For years, men have voiced frustration when their medical providers insisted on a cardiac workup prior to initiating an ED prescription. Some thought it was because they’d have a heart attack during sex. But it’s not. Erectile dysfunction is a vascular issue, and if the vessels of the penis are compromised, how does one know his heart vessels aren’t as well?
Now in a recent study from John Hopkins School of Medicine found an increase risk of stroke, heart attack and cardiac arrests in those men who suffered from erectile dysfunction. Study author, Michael Blaha, professor of Medicine, states, “Our findings suggest that clinicians should perform further targeted screening in men with erectile dysfunction, regardless of other cardiac risk factors and should consider managing any other risk factors — such as high blood pressure or cholesterol — that much more aggressively.”
Last December, a study published in the Journal of Vascular Medicine, found the same risk factors leading to erectile dysfunction are also culprits in heart disease.
Risk factors shared by both erectile dysfunction and heart disease include:
Last year, researchers from Mount Sinai Medical Center, Florida International University and Baptist Health South Florida reviewed multiple studies and found a link between erectile dysfunction and compromised blood vessels whose endothelium (lining) demonstrated impaired vessel relaxation. This is necessary for both erections as well as blood flow to the heart and rest of the body.
Moreover carotid media-intima thickness, a marker of atherosclerosis, appeared to be correlated to erectile dysfunction as well.
Both studies remind us that if one bodily function is impaired, other organs may be quietly suffering the same impairment.
I like to credit the pharmaceutical companies that created erectile dysfunction drugs with saving millions of men’s lives as:
Young men aren’t immune to cardiovascular disease and need to be screened as well if they have issues starting or maintaining erections.
Each year 45,000 Americans take their lives. That averages to 123 people a day. And each suicide affects everyone with whom the person has regular encounters. So why is it so common? Here are six reasons people choose to end their life.
Many of us have been trained to act on a whim. We quickly reply to a text, pop some food in the microwave, flick the controller while playing a video game…and these quick, instinctive acts are becoming a part of our daily behavior. So when one has a fleeting thought of suicide, they may be less likely to slow down and think it through.
When tragedy strikes, whether it be an accident, break up, job loss, missed opportunity, some can’t see “the light at the end of the tunnel.” Many think and navigate through life one step at a time, which may be productive when it comes to tackling tasks, but if they feel the obstacle in front of them is insurmountable they may believe their options are far and few between, with death being the only out.
This is one of the least discussed reasons people commit suicide, but unfortunately more common than we think. Although most of us fear death and dying, some pathologically can’t handle the thought of it happening out of the blue. Those who need control and need to plan ahead, may find solace in the fact that they are planning their own death. They can’t control their birth but they can control their death, they believe, and for those who feel they have lost control of their life may find this tragic option welcoming.
Hollywood stereotypes depression as a woman sitting on a couch eating ice cream to combat the tears and loneliness of a breakup. But many have symptoms of severe depression and don’t know it.
So many self medicate either by overeating, drinking alcohol, smoking weed, or taking pills, which when wears off, can sink one into a lower funk. Without psychological or medical intervention, one struggles to recover.
Since so many people are undiagnosed when it comes to depression, family members and friends are unaware their loved one is struggling. Going about one’s business may be inferred as indifference by someone suffering from a mood disorder. “They won’t even notice I’m gone,” pervades their thoughts and worsens their loneliness.
If one feels they’ve been ignored, unheard or wronged, this could incite an “I’ll show ’em” attitude in which their suicide is plotted to be a form of psychological revenge.
Sadly many out there secretly hope they get help but don’t know how to ask for it. It’s up to us to seek them out and guide them to a medical professional who can listen, understand, and work with them.
We commonly think of DUI’s, or Driving Under the Influence, a result of drinking alcohol and driving while intoxicated. However what many people fail to realize is drugs, including prescriptions, could decrease your ability to drive safely, hence putting you at risk for a DUI when alcohol wasn’t even ingested.
A report from the Governors Highway Safety Association (GHSA) and the Foundation for Advancing Alcohol Responsibility found that more fatal crashes were the result of drug use as opposed to alcohol use.
These findings showed that although alcohol was involved in 38% of fatal crashes, prescriptions and illegal drugs were responsible for 44% of driver- related deaths (similar to last year’s findings of 37% and 43% respectively).
Looking deeper they found 58 % of drug related fatal car crashes were the result of marijuana, opioids or both being on board.
