Health for a Lifetime

Stroke

Three Angels Broadcasting Network

Program transcript

Participants: Don Mackintosh (Host), Phil Mills

Series Code: HFAL

00:01 The following program presents
00:03 principles designed to promote good health
00:04 and is not intended to take the place of
00:06 personalized professional care.
00:09 The opinions and ideas expressed are
00:11 those of the speaker. Viewers are encouraged
00:13 to draw their own conclusions
00:15 about the information presented.
00:49 Hello and welcome to Health for a Lifetime
00:51 and I'm your host Don Mackintosh.
00:52 And today we're gonna talk about a
00:54 problem that many Americans face,
00:56 in fact far too many. Talking with us about
00:59 this problem is Dr. Philip Mills,
01:01 he's a specialist in physical medicine,
01:03 and you've been practicing that for,
01:04 you know over 20 years, isn't that right?
01:07 That is correct, and so one of the things that
01:09 you really see is you know the problem
01:11 we're talking about today which is stroke.
01:13 A lot of people in America have strokes,
01:15 yes it's the, it's the most common
01:18 rehabilitation problem that we see.
01:21 And what exactly is a stroke?
01:23 Well, it all depends when you're asking
01:26 the question. Anciently, in Bible
01:28 times, the stroke was actually leprosy,
01:31 the Jews regarded this as a judgment from
01:33 God, they call it a stroke from God or
01:36 the finger of God. But in the Middle Ages
01:39 when a person suddenly became
01:42 unable to speak or lost the ability to move
01:46 one side, it was is if they were struck
01:49 because it happens so suddenly, they called
01:51 that a stroke. Now, today we understand
01:54 that what happened was that they lost
01:57 blood supply either from a bleed or
02:00 actually from a clot and so there was no
02:02 oxygen to a particular portion of the body
02:05 and that's why they had this sudden onset
02:08 of symptoms which we call a stroke or a
02:11 cerebrovascular accident (CVA).
02:14 So, a certain part of the brain just loses
02:16 blood supply and that's a stroke.
02:18 Yes, okay how does a blood clot form in the
02:22 brain, why would that happen?
02:25 Well, a blood clot is actually a very
02:28 complicated process because you don't
02:30 want it to clot when it shouldn't clot.
02:33 But you need it to clots when you
02:34 needed to clot. So, God designed
02:38 a cascade, a series of events, checks and
02:41 balances to make sure that when it clotted
02:45 it was an appropriate time to clot.
02:47 Well, in the case of a stroke for some
02:49 reason the blood clots in the vessel itself
02:54 and if that is in the brain we called it a stroke.
03:01 If it clots maybe in the heart one of the
03:04 valves and then breaks lose and floats
03:07 up to the brain, we call it an embolus,
03:11 okay. Now, the other way you can get a
03:14 stroke is from a bleed and that's the opposite
03:19 of a clot, there it should clot but it
03:21 doesn't clot instead the blood just pours
03:25 out and fills the brain. And so you don't
03:29 know which of these it is until you kind a
03:31 look at it through testing or something.
03:34 They can, they can find out through CT
03:37 scans and other studies which it is
03:41 and it's important to know because
03:42 depending on which type of stroke that you
03:45 have, it will depend very dramatically on
03:49 what type of treatment your to give.
03:52 The, the bleed kind of stroke is actually the
03:56 most dangerous as far as death that can kill
04:00 you very rapidly. On the other hand
04:03 surprisingly enough if a person survives a
04:06 bleed; it may leave you with the least of
04:08 the residuals, so its sort of if it doesn't kill
04:11 you it actually maybe in some cases the
04:15 best, the better kind of stroke to have.
04:17 I suppose that's because the blood
04:19 supply's not cut off forever to that area,
04:21 is that what you mean? That's correct, and
04:23 also since the blood is a normal component
04:27 the body knows how to take care of blood,
04:29 it can absorb the blood and come back quite well.
