Judd Matsunaga
Growing up in Crenshaw Square in the 1960s, Halloween was a huge holiday. Mom would walk us around the neighborhood, and we’d fill our bags with candy. My brother and I would always spend the following days enjoying our favorites. My sister would save all her favorites and eat her “not-so-favorites” first. In two weeks, my brother and I would be all out of the good stuff. So, my sister would then proudly take out her stash and open her favorite. It was rotten. Good times!
Today, however, as a senior citizen, Halloween is no longer a top holiday for me. Still, Halloween ranks as the second-largest commercial holiday in the U.S. for retail spending on candy, costumes and decorations, trailing only behind Christmas.
So, October is a month retailers use to market Halloween, i.e., the scariest time of the year.
Ghosts, goblins and ghouls — scary? Yes, and perhaps “no.” The purpose of this Pacific Citizen article is to discuss what I think is really scary: strokes. A stroke is a much-feared medical emergency, and rightly so. According to the experts at Harvard Medical School, strokes are the fifth-leading cause of death in the U.S. and a significant cause of disability.
Someone in the U.S. has a stroke every 40 seconds, and someone dies of a stroke every 3.5 minutes, amounting to nearly 795,000 strokes and 133,000 deaths annually (source: Harvard Medical School Special Report — Strokes). Unfortunately, while some strokes are preventable, many are not, so part of this report is devoted to helping you recognize the early signs of a stroke so that you can get treatment as rapidly as possible.
Let’s start with “What is a stroke?” A stroke, sometimes called a brain attack, occurs when something blocks blood supply to part of the brain or when a blood vessel in the brain bursts. The brain controls our movements, stores our memories and is the source of our thoughts, emotions and language. The brain also controls many functions of the body, like breathing and digestion.
To work properly, your brain needs oxygen. Your arteries deliver oxygen-rich blood to all parts of your brain. If something happens to block the flow of blood, brain cells start to die within minutes because they can’t get oxygen. This causes a stroke. In either case, parts of the brain become damaged or die. A stroke can cause lasting brain damage, long-term disability or even death.
The odds of having a stroke more than double every 10 years after age 55. More than two-thirds of strokes involve people over age 65, and 88 percent of deaths from stroke are in that age group. But recently, stroke rates among young and middle-aged men and women have been rising, too, as risk factors like obesity, diabetes and high blood pressure have increased in younger populations.
You might think that strokes happen mostly to men. Not true. Each year, more women than men have strokes, and women are more likely to die from a stroke. Also, if someone in your immediate family has had a stroke, your risk is about 30 percent higher than it would be otherwise. Having a parent who had a stroke before age 65 triples your risk. Genetic factors can influence the potential for blood to clot abnormally, as well as other medical problems that affect your stroke risk.
But genes might not be the only culprit. In addition to sharing many genes, relatives may also share eating habits and other behaviors that can promote strokes. If you have a strong family history of strokes, talk with your doctor about preventive measures. Fortunately, you can take steps to reduce other risk factors for strokes by managing medical conditions and behaviors that increase your risk.
A temporary blockage of blood flow to the brain, known as a transient ischemic attack (TIA), can cause a range of unsettling symptoms, including slurred speech or arm weakness. The symptoms appear suddenly but usually last less than five minutes, which is why TIAs are often ignored or missed. Although TIAs are often referred to as “ministrokes,” the term “warning stroke” is actually more accurate. A TIA can be a harbinger of a future stroke, which has similar symptoms but can leave you permanently disabled.
Whether you’ve already had a ministroke or a major stroke or have been warned that your high blood pressure might cause a future stroke, your best defense is to make sure you know how to prevent a stroke and how to recognize one so that you can get treatment right away. Whether or not you’re in a high-risk category, you should learn the following warning signs and symptoms of a stroke:
- weakness in an arm, hand or leg
- numbness on one side of the body
- sudden difficulty speaking
- inability to understand what someone is saying
- sudden dimness or loss of vision, particularly in one eye
- dizziness or loss of balance
- sudden, lasting, excruciating headache
A decade ago, the American Stroke Assn. unveiled a stroke awareness campaign based on the mnemonic FAST. The first three letters (which stand for Face, Arm and Speech) cover the most typical symptoms people experience. But growing evidence suggests that adding two more letters (B for balance and E for eyes) may help people better recognize either a TIA or an actual stroke. Here are some additional details about each symptom.
“F” — Face. The face can droop on one or both sides during a TIA or stroke. Usually, the corner of the mouth appears pulled down, and the person isn’t able to smile. Drooping of the eyes and forehead is less common.
“A” — Arm or leg weakness. This symptom tends to affect arms more often than legs and usually occurs on only one side. People may describe the feeling as numbness or tingling rather than weakness. Sometimes, the entire side of the body is affected.
“S” — Speech difficulty. Slurred or garbled speech is the most common presentation. But in some cases, people struggle to find words or aren’t able to understand what other people are saying. This deficit also extends to writing and typing — including texting on a smartphone.
“T” — Timing. The final letter (T for time) underscores the importance of getting to an emergency room for an assessment as soon as possible, even if your symptoms have disappeared. Timing is crucial. Don’t make the mistake of going to the eye doctor first instead of going to the emergency room. As stroke experts often say, summarizing this urgency, “Time is brain.”
“B” — Balance. This symptom can be tricky because many other things can cause dizziness or balance issues, including low blood sugar or inner ear problems. Balance problems caused by a TIA often make it difficult to stand up, and you may fall to one side. This symptom is often accompanied by other symptoms, including slurred speech or vision problems.
“E” — Eyes. Vision problems can manifest in different ways, though the most common is not being able to see from one or both eyes. Often, people describe the experience as seeing a dark gray shade that blocks half or all their vision. Blurred or double vision can also occur.
Judd Matsunaga is the founding attorney of Elder Law Services of California, a law firm that specializes in Medi-Cal Planning, Estate Planning and Probate. He can be contacted at (310) 348-2995 or. The opinions expressed in this article are the author’s own and do not necessarily reflect the view of the Pacific Citizen or constitute legal or tax advice and should not be treated as such.
Past “Legal-Ease” columns may be viewed here.