Participants: Don Mackintosh, Phil Mils
Series Code: HFAL
Program Code: HFAL000033
00:52 Hello and welcome to Health for a Lifetime.
00:55 I'm your host Don Mackintosh and today we're joined with 00:58 Dr. Phillip Mills from Wichita, Kansas. 01:00 Welcome, Dr. Mills. 01:02 Thank you. 01:04 You told me that you have a specialty and you used a very 01:08 fancy word, physiatrist. 01:10 What exactly is a physiatrist? 01:12 It's physical medicine and rehabilitation. 01:17 There's several general specialties in medicine. 01:22 There is surgery, that's the diagnosis and treatment 01:24 of those diseases that are best treated with surgery. 01:27 There is internal medicine, that's the diagnosis and 01:30 treatment of those diseases that are best treated 01:32 with medications. 01:33 There's the psychiatric types of specialties which deals with 01:39 problems in the mind. 01:40 In physical medicine we deal with those diseases and 01:45 diagnosis of problems that are best treated with the physical 01:49 modalities - physical therapy, occupational therapy, speech. 01:54 And we deal with pain problems, muscular skeletal problems, and 02:00 sequela, the long term problems and some of the acute problems 02:05 of neurologic disorders. 02:08 Neurologic disorder would be like a stroke 02:10 or those type of things? 02:12 A stroke would be one, head injury, spinal cord injury. 02:16 Well, today we're going to talk about strokes. 02:19 I know it's tongue and cheek but it's going to help us. 02:24 We've entitled today's program 02:26 "Different Strokes for Different Folks" 02:29 There's really nothing funny about that but really what is a 02:32 stroke and how many strokes are there in the United States 02:35 each year? 02:36 Well, world wide there is varying numbers of strokes. 02:41 In Nigeria there is less than 100 strokes per 100,000 people. 02:46 Now they may have some problem counting accurately 02:49 so it may be slightly higher. 02:50 In Australia there are 329.1 strokes per 100,000 population. 02:59 We're somewhere in the middle. 03:01 We have about 150, actually varies depending on the study, 03:05 but approximately 150 per 100,000 people. 03:10 That means every year there are approximately a million strokes 03:15 here in this country and of those 600,000, more or less, 03:23 again I'm giving very round numbers, about 600,000 03:26 are people who have never had a stroke before. 03:29 That's interesting. 03:30 Now you know some of our viewers today, 03:33 people that have joined us, maybe thinking, "Well this 03:36 is nothing for me, I'm a young person. " 03:38 Is this something young people should worry about? 03:42 At what age do strokes occur? 03:44 Unfortunately strokes can occur at any age. 03:46 You can have strokes inside the mothers womb while the fetus 03:50 is developing. 03:51 And when they're born we call that, and that's one 03:53 form of cerebral palsy. 03:55 You can have strokes as a child. 03:57 Up to age 8 we call that adult cerebral palsy 04:02 for certain types of reasons. 04:05 Then you can have strokes as teenagers particularly among 04:09 drug users. 04:11 There's also strokes that we see in the 20-30 population 04:17 among females that are taking birth control pills 04:21 and smoking. 04:23 We see strokes among young people that have a 04:29 genetic problem of the blood vessels of the brain. 04:32 And then of course as a person gets older they have more 04:36 and more risk of stroke and by the time a person is over 80 04:41 there's about a 13% chance per year that a person would 04:46 have a stroke. 04:47 So it increases when you're older but a any age 04:50 anyone watching today should learn something very helpful. 04:53 Also, at every age you're exposed to stroke. 04:56 I remember I didn't understand anything about strokes 05:00 when I was 3 or 4. 05:02 But because my dad was a minister we'd go visiting 05:05 in hospitals and I would see people with strokes and it was 05:09 something I didn't understand. 05:12 And I think it is very helpful for us to understand the 05:15 common problems that people have. 05:17 Well, let's just go back then to try and understand 05:19 this a little bit. 05:20 What exactly is a stroke? 05:22 Well, historically the word stroke has actually been used 05:27 for different diagnosis. 05:30 At the time of Christ, if a doctor said you have a stroke or 05:33 they weren't talking about what we would 05:38 call a stroke today. 05:39 They were actually calling leprosy stroke and by that 05:43 they meant it was a judgment from God, the finger of God 05:45 is another name for stroke. 05:47 In the Middle Ages, however; people developed these symptom 05:54 complex that we now call a 05:55 cerebral vascular axon, or stroke. 05:58 And what happened in the middle of the night they would have 06:02 this sudden onset or maybe even during the day a paralysis 06:05 on one side of the body or they might not be able to speak. 