Heart Attack or Stroke?

It can happen to you, or right in front of you. What is the difference?  What do you do?…

By David A. Steenblock, MS, DO 

 

A heart attack occurs from blockage of the blood vessels that supply oxygen to the heart. This usually causes chest pain on one’s left side, and the left arm or neck. The pain is constant and may go from a dull ache to a more sharp pain in the left chest with exertion or stress. Nausea may be present as well.

If you are having CHEST PAIN , NAUSEA and/or SWEATING call 911 and go to the nearest emergency room for medical care!

A stroke happens when blood flow to the brain is impeded or blocked.

Sometimes these symptoms will go away after a few minutes or hours. When this happens it is likely you are having a Transient Ischemic Attack (TIA) which means that a blocked blood vessel to your brain has opened up and the blood flow has been at least partially restored.

For years doctors have thought that this type of event did not cause damage to the brain though recent studies have demonstrated that it not only does, but can result in long term problems like memory loss. If these symptoms return in a few hours, days or even weeks, the original symptoms usually stick around and may signal a full blown stroke.

If you should have this type of seemingly temporary problem, then insist that your doctors do a complete brain blood vessel evaluation and brain MRI so the exact cause of the symptoms can be determined and either repaired or treated to prevent the progression of the TIA into a full blown stroke.

Call 911 if….

If you or someone your observe exhibits any of the signs of stroke. Do not delay because timely treatment is critical to survival and recovery. Be safe rather than sorry! CALL NOW!

Summon an ambulance…

If the symptoms pass quickly this may indicate a brief blockage of blood flow to the brain (called a transient ischemic attack or TIA) that is often a forerunner of stroke. Do not ignore this warning sign.

In situations in which a stroke is due to a blood clot, an enzyme treatment (TPA) must be initiated within the first 3-6 hours of the onset of symptoms. If your pulse is irregular and or you have been diagnosed with atrial fibrillation or other forms of irregular heartbeat, your chances of having a blood clot as the cause of a stroke is high.

If you have HIGH BLOOD PRESSURE and especially if you have not been taking your blood pressure pills and TIA or stroke symptoms develop, your chances of having a “BLEEDING” type of stroke is high and the enzyme drug TPA cannot be used.

Bleeding into the brain is more likely to cause serious problems and even death than the blood clot type, especially if one’s blood pressure is high and remains so. Most preventable strokes are due to people not taking prescribed blood pressure lowering drugs or lifestyle changes or failing to measure their blood pressure on a regular basis and missing unusual changes.

ALTERNATIVE THERAPIES FOR ACUTE STROKE PATIENTS

People who have strokes are each different and therefore what follows are general treatment suggestions only and are not traditional ways used by doctors to deal with stroke.

Most of what follows are considered experimental by the FDA and are not endorsed or approved by this federal agency or the AMA, the FTC, any state medical or osteopathic board, etc. or other regulatory entities, but in my experience as a physician can help maximize the healing and restoration of stroke sufferers. These treatments should be considered unproven and will likely be labeled as “dubious” or “quackery” by some.

An acute stroke is one that has occurred within the last 24 hours. In general, acute stroke sufferers should rushed immediately to a hospital for a CT exam of their brain to determine the type of stroke. If a blood clot is detected, then the clot busting drug TPA can be given (but only if they get to the hospital within 3 to 6 hours after stroke onset). If it is a bleeding type of stroke the blood pressure may need to be lowered and if the patient is progressively worsening an OPEN CRANIOTOMY should be done to relieve the intracranial pressure so that the surrounding brain tissue is not compressed (Such swelling shuts off the blood supply to the surrounding tissues and worsens the stroke).

During the first hours and even 1 to 3 days thereafter the patient’s symptoms may gradually worsen. Remember President Richard Nixon being taken to the hospital awake and alert and then slowly going into a coma and dying? This process of gradually worsening is due to the area surrounding the central core of dead brain tissue swelling and compressing the surrounding blood vessels. This is called the “ISCHEMIC PENUMBRA” and is a major problem accounting for up to 80% of all long term disability from strokes. In my experience, the impeded blood flow and the resulting damage can be REVERSED if the patient is treated with the right therapies during the first 24 hours after the initial stroke.

Certain aspects of this process are not well known to doctors and has never been studied well by mainstream medical scientists, especially in terms of how to effectively reverse the brain swelling.

In my experience, hyperbaric oxygen is the single best method of treating this situation.