According to their report, entitled, Drug-Impaired Driving: Marijuana and Opioids Raise Critical Issues for States, “44% of fatally-injured drivers with known results tested positive for drugs, up from 28% just 10 years prior.”
Opioid overdose is currently responsible for 115 deaths per day. And as marijuana becomes legalized throughout the country, more people run the risk of being on a combination of the two, which can be deadly if they get behind the wheel.
“Drugged driving” manifests in less reaction time, poor coordination, memory loss, and distortion of one’s reality or surroundings.
Now what about prescription drugs? California Vehicle Code 23152(e) states, “It is unlawful for a person who is under the influence of any drug to drive a vehicle.”
So what prescription drugs could impair one’s driving?
The obvious ones include the following:
Narcotics such as hydrocodone, oxycodone, morphine, codeine…to name a few
Muscle relaxants such as carisoprodol, cyclobenzaprine, methocarbamol……
Sleep aids such as zolpidem, eszopiclone….
Anti-anxiety medications such as diazepam, lorazepam, alprazolam, clonazepam…..
However surprisingly, these next groups of medications can also cause sedation:
Cholesterol medications such as statins: lovastatin, atorvastatin, etc. may cause fatigue and recent studies have found them to cause “excessive tiredness”.
Stomach acid suppressants such as proton pump inhibitors: omeprazole, lansoprazole have been reported to cause vitamin deficiencies such as B12 and magnesium which in turn can cause fatigue.
Antibiotics that treat many common infections: Amoxicillin, azithromycin, ciprofloxacin have been known to cause fatigue.
Diuretics for blood pressure and water retention: hydrochlorothiazide, furosemide cause potassium loss in the urine which may contribute to fatigue
Antihistamines: anti-allergy medications such as diphenhydramine (Benadryl) are very sedating, which is why they are used in some over the counter sleep aids. There are some reports that the younger generation of medications such as Zyrtec can cause drowsiness as well.
Blood pressure medications: these can include the ACE inhibitors such as captopril, enalapril; calcium channel blockers such as amlodipine; beta blockers such as metoprolol as well as the diuretic family mentioned previously.
Antidepressants: many antidepressants additionally help with anxiety through their sedating effects such as trazodone, paroxetine, and escitalopram to name a few.
Mood stabilizers, anti-seizure medications, and antipsychotics can cause fatigue as well.
Despite the rarity of these types of cases, the potential is still there for one to not only receive a DUI but injure himself or others if the prescription makes him less alert, i.e. decreases his “sobriety.” Discuss with your medical provider if you feel drowsy after you take your medication and if there are less sedating options.
Roseanne Barr in, an apology for a tweet in which she alluded to ex-Obama aide, Valerie Jarret, looking as if the “muslim brotherhood & planet of the apes had a baby=vj” cited Ambien as the cause.
ABC News cancelled her hit show Roseanne on Tuesday.
In an apology, the actress tweeted, “I apologize to Valerie Jarrett and to all Americans. I am truly sorry for making a bad joke about her politics and her looks. I should have known better. Forgive me-my joke was in bad taste.”
She later tweeted, “I did something unforgivable so do not defend me. It was 2 in the morning and I was ambien tweeting — it was memorial day too — i went 2 far & do not want it defended — it was egregious Indefensible. I made a mistake I wish I hadn’t but…don’t defend it please.” CNN reports she also tweeted the following, “Not giving excuses for what I did(tweeted) but I’ve done weird stuff while on ambien — cracked eggs on the wall at 2am, etc.”
The makers of Ambien, Sanofi, tweeted the following response, “While all pharmaceutical treatments have side effects, racism is not a known side effect of any Sanofi medication.”
Millions of people use Ambien (zolpidem tartrate), a sedative hypnotic, in a 5 mg or 10 mg tablet form, that is used for fast-acting sleep initiation and is famous for not inducing a drowsy feeling the next morning.
Unfortunately multiple users have cited odd side effects such as driving to work in the middle of the night, or cooking breakfast.
According to rxlist.com, side effects of Ambien may include:
The medication is a gamma-aminobutyric acid (GABA) A agonist, inciting a neurotransmitter cascade that can inhibit activity between neurons, nerve cells. Lower levels of GABA are linked to sleep disorders, so inciting the GABA receptor as Ambien (zolpidem tartrate) does, can induce sleep. But once we’re affecting nerve signals other side effects may ensue since the GABA inhibitory neurotransmitter affects the central nervous system.