04:33 So, you've said this is the number one thing
04:35 that people see your specialty for.
04:39 How, big is it in terms of the other problems
04:42 that are causing problems for people in America?
04:47 Well, it's big, it's the third largest killer in
04:51 the United States and over age 60 it's a very
04:56 major cause of disability. In fact seven thousand
05:00 people will have strokes this year
05:03 that's one every 45 seconds, I figured that
05:06 during of this program 40 people in
05:09 America will have had strokes.
05:12 That's a huge number so you said in your,
05:15 your fact that you sent to me about 157,000
05:19 people per year. And, that's dying, that's
05:25 the ones that die. What I've said to you
05:27 is there's just a brand new sixty seven page
05:31 report of all the statistics of strokes,
05:35 it's very fascinating to go through and look
05:38 at these statistics every three minutes.
05:43 You have, a death from that, a death
05:45 from a stroke. And it says here something
05:49 about blacks versus whites,
05:51 more prevalence with African Americans
05:53 then whites. For reasons that are
05:55 not entirely clear black males have the
05:58 highest incident of stroke in this country.
06:02 You said the cost per year is in the billions for this.
06:04 Billions of dollars for stroke.
06:06 So, we've talked a little bit already about
06:08 what causes strokes but we wanna revisit
06:11 that again, I mean we've talked about a
06:13 bleed; we've talked about a clot.
06:16 What are some other causes we don't
06:17 normally think about? Well, I don't know
06:20 what we normally think about but you
06:22 have to consider age, genetics,
06:29 race as we mentioned, then the causes that
06:34 we can do something about include such
06:38 things as smoking, alcohol, certain
06:43 dietary factors and certain diseases, diabetes.
06:49 So, what about men versus women,
06:51 who have more. Men have more strokes
06:55 as a, as a group but women actually have
06:58 more strokes because they live longer.
07:01 I see, so other diseases that can
07:04 really predispose you say like HIV, HIV,
07:07 well or HIV behavior. HIV can in a small,
07:13 in small cases contribute to stroke
07:17 danger but really you have many of us
07:22 concerned about those types of behaviors
07:25 that cause HIV. We should actually
07:28 be also very concerned about
07:30 certain types of behaviors that cause strokes.
07:34 What we do today contributes to what
07:37 disease we have tomorrow. And everybody knows
07:40 that's true in the case of HIV, but some
07:43 people sort of think that strokes and
07:48 cancer, diabetes, heart attacks, never will
07:53 happen to them, well there is nothing they
07:54 can do about it. They don't realize that the,
07:57 that the lifestyle they choose today is going
08:01 to determine the problems they have tomorrow.
08:04 So, no smoking, no alcohol, proper diet
08:08 all these different things are gonna
08:09 protect you against it. Yes, what I choose to
08:12 do today is going to determine how I am
08:15 twenty years from now? So, someone comes in
08:17 or calls you on the phone or comes to the
08:19 emergency room or sees their family
08:20 physician, what are the symptoms they
08:22 look for to say whether not
08:24 someone's having a stroke. Well, of course the
08:26 number one symptom that you think about
08:28 in a stroke is sudden onset of weakness in
08:36 a side of the body, arms, legs, on the
08:39 right or on the left. There can be sudden
08:42 onset of numbness on the side of the body,
08:44 you think of the side of the body.
08:46 There can be some difficulties in
08:49 speeches, either they have garbled speech
08:54 or difficulty in, in speech and
08:59 understanding speech, confusion.
09:02 They can have present with dizziness and
09:06 these are various types. Blindness? Blindness
09:09 in one eye, one side of the body can be a stroke.
09:13 Stumbling around does or what do you
09:15 call that attacks here or something, yes.
09:17 And that's another sign, yes, okay.
09:20 So, these symptoms if they come on,
09:22 they usually come on when suddenly or
09:24 over hours? They come on suddenly
09:27 or over maximum of maybe three days,
09:30 if something is coming on gradually
09:33 over weeks to months then you think not in
09:38 terms of a stroke you think more in terms of
09:40 a, of a tumor or some other, other process.