However, in many instances the chamber needed for this is not available or the doctor in charge is afraid to do it since it is not mainstream and if, God forbids, the patient dies he can be sued and or even lose his license for offering a non-approved therapy.

If you are lucky enough to find someone with a chamber who is willing to treat the stroke patient then he or she will need to be treated to protect their airway since if they are unconscious they could vomit, breath this in and die of asphyxiation. The best HBO chamber for this is a large multiplace chamber where an attendant can be present to guard against the patient  experiencing this. If this is not available then the attending doctor will need to insert a trach tube so that stomach fluids cannot enter the lungs.

Once these hurdles are dealt with, then the chamber should be pressurized to 2 to 2.4 ATA (Atmospheres Absolute) and the patient treated for one full hour every 4 hours for the first 24 hours from the time they arrive at the hyperbaric treating unit.

If the patient is awake and is in control of their swallowing then treatment in a single place hyperbaric chamber should work just fine. In most cases results will be seen within 1-2 treatments. For less severe strokes, all of the symptoms may disappear within a few treatments.

After the first 24 hours, I then treat every 6 to 8 hours for another day and then every 12 hours for the next three weeks. If the symptoms persist at 3 weeks it is generally beneficial to continue for another 3 weeks at one treatment per day.

In my experience, hyperbaric is the best but if you combine the therapy with a special cocktail of intravenous antioxidants and anti-inflammatory agents.

For the patient who is comatose and essentially dying, the best method for immediate relief is the use of intravenous DMSO (dimethyl sulfoxide). This is a legal FDA drug that is used “off label” here because of its ability to decrease brain swelling. The dose for this can range from 20 to 70 ml given by intravenous (iv) slow push over 5-10 minutes. If this is not available or for some reason the DMSO fails to wake the person within 10 minutes of administration, another agent that is often helpful is solu-medrol 40 to 120 mg intravenous. This is a steroid and is more apt to cause side effects but is very good at helping to reverse the brain swelling immediately. A conservative approach would be 20 ml of DMSO and 40 mg of Solu-medrol by intravenous means, followed by waiting 15 minutes to see the effects. If the patient stops breathing during any of this, CPR is given plus these drugs. CPR is continued for 30 minutes before giving up. In general this combination will bring the person back as long as blood circulation to the brain is maintained.

Stroke patients who are not in a coma and dying can be treated less aggressively by giving an intravenous solution containing the following combination of ingredients:

Magnesium sulfate 2 gram

DMSO 20 ml

Disodium EDTA 10 to 20 ml

Mannitol 1 to 4 bottles

Vitamin C 10 grams

B-complex 2 ml

B-6 10 ml

Solu-medrol 40 mg (first iv)

If available SOD and catalase.

If the stroke is due to atherosclerosis and the blood is thick, doctors should consider giving heparin 2 to 5000 units in 400 ml of sterile water over 3 hours (between hyperbaric oxygen treatments).

This combination is done for 24 hours and within that time many patients should be improved to the point they are almost as functional as they were before their stroke. If not, hyperbaric oxygen on a daily basis should be continued as described above. If the stroke is ischemic (due to a lack of blood flow) and from atherosclerosis, then intravenous Disodium EDTA, heparin, magnesium, and vitamins should be given every other day for the next 3 to 6 weeks depending on the patient, their tolerance and the improvements or lack of improvements seen.

STEM CELLS for stroke…

Stem cells must enter into the brain to exert their therapeutic effects. The optimum time for the administration of stem cells is 72 hours after a stroke especially when only one injection of stem cells is to be given. However, if possible stem cells should be given daily by intravenous (iv) means or introduced into the CSF (cerebrospinal fluid) as soon as possible after a stroke.

Stem cells can not reverse the brain swelling nor take away the ischemic penumbra, but they can help foster repair of the damage after HBO and intravenous therapies (see above) have had a chance to work.

For the chronic stroke patient stem cells given into the CSF are the most cost effective and best therapy for reversing the symptoms of a stroke, at least in my considerable clinical experience. In some cases stem cells are used in combination with different brain growth factors that have to be taken daily for at least three weeks. Why three weeks? It takes a minimum of three (3) weeks for the body to make new blood vessels that grow into the damaged area of the brain. The growth of these new blood vessels is helped greatly by infused stem cells and is the main reason why the use of daily hyperbaric oxygen and stem cells work to help reverse the symptoms experienced by the chronic stroke patient.

By David A. Steenblock, MS, DO