So odd behavior could be a side effect. However, as with alcohol-induced behavior, exacerbations of feelings or tendencies may occur. Forming new opinions, which may be racist, would not be a side effect of this medication.
Medical providers warn users to hide car keys, lock of refrigerators and put child locks on stoves and ovens as “sleep walking” behavior could put them and their families at risk. This also includes posting on social media… so keep phones away from the bed and computers off.
The University College London Hospital (UCLH) in Bloomsbury London is launching a pilot program replacing some A&E (Emergency Room) physicians with robots.
In response to staff shortages and long wait times, the initiative launched by UCLH and Alan Turing will utilize artificial intelligence to triage patients and reduce wait times.
Robotic technology is already being used in the operating room, rehabilitation centers and for pharmaceutical dispensing. It’s just a matter of time that they become our main caregiver.
But will patients be pleased?
Where’s there’s demand, there’s supply. Patients tired of wait times, crowded waiting rooms, loss of sick leave hours to sit around a medical office or emergency room for half a day will want speed and efficiency. Kiosks may replace front desk clerks, taking your initial information (chief complaint, name, insurance info.), scanning it and offering you a number, like one given at a bakery.
Those embarrassed by having symptoms suggestive of having an STD will have less of an issue conveying this information to a machine than a human being. Gas, discharge, odors may be easier to discuss with someone or something that won’t wince.
Many patients cite seeing a medical provider and not being examined or asked to undress before an exam. Time constraints, or avoidance of being accused of wrongdoing, have caused some providers to refer out for heart, gynecological, and rectal examinations. Primary care providers who enter the room, say a few words and then promptly leave saying they will “bring in the nurse to review instructions” may not be missed by the patient receiving similar service from a robot.
We use Google, Wikipedia and Siri to answer our health questions currently. No wait time, no office visit, no cost….so a robot answering our questions in layman’s terms will be an easy task.
However, and this is the kicker……
There is no way to replicate the sixth sense humans have when it comes to something being wrong with you. Artificial intelligence cannot provide a “gut feeling.”
Let’s take a urinary tract infection, for example. I have had patients who were new to my office complaining something “felt funny” when they urinated and cited blood in their urine. A urinalysis may show inflammatory cells, and a robot may correctly diagnose the patient with a bladder infection. But I as a clinician may be suspicious that this new patient has something that is leaking blood into the urine, from the gynecologic tract maybe? And I’ve diagnosed endometrial and cervical cancer in cases where patients thought they were merely having bladder infections.
One patient presented to me in the emergency room feeling “odd” and suspecting a “UTI.” She was in her 60’s and started to complain of nausea. Her urine had inflammatory cells so while a culture takes 3 days to complete, I gave her a prescription for antibiotics in case the infection would spread during that time. But her nausea was concerning. The patient requested an injection of nausea medication prior to leaving so I obliged, giving her Compazine. While observing her for a few minutes, post injection, she began to have shortness of breath. We decided to look at her heart and came to the conclusion after more testing that she had suffered a heart attack in her sleep the night before and the “odd feeling” she felt the next day wasn’t due to her UTI (which she coincidentally had) but was from a heart attack. She was treated immediately and recovered nicely.
Would a robot have picked up on that? Multiple web resources include nausea in the list of symptoms associated with a UTI, so could be “blown off” by a robot bundling it with the patient’s urinary complaints. But I learned that nausea could be the first sign of a heart attack, especially in women.
Another case I had as an urgent care physician was the following:
A gentlemen came in saying he “felt fine” but his wife made him come in because he was burping the night before. Multiple bouts of eructation jogged an ancient memory of mine…..when as a little girl I saw a movie where the pilot was burping multiple times before he passed out and died. So I came to learn that chronic bouts of burps, or hiccups for that matter, could be a sign of an inferior MI (heart attack). I ran an EKG and blood work, and my instinct was right. Again I was looking at a patient who unknowingly had a heart attack the night before but thought he had something benign the next day.
So gut instinct, thinking laterally, tapping in on past experience, and acting on hunches is not something a robot can do. Humans may be satisfied with shorter wait times and receiving antibiotics when they demand them, but the education and intervention a medical provider can provide is priceless. Too bad cost gets in the way of real medicine.
