Oh, dear.
00:08:05.10\00:08:07.26
And they have a
condition called aspiration
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because the muscles in
the neck don't do well.
00:08:09.84\00:08:12.80
So they eat some food,
instead of going to stomach
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it goes around to the lungs.
00:08:14.69\00:08:16.34
And they get
pneumonia and they have,
00:08:16.37\00:08:17.94
what we call, aspiration
'cause they can't swallow.
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Some of those patients
actually need feeding tubes
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early on rather than
going home and trying to swallow
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and not being able to swallow
00:08:25.92\00:08:27.29
and all the food
ends up in the lungs.
00:08:27.32\00:08:28.80
That's called aspiration.
00:08:28.83\00:08:30.62
So there's lots of
things in stroke that can help.
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So not only that you care
something is very important
00:08:33.24\00:08:36.16
but after a stroke you
also need a lot of care,
00:08:36.19\00:08:38.77
a lot of rehab,
a lot of education,
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both for the person
as well as the family.
00:08:40.84\00:08:43.15
I had one person
that I helped care for.
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Everything is fine
but she can't talk.
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She can't talk.
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You know, how hard
it is to communicate
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when you can't talk? Yes.
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I mean, that's a
major issue, you know?
00:08:51.95\00:08:53.33
So she's had to
learn how to communicate
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without being able to talk
00:08:55.86\00:08:57.40
and because one of
her arms doesn't move well
00:08:57.43\00:08:59.59
she can't write as well.
00:08:59.62\00:09:01.10
So there's all sorts of issues
00:09:01.13\00:09:02.69
when parts of your
brain doesn't work well.
00:09:02.72\00:09:05.94
We got another
question, Dr. Marcum, here
00:09:05.97\00:09:07.65
from the
Heartwiseministries.org website.
00:09:07.68\00:09:10.22
What is a
thrombolytic and how is it used
00:09:10.25\00:09:14.16
in the acute
treatment of stroke? Yeah.
00:09:14.19\00:09:16.32
Thrombolytic if we think
that the cause of a stroke was
00:09:16.35\00:09:20.70
due to blood clot not a bleed
00:09:20.73\00:09:23.25
we give strong
medications called thrombolytic,
00:09:23.28\00:09:26.36
thrombo meaning thrombos,
lytic means break it apart
00:09:26.39\00:09:29.56
so they give this
medicine in the body
00:09:29.59\00:09:32.28
and it goes and
breaks up that clot
00:09:32.31\00:09:34.25
so all the sudden that
brain gets enough blood to it
00:09:34.28\00:09:37.58
and this is the
main extreme treatment
00:09:37.61\00:09:40.58
if it can be done very quickly.
00:09:40.61\00:09:42.43
There are some
risk of thrombolytics
00:09:42.46\00:09:44.94
and the main risk of a
thrombolytics guess what?
00:09:44.97\00:09:47.39
Its bleeding 'cause
it causes you to bleed
00:09:47.42\00:09:49.36
so if you're bleeding already
00:09:49.39\00:09:50.88
I mean, you give a thrombolytic
00:09:50.91\00:09:52.28
you're gonna
bleed more so that's why
00:09:52.31\00:09:53.68
they have to make
sure what the cat scan
00:09:53.71\00:09:55.25
that there is no
blood in the brain,
00:09:55.28\00:09:56.66
its not bleeding type of
stroke before they give it
00:09:56.69\00:09:59.08
but thrombolytics
before we have thrombolytics
00:09:59.11\00:10:01.12
it was very hard to
treat a stroke at all
00:10:01.15\00:10:03.25
'cause we really
didn't have anything to off it
00:10:03.28\00:10:04.65
but now we have that
00:10:04.68\00:10:06.05
for an acute stroke,
we also have some devices
00:10:06.08\00:10:08.67
modern medicines as devices
00:10:08.70\00:10:10.07
that we can go up in the brain
00:10:10.10\00:10:11.47
and certain type of
individuals we can treat that
00:10:11.50\00:10:13.51
but bottomline is people
have to get to a stroke thinner
00:10:13.54\00:10:17.00
rather quick if
they're having symptoms
00:10:17.03\00:10:19.21
to get this type
of therapy. Oh, boy.
00:10:19.24\00:10:21.38
I'm just amaze
at modern medicine
00:10:21.41\00:10:22.91
and I hope that listeners,
00:10:22.94\00:10:24.70
you are understanding that
modern medicine has a place
00:10:24.73\00:10:28.57
and very important
place but you know what,
00:10:28.60\00:10:30.67
Dr. Marcum, I wanna
do everything I can--
00:10:30.70\00:10:32.81
Do not needed.
But not needed ever.
00:10:32.84\00:10:34.68
That's what I'm
looking for. Okay.
00:10:34.71\00:10:36.08
Absolutely, Charles.
00:10:36.11\00:10:37.48
Our last question here we
have time for this is a T.I.A.
00:10:37.51\00:10:40.42
the same thing as a
stroke. What is that T.I.A.?
00:10:40.45\00:10:43.07
You know, T.I.A. they
are different than the stroke
00:10:43.10\00:10:45.26
'cause the T.I.A. is called
T transient ischemic attack
00:10:45.29\00:10:49.59
so it doesn't last as long,
so its usually lesson 24 hours.
