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Hispanics and Stroke: A Personal Account
By Rowena Alegrķa
In recent months, two members of my family faced stroke.
My godmother was sipping coffee when a severe headache hit and she couldn't keep the liquid in one side of her mouth. She eventually reached her daughter, who didn't believe it was a stroke. A day passed before my mother finally took her to see a doctor.
As I write this, one of Mom's younger brothers is in the hospital. He had stopped for cigarettes when suddenly he couldn't stand and could hardly speak. Because of confusion and fear, he drove off without his brother but somehow made it home. He was given coffee and observed before he was finally taken to an emergency room.
Why tell these stories? Because they are all too typical for Latinos, particularly Mexican-Americans, who have a far higher risk of stroke than non-Hispanic whites. Also because Latinos tend to have strokes at a younger age and suffer greater disabilities as a result of stroke. Most importantly, if we don't start talking about it, these startling statistics aren't going to change.
Stroke prevention is particularly important for Latinos since they face far higher stroke risk. Researchers at the University of Michigan (U-M) found that “Mexican-Americans aged 45-49 were twice as likely as their non-Hispanic white counterparts to have any sort of stroke or near-stroke, and those in their 60s and early 70s were about 60 percent more likely,” according to the study published in the American Journal of Epidemiology.
Why the difference? Dr. Lewis Morgenstern, lead author of the study, noted in a U-M release that although diabetes was thought to be a likely cause for the discrepancy, an in-depth analysis cast doubt on that theory.
“Obviously there are other factors contributing to the stroke risk faced by Mexican-Americans that still need to be determined,” he said.
And though many Latinos struggle with obesity and high blood pressure, both of which can increase risk for stroke, there are factors other than traditional health problems that can increase the incidence and impact of stroke. Consider these barriers to healthcare access among the Hispanic population:
If they are not talking to their doctors about stroke, or not seeing doctors at all, then many Latinos may not be doing what they need to do to prevent stroke, recognize symptoms and act fast to get life-saving treatment.
“We think we know all the risk factors for stroke, but I don't think we do,” said Morgenstern.
And that's not all we don't know. National Stroke Association reports that less than one in five Americans can name more than one symptom of stroke.
Ray Tafolla of Denver thought he was just tired. He got up and fell back on the chair. Though Tafolla argued he was fine, his son called 911. Dispatchers determined he was having a serious stroke.
“It's a good thing my son was with me,” Tafolla said.
Tafolla was out of the hospital within a week, and four years later, at the age of 69, says he does everything he did before, including playing golf. He feels lucky. His father had a stroke at 63 that affected his speech. “I never did understand him for the rest of his life,” Tafolla said. His father lived to be 95.
The difference was the clotbuster drug called t-PA, a treatment that restores blood flow to the brain, preventing further damage. Tafolla called it the “magic medicine.” But Tafolla's case is surprisingly rare. Studies show that as little as three percent of stroke patients who could receive t-PA actually do. Some don't get the treatment because their symptoms are too mild or are rapidly improving. Others don't get t-PA because they don't know when the stroke started; the clotbuster must be applied within three hours of the first symptoms. But many don't get the treatment simply because they arrive at hospitals too late. That's something that can change just by teaching people how to recognize stroke symptoms and act fast to get treatment.
“People will call 911 when they are confident they have recognized stroke symptoms. However, if they are unsure, they won't call due to fear of embarrassment or incurring negative consequences if it isn't a stroke,” said Kate Maddox, a stroke nurse at the University of Michigan. “We need to teach people that they don't have to diagnose the stroke themselves and they won't get in trouble if it turns out not to be a stroke.”
National Stroke Association recommends a simple test, called F.A.S.T., that will help you determine when to call for help.
Other symptoms to look for include a sudden, severe headache with no known cause; trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; sudden numbness, weakness, confusion, nausea or loss of consciousness.
One in 10 Latinos in the U.S. over the age of 65 has had a stroke. Yet, when stroke is suspected, many Latinos don't know what to do. And after stroke, they don't do enough to prevent another. Now is as good a time as any to change that.
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