The National Weather Service will soon issue an “excessive heat warning” for many parts of the Southwest United States. Phoenix received their first warning two weeks ago when their temperatures rose to 108 degrees.
This occurs “within 12 hours of the onset of extremely dangerous heat conditions”. This means that the heat index (air temperature and humidity) will be greater than 105 degrees for more than three hours a day for at least two days in a row and the night-time temperatures will not drop below 75 degrees. Although many of us may live in areas where this occurs each year, the onset can be one of the most dangerous times. Symptoms such as heat cramps, heat exhaustion and heat stroke must be identified.
At first when one feels symptoms, it may come in the form of heat cramps. Heat cramps are painful spasms that occur in the muscles of the arms and legs and even abdomen. We believe that when one loses fluids and salts from excessive sweating, cramps ensue. It's important in these cases to get the person out of the heat, hydrate them with sips of fluid and electrolytes and massage the body parts affected.
If one does not leave the heat and come indoors, the next risky event that can occur is heat exhaustion. This worsens as the victim sweats profusely becoming more and more dehydrated. They could also have cramps but nausea may ensue, they may look pale and clammy and their heart rate will increase to try to compensate for the lost fluid. These individuals may become dizzy, weak and even faint. Immediately bring the person indoors, lie them down, elevate the feet, give sips of fluid, cool down the body applying cool and wet cloths to the underarms and body, and contact medical authorities if symptoms continue or worsen.
Heat stroke will occur if a vulnerable person does not get out of the heat in time. It is a medical emergency and can be fatal. If an individual has heat stroke 9-1-1 must be called immediately. Bring the victim indoors away from sunlight, lie them down, remove unnecessary clothing, cool their body with cold compresses and watch for signs of rapidly progressive heat stroke in which they have difficulty breathing, seize or lose consciousness. If they are unconscious you cannot give them fluids. Only if they are alert, awake and able to swallow will you be able to give fluids. Do not give medications to reduce the fever such as aspirin or acetaminophen since their body may not be able to metabolize them properly and this could make matters worse.
Young children and elderly individuals may have issues adjusting to the outside environment and may be more prone to dehydration. Those with medical conditions such as heart, lung, thyroid disease can be at risk as well. If you’ve ever suffered from heat stroke you can be vulnerable again. And many medications could make you susceptible such as diuretics, vasodilators and beta-blockers for blood pressure and antidepressants.
The biggest risk comes when we are unprepared. Having an unusual cool week prior to a heat warning could preclude many from taking proper precautions. Staying indoors, checking air conditioning and fan devices to make sure they work properly, wearing cooler clothing is just the beginning. Stocking up and planning to hydrate frequently is paramount because when death occurs to excessive heat, dehydration is the main culprit.
Bring your pets indoors, and watch your kids, friends and family members frequently. If they are beginning to succumb to the heat, they may be quiet and not be able to voice it.
Avoid drinking alcohol in the heat. It can dehydrate you more and worsen the situation.
Avoid excessive exercise when outdoors and make sure to make use of shady areas.
The summer and early fall offer exciting and fun ways to enjoy nature. Don’t let the heat get to you. Remember….if you can’t take the heat, get out of the…..well heat…….
Twenty five people have died, and 45 others are suspected to be infected with Ebola in the Democratic Republic of Congo (DRC). The World Health Organization (WHO) has confirmed and reported the outbreak of Ebola on May 8.
This latest outbreak began in villages near Bikoro. New cases later surfaced miles away in Mbandaka, an urban city with a reported population of 1.2 million, located along the banks of the Congo River.
Vaccination has begun with ZMapp, a treatment used in the 2014 outbreak that shows promise as a prophylactic measure.
Dr. Karen Duus, Associate Professor of Microbiology and Immunology at Touro University Nevada, explains, “The vaccine is a recombinant Ebola virus protein vaccine that causes a similar type of neutralizing antibody response (as the ZMapp treatment). The neutralizing antibodies coat the virus particle and keep it from binding to the target cells and infecting them.” Its efficacy, however has not been extensively tested.
The DRC had a small outbreak last year but it was contained within 42 days.