09:45 A stroke by nature is sudden; however you
09:49 can still have an underlying tumor that
09:54 maybe causes a bleed or a clot, so we have
09:57 to check it out. So, you still have to
09:59 investigate just because they have a
10:01 stroke doesn't mean that there can't be
10:02 another cause contributing to the stroke.
10:05 So, you, do you see strokes a lot when
10:09 they, people first time them, are you like one
10:12 of the first people they call?
10:14 No, I see them at the end of the medical
10:18 process in the rehab phase but actually
10:21 because of the first aspect there is,
10:24 actually three aspects of stroke treatment, okay.
10:28 There is the emergency phase and that's very
10:31 important, we should talk about that,
10:33 then there is the hospital phase and
10:36 then there is the phase which most excites
10:38 me which is the rehab phase.
10:41 So, if you think you're having a stroke
10:44 what should you do? The immediate 911
10:50 call, because if it's a certain type of stroke
10:54 that is a clot type of stroke.
10:58 Then you have a window of opportunity of one
11:02 hundred and eighty minutes from the time
11:05 you first have your symptoms through
11:07 some of the modern wonderful treatments
11:10 that they have for strokes today.
11:12 And so, during that time if you're outside
11:15 of that window of opportunity, it can't
11:18 work, is that like some of those clot
11:20 busting drugs and stuff. Exactly, so you have
11:23 this time, during that time that means
11:25 transporting to the emergency room,
11:28 that means the testing time, that means the
11:31 decision that this is not a bleed that
11:34 you're an appropriate candidate and you
11:37 may think three hours is a long time.
11:39 But, it's not in an emergency room,
11:40 speed is of the essence and doing the
11:44 right thing at the right time is the essences of
11:46 good medicine. So, after you get that
11:48 done, lets say you have excellent team
11:51 there that gets you right in, you're, you're
11:53 under the two hours or, the three hours,
11:55 yeah right you're between two and
11:57 three hours there, you're all done.
11:59 And they know it's a stroke, they know it's
12:02 a clot, what's the next thing that happen,
12:03 what kind of gold standard treatment comes next?
12:06 Well, then they would do one of the clot
12:07 busters, that you were talking about and
12:11 hopefully with proper care and the blessing
12:15 of the Lord. Then you will have very little
12:19 residual, in many cases however you
12:23 can't get for some reason or another that
12:28 treatment care. And so, then you
12:30 were in the hospital because if you look at
12:34 the statistics, if you will have a Transient
12:38 Ischemic Attack, which is a very mild
12:39 stroke, temporary kind of stroke.
12:42 And you have a stroke you're at high risk
12:47 before the stroke you either progress or you
12:49 can have a recurrent stroke.
12:52 So, you want to be in the hospital to see if
12:55 there's other testing, other medicine that
12:59 needs to be given to prevent future strokes.
13:04 So, you're there to stabilize and during
13:08 that time of stabilization you start
13:10 early rehab intervention. In a good hospital
13:16 what you'll have as a stroke team.
13:19 And you go through the evaluation in
13:22 emergency room, you go to the hospital with
13:24 the stroke team and they're immediately
13:26 implementing the proper measures to
13:29 prevent future strokes and minimize the
13:33 damage of the stroke. Once that's all done
13:35 then they go to a rehab specialist like yourself.
13:37 Yeah, but I want to talk about what needs
13:40 to happen in the acute setting and hospital
13:42 setting, because one of the problems that
13:45 can be missed, in strokes it's very
13:48 common if you're weak on one side that
13:51 includes your swallow. I see.
13:55 So because you have problems with
13:57 swallow, you might get pneumonia.
14:00 You have a danger of swallowing into the
14:03 lungs and that's not designed to digest
14:05 your food and then you get what's called
14:08 Pneumonitis. So, to prevent that they've
14:12 develop special diets, special studies to see
14:15 whether you're what's called Aspirator that
14:18 is swallowing into the lungs and then you
14:24 and put them on this diet.