06:09 And it was so sudden and so striking they thought that 06:14 this must be a judgment of the hand of God on them. 06:16 They would call it the stroke of God - a stroke. 06:19 So today we still have the residual of that term. 06:24 We call it a stroke. 06:26 Would it be safe to say that anything that happened suddenly 06:29 is what they thought was a stroke? 06:31 Well, if it had certain symptoms as sudden onset, 06:34 lack of movement on one side of the body, 06:40 sudden onset of difficulty of talking and generally 06:43 that would also be associated with a weakness on one side 06:46 of the body. 06:47 Memory loss, is that something that happens with strokes? 06:50 Yes, in fact that may be the only symptom of a mild stroke 06:54 They have a sudden decrease in memory. 06:57 Or maybe have a sudden episode of confusion. 07:01 And that maybe the only symptom of a stroke. 07:04 There are other strokes that have no symptoms at all. 07:07 But if someone has a question about whether or not they've 07:10 had a stroke, would it be fair to say that if it hasn't 07:15 come on suddenly it's probably not a stroke? 07:17 If a person is getting gradual weakness on one side 07:21 of their body, gradual loss, then you have to think of some 07:25 other causes including tumor, whereas strokes are 07:28 generally sudden. 07:29 We have a nice model here. 07:32 Looks like this person may be left brained - laughter - 07:35 I think he's just open-minded. - laughter - 07:36 Tell us a little bit more about what happens in a stroke 07:41 maybe using the model here. 07:42 What a stroke is actually loss of blood supply 07:46 to some area of the brain. 07:48 And since every area of the brain has certain blood vessels 07:52 that go to it. 07:53 Obviously you can have many different types of stokes. 07:57 In fact in my practice, and I've seen thousands of strokes, 08:00 I have never seen a stroke that was exactly the same 08:04 as another stroke. 08:05 Now there are three major blood vessels that service 08:09 the brain here. 08:11 To the front there is a blood vessel that goes to this area 08:17 that's called the anterior. 08:20 So that's the frontal lobe? 08:21 Yes, in that area. 08:23 In the back this has to do with some vision, 08:28 the posterior cerebral artery. 08:31 In the middle, surprisingly enough, it's the 08:35 middle cerebral or brain artery. 08:38 There are of course many other blood vessels but those are some 08:44 of the major ones. 08:45 Depending on which blood vessel is involved 08:50 that depends on the symptoms that a person has. 08:52 Let me ask you a question that is sort of about the subject 08:54 and we want to come back, of course, to strokes. 08:56 You know you hear a lot of talk today about some of these 08:59 left brained or right brained being creative or analytical, 09:03 being this or that, is there anything to that? 09:06 Actually early on when they were studying strokes, a person 09:10 that would have left side involvement or 09:12 right side involvement, they did notice some differences. 09:15 But in actual fact the pop psychology idea of 09:21 left brain or right brain, for the last 25 years those 09:27 who have really studied it, have shown that 09:30 is really nonsense. 09:32 There are some differences but it's not like you hear 09:36 in the popular psychological culture. 09:43 In fact that just shows that most people don't really 09:47 know the differences in the areas of the brain. 09:51 Now if someone does have a stroke on the right side or 09:55 left side different things do happen to them, right? 09:57 Yes. 09:58 Now the way that God designed the brain - one of my professors 10:03 said He did it because He wanted to confuse the neurosurgeons. 10:07 Actually the left side of your brain controls 10:10 the right side of your body. 10:12 For most people it also controls the speech center. 10:17 So if you have a stroke effect in the left side you may have 10:23 some problems on the right side. 10:25 If you have a stroke on the right side, you may have some 10:27 problems on the left. 10:29 There is also generally associated with a right sided 10:32 stroke you may have some problems with judgment. 10:35 You'll also have problems with spatial orientations. 10:38 Difficult to get your clothes on for example. 10:41 One of the most interesting problems in a person who has 10:44 a right sided stroke and a left sided weakness, 10:48 if it's profound, they may have difficulty in reading 10:52 a person's face. 10:53 And so what you say to them is all they can interpret 10:56 from what you are saying. 10:58 So you can't wink and then you can't make gestures 11:03 or those kind of things they just don't pick up on? 11:05 No. 11:06 If you say the opposite of what you mean, you know 11:08 sometimes we'll say the opposite of what we mean but we're saying 11:12 it in such a way that the other person knows 11:14 that we don't mean it. 11:15 For example: Great, I'm doing great but said sarcastically. 11:16 Right, they won't be able to be able to understand that. 11:20 There is those changes and they become what we call very 11:25 concrete in their understanding of conversation. 11:29 In a few minutes we're going to be taking a break. 11:32 Before we do that I want you to cover with us, you know 11:37 this title "Different Strokes for Different Folks" are there 11:39 actually different types of strokes? 11:41 There are three major causes of strokes. 11:44 The first cause is right in the brain itself the blood vessel 11:52 begins to get sludge on it and we call it atherosclerosis 11:56 and as it begins to worsen then a person can actually develop 12:03 a clot right in the brain itself. 12:07 Now that type of stroke often will show itself first with very 12:14 short strokes that we call transient ischemic attacks 12:17 or TIA's that lasts for just short times. 12:20 There's another type of stroke and that type of stroke is 12:25 where the clot forms in some other part of the body. 12:29 In about 45% of these strokes, this is embolic and the other 12:34 would be thrombotic, it would come from person who has an 12:39 arrhythmia in the heart and the blood is not circulating 12:42 quite right in the heart. 12:43 They have atrial fibrillation. 12:45 So it clots there and just sits there milling around. 12:48 It breaks up some of those little blood cells and they form 12:51 a clot and then they go to the brain. 12:53 They go into the brain and they get caught 12:56 in one of the blood vessels. 12:58 That's another type of stroke. 13:00 A third kind of stroke is where one of the blood vessels burst 13:04 and you have a bleed. 13:07 That of course is very dangerous. 13:10 The treatment of these three different types of strokes is 13:15 different so it's very important to have a complete evaluation. 13:19 Now there is another way that a stroke can form 13:23 and that is the blood vessel goes into a spasm. 13:25 It can't spasm forever, but as it relaxes there may have been a 13:30 clot that formed. 13:31 Certain types of disorders can cause the blood vessel 13:35 to tighten up and cause a spasm. 13:38 Let me see if I have this straight. 13:40 Then we want to come back and talk a little bit more about how 13:41 we can avoid this, hopefully, a stroke. 13:44 We have a vascular spasm that can go into a stroke, 13:47 we have a rupture of the actual blood vessel, 13:50 we have a blood clot, and then the other was... 13:54 what was the other one we talked about? 13:55 You have two kinds of blood clots. 13:57 You can have a blood clot right there in the brain itself, 14:01 or you can have a blood clot elsewhere that sort of makes 14:05 its way up to the brain. 14:07 That's amazing that there's so many types of strokes. 14:10 When we come back hopefully you're going to share 14:13 with us how to avoid having a stroke. 14:16 We hope that you will join us. 14:30 Have you found yourself wishing that you could 14:32 shed a few pounds? 14:33 Have you been on a diet for most of your life, 14:36 but not found anything that will really keep the weight off? 14:39 If you've answered yes to any of these questions, then we 14:42 have a solution for you that works. 14:45 Dr. Hans Diehl and Dr. Aileen Ludington 14:47 have written a marvelous booklet called: 14:50 Reversing Obesity Naturally, and we'd like to send it to you 14:53 free of charge. 14:55 Here's a medically sound approach successfully used 14:57 by thousands who are able to eat more 14:59 and loose weight permanently 15:01 without feeling guilty or hungry through lifestyle medicine. 15:05 Dr. Diehl and Dr. Ludington have been featured on 3ABN 15:08 and in this booklet they present a sensible approach to eating, 15:12 nutrition, and lifestyle changes that can help you prevent 15:15 heart disease, diabetes, and even cancer. 15:17 Call or write today for your free copy: 15:41 Welcome back. 15:42 We've been talking with Dr. Phillip Mills about strokes. 15:46 We've discovered that there are three different types of strokes 15:50 but as we were talking we want to know how to avoid strokes, 15:53 Dr. Mills, we're not so interested in the different 15:55 types, although I know that's very important. 15:57 Has there been anyone in your life or your experience, 16:01 I know you've seen thousands of strokes, but anyone in your 16:04 experience that has had a stroke that really touched 16:07 you personally? 16:08 First let me say this, Don. 16:11 Not only am I concerned about strokes, and people have them, 16:14 but a lot of the people around the listeners and around 16:19 me have pre-stroke behavior. 16:22 By pre-stroke behavior I mean they are engaging in activity 16:27 that produces strokes in a certain percentage of people. 16:31 There was a lady that worked in my hospital. 16:35 She was just really vibrant, vivacious, fun to be with 16:39 and she was only 50 years old. 16:41 But I discovered certain life styles that had caused her 16:45 blood pressure to be quite high. 16:48 In fact she was having blood pressure of 240 over 150 16:53 when I took it one day. 16:54 I was of course very concerned about that and urged her to 16:58 immediately get that blood pressure under control 17:01 and see her primary care physician regarding it 17:05 and take appropriate steps to get it down now. 17:08 With high blood pressure what can happen is the blood vessels 17:13 burst and then you have a bleed. 17:15 That's one of the most life threatening types of strokes 17:19 which you can have. 17:21 Well, nothing changed. 17:24 I even made arrangements for her to see a primary care physician. 17:28 She was too busy to go. 17:30 So she wasn't listening to you. 17:32 She wouldn't make changes. 17:33 Then I begged her. 17:35 I said, "You see the patients as they come in, you're only 17:38 50 years old, I don't know when it's going to happen to you, 17:41 but one day you're going to be not a receptionist here at this 17:44 hospital, you're going to be a patient here, and you're 17:46 going to be paralyzed on one side, 17:49 and that's if you're lucky. 17:50 A month went by, two months, three months went by, and 17:56 two years ago, which was just fairly recently, I had my nurse 18:04 run into the examining room where I was, I was actually 18:08 seeing a patient. 18:09 She says, "You have to come out right now, my nurse is crying. " 18:14 She said, "This receptionist was just ready to leave work and she 18:18 had developed a very severe head ache and she was beginning 18:21 to loose consciousness, would I go see her?" 18:23 I ran back to Physical Therapy where this worker was laying 18:29 down on a mat. 18:30 There she was mumbling almost incoherently but I could tell 18:35 she was saying, "My head, my head, it's the worst 18:38 headache I've ever had!" 18:39 She was becoming less and less conscience. 18:43 I was very concerned that she had a bleed - a blood vessel 18:47 had burst. 18:49 We called the ambulance and had her taken immediately to the 18:56 large acute care hospital that our rehab center 19:01 is associated with. 19:02 By the time she arrived at the hospital 19:06 she was completely unconscious. 19:07 They did special studies, CT scans, and they did find 19:10 a great deal of blood in her brain. 19:13 In fact the neurosurgeon went in and took a grapefruit size clot. 19:19 He called me up and said, "She's not going to live. " 19:22 Very fortunately for her the surgery was successful. 19:28 Over a prolonged period of time she began to improve and she 19:32 did come back to our rehab hospital paralyzed on one side. 19:37 At 50 years old she had a very severe problem. 19:42 She was severely handicapped and will not be able to work 19:49 ever again. 19:50 I determined after I saw this that I would do everything I 19:56 could to encourage people to avoid those factors 20:00 that lead up to strokes - the pre-stroke behavior as I 20:05 always refer to them. 20:07 One of the big things that I hear in that story, 20:09 every good physician will tell a story, because I think 20:13 Doctor meets teacher, doesn't it? 20:14 What I hear in that is, listen when somebody is talking to you, 20:18 especially someone who knows what they're talking about. 20:21 But the other thing I heard is high blood pressure is not 20:24 something toy around with. 20:26 Is there anything else that we can really focus in on 20:30 that we need to avoid if we want to avoid having the 20:34 "big one" or a stroke? 20:35 Another real big one is high blood pressure. 20:39 High blood pressure, let me say is dangerous because it doesn't 20:42 cause any discomfort as a general rule. 20:45 So it's a silent killer. 20:47 But it's very important. 20:49 Another biggy in the area of stroke is smoking. 20:53 I already referred to smoking and birth control pills. 20:56 But smoking in and of itself is a big contributor to stroke. 21:03 Why is that? 21:05 We believe that the problem is it's a vascular constrictor. 21:10 And there are other poisons and effects of 21:13 the cigarette smoking. 21:15 But if a person stops within a very few months their risk of 21:22 stroke begins to decrease. 21:24 So a person, immediately when they stop smoking, is decreasing 21:30 their risk of stroke. 21:33 If you have high blood pressure get it checked. 21:35 If you're smoking, stop smoking. 21:37 What about having a little alcohol? 21:39 I hear that thins the blood, is that good for strokes? 21:41 Alcohol is a major contributor of strokes, and also it causes 21:48 not only problems with strokes but it also has problems with 21:54 balance. 21:55 So a person may have a stroke and fall and if they have a 21:59 little bit of alcohol on board they might not have 22:02 good judgment to get help and so it is a complicated 22:05 complicator and a causer of strokes. 22:10 A person should not drink one alcoholic beverage. 22:16 What about things you eat? 22:17 Are there things you can eat that hurt you or that help you? 22:21 Yes. 22:24 The very same foods that hurt your heart cause strokes. 22:28 It's exactly the same. 22:30 So the person who is being kind to his heart 22:33 is being kind to his blood vessels. 22:35 He's being kind to his brain and decreasing his risk of stroke. 22:40 What that means is the fruits, grains, nuts, vegetables - those 22:46 are the good foods. 22:48 The foods that are high in fats are meats. 22:50 The high fat gravies, the high fat dressings, those are all 22:59 stroke contributors. 23:02 We should avoid those and go for the low fat and avoid the 23:08 high fat diet. 23:09 So the fettuccini alfredo and all those things that make 23:11 our mouths water are pre-stroke behaviors. 23:14 I worked for several years in a hospital as a nurse. 23:22 I noticed that the diabetics many times seem to have problems 23:26 with strokes. 23:28 Was I just noticing that or was that a fact? 23:30 No. 23:31 Diabetes is another contributor for stroke for several reasons. 23:34 One of them it also effects blood vessels but it is 23:38 associated with stroke as well as other vascular problems. 23:41 One thing that you said at the beginning of the program, 23:44 people just joining us may not remember this, 23:47 it fascinated me when you said that you can have a stroke 23:51 even before you're born. 23:52 Explain that. 23:54 How can we avoid that? 23:55 Maybe there's some pregnant mothers or those thinking of 23:57 starting a family. 23:59 Sometimes they're caused by forces that we don't understand. 24:05 But some drugs that people take increase the risk of a stroke 24:12 in utero and certainly the illegal drugs increase 24:17 the risk of stroke. 24:18 If a mother who is pregnant can have a good healthy diet 24:23 and can have abundant exercise that decreases the risk of 24:27 stroke for not only her later but it decreases the risk of 24:32 stroke in the baby. 24:34 Exercise - that helps us avoid stroke. 24:38 How does that work? 24:39 It works several ways. 24:41 One way is it improves the vascular strength of the 24:47 blood vessels and it also can help decrease your 24:54 blood pressure. 24:55 But in general we find that the people who are slothful, 24:59 lack exercise, have an increase in strokes. 25:04 When you talk about the vessels being improved by exercising 25:09 does that mean when the when your heart beats 25:14 more strongly and firmly that interplay of the vessels 25:21 that makes them healthier, is that what you're saying? 25:23 It does, yes. 25:25 Big meals, are they dangerous? 25:29 Particularly what has been very amazing in the last two or three 25:35 years there have been some studies that have come out 25:37 that show that one fatty meal increases your risk of both 25:41 heart attack and stroke - just one high fat meal. 25:45 If a person has a high fat meal and immediately sleeps 25:50 after that, that can also increase his risks because of 25:55 pooling of the blood and because of pooling with 25:58 real high fat in it. 26:00 So get up right after you eat, do the dishes, walk the dog, 26:05 do something. 26:06 Don't lay down on the couch. 26:07 I've got to say that's been a temptation of mine in the past. 26:11 That's a tip for me and I'm sure many others as well. 26:15 A lot of people that have joined us today probably know people 26:22 or maybe they've experienced a stroke themselves. 26:26 We've got about a minute left here in the program. 26:29 I know you're a Christian physician. 26:31 What do you say to a patient whose done everything right 26:36 but something like a stroke happens? 26:39 I'd say the same thing that Paul says, and I'm just 26:41 memorizing this text. 26:43 This is Romans 8:22-23 "For we know that the whole 26:53 creation groaneth and travaileth in pain together until now. " 26:56 That is certainly true with all the problems. 27:00 But he then adds something very interesting. 27:03 "And not only they but ourselves also, which have the firstfruits 27:08 of the Spirit, even we ourselves groan within ourselves, waiting 27:13 for the adoption, to wit, the redemption of our body. " 27:15 In other words, Paul is saying that even though he was 27:19 filled with the Spirit, he had problems in his body and he 27:23 couldn't wait for the second coming. 27:25 I would say to the person who has a stroke that the good news 27:31 is there is deliverance at the soon coming of Christ 27:36 and look for it just like Paul did. 27:39 Thank you for being with us Dr. Mills. 27:42 You've given suggestions for those who want to avoid a stroke 27:46 and you've given hope to those that maybe had a stroke. 27:49 I hope you can come back on another program and share 27:52 more with us for those people that maybe had a stroke. 27:55 Thank you for joining us. 27:57 We hope you have health for lifetime. |
Revised 2014-12-17