Health for a Lifetime

Different Strokes For Different Folks

Three Angels Broadcasting Network

Program transcript

Participants: Don Mackintosh, Phil Mils

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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.
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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.


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Revised 2014-12-17