How to prevent strokes and get in shape

The Healthy Woman Ladies Night Out event on Jan. 30 at Fallbrook Library was another well-attended program sponsored by Fallbrook Hospital. Dr. Christopher Toupin, M.D. presented “Stroke Awareness – Risk Factors, Prevention and Treatment,” while Danny Torgl, a trainer at Club Paradise, which hosted the event, talked about “Keeping in Shape.”

Toupin said that in the U.S., 700,000 people a year have a first or second stroke; more than 20 percent of those strokes are fatal. A stroke is an interruption of blood flow to the brain which causes tissue death. The location and type of stroke determines the kind and extent of the damage done.

Eighty-five percent of all strokes are ischemic, Toupin said, which is a decreased amount of blood flow somewhere in the brain. Causes of this kind of stroke include thrombosis, a blood clot that clogs a blood vessel; an embolism which is a clot that travels up from another part of the body; and stenosis, a narrowing of the arteries.

The other kind of stroke is hemorrhagic, which is caused by an artery leaking blood from a rupture or aneurysm. There are two types of hemorrhagic stroke. One is bleeding in the brain tissue and the other is bleeding between the brain and the thin tissue surrounding the brain.

A transient ischemic attack (TIA) is a mini-stroke which can be a warning of future strokes. Toupin said that TIA patients have a 33 percent chance of having a major stroke within a year and 10 to 15 percent of them will have one within three months. The symptoms of a TIA are temporary; damaged cells can be regenerated with rehabilitation and the symptoms go away.

According to Toupin, “Stroke is a potentially devastating condition. Some risks are not controllable... some are controllable.”

Non-modifiable risks are age (risk doubles each decade from age 55 to 85), gender (females are more likely to have strokes and more likely to die from them), ethnicity (people of African descent and Hispanics are at higher risk), and family history (relatives of stroke patients are also more likely to have a stroke).

There are modifiable risks that can be controlled. Cigarette smoking “causes damage to everything,” Toupin said, adding that it causes a twofold increase in the risk of having a stroke. Smokers are more likely to develop plaque buildup, thickened blood, and aneurysms.

High blood pressure increases the risk for stroke as does heart disease which can cause blood clots that break off and travel to the brain. Diabetics suffer more extensive damage if they have a stroke as their blood vessels are brittle. High cholesterol causes plaque buildup, narrowing the arteries and decreasing blood flow. Obesity cause all of those conditions and a threefold increase in stroke risk.

The signs of a stroke are sudden weakness or numbness, especially on one side of the body; sudden confusion; difficulty speaking and/or understanding; sudden dizziness and lack of coordination; sudden severe headache out of nowhere and trouble seeing out of one eye or both eyes.

If anyone suspects they or someone else is having a stroke, they should act FAST (face, arms, speech and time). Check for facial drooping by asking the person to smile; ask him or her to raise both arms at the same time and watch for one arm drifting; check for slurred or strange speech by asking the person to repeat a certain phrase. If any of these signs are present, one should act fast and call 911, noting the time of the symptom’s onset.

Some medications can halt the damage caused by a stroke, but only work within first three hours after the stroke occurs, which is why it is important to get help right away. The medicine does not help in the cases of hemorrhagic stroke.

To prevent strokes, Toupin recommended that smokers stop smoking, that everyone should engage in physical activity, eat properly, reduce excessive weight, control their blood pressure, cholesterol and blood sugar, limit alcohol (one drink per day) and take aspirin as advised to prevent clotting.

To help with local residents’ physical activity, Torgl said he travels an hour each way from San Diego to come to Fallbrook; he gets up at 4 a.m. to come here and doesn’t leave until 6 p.m. He said what he does for people includes prevention and rehabilitation, “It is about changing people’s lives.”

When it comes to general fitness, he said, “Eighty-five percent is nutrition and everything else is exercise.” In response to a question about belly fat, he said it is caused by diet and exercise won’t help. His advice was “don’t eat carbohydrates after 5 p.m.”

He also suggested eating every two to three hours to speed up one’s metabolism and explained that people lose weight in the face first, neck and shoulders, then legs and thighs. The middle of the body is the last place to lose weight. Even so, exercising can “transform your life.”

For more information on the Healthy Woman program, visit http://www.fallbrookhospital.com or call (760) 731-8143.