Time Is Of The Essence

After all of these years doing this column (since 1995), I have never missed a deadline – until last month. Like most of us, I am somewhat of a procrastinator. I organize my thoughts and time against a fixed date, usually working up to that deadline. Last month was different, and the consequences and results are what I would like to share with you. This month, I will stray off of the subject of insurance and talk instead about a life-changing event that happened to me.

I think all of us treat each day as it comes, without any thought of accidents or illness. Accidents happen, and the accident itself dictates what actions have to be taken to resolve the outcome. But, very different from an accident, is a life-threatening medical emergency or illness. Believe me, even at my age, I never gave such things as a heart attack or stroke any concern. My major concerns were such things as falling off of the roof, loosing a finger or torching myself while welding some project that I have going. Last month was different.

It was eleven o’clock in the evening. While watching television, I suddenly lost all of the feeling on my right side, as well the ability to talk. Fortunately, I live with a lady that knew what was going on and reacted quickly and efficiently to the problem. Within thirty minutes she had me at the hospital. Within 45 minutes I had a CAT scan and was being prepared for TPA therapy (this will be talked about later). I now realize the utmost importance of reaction time when having a stroke.

The following is what I researched and found out about strokes. It is information that everyone should be aware of. Do not ignore any symptom that is strange or different. Reaction time is the single most important component of treatment and a successful recovery. Strokes and heart attacks fall into the same category in regards to the importance of timing during the event. Now keep in mind, I am not overweight, I have low blood pressure, my cholesterol levels are normal, I do not smoke and I do not have a cardiovascular disease. Strokes fall into three categories – of these, 87 percent are ischemic, 10 percent are intracerebral hemorrhage and 3 percent are subarachnoid hemorrhage.

Strokes are the third leading cause of death in the United States. Over 140,000 people die each year from strokes. Strokes are the leading cause of serious, long-term disability. Each year, 795,000 people suffer a stroke. Of these, 600,000 are first attacks and 195,000 are recurrent attacks. The risk of having a stroke more than doubles each decade after the age of 55. Each year, about 55,000 more women than men have a stroke. Men’s stroke incidence rates are greater than women’s at younger ages, but not at older ages. The risk of an ischemic stroke in smokers is about double that of nonsmokers. Strokes account for about one of every 17 deaths in the United States. Strokes can occur at any age. Nearly one quarter of strokes occur in people under the age of 65. Stroke death rates are higher for African Americans than whites, even at younger ages. High blood pressure is the most dominant risk factor for a stroke.

87 percent of strokes are ischemic. Basically, this is caused by a blood clot or clots that block an artery where they are formed or can dislodge and become trapped in arteries closer to or in the brain. Another cause of a stroke is blood clots in the heart. Within 45 minutes I was plumbed and had a CAT scan (one of three plus an MRI over the next two days). At that point, since there was no bleeding, I became a candidate for “Tissue Plasminogen Activator” (TPA) therapy.

TPA therapy is nothing more than a blood clot blaster. Protocol guidelines require its use intravenously within the first three hours of the event, after which its detriments may outweigh the benefits. There is a risk of hemorrhage with its use and the attending doctors outlined the possible pitfalls of the therapy to me. Only about 3 percent of patients qualify for this treatment, since most patients do not seek medical assistance quickly enough. If there are any signs of bleeding, you are not a candidate for TPA. This is the one thing that I really want to stress – time is against you – so make sure that you and those that you love around you are prepared to react and respond quickly. If you have a stroke, you might not be able to respond at all on your own.

An intracerebral hemorrhage occurs when a diseased blood vessel within the brain bursts. The most common cause of this type of stroke is high blood pressure (hypertension). Less common causes include trauma, infections, tumors, blood clotting deficiencies and abnormalities in the blood vessels. Treatments for an intracerebral hemorrhage type of stroke include medical hyperventilation, surgery and/or medicines.

Subarachnoid hemorrhage is bleeding in the area between the brain and the thin tissues that cover the brain. Subarachnoid hemorrhage is often seen in the elderly who have fallen and hit their head. Among the young, the most common injury leading to subarachnoid hemorrhage is motor vehicle crashes. “Head Trauma” treatments include surgery that may involve Craniotomy or Endovascular Coiling, draining of the brain, life-support and medicines.

Smoking is a major factor that contributes to cardiovascular disease, so if you smoke, you should quit. Excessive weight can also contribute to your risks, so if you need to lose a few pounds, do so. Your life may depend on it! Remember, time is of the essence, so do not wait to get treatment if you begin to experience any of the symptoms discussed here or anything else abnormal. I am glad to be alive and recovering well. If you have any comments or questions, I can be contacted through California Plus Insurance Service, Inc. in Modesto, CA at 1-800-699-7101.

~ On a final note, when preparing this page for print, we found a stroke awareness campaign poster online that outlined the easy-to-remember acronym FAST (Face, Arms, Speech, Time) for quick home diagnosis of a stroke. Face: has their face fallen on one side and can they smile? Arms: can they raise both arms and keep them there? Speech: is their speech slurred? Time: time to call 911 if you see any of these signs. 10-4!

About Roland L. Enz

Roland L. Enz has specialized in insurance for the truck and transportation industry for over 30 years and he has written exclusively for 10-4 Magazine since 1995. Roland is currently the president of California Plus Insurance Service, Inc. in Modesto, California.