The West African Ebola epidemic spanned from the end of December 2013 to 2016 infecting over 28,000 people and killing over 11,300. The epidemic was one of the worst in Ebola’s history and its high mortality rate took countries such as Sierra Leone, Guinea, and Liberia by surprise. A vaccine was not available, and medications such as ZMapp were experimental and not in great supply. Hospitals were not stocked with protective clothing able to prevent the minutest of exposure to the deadly virus. Travel bans were difficult to institute and top that off with a lack of education on what we were dealing with and it was unfortunately the perfect storm for one of the deadliest outbreaks in recent history.
Ebola however emerged far before this. Ebola was named after the Ebola River in Zaire and was first recognized in 1976 when it caused two outbreaks affecting 318 and 284 people respectively. Multiple small outbreaks have occurred since then, according to the CDC:
1995 – Democratic Republic of Congo – infected 315
2000 – Uganda – infected 425
2007 – Democratic Republic of Congo – infected 264
And multiple smaller sporadic cases occurred in the years between.
In January 2016 health officials declared the Ebola outbreak had ended, however cases continued to smolder.
Why this occurs is the virus may not leave the body completely. Its been found to live in semen up to a year and some survivors can suffer a reinfection months later. For example, in 2015 Dr. Ian Crozier successfully fought Ebola but two months after discharge, suffered a severe eye infection which turned out to be Ebola lurking in his eye.
A study in 2015 found Ebola be able to survive outside a human body for days and longer if within a liquid such as water or blood. Mosquitoes are not known to transmit the virus however it can live in bats as well as monkeys and apes. Pets have not been known to contract Ebola from their sick owners but its been postulated that pigs could, if in contact with a victim.
Dr. Duus states that although the virus reservoirs are not clear, “people are most likely infected by butchering or eating infected animals.”
Ebola is a virus from the Flavivirus family that causes a hemorrhagic fever with symptoms of sudden fever, myalgias, headache and sore throat. It could then progress to nausea and vomiting, liver and kidney issues and internal and external bleeding, ultimately resulting in death in 90% of cases.
Thursday morning Hawaii’s Kilauea shot ash and smoke into the air and blew a volcanic cloud that could reach 30,000 feet into the sky. The volcano has been spewing lava for weeks, prompting thousands of nearby residents to evacuate. Volcanic ash can prompt a multitude of health risks…not only from a particulate standpoint but also from the sulfur dioxide levels. Sulfur dioxide is a colorless, though stinky gas that can cause irritation to skin, eyes, and respiratory system linings.
Let’s break these health risks down:
Volcanic ash can irritate the respiratory passages causing the following symptoms:
Those with asthma, COPD, chronic bronchitis or other respiratory ailments may find themselves having exacerbations of their symptoms. Oxygen requirements will increase. Those requiring oxygen or inhalers will need to have extra supply during this time (medical offices may be closed during ash clean up so don’t wait until the last minute.)
Volcanic ash has large and small particles that can irritate the eyes increasing their sensitivity to light and making vision difficult. Moreover ash can irritate the cornea and conjunctiva causing redness, discharge and itching.
Skin may become irritated during these times and those with skin allergies or eczema may find themselves having flare-ups.
During a volcanic eruption, smoke plumes not only change the air quality but also visibility. During times of day when there is less light, road visibility obscures pedestrians and nearby cars. Drivers are urged to avoid the road during these smoky times.
Water quality can become affected by the ash or pH changes if supply becomes contaminated. Moreover, water use increases for cleanup so shortages may ensue.
Those who donate blood in nearby areas may be less likely to donate during this difficult time leading to local blood shortages. Those who can donate blood are urged to contact the American Red Cross, United Blood Services, or Blood Bank of Hawaii.
May is Skin Cancer Awareness Month as 5 million cases of skin cancer are diagnosed each year in the United States. This week, Consumer Reports released its 2018 Annual Sunscreen Guide on the best sunscreens to offer protection against UV (ultraviolet) rays. They looked at 73 various sunscreen lotions, sprays and sticks, which touted 80 minutes water resistance and an SPF of 30.
The top 5 sunscreens reported are:
La Roche-Posay Anthelios 60 Melt-In Sunscreen Milk, $36 (lotion)
Equate (Walmart) Sport Lotion SPF 50, $5.00 (lotion)
BullFrog Land Sport Quik Gel SPF 50, $8.50 (lotion)
Coppertone WaterBabies SPF 50 Lotion, $9 (lotion)
Trader Joe’s SPF 50+, $6 (spray)
Sunscreens use chemicals to disperse or absorb UV rays. Inorganic compounds in sunscreen such a titanium dioxide or zinc oxide attempt to scatter the UV rays. Organic compounds such as PABA and oxybenzone attempt to absorb UV rays so they can’t damage the skin.
UVA rays penetrate deeply into both the epidermis and dermis. They can cause premature aging of the skin, wrinkles, and skin cancer.
UVB rays are shorter and primarily affect the epidermis. They are responsible for causing sunburns as well as skin cancer.
SPF stands for Sun Protection Factor. The higher the SPF, the less sun photons enter the skin and cause damage. SPF primarily measures the protection against UVB rays. We multiply the SPF factor by how long it takes one’s skin to burn by the SPF number to determine the protection factor.
In theory, an SPF of 30 suggests your skin, if it burns within 10 minutes without protection, will not burn until 300 minutes has lapsed (30 times 10). However, we find this isn’t always the case. People sweat or swim and the sunscreen dissipates. Moreover many don’t put on the proper amounts (see below.)
So instead we use SPF as a grade to how much protection the product can offer.
An SPF of 15 blocks 93% of UVB rays
An SPF of 30 blocks 97% of UVB rays
An SPF of 50 blocks 98% of UVB rays
As we see, the relationship is not linear, however the higher the SPF, the more protection we have against UV rays.
Although the SPF alludes to protection against burning, hence UVB rays, a sunscreen may still protect against both UVA rays and UVB rays if it’s a broad spectrum sunscreen.
At least one in three adults has high blood pressure and strokes are the 5th leading cause of death in the United States.
In May we raise awareness of both these conditions during American Stroke Monthand National High Blood Pressure Education Month.
Every 40 seconds, someone in the United States suffers a stroke. And high blood pressure puts one at risk of a stroke, as well as heart disease.
Here are your questions answered.
The top number, or systolic pressure, is the pressure the heart exudes during a beat or pumping of the blood.
Diastolic pressure is the pressure in your arteries between beats while the heart is “filling.”
Both numbers are equally important as elevation of either can increase one’s risk of cardiovascular disease.
High blood pressure has now been redefined as being greater than 130/80 mmHg, down from 140/90 mmHg. Last year it was guestimated that 42% of Americans would soon be considered “hypertensive.”
Chronic high blood pressure can be dangerous. It may cause:
The stages of blood pressure are defined in the chart above. At the elevated or early stages of high blood pressure the following lifestyle changes will be recommended:
As a family physician I would also screen for diabetes, high cholesterol, low thyroid, kidney disease and sleep apnea.
If blood pressure cannot be controlled and continues to rise, medications may be prescribed to decrease blood volume, or lower the heart rate, or relax the blood vessels.
A stroke occurs when an area of the brain does not get the proper oxygen and blood flow it needs. There are two major types of stroke: ischemic and hemorrhagic.
Ischemic strokes are more common than the latter and occur when a clot prevents blood flow to part of the brain. 80% of all strokes fall under ischemic. It is a likened to a heart attack, except the brain tissue is being deprived of blood and nutrients. Plaques commonly arise from arteriosclerosis that break off travel to the smaller vessels of the brain.
Hemorrhagic strokes are less common and occur when there is a bleed of one of the brain vessels. The bleed prevents blood flow into the brain since it is seeping outside the brain tissue, causing damage to nearby cells. The bleeds could occur from high blood pressure or aneurysms that rupture.
What are the signs of a stroke?
Since a clot or bleed usually affect one area of the brain, we see symptoms on one side of the body, many times its contralateral (opposite) side. We can also see central effects. The symptoms of stroke include the following:
If the stroke was caused by a clot (ischemic) immediate treatment includes dissolving/removing the clot. Aspirin is used initially and if within the proper time frame, tissue plasminogen activator (TPA). These clots can also be surgically removed and arteries widened to bring blood flow to the brain.
With a hemorrhagic stroke, we need to stop the bleed and improve flow to the brain. Controlling the bleed, bypassing the vessel, “clogging” the aneurysm with techniques such as “coiling” (endovascular embolization) are sometimes utilized.
Time is of the essence, so it's crucial to identify the warning signs and call 911 immediately. The American Stroke Association uses the acronym “FAST” (Facial drooping, Arm weakness, Speech difficulty, and Time to call 911). The sooner a stroke victim receives medical attention the better the prognosis.
The following put us at risk of having a stroke.
Avoid the following: