Two Things You Can Do To Improve Stroke Survival Chances

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Dr. Andrew’s Stroke Survival Guide

This is Dr. Nadine Andrew. She’s a Senior Research Fellow in the Department of Medicine at Monash University. She’s the Research Data Lead for the National Center of Healthy Aging. She is lead investigator on the NHMRC-funded PRECISE project… The most comprehensive stroke data linkage study to date! In short, she knows her stuff.

We’ve talked before about how sample size is important when it comes to scientific studies. It’s frustrating; sometimes we see what looks like a great study until we notice it has a sample size of 17 or something.

Dr. Andrew didn’t mess around in this regard, and the 12,386 participants in her Australian study of stroke patients provided a huge amount of data!

With a 95% confidence interval because of the huge dataset, she found that there was one factor that reduced mortality by 26%.

And the difference was…

Whether or not patients had a chronic disease management plan set up with their GP (General Practitioner, or “family doctor”, in US terms), after their initial stroke treatment.

45% of patients had this; the other 55% did not, so again the sample size was big for both groups.

Why this is important:

After a stroke, often a patient is discharged as early as it seems safe to do so, and there’s a common view that “it just takes time” and “now we wait”. After all, no medical technology we currently have can outright repair that damage—the body must repair itself! Medications—while critical*—can only support that and help avoid recurrence.

*How critical? VERY critical. Critical critical. Dr. Andrew found, some years previously, that greater levels of medication adherence (ie, taking the correct dose on time and not missing any) significantly improved survival outcomes. No surprise, right? But what may surprise is that this held true even for patients with near-perfect adherence. In other words: miss a dose at your peril. It’s that important.

But, as Dr. Andrew’s critical research shows, that’s no reason to simply prescribe ongoing meds and otherwise cut a patient loose… or, if you or a loved one are the patient, to allow yourself/them to be left without a doctor’s ongoing active support in the form of a chronic disease management plan.

What does a chronic disease management plan look like?

First, what it’s not:

  • “Yes yes, I’m here if you need me, just make an appointment if something changes”
  • “Let’s pencil in a check-up in three months”
  • Etc

What it actually looks like:

It looks like a plan. A personal care plan, built around that person’s individual needs, risks, liabilities… and potential complications.

Because who amongst us, especially at the age where strokes are more likely, has an uncomplicated medical record? There will always be comorbidities and confounding factors, so a one-size-fits-all plan will not do.

Dr. Andrew’s work took place in Australia, so she had the Australian healthcare system in mind… We know many of our subscribers are from North America and other places. But read this, and you’ll see how this could go just as much for the US or Canada:

❝The evidence shows the importance of Medicare financially supporting primary care physicians to provide structured chronic disease management after a stroke.

We also provide a strong case for the ongoing provision of these plans within a universal healthcare system. Strategies to improve uptake at the GP level could include greater financial incentives and mandates, education for patients and healthcare professionals.❞

See her groundbreaking study for yourself here!

The Bottom Line:

If you or a loved one has a stroke, be prepared to make sure you get a chronic health management plan in place. Note that if it’s you who has the stroke, you might forget this or be unable to advocate for yourself. So, we recommend to discuss this with a partner or close friend sooner rather than later!

“But I’m quite young and healthy and a stroke is very unlikely for me”

Good for you! And the median age of Dr. Andrew’s gargantuan study was 70 years. But:

  • do you have older relatives? Be aware for them, too.
  • strokes can happen earlier in life too! You don’t want to be an interesting statistic.

Some stroke-related quick facts:

Stroke is the No. 5 cause of death and a leading cause of disability in the U.S.

Stroke can happen to anyone—any age, any time—and everyone needs to know the warning signs.

On average, 1.9 million brain cells die every minute that a stroke goes untreated.

Stroke is an EMERGENCY. Call 911 immediately.

Early treatment leads to higher survival rates and lower disability rates. Calling 911 lets first responders start treatment on someone experiencing stroke symptoms before arriving at the hospital.

Source: https://www.stroke.org/en/about-stroke

What are the warning signs for stroke?

Use the letters F.A.S.T. to spot a stroke and act quickly:

  • F = Face Drooping—does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
  • A = Arm Weakness—is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • S = Speech Difficulty—is speech slurred?
  • T = Time to call 911

Source: https://www.stroke.org/en/about-stroke/stroke-symptoms

Last but not least, while we’re sharing resources:

Download the PDF Checklist: 8 Ways To Help Prevent a Second Stroke

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  • Fast Like A Girl – by Dr. Mindy Pelz

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    A lot of information out there when it comes to intermittent fasting is very much centered on men in the 25–35 years age range. What about the rest of us?

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  • Why Going Gluten-Free Could Be A Bad Idea

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    Is A Gluten-Free Diet Right For You?

    This is Rachel Begun, MS, RD. She’s a nutritionist who, since her own diagnosis with Celiac disease, has shifted her career into a position of educating the public (and correcting misconceptions) about gluten sensitivity, wheat allergy, and Celiac disease. In short, the whole “gluten-free” field.

    First, a quick recap

    We’ve written on this topic ourselves before; here’s what we had to say:

    Gluten: What’s The Truth?

    On “Everyone should go gluten-free”

    Some people who have gone gluten-free are very evangelical about the lifestyle change, and will advise everyone that it will make them lose weight, have clearer skin, more energy, and sing well, too. Ok, maybe not the last one, but you get the idea—a dietary change gets seen as a cure-all.

    And for some people, it can indeed make a huge difference!

    Begun urges us to have a dose of level-headedness in our approach, though.

