Participants: Don Mackintosh (Host), Phil Mills
Series Code: HFAL
Program Code: HFAL000211
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. 15:14 Are you confused about the endless 15:16 stream of new and often contradictory 15:18 health information with companies trying 15:20 to sell new drugs and special interest groups 15:23 paying for studies that spin the facts, 15:26 where can you find a common sense 15:27 approach to health. One way is to ask for 15:30 your free copy of Dr. Arnott's 24 realistic 15:33 ways to improve your health. Dr. Timothy 15:35 Arnott and the Lifestyle Center of 15:37 America produced this helpful booklet of 15:39 24 short practical health tips based on 15:42 scientific research and the Bible, that will 15:44 help you live longer, happier and healthier. 15:47 For example, did you know that women 15:49 who drink more water lower the risk of heart attack. 15:52 Or the 7 to 8 of sleep a night can minimize 15:55 your risk of ever developing diabetes. 15:57 Find out how to lower your blood pressure 15:59 and much more if you're looking for 16:01 help not hike, then this booklet is for you. 16:03 Just log on to 3abn.org and click on 16:06 free offers or call us during regular 16:08 business hours, you'll be glad you did. 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. |
Revised 2014-12-17