When it comes to a stroke, every minute is critical

DOWNEY - As a seemingly endless line of participants for Wednesday's Primary Stroke Prevention Seminar snaked outside the door and past the fountain at the Rio Hondo Event Center, a white-haired woman walking gingerly with a cane was slowly moving nearer to the ballroom, unaware that her life was about to be saved. She was one of more than 200 Downey-area residents who attended the second Primary Stroke Prevention Seminar to be offered free this year by the team of the RTH Stroke Foundation, Rancho Los Amigos Foundation, Rio Hondo Event Center and The Downey Patriot.

During the morning event, participants heard a compelling presentation on the causes of strokes and strategies to prevent them from Rancho Los Amigos National Rehabilitation Center's Amytis Towfighi, MD. Dr. Towfighi is Chair of Rancho's Neurology Department and Director of its Acute Neurology/Acute Stroke Unit. In addition, she is an Assistant Professor of Neurology at USC's Keck School of Medicine.

As one of the world's preeminent neurological researchers and physicians, Dr. Towfighi has spent her entire adult life working to reduce the incidence of stroke in underserved communities.

"Stroke is the number four cause of death and the leading cause of disability in the United States," she said. "Every year, about 800,000 Americans will suffer a stroke. That's one every 40 seconds." Dr. Towfighi said that strokes kill about 140,000 Americans each year. "That means that on average, someone dies of stroke every four minutes," she said. The doctor also pointed out that about 60 percent of stroke deaths occur in women and 40 percent in men.

"It's important for everyone to learn the warning signs of a stroke," Dr. Towfighi said. "It's critical to call 911 as soon as a stroke occurs, because there is a three-hour window from the time someone has a stroke to the time they can receive the clot-dissolving drug called tPA.

Dr. Towfighi said that every minute is critical, because a person loses more brain function each minute a stroke goes untreated. As the audience listened in rapt attention, she listed the five warning signs of stroke, including:

* Sudden numbness or weakness of the leg * Sudden confusion or trouble understanding * Sudden trouble seeing in one or both eyes * Sudden trouble walking, dizziness, loss of balance or coordination * Sudden severe headache with no known cause

"If you or someone you know has any of these symptoms, call 911 and tell the emergency operator you think someone is having a stroke," Dr. Towfighi said.

She emphasized that an easy and effective way for people to deal with a potential stroke is to remember the "FAST" acronym. "The 'F' stands for face drooping," she said. "If you believe someone may have had a stroke, first ask the person to smile. If one side of the face droops or appears numb, call 911 because it's likely they are having a stroke."

Dr. Towfighi pointed out that the "A" stands for arm weakness. "If one arm appears weak or numb, ask the person to raise both arms," she said. "If one arm drifts downward, they may be having a stroke. Call 911."

The 'S' stands for 'Speech Difficulty. "Is the person's speech slurred, are they unable to speak or are they hard to understand?" Dr. Towfighi asked. "Ask the person to repeat a simple sentence, such as 'the sky is blue'. If the person can't repeat the sentence correctly, or they have slurred speech, are unable to speak or hard to understand, they may be having a stroke. Call 911.

"The 'T' stands for time to call 911," Dr. Towfighi said. If the person shows any of these symptoms, or even if the symptoms go away, call 911 to help get them to the hospital immediately."

After she finished her wide-ranging presentation, Dr. Towfighi stayed at the seminar for nearly an hour, speaking individually to more than 30 attendees about their individual health issues and answering questions.

"Dr. Towfighi's dedication and her passion for caring for stroke patients is amazing," said RTH Stroke Foundation President Deborah Massaglia. "She delivered a very powerful message to those who attended today's seminar. It's hard to find a doctor who's as talented, as caring and as dedicated as Dr. Towfighi. She is simply remarkable."

In addition to hearing Dr. Towfighi, attendees also received free screenings for Abdominal Aortic Aneurysm (AAA) and blood pressure provided by the RTH Stroke Foundation, and cholesterol and blood glucose screenings administered by staff from the Los Angeles County Department of Health Services' Hubert H. Humphrey Comprehensive Health Center in Los Angeles. The total value of these screenings was estimated at approximately $100,000.

"The ultrasound AAA screening is especially important, because by the time symptoms are noticeable for Abdominal Aortic Aneurysm, it is usually too late to save the patient," Deborah said. "Each year, more than 15,000 Americans die from AAAs," she said.

Earlier this year, famed record producer Phil Ramone was killed by an Abdominal Aortic Aneurysm. Other notable deaths from AAA include scientist Albert Einstein, statesman Charles De Gaulle, country singer Conway Twitty and actors Lucille Ball, Harvey Korman, Walter Huston, George C. Scott, Jack Oakie and Betty Garrett.