    Specifically, she advises:

    • Don’t ignore symptoms, and/but…
    • Don’t self-diagnose
    • Don’t just quit gluten

    One problem with self-diagnosis is that we can easily be wrong:

    Suspected Nonceliac Gluten Sensitivity Confirmed in Few Patients After Gluten Challenge in Double-Blind, Placebo-Controlled Trials

    But why is that a problem? Surely there’s not a health risk in skipping the gluten just to be on the safe side? As it turns out, there actually is:

    If we self-diagnose incorrectly, Begun points out, we can miss the actual cause of the symptoms, and by cheerfully proclaiming “I’m allergic to gluten” or such, a case of endometriosis, or Hashimoto’s, or something else entirely, might go undiagnosed and thus untreated.

    “Oh, I feel terrible today, there must have been some cross-contamination in my food” when in fact, it’s an undiagnosed lupus flare-up, that kind of thing.

    Similarly, just quitting gluten “to be on the safe side” can mask a different problem, if wheat consumption (for example) contributed to, but did not cause, some ailment.

    In other words: it could reduce your undesired symptoms, but in so doing, leave a more serious problem unknown.

    Instead…

    If you suspect you might have a gluten sensitivity, a wheat allergy, or even Celiac disease, get yourself tested, and take professional advice on proceeding from there.

    How? Your physician should be able to order the tests for you.

    You can also check out resources available here:

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    Or for at-home gluten intolerance tests, here are some options weighed against each other:

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    Want to learn more?

    Begun has a blog:

    Rachel Begun | More than just recipes

    (it is, in fact, just recipes—but they are very simple ones!)

    You also might enjoy this interview, in which she talks about gluten sensitivity, celiac disease, and bio-individuality:

    !

    Want to watch it, but not right now? Bookmark it for later

    Take care!

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  • Vibration Plate, Review After 6 Months: Is It Worth It?

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    Science & Experience

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    • Reduced back pain and improved posture (not surprising, given the need for stabilizing muscles when using one of these)
    • Better circulation and (likely resulting from same) skin clarity

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    • Any reduction in cellulite
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  • What you need to know about the new weight loss drug Zepbound

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    In a recent poll, KFF found that nearly half of U.S. adults were interested in taking a weight management drug like the increasingly popular Ozempic, Wegovy, and Mounjaro. 

    “I can understand why there would be widespread interest in these medications,” says Dr. Alyssa Lampe Dominguez, an endocrinologist and clinical assistant professor at the University of Southern California. “Obesity is a chronic disease that is very difficult to treat. And a lot of the medications that we previously used weren’t as effective.”

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    Keep reading to find out more about Zepbound, including who can take it, its side effects, and more. 

    What is Zepbound? 

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    How is Zepbound different from Ozempic?

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    “I have seen overall lower rates in severity of side effects with the tirzepatide medications. Mounjaro [tirzepatide] in particular is the one that I’ve used up until this point, but there’s a thought that the GIP component of the medication actually decreases nausea,” adds Lampe Dominguez. “Anecdotally, patients that I have switched from semaglutide or Ozempic to Mounjaro say that they have less side effects with Mounjaro.”

    How is Zepbound different from Mounjaro? 

    Zepbound and Mounjaro are the same medication—tirzepatide—but they’re approved for different conditions. Zepbound is FDA-approved for weight loss, while Mounjaro is approved for type 2 diabetes. (However, Mounjaro is also at times prescribed off-label for weight loss.) 

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    According to the FDA, side effects include nausea, vomiting, diarrhea, constipation, stomach discomfort and pain, fatigue, and burping. See a more comprehensive list of side effects here

    Who can take Zepbound?

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    “I tend to advise patients who don’t meet those criteria to not take these medications because we really don’t know what the risks are,” says Lampe Dominguez, adding that people with lower BMI weren’t included in the medication’s studies. “We don’t know if there are specific risks to using this medication at a lower body mass index [or] if there might be some negative outcomes.”

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    This article first appeared on Public Good News and is republished here under a Creative Commons license.

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  • Delicious Quinoa Avocado Bread

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    They’re gluten-free, full of protein and healthy fats, generous with the fiber, easy to make, and tasty too! What’s not to love? Keep this recipe (and its ingredients) handy for next time you want healthy burger buns or similar:

    You will need

    • 2½ cups quinoa flour
    • 2 cups almond flour (if allergic, just substitute more quinoa flour)
    • 1 avocado, peeled, pitted, and mashed
    • zest and juice of 1 lime
    • 2 tbsp ground flaxseed
    • 1 tsp baking powder
    • ½ tsp MSG or 1 tsp low-sodium salt
    • Optional: seeds, oats, or similar for topping the buns

    Method

    (we suggest you read everything at least once before doing anything)

    1) Preheat the oven to 350℉/175℃.

    2) Mix the flaxseed with ⅓ cup warm water and set aside.

    3) Mix, in a large bowl, the quinoa flour and almond flour with the baking powder and the MSG or salt.

    4) Mix, in a separate smaller bowl, the avocado and lime.

    5) Add the wet ingredients to the dry, slowly, adding an extra ½ cup water as you do, and knead into a dough.

    6) Divide the dough into 4 equal portions, each shaped into a ball and then slightly flattened, to create a burger bun shape. If you’re going to add any seeds or similar as a topping, add those now.

    7) Bake them in the oven (on a baking sheet lined with baking paper) for 20–25 minutes. You can check whether they’re done the same way you would a cake, by piercing them to the center with a toothpick and seeing whether it comes out clean.

    8) Serve when sufficiently cooled.

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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