Guest Post, Health, Heart Health

About Stroke

By Aparna Mani, MD, PhD
MGH Medical Walk-In Unit

Aparna Mani, MD, PhD

It’s thought that the medical term stroke comes from ancient Greek for ‘struck down’. This meaning makes sense when you think of what happens when someone suffers the symptoms of a stroke. They may experience sudden weakness, numbness or paralysis of the face, arms or legs, a sudden loss of vision, difficulty speaking or an inability to understand speech.  Our brains are responsible for all of these specialized, unique functions. Blood vessels carry oxygen-rich blood and glucose to the brain cells, powering them to do this work. With a stroke, there is a sudden block in the flow of blood through the arteries that supply blood to the brain. 

This sudden ‘block’ in flow most commonly happens due to a clot getting stuck in an artery, or bleeding of the artery itself. When this happens, the blood flow is interrupted, and the cells in the affected area of the brain don’t get the oxygen and glucose that they need to function. If the blockage clears and blood flow resumes within a very short period of time, the patient may have had a transient ischemic attack (TIA) or ‘mini-stroke. If, however, blood flow does not resume for a longer period of time, the brain cells will start to die. A person suffering a stroke will show symptoms based on the specific portion of the brain that has bad blood flow.  Emergency care is required for both strokes and TIAs.  Doctors may use a CT scan or MRI to get an image of the brain to assess someone who has symptoms of a stroke. Depending on the time that has elapsed since symptoms began, doctors may be able to intervene and restore good blood flow to the brain. 

Risk factors for stroke include high blood pressure, smoking, high cholesterol, family history of stroke, age, obesity and diabetes.  Stroke prevention begins with a discussion of your personal risk factors with your doctor. By recognizing these personal risk factors you and your doctor can come up with strategies for lifestyle changes and medications to reduce your risk for stroke. 

Strokes can have serious consequences and can lead to permanent brain damage, long-term disability and death. In fact, Strokes are one of the leading causes of death in the United States today.  Know the signs:  watch out for sudden weakness, numbness, paralysis, and difficulty with speech or vision.   If you or someone you know has any symptoms of a stroke, Call 9-1-1 immediately.  With fast treatment, it may be possible to avoid the long-term consequences of a stroke.  Remember, time is of the essence and every minute counts.

Aparna recently finished an internal medicine residency at Mass General and sees patients at the hospital’s Medical Walk-In Unit.
Health, Heart Health

FYI: BMI

Scale. Photo Credit: Victor Maltby

We use a lot of acronyms and abbreviations in our modern world.  LOL—laugh out loud; ASAP—as soon as possible; TTFN—ta ta for now.  Here’s another one you may be familiar with:  BMI. 

Body Mass Index (BMI) is a simple calculation used to determine if a person’s weight is appropriate for their height and is a fairly reliable estimate of body fat for most adults. You can easily find your BMI using a calculator like this one from CDC.  A BMI between 18.5 and 24.9 is considered normal; anything below 18.5 is classified as underweight.  Along the same lines, a BMI between 25 and 29.9 is considered overweight and, taking it one step beyond, anything above 30 is considered obese.  Because there is a connection between weight and some chronic diseases, BMI is often used as a screening tool to identify potential risk for developing conditions such as hypertension, Type 2 Diabetes and stroke.  

However, BMI does have some limitations.  For starters, BMI is calculated using the total weight—meaning it doesn’t distinguish between body fat and other elements that contribute to a person’s weight (bones, organs, muscle, etc).  Since muscle weighs more than fat, it’s possible for someone with a muscular build and little body fat to fall in the “overweight” category.  Many professional athletes, for instance, have BMI in the overweight range because of the muscle they develop during training.  Secondly, BMI is a generalization.  Everyone is different and body composition varies by age and gender. 

The important thing to remember is BMI is a guideline and isn’t meant to be used to diagnose health risks.  However, regular exercise and a healthy diet can help you reach or maintain a healthy weight.  If you have questions about weight loss or BMI, you may want to talk to your health care provider or a registered dietitian.

(Post content reviewed by MGH Primary Care Physician.  Photo credit: Victor Maltby)

Heart Health, Nutrition

Hold the Salt

Salt and Pepper Shakers

Last week the USDA released the updated Dietary Guidelines for Americans for 2010.  In addition to limiting trans fats and eating more whole grains, fruits and vegetables, the new guidelines recommend people over 51 and those who have Diabetes or hypertension consume no more than 1,500 mg of sodium a day (that’s about a half a teaspoon).  Sodium—or salt— is a necessary nutrient for living; it balances water and electrolytes in cells, and helps nerves send messages to our muscles.  Most Americans consume much, much more than the recommended daily amount, and although we need some sodium in our diets to keep our bodies functioning, too much sodium can actually be harmful. 

High blood pressure (hypertension) is a medical condition where blood passes through blood vessels with too much force, forcing the heart to work harder to pump blood through the body.  Uncontrolled blood pressure can damage blood vessels which in turn can lead to serious heart complications such as heart attack and stroke.  So where does sodium fit in to this? Sodium attracts water; eating too much sodium can cause the body to hold on to water.  The extra fluid in the body puts pressure on blood vessels which in turn raises blood pressure.  

Some foods are natural sources of sodium, for instance dairy, meat and bread (salt works with yeast to make bread rise) and of course salt is added to many foods during the cooking process and at the table right before eating.  The greatest source of sodium in our diets, however, comes from packaged and processed foods where salt is used to preserve shelf-life and add flavor.  To get an idea of the sodium in food, check out this page which lists sodium content in many popular grocery store and restaurant items.    

When in doubt, check the Nutrition Facts on the back of the package; it’ll say how much sodium is in each serving.  Even foods whose packaging saying it’s “healthy” (like some brands of frozen dinners and canned soups) contain large amounts of sodium.  Whenever possible, opt for fresh foods over deli meat and packaged meals.  Try using dried spices and herbs for a low-sodium way to add flavor to a meal. 

What do you think about the new recommendations?  Do you think cutting back on the sodium in your diet will be difficult?

(Information reviewed by MGH Cardiologist and  Nutrition Department)