00:10:49.62\00:10:54.00
You might have a
neurologic symptoms
00:10:54.03\00:10:55.64
then all the
sudden the cause of it
00:10:55.67\00:10:57.04
gets better on
its own spontaneously.
00:10:57.07\00:10:59.27
But you still had that symptom
00:10:59.30\00:11:01.01
we'll thank
goodness it got better
00:11:01.04\00:11:02.70
but this could be a
precursor for a stroke.
00:11:02.73\00:11:05.70
So people that have
T.I.A. we wanna make sure
00:11:05.73\00:11:07.87
their risk
factors are maintained
00:11:07.90\00:11:10.05
we gonna make sure
there is no plots places
00:11:10.08\00:11:12.23
in the body that
they could have a clot,
00:11:12.26\00:11:13.65
make sure they don't have
00:11:13.68\00:11:15.05
Atrial
Fibrillation or weak heart,
00:11:15.08\00:11:16.45
make sure they don't
have a whole in the heart,
00:11:16.48\00:11:18.16
we also wanna make sure
that there is no blockages
00:11:18.19\00:11:20.93
in the arteries very
important if you have T.I.A.
00:11:20.96\00:11:23.57
to get a major
evaluation to make sure
00:11:23.60\00:11:25.75
there is
nothing that can be done
00:11:25.78\00:11:27.15
'cause if you
have a little stroke
00:11:27.18\00:11:28.55
the big one could be
right around the corner.
00:11:28.58\00:11:30.56
Oh, Boy, okay. we'll
take a short break now
00:11:30.59\00:11:33.18
and when we come
back let's spent sometime
00:11:33.21\00:11:35.69
with the master
physician. Stay tuned.
00:11:35.72\00:11:37.67
I've taken care of many
patients over the last 20 years.
00:11:41.40\00:11:45.51
And I think the
ones that are the hardest
00:11:45.54\00:11:48.19
to care for is
people that have had strokes
00:11:48.22\00:11:51.12
and haven't got
any treatment in time.
00:11:51.15\00:11:54.03
And they were stuck with
some devastating consequences,
00:11:54.06\00:11:57.55
both in their lives and
the lives of their families.
00:11:57.58\00:12:00.25
And I hope you've listened
to this today and realize,
00:12:00.28\00:12:02.92
"I want to do everything
00:12:02.95\00:12:04.32
I can to lower my
risk of having a stroke."
00:12:04.35\00:12:07.44
And this might be
changing some lifestyles.
00:12:07.47\00:12:10.24
And if you're
having a symptom I hope
00:12:10.27\00:12:12.01
you've learned right away
you want to get to the hospital,
00:12:12.04\00:12:14.73
get to a stroke
center that can treat you,
00:12:14.76\00:12:17.51
and if you've had a stroke
00:12:17.54\00:12:19.85
that's one of the
most devastating things.
00:12:19.88\00:12:22.05
Hopefully you've
gone through stroke rehab.
00:12:22.08\00:12:24.91
And if you had a stroke
I want to also remind you
00:12:24.94\00:12:27.45
that there is hope.
00:12:27.48\00:12:28.85
There is hope in
that relationship
00:12:28.88\00:12:30.25
that you have with God
00:12:30.28\00:12:31.65
that He can make everything
right in His own time.
00:12:31.68\00:12:34.64
And remember there is a
place for modern medicine.
00:12:34.67\00:12:36.66
It doesn't fix everything.
00:12:36.69\00:12:38.36
There is a place for lifestyle,
00:12:38.39\00:12:39.76
but that doesn't fix everything.
00:12:39.79\00:12:41.81
But in that relationship
with the Heavenly Father
00:12:41.84\00:12:44.70
you can have healing.
00:12:44.73\00:12:46.65
And that healing
might not be here on earth
00:12:46.68\00:12:48.61
that might be in heaven
but we could have healing
00:12:48.64\00:12:50.55
and what a hope
that is if you've been
00:12:50.58\00:12:52.31
one that's had a stroke.
00:12:52.34\00:12:54.23
I want to spend sometime
there might be someone out there
00:12:54.26\00:12:56.76
that needs a prayer today
to enter this relationship.
00:12:56.79\00:12:59.45
So let's all bow
our heads together.
00:12:59.48\00:13:03.35
Dear Heavenly
Father, we want to thank you
00:13:03.38\00:13:05.46
for giving us life
00:13:05.49\00:13:06.86
and ability to have a
relationship with you.
00:13:06.89\00:13:10.63
If there might be someone
out there in the audience today
00:13:10.66\00:13:12.70
that needs to enter
into this relationship
00:13:12.73\00:13:15.05
as a part of
their healing process,
00:13:15.08\00:13:17.29
Father, please
enable this to happen.
00:13:17.32\00:13:20.15
And we want to
thank you for being a God
00:13:20.18\00:13:21.74
that loves us,
that takes care of us
00:13:21.77\00:13:23.84
and wants us to be
our ultimate physician.
00:13:23.87\00:13:26.37
This is our humble prayer, Amen.
00:13:26.40\00:13:30.24
I want you to remember that
00:13:30.27\00:13:31.75
at the top of
every treatment plan
00:13:31.78\00:13:34.42
is not modern medicine,
it's not lifestyle changes
00:13:34.45\00:13:38.03
though those are important at
the head of every ultimate plan
00:13:38.06\00:13:41.66
is that relationship
with the great creator,
00:13:41.69\00:13:44.16
your ultimate physician.
00:13:44.19\00:13:45.77