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What Harry Reid's Hospitalization Teaches Us About Emergency Health Care

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Stroke is a serious health risk for everyone, the fourth leading cause of death and a leading cause of disability. Now, Harry Reid's illness has just reminded us of how we should prevent stroke and care for stroke symptoms.

Always in the news, Senator Harry Reid was admitted to the hospital on Dec. 20, 2013. Fortunately, he was found only to have exhaustion, and has been discharged. But Harry Reid's courageous decision to rapidly get to the hospital is a lesson to all of us: Everyone is at risk for stroke, you should take steps to prevent stroke, and when you have symptoms suggesting a stroke or think you might be getting one, get to the hospital fast... and by paramedics if possible!

Every year, about 795,000 people are diagnosed with stroke, and 140,000 people die of it (mortality 1 of 6). Harry Reid had a mild stroke, or a transient ischemic attack (TIA), in August 2005. Most likely, because of his history, Harry Reid's symptoms on Dec. 20 worried him enough that he might be having another stroke that he immediately stopped what he was doing (planning to finish leading the current Senate session) and went into the hospital. Since 42 percent of men and 24 percent of women who have had a stroke suffer from another stroke within five years, this was good judgment, and shows us what we should do.

What causes stroke? High blood pressure, smoking, heart disease and atrial fibrillation, diabetes, high cholesterol, obesity and inactivity, alcohol abuse, sleep apnea and clots in the carotid arteries in the neck. And stroke is 80 percent preventable: Take pills to keep blood pressure and cholesterol normal, stop smoking and excessive drinking, take blood thinners and/or anti-platelet drugs for heart disease or atrial fibrillation, exercise and maintain normal weight, eat a healthy diet with five or more helpings of fruits or vegetables, get sleep apnea diagnosed and treated, and have carotid stenosis (narrowing) diagnosed with ultrasound and treated with radiology or surgery if necessary. So it is important to discuss your own risk of stroke with your doctor, and get prescriptions and advice to avoid a stroke.

Treating a possible stroke is a real medical emergency. The sooner you get care in an emergency room in a hospital that has a stroke center, the more successful your outcome from stroke. In an important article, researchers evaluated over 58,000 patients who had symptoms of a stroke, went to an emergency room, were found to have a stroke, and were then treated with tissue plasminogen activator (tPA or altepase), a clot-dissolver that improves stroke outcomes. This medicine must be given within three hours of the first symptom of stroke.

The authors found that if patients got to the emergency room faster, and received treatment more quickly, there was a 2 percent increase in subsequent ability to walk for every 15 minutes shorter time from onset of symptoms until getting treatment initiated. There was 1 percent to 2 percent increase in ability of a patient to return to independent living for every 15 minutes shorter time until treatment began.

Treatments began more rapidly if there was arrival by ambulance. Amazingly, treatments began 600 percent more quickly when patients arrived by ambulance than coming to the emergency room by car!

So recognizing symptoms of stroke are most crucial. Symptoms include: sudden numbness or weakness of one side or arm or leg, sudden confusion or speech problems, sudden trouble with vision, sudden difficulty walking and sudden severe headache.

The national stroke association (www.stroke.org) has a short memory aid that sums up when to suspect stroke, called FAST. Face droop, Arm drifting when you hold them out straight, Speech slurring, Time to call 911.

So here are my tips for you about stroke:

• If you are having symptoms of any kind, try to get to the emergency room to have symptoms resolved as soon as possible.

• Use an ambulance or paramedic to get to the hospital in case of symptoms of stroke or heart attack. Patients arriving by ambulance receive emergency care much more rapidly than patients arriving by car.

• Never think, the symptoms are only mild, I can wait it out.

• Check out your own personal risk of stroke using a stroke risk calculator. As an example use this.

• See your doctor and get your personal advice about preventing stroke. For more information about how to discuss prevention with your doctor, see my book Surviving American Medicine.

The illnesses of our leaders and celebrities help to focus our attention on what diseases we might develop. Harry Reid had a stroke, showed us how to get to the hospital fast, and is now well.

You can be a survivor of stroke. Take action today.

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