How Did "Stroke" Become Its Name?

This post is a change from the usual, which I needed, having researched and wrote about urination and constipation in my last two posts. Give this girl a break! They were important to write about and nobody else seemed to be doing it, but c'mon. Thus, a change from the usual.

So I was always fascinated with the derivation of words. I probably should have taken Latin in high school, but I didn't, being too occupied by the male gender and taking as little effort as possible with my studies. That's why I went to Temple University. Everybody gets in to Temple. 

Anyway, because of my love for the written word, and finding writing easy, I had a column in the local paper, Teen Scene, at the tender age of 16. I got paid $10 a column in the mid-60s which was a lot of money for me back then. I went on to many other opportunities including columns at other local papers when I was in my twenties and a freelance gig with a consumer column in the The Philadelphia Daily News and articles in The Inquirer when I was in my thirties. I tell you all this because writing came effortless to me, and it was the one thing which made me proud to be a writer. I went on to many other jobs, but they all involved writing. Thus, my magnetism to the written word was notable. 

So I always wondered about the word "stroke" and its derivation after a few years of depression when I had a stroke. I wondered but didn't do anything about it until now. So here is what I found, compliments of Johns Hopkins Health Library. 

In ancient Greece over 2400 years ago, Hippocrates, the father of medicine, first knew of "stroke" who referred to it as apoplexia, a term meaning "struck down by violence."  In the mid-1600s, Jacob Wepfer discovered that patients who died with apoplexia also had bleeding in the brain and realized that a blockage in one of the brain's blood vessels could cause apoplexia. Apoplexy, as the term was used more in centuries that ensued, meant that a person suddenly developed paralysis and a variety of changes in appearance and mood. At that time, doctors had no or little knowledge of paralysis and the brain.  

The science of medicine at times continued to study the cause, symptoms, and treatment of apoplexy when in 1928, apoplexy was divided into categories, based on the source of the problems with the blood vessel. This progression evolved to the term "cerebral vascular accident" (CVA). CVAs were referred to as a "brain attack" to note a lack of blood supply to the brain, similar to a heart attack which is caused by a lack of blood supply to the heart. Brain attack also suggested an immediate emergency procedure.

The original Greek terminology, "struck down by violence," (it  could have been called "struck") eventually turned into "stroke" (or apoplexy, which means the same thing as stroke), and apoplexy became "old school" in the 20th century. Doctors still say CVA, but stroke became the usual term with the general public. 

Doctors most often recommend to stop smoking, a healthy diet low in sodium and plenty fruits and vegetables (fruits are higher in carbohydrates than vegetables, so think about that if you're watching your carb intake), and exercise at least 3 to 4 days a week for at least 40 minutes a day. For stroke survivors who have trouble doing the 40 minutes all at once, most PTs (physical therapists) say break the 40 into smaller intervals until your endurance can handle 40 minutes at one time.

While a stroke can’t always be prevented--I got my stroke from lousy genes, Protein S Deficiency, which messes with coagulation and clots--taking these guidelines can only help reduce your stroke risk as much as possible besides leading you to a more healthy lifestyle. In addition, it may help you avoid another stroke if you've already had one. 

Stroke Survivors: How Allergies and Stroke Are Related

It seemed a good time to reveal the connection between allergies, or sinusitis, and stroke with allergy season right around the corner. 

A long, long time ago, when I was 12, I went to the circus with my parents and to their friends' house after. I developed allergies then, to all the animals, never having a pet of my own at home. My mother wouldn't allow any pet to wander about except those that were boxed, caged, or swam under water. Thus, I never was subject to knowing.

When we stopped at the friends' house after the circus, I was already wheezing, congested, hive-y, and miserable. My mother told me to be friendly and stop whatever I was doing. But I didn't stop because I couldn't. Finally, after 2 hours, we arrived home and I took the next day off from school because I was so fatigued. Welcome to anaphylaxis.  

First, a little background. Anaphylaxis, aka a severe allergic reaction, is known and diagnosed by respiratory and circulatory dysfunction, and usually associated with skin (for example, hives) and mucous changes. Anaphylaxis may be deadly when the circulatory and respiratory systems are severely disrupted. When death occurs, it is usually the result of anaphylactic shock. I was lucky. The symptoms went away by themselves by the next afternoon. 

I'm allergic to aspirin and NSAIDS (non-steroidal anti-inflammatory drugs), too. About 20 years after the wheezing et al episode, I took a Motrin, an NSAID, for a bad back and the exact thing happened. This time, I went to the doctor that same day and he told me that I had an anaphylactic reaction.  

