• September 15, 2019

CATES: Know the signs of stroke - Odessa American: Opinions

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CATES: Know the signs of stroke

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Posted: Sunday, August 11, 2019 12:30 am

My first job as a nurse was on an ortho/neuro unit, and in that job I took care of many, many people who had suffered strokes, had fractures, or worse, both. Very early on, I learned the devastation that stokes can cause patients and families, and the different but still devastating effects of serious fractures. When stroke and fracture were combined, the outcomes were far too often poor. That knowledge is something I carry to this day. While the treatments for stroke and fracture has improved greatly in the 25-plus years I have been a nurse, the combination of stroke and fracture is still one that has a great ability to cause serious disability or death. As with so many things in health care, our best weapon against that ugly combination of stroke and fracture is prevention.

The American Heart Association recently put out a recommendation that stroke patients pay attention to bone health. According to one study, stroke patients are 47% more likely to suffer a fracture than those without a history of stroke, and the five year survival rate for those patients with a stroke followed by a fracture was 42% (in other words, 58% of the people who had a stroke and then a fracture passed away within 5 years). 62% of the stroke victims who suffered fractures were women. When you understand how stokes set patients up for fracture, it is easy to see where these frightening statistics come from. There is a strong link between sedentary lifestyles and osteoporosis (a condition, more common in women than men, where bones become fragile and porous). There is another significant link between balance and gait issues and falls. People who have had strokes are often at risk for both of those problems. Because of their stroke they are less mobile, which leads to a sedentary lifestyle, and then osteoporosis. Add that to the changes in balance and gait that many people experience with a stroke, and you get a person who is more likely to fall, and more likely to break bones when they fall.

Yet, bone health is something that is not generally on the priority list for most post-stroke treatment and prevention programs. A recent study of over 16,000 stroke survivors showed that only 5.1% of those patients had bone density testing, and only 15% were prescribed medication for osteoporosis. Education to stroke patients is generally focused around life-style changes to prevent recurring strokes and management of any disabilities caused by their stroke. Depending on the patient’s mobility, stroke patients also receive fall education, but rarely does stroke education emphasize bone health. Providers too, often forget to consider bone health as they are developing management plans for the complex problem of post-stroke care. Considering one in five individuals who have had a stroke have a second stroke in five years, it is not surprising that their physicians are monitoring and treating those things that can cause those repeat strokes, high blood pressure, diabetes, high cholesterol and an irregular heartbeat—and they should be, with that rate of repeated strokes. That is why that American Heart Association is making these recommendations regarding the care of post-stroke patients—so both patients and providers include bone health in their post-stroke management plans.

The absolute best prevention for all of this is stroke prevention. Exercise, a heart healthy diet, and regular visits to a primary health care provider so they can treat stroke risk factors, will hopefully make sure you never experience as stroke. The second best thing is to minimize the effects of a stroke. Most strokes are very treatable IF the person experiencing a stroke seeks medical attention quickly—within 3 hours. Remember the stroke acronym F.A.S.T. and teach it to those you love: F—Sudden Facial weakness or drooping—particularly on one side, A—Sudden weakness of the Arms and/or legs—particularly on one side, S—Sudden changes to Speech or Sight, and T—if you see any of these things it’s Time to call 911 and remember the Time the symptoms started. If we prevent or minimize a stroke, then the issues that lead to fractures, and the further devastation those fractures can cause after stroke, can never happen.

Odessa, TX

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