Positive Aging: Stroke 101

I never run out of ideas for my column because the topic of positive aging covers so many aspects of life. But every now and then, I can't help but feel that the universe is nudging me to address a particular topic. The reason I've decided to explore strokes this month is I've recently had five different stroke encounters.

The topic first came to my attention when one of the smartest and most powerful men I know experienced a series of TIAs, or transient ischemic attacks, otherwise known as mini-strokes. The second nudge came when an elderly woman I know was recently hospitalized with a stroke. It left her still looking beautiful, and able to walk and drive just as before, but with enough anomia (difficulty finding words, naming objects or describing pictures) that it was practically impossible to communicate with her. The third event involved one of my writing students, a young man in his 20s, who suffered a stroke immediately following surgery. He endured four years of physical therapy and now walks with a pronounced limp, but he managed to graduate from college this past week even though all the experts felt that the effect of his stroke would render that dream impossible.

Then, while my husband and I were watching an episode of "Grace and Frankie," Frankie, played by Lily Tomlin, suffered a mild stroke. Because of that incident, earlier plotlines were altered; treatment techniques were discussed by those close to her; and lifestyle choices had to be closely reexamined.

As you can see, the prevalence and variety of strokes that were on my mind were increasing. To top it all off, I was lucky enough to meet Diane Ackerman, the author of "The Zookeeper's Wife," just before the movie based on her book was released. She told me about her husband's stroke, which had become the topic of one of her earlier books, "One Hundred Names for Love." He, an English professor who has written dozens of books, suffered a stroke that left him with global aphasia, which meant that he lost most of his ability to speak and understand language.

These experiences prompted me to learn more about this medical event. Essentially, a stroke occurs when part of the brain loses oxygen. During every minute without oxygen, the affected part of the brain loses 1.9 million neurons, 14 billion synapses and 7.5 miles of protective fibers. It is a really serious medical emergency. Some of the initial symptoms include balance problems, changes in or loss of vision, confusion, difficulty speaking, nausea or vomiting, numbness, severe headache, tingling and trouble understanding speech.

If you think someone might be having a stroke, here are the four most obvious signs that indicate medical help is needed, which form the acronym FAST:

-- Face drooping.

-- Arm weakness.

-- Speech difficulty.

-- Time to call 911.

According to the latest statistics from the Centers for Disease Control and Prevention, strokes kill more than 130,000 Americans each year — one every four minutes. That means that 1 out of every 20 deaths in our country is the result of a stroke. Fortunately, not every stroke is fatal. But it can lead to death or a wide range of permanent disabilities. Overall, the most common risk factors that can contribute to having a stroke are:

— Diabetes.

— High blood pressure.

— High cholesterol.

— Increasing Age.

— Smoking.

Additionally, heart conditions like atrial fibrillation or heart valve disease can potentially cause a stroke. Unfortunately, two-thirds of Americans have at least one of the above-listed conditions or habits, which can't help but affect our national health care costs. Strokes are estimated to cost the U.S. about $33 billion each year. This figure includes the cost of health care services, stroke medications and missed days of work.

Every year, more than 795,000 people in the U.S. have a stroke. One happens every 40 seconds. For about 610,000 of those individuals, it is their first stroke. The remaining individuals, which is about 1 in 4, happen to people who have already suffered a stroke. The vast majority of strokes occur in people over 65 years old.

For people who are 45 and younger, the risk of having a stroke drops to 1 in 1,000, but there are caveats to that much-lowered risk level. There has actually been a steep increase in strokes among people in their 30s and 40s, in part because of a sharp rise in risk factors like abnormal blood clotting, diabetes, high blood pressure, obesity, sleep apnea and smoking. Additionally, alcohol abuse, illicit drugs (amphetamines, cocaine, etc.), genetic predisposition to strokes and a ruptured aneurysm have been cited as contributing factors. For females, oral contraception have been known to raise the risk of blood clotting, which can cause a stroke. And, for some mysterious reason, regardless of age, migraine sufferers also seem to have an increased risk of stroke.

One of the problems for younger stroke victims, according to a study by doctors at the Wayne State University Comprehensive Stroke Program, was that they were often given a misdiagnosis (like a possible inner ear disorder, intoxication, migraine, seizure, vertigo or other problem) and sent home. This can have serious repercussions because the optimum time for stroke diagnosis and treatment is as short as three to four hours after the onset of symptoms. The standard treatment during the narrow window of time after diagnosis involves thrombolytic therapy, which relies on the tissue plasminogen activator drug that has the ability to dissolve a patient's artery-blocking clot in the brain.

The three major types of stroke that need to be addressed are TIAs, or mini-strokes, which are short-lived episodes that usually resolve within 24 hours. They are a temporary impairment of brain function caused by a loss of blood supply, as opposed to the much more serious ischemic stroke, where part of the brain loses blood flow, or hemorrhagic stroke, where bleeding occurs within the brain.

Again, if you think someone might be having a stroke, just remember the acronym "FAST."

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Marilyn Murray Willison has had a varied career as a six-time nonfiction author, columnist, motivational speaker and journalist in both the U.K. and the U.S. She is the author of The Self-Empowered Woman blog and the award-winning memoir "One Woman, Four Decades, Eight Wishes." She can be reached at www.marilynwillison.com. To find out more about Marilyn and read her past columns, please visit the Creators Syndicate webpage at www.creators.com.