14:25 So, you wanna minimize complications, other
14:28 things that you do in the acute setting
14:31 is make sure you're protecting range of
14:34 motion, you're protecting the skin
14:37 so that you're not getting precious sores
14:39 and moving them around enough, yes
14:40 and putting things on them. And these are kind of
14:42 things that relatives can do as they,
14:44 if their relative goes in, they can be saying,
14:46 hey make sure, then check the swallowing,
14:49 make sure this, make sure that, a great list
14:51 to have around just in case that would happen.
14:53 Yes, and in a good rehab, with a rehab
14:57 team they're going to do all this,
14:59 they're gonna know what needs to be done.
15:02 We're talking with Dr. Philip Mills,
15:04 he's a rehab specialist, he deals
15:05 with strokes everyday. When we come back,
15:07 we're gonna talk about what he does specifically
15:09 in a rehab setting, join us when we come back.
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16:13 Welcome back we're talking with Dr. Philip
16:15 Mills, we've been talking about strokes
16:17 and this is a very serious problem in America.
16:20 Third living cause of death, many people
16:23 during, even the course of this
16:24 program they've had strokes and it's best to
16:27 get to the hospital within three hours
16:29 we've learned and we've learned of those
16:31 things to watch for when we're in the
16:32 hospital setting and we're gonna take the
16:34 next step now as we talk to Dr. Mills.
16:36 So, the next thing we do once they've been
16:38 in the hospital, once they've walked,
16:40 watched out so they don't get Pneumonitis
16:41 because of that swallow reflex they
16:43 have watched out that they have,
16:45 proper range of motions so they don't
16:47 gets sores developing and once they've
16:49 watched out for, what was the other thing
16:50 we talked about. There was several
16:52 other different things we watch out.
16:54 How do we know when they're ready to
16:56 go to a rehab hospital? Well, you're actually
16:58 looking for two key components;
17:00 rehab is very intensive training,
17:04 so you need to be able to tolerate two hours,
17:06 have the endurance to tolerate two hours of
17:10 therapies a day. And then the other
17:14 key component, they have to be able
17:16 to learn from day to day and you can
17:18 measure that if there is no carry over then
17:21 it's difficult for person to be benefited by the
17:26 intensive rehab. In another words,
17:27 they had to be able to remember what they
17:28 did the day before. Yes. Okay.
17:29 The way you test for that is do they know
17:32 the year, if they have difficulty
17:35 remembering what year it is then their
17:38 carry over is a general rule.
17:39 This is a rule of thumb there might be
17:40 some exceptions. But it's rule of thumb
17:43 if they can't tolerate two hours of therapy a
17:45 day and if they can't tolerate, remember
17:51 what year it is, they really aren't ready for rehab.
17:55 So, what is rehab exactly, what is
17:57 rehabilitation hospital? What do they do there?
18:00 Well, rehab hospital or a rehab wing in a
18:06 hospital is where you have very intense
18:11 physical, occupational and speech therapy
18:16 when we're talking about strokes.
18:18 So this is like re-educating how
18:20 to walk, how to talk, how to eat, how to all
18:22 those different things. Yes, there are
18:23 activities that are necessary in life.
18:27 Now I've actually visited the hospital
18:29 that you've served in and they have all
18:31 these, they have stairs, they have a
18:33 little kitchen, they have,
18:37 they throw balls back and forth for hand eye
18:39 coordination, they have a whole bunch
18:41 of therapists that work with their peoples
18:43 hands and all these, that's what you're
18:45 talking about. Yes, and with that it's very
18:48 individualized, it's very directed
18:53 and what your aim is, is to make sure that
18:56 they can dress themselves if
18:58 possible, you want them independent,
19:01 you want them to be independent in
19:04 tolerating themselves, you want them to be
19:06 independent in eating, so they can feed
19:09 themselves. You want them as independent
19:13 as possible in walking, or transforming themselves,
19:17 transfer or assisting in this.
19:20 If it's not walking then you want them
19:22 as independent as possible in a wheelchair.
19:26 And this is probably quite discouraging not
19:29 only the person that has a stroke but also
19:30 to their relatives. Well, they can be,
19:34 because it changes a person almost
19:36 overnight, if you have a severe stroke from
19:40 one with complete activity in their hands
19:43 and their legs to one, to one that has
19:45 difficulty in coordination of hands and legs.
19:49 Particularly early on and maybe some
19:52 difficulty in communication.
19:55 So, I mean I think they're probably just
19:56 reaching out for any kind of hope and
19:58 encouragement they can find in that setting.
20:01 And, and rehab therapists by enlarge
20:05 are wonderful, causing people,
20:08 yes and because stroke isn't into the
20:10 world, stroke is just new challenges and
20:14 new ways to do old things, which is
20:18 dressing and eating and all the things
20:21 there are necessary for life, it maybe a
20:22 little slower, it maybe a little different.
20:25 But, our aim is to bring you back to
20:28 those goals of caring for yourself.
20:31 Strengthening that which remains and
20:34 being able to do the first works, yes so just be.
20:37 Now, of course the best thing to do is to
20:41 avoid strokes, to begin with or prevent
20:44 them, what can we do to prevent strokes
20:47 Dr. Mills? Well, I like to say that life is like
20:51 golf, we want to have as few strokes as
20:54 possible. Okay, all the Tiger Woods
20:57 fans would like that, yeah, that's true so
20:59 you wanna decrease even having one, yes.
21:04 And so the question is how do we decrease
21:09 the blood clotting or the bleed in the brain,
21:13 what we need to look at what makes the
21:15 blood clot abnormally or what makes the
21:18 brain bleed, when it's not suppose to.
21:22 And let's look at the bleeding problem first,
21:25 okay with bleeding you can think of high
21:29 blood pressure, which puts pressure on the
21:33 blood vessels and they can burst.
21:38 So, you watch our blood pressure,
21:40 make sure we don't have high salt,
21:41 make sure we don't have overweight,
21:43 make sure we don't have all those
21:44 different things. Exactly, so that blood
21:48 pressure is not something that
21:50 typically kills you instantly,
21:52 it's something that's slow, kills you overtime.
21:56 And so it's important to check and measure
21:59 your blood pressure and make sure that
22:02 isn't a problem. My patients typically
22:05 would have a triad of problems, they would
22:08 have diabetes, they would have high
22:12 blood pressure and then they'd have other
22:17 high cholesterol. Other problems such
22:20 as cholesterol, these triad and associated
22:27 diseases don't just add to your risk.
22:33 They multiply your risk. I think probably for
22:36 everyone you would say stop smoking but
22:39 would you say that for someone who had a stroke?
22:41 Well, you want to stop smoking before
22:44 you have the stroke, does it really
22:46 predispose you to stroke. It's a , it's a major
22:49 component to, to strokes. Now you have to
22:52 think of stroke as a heart attack of the
22:55 brain or you might think of the
22:59 heart attack as a stroke of heart.
23:02 In fact if you look at the 67 pages of
23:05 documentation of causes and the
23:09 statistics of strokes, it's actually strokes
23:12 and heart attacks, because these are
23:14 blood vessel disorders and what's bad for the
23:19 heart, is also bad for the health;
23:21 Is bad for health. So, you, you talk also
23:23 about the electrolyte to get calcium,
23:25 potassium, magnesium, all those for just
23:29 optimal functioning of the body,
23:30 how are those related to stroke?
23:32 Well, what you want is to have healthy
23:35 nutrition to the brain. Okay, and so that
23:39 your blood vessels are in the maximum
23:44 health possible. Now, you're not a
23:46 prophet or the summer prophet.
