We have talked about what causes stroke, today we will talk about how stokes can be treated once they occur. This is most important. Dr. Luke will tell us about some very important old and new treatments available. The treatment of stroke in the past five years has undergone remarkable changes all over the world. Before five years ago the treatment of strokes had not changed much for many decades. What brought about this change? Also, what difference does this change make to patients today?
First, recall what causes strokes? Strokes can be caused by several different means. Three are most important. First, the stroke that is caused when a blood clot, which occurs right in the artery due to hardening of part of the artery, stops the artery in the brain up. This hardened part then breaks off and obstructs the artery causing a local blood clot to form andthus totally stops blood flow to that part of the brain. This is the most important type of stroke and the most common type of stroke. Second, is the stroke from when a blood clot comes from a heart, which is not beating regular. This blood clot goes from the heart to the brain and stops up the artery in the brain. The clot does much the same thing as the first type of stroke, that is cuts off blood flow but the causes and treatments are very different. The third type of stroke is one where a blood vessel or artery in the brain has a leak and blood is released from the artery into the brain. This is not a very common type of stroke.
Let’s look at the first type of stroke first. This is the one where a local part of a hardened part of the artery breaks off and a blood clot then forms. This type of clot is the most common type of stroke and the one now where most help can be given. This is the type of stroke we will discuss in this talk. These people if helped immediately can be completely cured of side effects of their strokes.
Let me tell you the story of one man whom I will call Mr. Zhang. This is a true story, which happened in the United States, but we have changed his name for this story. Mr. Zhang was had never had a stroke before and was having a typical day when suddenly his left arm and leg became weak. He called his wife who called the ambulance. This man’s wife told the ambulance that her husband might be having a stroke. Thus the ambulance came immediately. This is very important, as the ambulance needs to know how severe the problem might be. If the ambulance knows that they will be seeing a patient with a stroke they will come extra fast. Upon arriving at the emergency room the doctors immediately order a CT scan of the brain. Mr. Zhang’s CT scan of his brain was normal so the doctors wanted to give Mr. Zhang a very new powerful and amazing medicine called tPA. This medicine broke up the clot in Mr. Zhang’s artery in his brain and restored the flow of blood to the brain. Mr. Zhang was saved from possibly having a stroke, which could cause permanent damage and permanent arm and leg weakness and never being able to work. Mr. Zhang within several weeks to a month was able to return to work. He was like new. It was as if he had never had a stroke.
When later asked about this, all Mr. Zhang could say was, ‘I thank God for all he had done for me. Through the amazing miracles of modern medical science I am able to have a brand new life.’ Mr. Zhang gave credit where credit was due, that is to God.
How does this amazing medicine work? First, remember that a blood clot has formed in the artery. If doctors can give this new medicine within three hours after the beginning of symptoms then the clot in the artery in the brain can be broken up and the patient saved from having a stroke. There are some patients who cannot have this medicine for various reasons thus you should check with your doctor. This medicine is available in most countries of the world and even in China. Besides some patients not being able to use this medicine due to side effects it is a very expensive medicine. The major drawback to the medicine, that is the tPA is that it is so very expensive.
Many people who have strokes actually die from the stroke within minutes to hours. Thus prevention is the best thing for these patients and any patient who will have a stroke. However, this shows that all patients cannot be saved by medical science. The question must be asked, what happens to these people after they die? Medical science with all of its advances cannot help these people. Do people just cease to exist or is there another life after death? The Bible says that all who die will live forever, however some will live and have eternal life and others will have a living eternal death. How can we know which we will have? Can we know this answer? Yes, the Bible talks about eternal life, which begins during the life we now live. But before answering this question let us talk about those people who are not healed completely from strokes.
Some people may not, like Mr. Zhang, be able to receive this medicine, that is the tPA. They may go onto having a stroke with the results of weakness in their arms or legs or speech or swallowing or thinking problems. What can be done to help these patients? Let me introduce you to another patient named Mrs. Wang.
Mrs. Wang was 75 years old when she had a stroke. She could not walk or eat well after the stroke as her left arm and leg was weak. She also had some trouble talking and swallowing. What was done to help Mrs. Wang? First, it must remembered that most stroke patients have some improvement in the first 3-6 months after the stroke. After that period of time most patients do not have much improvement. What though can be done to help patients like Mrs. Wang get better after a stroke?
