Participants: James Marcum & Charles Mills
Series Code: UP
Program Code: UP00016B
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00:01 Welcome back to the program.
00:02 I'm Charles Mills here with Dr. James Marcum 00:04 and we're talking about the causes of death 00:07 in this world and one of the major causes, 00:10 of course, is heart disease. 00:11 And we're talking about stroke here. 00:13 Make the connection for us, Dr. Marcum, 00:15 between heart disease and stroke. 00:19 How are they connected? 00:20 Well, you know, they're connected 00:21 'cause the heart pumps blood and oxygen 00:23 and nutrients to everything. Right. 00:25 So if the heart doesn't work good, 00:27 of course, the brain is not gonna work good 00:29 but the same process is having in the arteries 00:31 of the heart can also happen 00:33 and the arteries of brain requires cholesterol. 00:35 In addition, blood clots 00:37 which can originate in the heart. 00:38 It can be pumped to the brain 00:40 which causes these tubes to be clogged up. 00:44 And, really, I want to let our audience know 00:46 the stroke is a medical emergency 00:48 just like heart attack. 00:50 I mean, if you're not moving your arms, 00:51 if you're not thinking right, 00:53 if you're not speaking right, 00:54 severe headache, if you can't see, 00:56 this is a medical emergency 00:58 and you want to get help right away 01:00 'cause if we don't get help you could be devastated. 01:03 It could be something that damages your body. 01:06 You might not ever get it back. 01:07 So stroke is a medical emergency. 01:09 Get help right away and it's just so scary 01:13 that people are out there that have had stroke 01:15 and what they've had just live through and suffer through. 01:17 And unfortunately, our treatments for stroke 01:19 aren't as advanced as they are for the heart. 01:22 The blood vessels are smaller. 01:23 The brain's a little bit trickier to navigate. 01:26 So it's so important that if you have 01:28 a family history of stroke 01:29 or if you have risk factors of stroke 01:31 that you address it early 01:33 before you run into the problem with these symptoms. 01:36 All right, well, let's get to some questions 01:38 from the Heartwiseminstries.org website. 01:41 Here is the first one on this subject. 01:42 Can atrial fibrillation cause a stroke? 01:44 Yes, it can. 01:46 And we talked a little bit about 01:47 how the blood circulates the body. 01:49 Let's talk about that. 01:51 If the top part of the heart is not squeezing well 01:54 it could get a blood clot. 01:55 And we see that in atrial fibrillation. 01:57 That blood clot can be pumped 01:58 to other places including the head. Okay. 02:01 So it's been estimated that almost 15% of all strokes 02:05 come from atrial fibrillation. 02:07 Atrial fibrillation is a very common abnormality. 02:10 Some people don't even know they have it. 02:12 That's why we always talk about blood thinners 02:14 and people that have atrial fibrillation 02:16 to lower the risk of getting a blood clot. 02:18 Also people that have weak hearts, Charles. 02:21 If you're heart's weak sometimes 02:22 the bottom doesn't squeeze very good. 02:24 If the blood doesn't move sometimes you can get a clot 02:27 from a weak heart that can pump into the brain. 02:30 Now there's another condition. 02:32 Sometimes you have blood clots in your legs. 02:34 And if you have blood clots in your legs 02:36 usually those clots go to the lungs. 02:38 We called that a pulmonary embolism. 02:40 But in some instances there could be 02:42 a hole in the heart. 02:43 And a blood clot could cross to that hole 02:45 and then pump up to the brain, too. 02:47 So, you know, there is a condition called 02:49 an atrial septal defect where there is a hole 02:51 in one of the chambers of the heart 02:53 where actually clot from leg could pass to that. 02:55 So blood clots could pump into the brain. 02:58 That could cause a stroke 02:59 because once it gets to a small blood vessel, guess what? 03:02 No blood can get through that part of the brain 03:05 that that blood vessel nourishes dies. 03:07 If it's your talking part, all of a sudden you can't talk. 03:11 If it's your seeing part, all of a sudden you can't see. 03:13 If it's your moving part, 03:14 you might have the left or the right side go numb. 03:16 Then all of a sudden you have a medical emergency. 03:19 All right, this really underlines 03:21 the fact that we should be moving. 03:22 That we should have an exercise program 03:24 because you're saying that when we are lazy, 03:27 when we are sedentary and our heart 03:29 is just slowly pumping 03:31 and everything that this pulling of the blood, 03:33 this clotting could happen? 03:36 Well, mainly if the heart's damaged, Charles. 03:38 Now if the heart's damaged and weak 03:39 but, you know, if you're laying on a couch 03:41 and your heart's strong, 03:43 you're not that that big of a risk. 03:44 If you lay there for weeks and weeks 03:46 and months and months? Right, right. 03:47 But what we want to do, though, is if you lay around 03:48 and don't do anything what happens is 03:50 you might have high blood pressure 03:52 'cause you're gaining weight. You might get diabetes. 03:53 You might have high cholesterol. 03:55 Those are the things-- those risk factors 03:57 that can raise a chance of you having a stroke. 03:59 And since our treatment for stroke is not very good 04:02 and since it's a leading cause of death 04:04 we've got to do everything we can right now 04:06 wherever you're at everything you can 04:08 to lower the risk of stroke. 04:10 And if you're having a stroke get in right away. 04:12 I can't tell you how many people I've seen through the years. 04:15 Oh, it's nothing serious, you know? I can't move. 04:18 It's gonna go away or you know, it will go away. 04:21 I don't wanna wake up my wife 04:23 and then the next thing 04:24 they can't even move part of their body. 04:25 It's just devastating. 04:27 So atrial fibrillation is a cause of stroke. 04:29 All right. Question number two from Heartwiseministries.org. 04:33 What should be done for a family history of strokes? 04:36 Everyone in my family has had a stroke at some point. Wow. 04:39 Yeah, and it's just the things we've talked about. 04:41 You'd be concerned if someone said that. 04:43 I would be very concerned. 04:44 And I would tell them, you know, we got a-- 04:45 just like heart disease, we've got to lower the stresses 04:47 as we've got to lower the stress of high blood pressure. 04:50 If they carry extra weight we got to loose weight. 04:52 Control the diabetes. 04:54 Some people need a cholesterol medication. 04:56 Get in an exercise program 04:59 and then lower all the other stressors 05:01 that might have--sleep apnea is a stressor on the body. 05:04 So anything that raises blood pressure 05:06 and put stress is gonna raise a chance of having a stroke. 05:08 Very similar to what we tell someone with heart disease. 05:11 And we want to lower that but if you've have 05:12 a family history things tend to run in families. 05:15 And if these arteries are getting blocked up in the brain 05:18 you're gonna be at a higher risk of having a stroke. 05:20 You know, if everyone in the family has had a stroke 05:24 that can talk about genetics. 05:26 We could also talk about lifestyle. 05:27 Yes. Maybe whole family had bad lifestyle, you know? 05:30 Maybe, everyone smokes cigarettes 05:31 and had high blood pressure and weighed a lot 05:34 but these are things that, 05:35 you know, family history can be changed, you know? 05:38 We talked about bad genetics. 05:39 You can change your genetics 05:40 by the way you live sometimes. 05:42 Absolutely. Okay, next question from heartwiseministries.org. 05:46 Is it possible to regain function 05:50 and I'm sure that this person would like to know 05:52 if we can regain full function after a stroke? 05:54 After the clot has gotten there 05:56 and something has been damaged can you get it back? 05:59 Yeah, and that's why it's so important 06:02 to get treatment right away 06:03 if you think you've had a stroke. 06:05 If you can get into the hospital 06:07 and they can give a blood thinner within the, 06:09 you know, four or four and a half hours 06:10 or if they can go in and pull out the clot, 06:12 you're brain can be totally, completely better. 06:15 Now sometimes we have a stroke and the strokes there at home 06:18 and we can grow collateral blood vessels, okay? 06:21 What we can--you know, retrain the brain that's been damaged. 06:24 Sometimes that occurs and that's why its very important 06:27 especially the six months after they've had a stroke 06:31 to go through stroke rehab where they try to retrain 06:34 the brain to do things 06:35 depending on what part of brain has been damaged. 06:38 You might see a speech therapist. 06:40 You might see an occupational therapist, 06:42 other people to help retrain the brain. 