But with early detection through ultrasound screenings, AAAs can be surgically repaired and lives can be saved. As the white-haired woman with the cane advanced to the table where she would be screened, she had no idea her life was about to change less than a minute later.

When the ultrasound detected a major aneurysm, Deborah went into action. "It's by far the largest aneurysm we have ever detected in 15 years of doing AAA screenings," she said. "But because we caught it at this stage, her life can be saved by surgery. Without this screening, she would have never known about life-threatening condition and she would surely have died."

Deborah spent more than a half hour with the white-haired woman, explaining her situation in detail and arranging immediate medical care for her.

For RTH Stroke Foundation Executive Director Guy Navarro, this life-saving portion of the day made the entire event worthwhile. "We accomplished our goal of primary stroke prevention today," he said. "Dr. Towfighi delivered a very important message about knowing what to do when a stroke occurs, and we did more than 500 screenings that provided important information about the health status of everyone who attended."

"We especially wish to thank Mark Shelton and the Rio Hondo Event Center for hosting this very important seminar that provided life-changing information for so many people today," he added.

Deborah said that in addition to the woman whose life was saved by her screening, there were many others whose screenings detected major issues. "We counseled more than 15 people about their high cholesterol levels and we had just as many with dangerously high blood glucose levels," she said. "We are very grateful to the Los Angeles County Department of Health Services for providing these very important screenings for the community."

She said that more than 10 percent of the attendees had very high blood pressure. "We saw many individuals with systolic blood pressure readings over 160, which is very dangerous." Systolic blood pressure is the pressure in the arteries when the heart beats and fills the arteries with blood. The ideal systolic pressure is 115 and the normal range extends up to 120. A reading between 120 and 139 is considered in the prehypertension range.

When blood pressure reaches 140 to 159, it is considered high blood pressure, known as Hypertension Stage 1 as defined by the American Heart Association. This requires medical lifestyle modifications and medical intervention, which usually includes blood pressure medication. Readings ranging from 160 to 179 indicate very high blood pressure, or Hypertension Stage 2, which requires more extensive lifestyle modifications and blood pressure medication. When systolic blood pressure readings exceed 180, emergency medical care is required. None of those screened on Wednesday required emergency care for high blood pressure.

The lower number of a blood pressure reading is called the diastolic number. It measures the pressure in the arteries as the heart rests between beats. The ideal diastolic pressure is 75, and normal extends up to 80. Prehypertensive readings are from 80 to 89, and 90 to 99 indicates high blood pressure. Very high blood pressure is 100 or higher. Higher than 110 requires emergency care.

"We saw several individuals with diastolic readings above 100, which will require a visit to a physician," Deborah said. ""It's good we caught these issues today, because if any of the individuals we detected with very high blood pressure see it raise even a few more points, they will need to be treated at a hospital emergency room."

"Blood pressure monitoring is critical for avoiding a stroke," Guy said. "We recommend purchasing a blood pressure monitoring device at a local drug store, which usually runs about $30. As many people found out today, knowing your blood pressure is very important to your overall health."

"Each of the screenings helped people who think they're living right to realize they have a lot of adjustments they need to make to their lifestyle to stay healthy," Deborah said. "Our staff has a lot of follow-up to do with those who attended today, but by catching issues early, we are also providing them with a chance to change their lifestyle to avoid a stroke or other life-threatening illness."

"That's why we do what we do," she said, "and why we worked with the leadership of the Rancho Los Amigos Foundation to create this wonderful partnership to improve the health of people throughout the greater Downey area. We are very excited about the outstanding turnout we have had at these two seminars, and we look forward to changing more lives for the better at our next seminar."

The two Downey seminars have been the best-attended by far of the hundreds of seminars the Foundation has conducted throughout Southern California. The next Stroke Prevention Seminar will be held from 9:30 a.m. to 11:00 a.m. on July 17, 2013 at Rio Hondo Event Center in Downey, and will feature Dr. Nerses Sanossian, director of the Roxanna Todd Hodges Comprehensive Stroke Clinic and the Roxanna Todd Hodges Transient Ischemic Attack Program at the USC Keck School of Medicine. Free Carotid Artery and Abdominal Aortic Aneurysm screenings will be provided.

To register for the seminar, call (888) 794-9466. "I would recommend that anyone who wishes to attend the July 17 seminar register immediately, because each of our previous Downey seminars were sellouts within a matter of a few days," Deborah said.

"They say the best things in life are free, and this is one of them," she said. "Attending this seminar and getting one of these critical screenings is probably one of the very best things you can do to protect your health and get the information you need to lead a healthier life."

********** Published: May 23, 2013 - Volume 12 - Issue 06