Stroke Awareness Month (and Loreen’s story)
About 4 years ago I was away on holidays with family and friends and woke up one day with a headache. It was a fairly bad headache so I took a couple Advil and didn’t think much of it. We arrived home from holidays and got busy with work, school and kid activities. 2 weeks later I was getting ready for bed and reached for the Advil. I stopped myself and reflected on the past few weeks and realized the headache I had while on vacation hadn’t gone away and that 2-3 times each day for the past 2 weeks I had been taking Advil to manage it. I decided that I would call my doctor in the morning to make an appointment. When I woke up in the morning the headache was gone but something else was wrong. The entire right side of my body from head to toe felt really cold to me. It wasn’t cold to others but when I touched any part of my skin on the right side of my body the sensation I felt was ice cold. Over the next few months, I saw my doctor, a neurologist, had an MRI, CT scan all to figure out what happened.
At the end of the day I was told that I was a healthy woman with no risk factors and what they think I experienced was an idiopathic TIA (trans-ischemic attack). In non-medical terms that means a mini stroke with an unknown or spontaneous cause.
I remember walking out of the neurologist’s office in complete shock and as a health care professional my natural reaction was “what can I do to prevent any further risk?” The frustrating reality in my case was there was nothing else I could do. It’s a very sobering experience to have your own fate flash in front of you as a health care professional-this is when you wish you could bury your head in the sand and pretend you don’t know anything about what is going on as it’s scary to face your own reality sometimes.
Unfortunately I knew that strokes are the third leading cause of death in Canada (1). I also knew that when you have a TIA you are five times more likely to have a stroke over the next two years compared to the general population (2). I didn’t want to believe my doctor or my “rational brain” that there was nothing I could do to reduce my risk so I read as much as I could to see what I could find.
The risk factors for a stroke are split up into two groups non-modifiable and modifiable.
Non-modifiable are the ones you can’t do anything about:
- advanced age,
- gender,
- race and
- genetic predisposition.
Out of all of these risk factors the only one working against me was my sex but the fact that I haven’t gone through menopause yet left me at lower risk since my estrogen and progesterone levels are still optimal.
Modifiable risk factors include:
- diet,
- exercise,
- use of tabacco and alcohol.
As a Dietitian, I’ve researched the dietary habits that have been shown to reduce the risk of stroke. Here they are:
- Consume 3-5 servings of fruits and vegetables each day
- Include moderate levels of fish (unsalted and unfried) (2-3 times per week)
- Limit sodium to decrease blood pressure
- Increase potassium to offset sodium.
- Moderate your intake of coffee to 3-4 cups.
- Moderate your intake of alcohol (2 for men and 1 for women daily)
These recommendations are in line with two diets:
DASH Diet (Dietary Approaches to Stop Hypertension) This approach is high in fruits, vegetables, whole grains, low fat dairy products, nuts, chicken, and fish and low in red meat, sweets, refined carbohydrates and sodium.
Mediterranean Diet: high in fruits, vegetables, nuts/beans/seeds, heart healthy fats (olive oil), whole grains, fish, limited consumption of red meat, poultry, dairy, and moderate intake of red wine.
Some non-dietary recommendations include being physically active on a regular basis. Activity plays a role in helping reduce our stress level. Regular activity will also help us build and maintain lean muscle mass.
These findings were reassuring to me that my knowledge was up to date but disappointing because I wanted to believe I missed something. I wanted to believe there was something else I could do to reduce my risk of a stroke. I explored further into reading about supplements and trying to find out whether there was some magic pill I could take to help reduce my risk. The results “ambiguous” which basically means we don’t know for sure if any supplementation (beta carotene, vitamin A, vitamin E, folic acid, vitamin D…) show a direct relationship between supplementation and decreased risk of stroke. But what’s the harm in vitamin supplementation; it’s natural and beneficial isn’t it? This is where my background came in handy as I had a reality check and realized the evidence we know so far is pointing to the fact that taking a supplement will never replace a balanced diet.
So I concluded the best thing I could do was continue living my life the way I am. Stay active, eat a balanced diet, keep my stress level in balance and accept that is all I am in control of.
The reason I wanted to share my story with you is to show you the natural progression of what we as humans want to do when it comes to our health-even us health care professionals! We tend to look for the quick fix, the path of least resistance to fix our problems but unfortunately there are no quick fixes or magic pills that solve our problems. I have seen many people at high risk for stroke throughout my career.
A typical scenario is a middle age women who smokes, doesn’t exercise, struggles with her weight, has high blood pressure and high cholesterol, doesn’t eat any vegetables and takes at least 5 different vitamin/mineral/herbal supplements daily. The first question I am asked is “What else can I take to reduce my risk of a stroke? Trust me, I would love to say I have a magic pill for them but that isn’t reality. Lifestyle changes are the only thing in our control that will reduce our risk of stroke. It is literally that simple. We need to stop looking for the quick fix, recognize we need to be mindful of what we put in our mouth, how we use or abuse our body because at the end of the day it does impact both the quantity of our life but most importantly the quality of our life.
Hippocrates had this figured out back in the 3rd Century when he wrote
All parts of the body which have a function, if used in moderation and exercised in labours to which each is accustomed, become thereby well-developed and age slowly; but if unused and left idle, they become liable to disease, defective in growth and age quickly.
References
- Statistics Canada, 2012 data
- Canadian Stroke Network, 2011