06:44 Sometimes you have to start over. 06:46 And we've seen the greatest benefits 06:48 in the first six months. 06:49 However, some people, you know, it's like after a heart attack 06:52 I want people to start exercising, 06:54 doing things even if they've never done it before 06:56 to help the heart regain its function. 06:59 Some people after stroke they don't go 07:01 and get anything done. 07:02 They just say, oh, you've had a stroke. 07:04 Go home, live with it. 07:05 The doctor fixed it. You can go. 07:06 Yes, or they haven't done anything for it. 07:08 They've just had the stroke. 07:10 The part of the brain hasn't been tried to retrain. 07:12 So it's very important to get stroke rehab. 07:14 And they've shown that up to six months 07:16 you can retrain parts of the brain. 07:17 So even if you don't get it on time sometimes, 07:20 if you have the appropriate therapy 07:21 after the stroke it could be retrained. 07:23 Now unfortunately, if the brain is damaged 07:26 you have to learn things over again. 07:28 Like, what if you can't swallow well and, 07:30 you know, the food's getting into your lungs? 07:32 What if you can't move 07:33 and you're getting bedsores on you? 07:35 What if you're having seizures? 07:37 What if you can't do a lot of the things you knew? 07:39 What if you're eyes can't close 07:41 and you need drops in your eyes 07:42 just to keep them moist and help your vision? 07:44 So there is a lot of things that go along with the stroke 07:46 even if you can't get to retrain the brain 07:49 that must be done to care for a person with the stroke. 07:52 So it's very important that the caregivers 07:54 as well as the person themselves learn everything they can 07:56 not only to retrain the brain but the brain 07:59 can't retrain the brain doing the things 08:00 you do to function well. 08:02 One of the scariest things after stroke, Charles, 08:05 that I see is people can't swallow. Oh, dear. 08:07 And they have a condition called aspiration 08:09 because the muscles in the neck don't do well. 08:12 So they eat some food, instead of going to stomach 08:14 it goes around to the lungs. 08:16 And they get pneumonia and they have, 08:17 what we call, aspiration 'cause they can't swallow. 08:20 Some of those patients actually need feeding tubes 08:22 early on rather than going home and trying to swallow 08:25 and not being able to swallow 08:27 and all the food ends up in the lungs. 08:28 That's called aspiration. 08:30 So there's lots of things in stroke that can help. 08:33 So not only that you care something is very important 08:36 but after a stroke you also need a lot of care, 08:38 a lot of rehab, a lot of education, 08:40 both for the person as well as the family. 08:43 I had one person that I helped care for. 08:45 Everything is fine but she can't talk. 08:47 She can't talk. 08:49 You know, how hard it is to communicate 08:50 when you can't talk? Yes. 08:51 I mean, that's a major issue, you know? 08:53 So she's had to learn how to communicate 08:55 without being able to talk 08:57 and because one of her arms doesn't move well 08:59 she can't write as well. 09:01 So there's all sorts of issues 09:02 when parts of your brain doesn't work well. 09:05 We got another question, Dr. Marcum, here 09:07 from the Heartwiseministries.org website. 09:10 What is a thrombolytic and how is it used 09:14 in the acute treatment of stroke? Yeah. 09:16 Thrombolytic if we think that the cause of a stroke was 09:20 due to blood clot not a bleed 09:23 we give strong medications called thrombolytic, 09:26 thrombo meaning thrombos, lytic means break it apart 09:29 so they give this medicine in the body 09:32 and it goes and breaks up that clot 09:34 so all the sudden that brain gets enough blood to it 09:37 and this is the main extreme treatment 09:40 if it can be done very quickly. 09:42 There are some risk of thrombolytics 09:44 and the main risk of a thrombolytics guess what? 09:47 Its bleeding 'cause it causes you to bleed 09:49 so if you're bleeding already 09:50 I mean, you give a thrombolytic 09:52 you're gonna bleed more so that's why 09:53 they have to make sure what the cat scan 09:55 that there is no blood in the brain, 09:56 its not bleeding type of stroke before they give it 09:59 but thrombolytics before we have thrombolytics 10:01 it was very hard to treat a stroke at all 10:03 'cause we really didn't have anything to off it 10:04 but now we have that 10:06 for an acute stroke, we also have some devices 10:08 modern medicines as devices 10:10 that we can go up in the brain 10:11 and certain type of individuals we can treat that 10:13 but bottomline is people have to get to a stroke thinner 10:17 rather quick if they're having symptoms 10:19 to get this type of therapy. Oh, boy. 10:21 I'm just amaze at modern medicine 10:22 and I hope that listeners, 10:24 you are understanding that modern medicine has a place 10:28 and very important place but you know what, 10:30 Dr. Marcum, I wanna do everything I can-- 10:32 Do not needed. But not needed ever. 10:34 That's what I'm looking for. Okay. 10:36 Absolutely, Charles. 10:37 Our last question here we have time for this is a T.I.A. 10:40 the same thing as a stroke. What is that T.I.A.? 10:43 You know, T.I.A. they are different than the stroke 10:45 'cause the T.I.A. is called T transient ischemic attack 10:49 so it doesn't last as long, so its usually lesson 24 hours. 10:54 You might have a neurologic symptoms 10:55 then all the sudden the cause of it 10:57 gets better on its own spontaneously. 10:59 But you still had that symptom 11:01 we'll thank goodness it got better 11:02 but this could be a precursor for a stroke. 11:05 So people that have T.I.A. we wanna make sure 11:07 their risk factors are maintained 11:10 we gonna make sure there is no plots places 11:12 in the body that they could have a clot, 11:13 make sure they don't have 11:15 Atrial Fibrillation or weak heart, 11:16 make sure they don't have a whole in the heart, 11:18 we also wanna make sure that there is no blockages 11:20 in the arteries very important if you have T.I.A. 11:23 to get a major evaluation to make sure 11:25 there is nothing that can be done 11:27 'cause if you have a little stroke 11:28 the big one could be right around the corner. 11:30 Oh, Boy, okay. we'll take a short break now 11:33 and when we come back let's spent sometime 11:35 with the master physician. Stay tuned. 11:41 I've taken care of many patients over the last 20 years. 11:45 And I think the ones that are the hardest 11:48 to care for is people that have had strokes 11:51 and haven't got any treatment in time. 11:54 And they were stuck with some devastating consequences, 11:57 both in their lives and the lives of their families. 12:00 And I hope you've listened to this today and realize, 12:02 "I want to do everything 12:04 I can to lower my risk of having a stroke." 12:07 And this might be changing some lifestyles. 12:10 And if you're having a symptom I hope 12:12 you've learned right away you want to get to the hospital, 12:14 get to a stroke center that can treat you, 12:17 and if you've had a stroke 12:19 that's one of the most devastating things. 12:22 Hopefully you've gone through stroke rehab. 12:24 And if you had a stroke I want to also remind you 12:27 that there is hope. 12:28 There is hope in that relationship 12:30 that you have with God 12:31 that He can make everything right in His own time. 12:34 And remember there is a place for modern medicine. 12:36 It doesn't fix everything. 12:38 There is a place for lifestyle, 12:39 but that doesn't fix everything. 12:41 But in that relationship with the Heavenly Father 12:44 you can have healing. 12:46 And that healing might not be here on earth 12:48 that might be in heaven but we could have healing 12:50 and what a hope that is if you've been 12:52 one that's had a stroke. 12:54 I want to spend sometime there might be someone out there 12:56 that needs a prayer today to enter this relationship. 12:59 So let's all bow our heads together. 13:03 Dear Heavenly Father, we want to thank you 13:05 for giving us life 13:06 and ability to have a relationship with you. 13:10 If there might be someone out there in the audience today 13:12 that needs to enter into this relationship 13:15 as a part of their healing process, 13:17 Father, please enable this to happen. 13:20 And we want to thank you for being a God 13:21 that loves us, that takes care of us 13:23 and wants us to be our ultimate physician. 13:26 This is our humble prayer, Amen. 13:30 I want you to remember that 13:31 at the top of every treatment plan 13:34 is not modern medicine, it's not lifestyle changes 13:38 though those are important at the head of every ultimate plan 13:41 is that relationship with the great creator, 13:44 your ultimate physician. |
Revised 2014-12-17