The most important thing is exercise, which begins the first day or so after the stroke. Mrs. Wang was in the hospital and there the physical therapists began to give here some exercises even while she was in bed before she could walk. What types of exercises? First are what we call ‘range of motion’ exercises which any family members can do. This is just simply moving the arms and legs back and forth. This helps keep the muscle tone and strength. Then as soon as the patient has strength they should start to walk. This is very important. Once patients with strokes begin to exercise regularly they began to overcome some of the weakness from the stroke.
Dr. Luke tells of a man who had, like Mrs. Wang a severe stroke on one side of his body, including his arm and leg. His walking and arm strength was at the beginning of the stroke very weak. Helping him to walk, he used a cane in each arm for years. He never was able to completely walk normally without a limp. Thus he had to use the two canes to help him walk. However, using these two canes over the years his arms became very strong. In fact his arms became not only are normal but also much stronger than before his stroke because he had to use the two canes all-day and everyday. This shows the great value of exercise for stroke.
Many people ask are their medicines for patients after they have strokes to help them from having further strokes? The answer to this question is yes. But there are two answers to this question. The first answer is for diseases, which can cause strokes or make them worse. The two diseases, which are most important, are diabetes and high blood pressure. These two diseases should be controlled with medicines after the stroke or the risk of more strokes will be greater. You should talk with your doctor to find out if taking medicines for these two diseases is necessary for your health. Exercise also helps diabetes and high blood pressure become better.
The second answer to this is that two groups of medicines also help prevent further strokes. The first medicine is Aspirin. Aspirin taken in amounts of 325mg everyday will prevent further strokes. Also a medicine called Plavix will prevent further strokes. Before taking these medicines you should talk with your doctor to find out if these are good medicines for you to take. All medicines have side effects and can cause problems if they are not used correctly. That is why you should consult your doctor.
Finally there is diet and how it helps stroke. Older people generally have more strokes than younger people. Also older people generally weigh more. This added weight is what can contribute to a stroke. Thus it is important for people who have had a stroke to work on their diet. For example if the patient has diabetes then they should eat less sweats. If they have high blood pressure then they should eat less salt. If they are significantly overweight then they should try and loose weight. A dietician can help give advise on this as well as the patients doctor.
Let us go back and think about what happens to a patient who gets very sick from a stroke and for example cannot walk or what about those people who die. People who have strokes have much more depression than people their age who have never had a stroke. This actually makes sense. Strokes cause a great deal of disability. They can affect a person’s speech, how they look and their ability to get out in the world. After a stroke many people never walk again or talk without being hard to understand. How can these people be helped?
Dr. Luke in his writings, which are included in the Bible, tells of a man who had been crippled from birth. One day two men who were followers of Jesus met this man. The crippled man asked these two men, named Peter and John for some money. Peter and John told the crippled man that they did not have money. But that they would give him what they had. What they had was Jesus and his power to heal. Instantly on saying the name of Jesus the crippled man’s feet and ankles became strong and he began to walk.
Later on being asked how this man could walk Peter and John said, ‘By faith in the name of Jesus, this man whom you see and know was made strong. It is Jesus’ name and the faith that has come through him that has given this complete healing to him, as you can see (Acts 3.16). What an incredible story. However, what is more incredible is that this man not only could walk because of the healing in the name of Jesus but also that this same Jesus could then and can now give new life also through his name. What does this, ‘new life’ mean?
Listen again to what Dr. Luke records what Peter and John say about Jesus. ‘Salvation is found in no one else, for there is no other name under heaven given to men by which we must be saved (Acts 4.12).’ This is an amazing truth. Only through the name of Jesus can salvation be given. What is meant here by salvation? Salvation from sin. What type of sin? The sin, which separates us from God. The sin of pride, hatred, greed, selfishness, bitterness, bad thoughts and so on. These are the sins, which separate us from God. What difference does this make?
God says that the ‘wages of sin is death but the gift of God is eternal life through Jesus our Lord (Romans 6.23). ‘ This is certainly an amazing fact. Even when we deserved to die Jesus took on himself our sins so that we could have eternal life. Jesus also said, ‘I have come that you might have life and might have it more abundantly (John 10.10).’ Thus even if you have a stroke which leaves you very ill and with a permanent loss of the use of your arm or leg, you can have a full life through Jesus Christ. Also, even if you were to die today from a stroke or know of someone who did, you do not need to fear because you or they can have eternal life through Jesus Christ. How, you might ask. Simply pray the following prayer.
Lord Jesus, I know that I have sinned and now admit I have sinned to you. I ask that you take my sins upon you. I believe that after you died on the Cross for my sins you rose from the dead and are alive even now.’ If you have prayed this prayer you are now a child of God forever.