Sinus problems, or acute sinusitis, related to anaphylaxis affect 1 in 5 American adults each year, according to the Asthma and Allergy Foundation of America. Sinus conditions can trigger headaches and congestion (and there's much more), but a new study from Taipei Medical University in Taiwan says "the inflammation that causes the pain and pressure of a sinus infection also increases the odds of suffering a stroke— by 34 percent for people with chronic sinusitis and by 39 percent for those with occasional acute infections." The relationship of acute sinusitis to stroke reflects more of a risk to adults in midlife, since about 37 percent of stroke patients are between 45 and 65, according to the Centers for Disease Control and Prevention. "Sinus infections are most commonly caused by the same viruses associated with the common cold," says Dr. Meera Gupta, assistant professor of allergy and immunology at University of Texas Medical Branch at Galveston.  "When a virus sets up shop in your sinuses, it produces inflammation that causes the telltale pressure around the nose and eyes. In addition to a headache, the infection can sometimes bring on congestion that lasts about a week, along with thick, discolored mucus and facial or tooth pain. Typically, these infections will resolve on their own within 7 to 10 days," Gupta says.  In roughly 2 percent of cases, the infection doesn't resolve, an indication that a bacterial infection requiring antibiotics may happen.  The constant need to blow your nose and the pain can be bothersome. The inflammation in your sinus cavities can also trigger a stroke. Sinus inflammation, located close to your brain [the operative phrase], may also put pressure on the  arteries which could prevent normal blood flow and lead to a stroke. So the relationship between anaphylaxis and sinuses is this: The first step in preventing anaphylaxis is avoiding the allergen(s) that can cause you to react.   For typical inflammation, over-the-counter nasal sprays should suffice," says Dr. James Stankiewicz, chairman of the Department of Otolaryngology at Loyola University Medical Center in Illinois.  "Sprays made from saline or saltwater are sold over the counter and help drainage. Decongestant sprays, which may be prescription or over the counter, help open the nose to breathe and reduce congestion and drainage." Steroid sprays and nasal saline irrigation, usually with salt water, are good as well, Stankiewicz says. "Seasonal allergies are another major cause of sinus inflammation. Allergies can block normal sinus drainage and predispose a person to developing sinus infections," Stankiewicz says. If you experience congestion or sinus irritation during hay fever season, when the pollen count is high, or if you are exposed to animal dander or mold, there's always allergy shots that usually take a minimum of 9 months to determine protection from allergens. Sinuses can also be a path to leave you vulnerable to compromised health beyond the proven stroke risk.  "Chronic sinus congestion can lead to snoring and sleep apnea, which is associated with an increased risk of cardiovascular disease," Stankiewicz says. "In addition, chronic inflammation in the sinuses associated with allergies can cause lethargy, fatigue, and cognitive impairment." Most anaphylactic reactions occur after eating or drinking a particular food, taking certain medication, after an insect sting, or after exposure to an allergen like latex gloves.  In rare cases, anaphylaxis can happen after exposure to the cold or after exercising, as it did to me after running in the cold with wheezing and hives in the aftermath. Sometimes, you'll find out the hard way, never knowing before that you were allergic. Life's a bitch, but it beats the alternative.

Constipation for Stroke and Other TBIs: Well, SOMEBODY Had to Write About It and It Might As Well Be Me

I had constipation after the stroke. It wasn't unusual for me to defecate once every 5 or 6 days. A few doctors told me that the muscles in the bowel weren't working correctly. That was the easy answer. And I believed it because nothing was working correctly. I believed it until I did research on constipation. And the doctors may have been wrong. 

According to researchers at the University of Michigan, "Stroke by itself does not cause constipation. But constipation often occurs after a stroke because you 1) are not drinking enough liquids, 2) are in bed most of the time, or 3) are taking certain medicines as part of your treatment. If your constipation is severe, stool can become lodged (impacted) in the bowel."

That was me, all right. All of it. 

In another article in the Annals of Rehabilitation Medicine, the researchers took 55 brain-injured patients. They divided the patients into constipation (number=29) and non-constipation (number=26) groups, achieving 7.32± (plus or minus) 3.63 and 5.04± (plus or minus) 2.46, respectively. 

The constipation group had significantly elevated constipation scores, with prolonged CTT (Colon Transit Time, the colon responsible for producing the bowel) of total right and left colon, and it depended on these factors in a table entitled, "The General Characteristics of Patients with Brain Injury:" 

Total Number of subjects                                   55

Mean age in years                                               61 +- 14.1

Sex (male/female)                                               37/18

Brain injury in months                                       11.1 +- 17.5

Type of brain injury (infarction, bleed, other)  33/20/2
(Press your doctor for where in the brain your injury occurred)
Site of brain injury 
Frontal/Parietal          5
Temporal/Occipital    7
Basal ganglia           24
Thalamus                   6
Multiple                      3
Other                        10

But the article didn't say how much liquid they drank, how much bed rest, or what kind of medicines they took. In my opinion, University of Michigan hit the mark: ie, too little liquids, too much bed rest, and/or medications.

My solution to constipation was when a doctor recommended a stool softener. I was afraid at first because I thought it would give too strong an urge to make it to the bathroom. 

After 5 years of constipation, the stool softener improved my quality of life because I "go" once a day or so without any urgency. And I eat everything that's supposed to be in a healthy diet with no restrictions (except keep a consistent diet of Vitamin K because I'm on Coumadin). See a doctor first because something else may be afoot, but if the doctor says to try stool softeners for constipation, permit the bowel to go forth. I buy the cheap kind from Walmart. 

I'll end with this cartoon that says it all, to both pee (https://stroketales.blogspot.com/2019/03/incontinence-for-stroke-and-other-tbis.html) and poop: