How to avoid strokes

Once people hit their forties, the risk of suffering a stroke doubles every ten years. But even people in their twenties are in danger, especially with the sedentary lifestyle that is typical of the office crowd today.

 

Technology has made things so convenient that we rarely opt to take the stairs instead of the elevator. In fact, we even send messages online, when we could just as easily walk over to have a real conversation. Habits like these, combined with dangerous diets, put not just our hearts, but our brains at risk.

 

Neurologist and stroke specialist Dr. Alejandro Diaz explained in an interview on News to Go on Monday that strokes are brain attacks, and not heart attacks as people used to think. While heart conditions may cause strokes, the stroke occurs in the brain. 

 

Watch out for HMB signs

 

Diaz says that patients must watch out for the HMB symptoms: biglang Hina ng kalahati ng katawan, biglang Manhid ng kalahati ng katawan, and biglang pagkaBulol.

 

 

He said that once people suspect that anyone is having a stroke, the patient must be brought to an emergency room immediately. Diaz said a stroke is an emergency, and time should not be wasted waiting at a clinic. "Bawat minuto na nawawalan ng oxygen at sugar ang blood supply sa part ng utak na ‘yan, milyon ang brain cells na namamatay," he said. 

 

Diaz also said that patient care must be entrusted to specialists. While symptoms appear in a few minutes, he said it is very dangerous to try to lower the blood pressure. "Huwag na huwag nilang lalagyan ng sublingual (medicine). Dalhin na lang sa emergency room. Kasi ‘pag nabagsak ang blood pressure, ‘yung walang blood supply diyan, magkakaroon ng ripple effect, lalong lumalaki," he said. If a CT scan reveals hemorrhaging, then the blood pressure will be lowered to control the bleeding. 

 

"Nalalaman 'yan very easily. Within 30 minutes dapat ang pasyente ay na-CT scan kaagad para makita ‘yung brain, para malaman kung nag-hemorrhage ba o nag-stroke, nagbara o nagkaroon ng clot," he said.

 

Types of strokes

 

The American Stroke Association explained on its website that there are three types of strokes. Strokes can be ischemic (clots), hemorrhagic (bleed) or TIA (transient ischemic attacks that are often called a “mini-stroke”). Most strokes are ischemic, and are caused by an obstruction within a blood vessel that supplies blood to the brain. 

 

Meanwhile, hemorrhagic strokes are caused by the rupturing of a weakened blood vessel, which can be either aneurysms or AVMs (arteriovenous malformations). Mini strokes are warning strokes caused by a temporary clot, and these should be taken very seriously. 

 

Diaz said that a stroke can have different symptoms, as it depends on which part of the brain is affected. "Kung ‘yung ugat na ‘yun ay nabarahan doon sa speech center, magkakaroon ng depekto sa language. Either sa pagsasalita o sa pag-iintindi. Mabubulol siya. Kapag tinamaan ‘yung motor strip, mawawalan ng function ‘yung katawan," he said.

 

Avoiding a stroke

 

Diaz said that one can be at risk as early as 20 years old, and not exhibit symptoms until later. Those who frequently consume food that are high in fat and cholesterol as well as smokers are especially at risk. "Nag-uumpisa nang tumubo ‘yung yellow strip—taba ‘yan eh—sa lining ng ugat. Habang tumatagal, decades ‘yan, hindi napapansin. Walang symptoms. Nagde-deposit," he said.

He warned that smoking has both acute and chronic effects. "Pagka malakas ang paninigarilyo, whether it's active or passive, eh biglang na-co-constrict ang blood vessel. Kung ikaw ay ‘di mo alam may high blood ka, puwedeng tumuloy 'yun sa stroke. At ‘yung chronic effect, habang tumatagal nagiging mas matigas ‘yung ugat," he said.

 

According to a study done by the Philippine Neurological Association and the Department of Health, the risk factors include high blood pressure, diabetes, cholesterol, age, obesity, and smoking.

 

While Diaz said moderate drinking actually increases good cholesterol, he warned that overindulging increases the risk of ischemic and hemorrhagic strokes. He noted that 1-2 bottles of beer a day is okay, but binge drinking is very dangerous. "Mas delikado, kasi hindi sanay ‘yung katawan mo. ‘Yung liver mo, pancreas mo, ‘yung systems mo nabibigla," he said.

 

He said the lifestyle of modern society is the opposite of the earlier times. "Noong araw wala masyadong bisyo. Laging naglalakad noon. Ngayon online, nakaupo, tapos couch potato, may pagkain parati," he said, adding that the lack of exercise and eating processed food is a dangerous combination.

 

"Anong breakfast natin? Tuyo, longganisa, may sawsawan pa, may patis. Itlog na maalat. Ang sasarap noon eh. Pero ‘yung high-salt diet, pagdating ng edad natin nagpapataas ng blood pressure," he said, noting that Filipinos don't eat enough fruit. "Pero ang prutas kasi mataas ang potassium. The higher the potassium, it lowers the blood pressure," he said, recommending at least five servings of fruits and vegetables every day.

 

He explained that there are good and bad kinds of fat. Animal fat is bad for the brain and heart, while fat from tuna, fish, and nuts are good for the body.

 

He also suggested getting a carotid ultrasound scan, which will reveal the condition of the carotid artery. "Kapag in-ultrasound mo ‘yan, that is reflective sa ugat all over the body. So ‘yung lining na ‘yan dapat hindi kumakapal. ‘Yung iba hindi lang kumakapal, may tumutubo ng plaque—cholesterol plaque," he said.

 

As the lining gets thinner over time, the plaque may rupture, and the red platelets of the blood will stick together and clog the arteries, cutting off the blood supply. Diaz said that even a 50 percent clot can result in a stroke.

 

Apart from the carotid scan, he suggested checking the blood pressure regularly. "Dapat kung puwede, less than 120/80. Dati sinasabi nila 'pag 120/80, normal, but that is already what we call pre-hypertension. Kumbaga sa departure, pre-departure. Papunta na ‘yan diyan. Kapag ‘di mo ‘yan inaalagaan, tumataas nang tumataas ‘yan," he warned.

 

According to Diaz, the best advice can be summed up in two sentences: Eat less. Exercise more.

 

He said that even those who appear to be thin may actually have visceral obesity, which means they are Thin Outside, Fat Inside (TOFI). "’Yung taba doon napakalapit sa ugat, sa liver, sa puso. So ‘yung may malalaking tiyan ay very at risk sa stroke," he said. 

 

Recovering from a stroke

 

Recovery from a stroke depends on how severe the stroke is. "May 10 percent na nagkakaroon ng mild stroke na nakaka-recover fully," said Diaz, adding that medicine combined with physical therapy can help the patient recover. 

 

"The neurologist and the physiatrist will help them restore the lost function of the brain nang mas maaga," he said.

 

He emphasized that stroke patients need TLC—not tender loving care, but a total lifestyle change. "Pagka may pasyenteng nagkaroon ng stroke, kailangan kakausapin ko ang buong pamilya... ang risk factor ng stroke, most of the time is modifiable. Puwedeng kontrolin, puwedeng pigilin," he said. 

 

He suggested engaging in NEAT: non-exercise activity thermogenesis, like using the stairs. "Just by doing that you're building up heat in your body and that already exercises your heart," he said. –KG, GMA News