23:48 But what do you think the direction is in
23:51 terms of future medical breakthroughs concerning
23:55 stroke treatment or therapy,
23:57 all these different things?
24:00 Well, predicting tomorrow's surprise is
24:07 really difficult, right and what technology
24:09 we will do we don't know, but they are breakthroughs
24:15 that the Bible predicted in the area of stroke.
24:19 Isaiah said there was going to come a time
24:22 where the lame man would leap as a hart,
24:27 and the tongue of the dumb would sing.
24:31 So, that's, that's definitely talking
24:33 about someone that had a stroke.
24:34 Well, those are the two key components
24:36 of strokes, you're weak, you're lame and
24:39 you have communication difficulties and this
24:41 said that this breakthrough would
24:43 occur when Christ broke through the
24:46 clouds and came in the clouds of the heaven.
24:49 So, that's the breakthrough that
24:50 I see in the future that's going to really
24:52 solve the problem with stroke.
24:53 It wasn't that also the healing that was done
24:55 in Acts 3 or you had, that was the quote,
24:58 quotation from that, I mean the man was
25:00 unable to walk, unable to enter the
25:02 temple and rejoice, he probably had a stroke
25:05 didn't he? Well, I don't know what
25:06 he had, but it certainly could have been a stroke.
25:10 Interesting, so of course we also may
25:13 look to Christ as the ultimate healer for
25:16 these, these types of things talk to me a
25:18 little bit as we close, we've got about two
25:20 minutes left. You know, the family
25:22 people, the family members that are
25:23 supporting someone what can they do to
25:25 support someone that's had a stroke.
25:27 I mean the person who is being
25:28 supported in the hospital, in the acute
25:31 phase and also in rehabilitation hospital.
25:34 And then that, that comes to an end and
25:37 they go home what kind of things can that
25:39 family member be doing to just kind of
25:41 get themselves ready to be helping others
25:44 and I know, you know it's a big change for
25:46 people but what do you tell people,
25:48 how do you help them? Well, there is, two
25:52 factors here the first one is sometimes they
25:55 feel guilty if they're not able to provide
25:58 assistance and the loved one if they've
26:01 had severe stroke may need extended care
26:04 facilities, really can't do it in a home setting.
26:07 Now, if a parent or a loved one is not able
26:13 to feed themselves, if they're not able to
26:16 tolerate themselves, if they're not able to
26:18 provide some assistance in transfers.
26:23 It really, you can't take care of them at
26:25 home, they need some external help.
26:28 And they shouldn't feel guilty about that?
26:30 No, because it's actually gonna hurt
26:32 them to try and do that. Yeah, and they won't,
26:34 you really can't care for the person
26:36 efficiently as is needed, so they can
26:40 need an extended care. But, if they have
26:42 those things and they go home?
26:44 Then you can assist them, now we have to
26:47 remember stroke is a continuum.
26:48 And many people have strokes and they
26:50 have very little in terms of the
26:52 impairment. Can you over help someone
26:54 who has had stroke? Yes, you want them
26:55 to be as independent as possible.
26:58 You may need to provide a ramp so that
27:02 they have ease and safety of entry,
27:05 you want to provide a, a way for them to be
27:10 able to get into and out of their bathroom,
27:13 so grab bars maybe necessary.
27:15 These are the sorts of things that you wanna
27:17 do in the home to make a stroke ready.
27:21 You know, I watch my grandfather take
27:23 care of my grandmother who had six strokes.
27:25 And as he was taking care of her, he would
27:28 sing wonderful words of life.
27:30 And he learned to how to in that setting
27:33 still show love and help his wife.
27:36 It was a great testimony to me
27:37 and the family. And you know we can see,
27:40 we can grow through these times and I'm
27:43 sure you've seen that many times.
27:45 Yes, these stresses can with, the Lord has
27:50 a way to over rule problems so that even
27:53 in the middle of it he provides us support
27:56 and we actually improve.
27:58 Thanks for watching, God bless you.

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Revised 2014-12-17