A Stroke Was My Teacher
By JAMES G. CRAWFORDBALBOA PRESS
Copyright © 2011 James Crawford
All right reserved.
ISBN: 978-1-4525-3567-8
Contents
Key Topics..........................................................................vDedication..........................................................................viiForeword............................................................................xviiPrologue............................................................................xxAcknowledgments.....................................................................xxiiSpecial Thanks......................................................................xxvPermissions Granted.................................................................xxviChapter One Purposes Of Book........................................................3Chapter Two How The Odyssey Began...................................................16Chapter Three Proposed Stroke And Heart Attack Mechanisms...........................24Chapter Four Neuropathy Hypothesis..................................................65Chapter Five The Evolution Of Vascular Disease Study In America.....................84INTRODUCTION TO LESSONS.............................................................89Lesson One Why Me?..................................................................91Lesson Two Simple Truths About Stroke And Our Bodies................................97Lesson Three Treatment Modalities Evaluated.........................................104Lesson Four Health Maintenance Post-Stroke..........................................121Lesson Five The Practical Side Of Stroke............................................131Lesson Six Stroke ER: What Was And What Should Have Been............................145Lesson Seven The Intuitive Side Of Stroke Recovery..................................149Lesson Eight The Philosophical Side Of Stroke.......................................151Lesson Nine Delayed-Progressive Stroke Symptoms.....................................160Lesson Ten An Advocate Is A Needed Friend...........................................163Lesson Eleven Medical Solutions Of Last Resort......................................164Lesson Twelve Final Lesson..........................................................167Epilogue............................................................................171Appendix I Helpful Drugs For Recovery...............................................181Appendix II Literature Research Tools...............................................184Appendix III How Medicare Could Save Money..........................................186Appendix IV Nutrients And Supplements...............................................190Glossary............................................................................199References..........................................................................204Index...............................................................................214
Chapter One
Purposes Of Book Introduction
This book was written not to convince anyone of anything, rather to show how it is possible to look at some of the data others have seen, and then through that effort, how one can be lead to a different conclusion. For this account of stroke and heart attack, the roots of this path of thought can be traced back to the Framingham study that originated in 1947, and continues today 50 years later.
A Stroke was my Teacher is offered to that category of the population who takes responsibility for their own health, and chooses to look beyond the offerings of the traditional approach to medical practice. Readers attracted to this book are proactive and usually challenge medical dogma and our national sense that medical success is defined as management of symptoms.
In this book, you will find many of the details for what it is like to experience and then try to manage and understand the effects of an embolic stroke. Within this record of events as they happened, may be found results and assessment of numerous stroke-treatments. These include modalities recognized for stroke, and those only recommended by product merchants. I have discussed what has been helpful to me, and what has not. An important goal for this book is to tell you what steps you can start today to minimize risk/prevent these vascular events from occurring. Also discussed is what to do if you have already had a warning stroke.
This account is presented from the perspective of a life-long career in medical science from graduate school at the University of Michigan, through 37 years of research at NIH and the Pfizer Corp.
This book was written for general public consumption as a handbook on what to expect from the experience. It was also written for use by vascular scientists who are willing to look at stroke and heart attack through a lens not colored by accepted medical dogma.
Book Strategy
I have referred to a quote throughout my entire career that captures my sense of the definition of a scientist. From memory I believe it was Compte de Denois who stated something to the effect that, "A scientist is a person who can look at what everyone else looks at but sees what no one else has seen".
As for strategy, there are two important aspects of this work of which the reader should be aware. One, the contents of this book as assembled, have not been the subject of peer review, and thus have not received scrutiny by vascular research authorities. I have left it up to the reader to decide if what I have said makes sense. What it does offer are supporting references for my story which themselves were subjected to peer review, and thus are considered valid. Where I have discussed my theories that represent a new interpretation of existing scientific records, I have clearly identified those sections of the book with the word Hypothesis or Theory in the title. This is especially notable in the book section where I have discussed the mechanisms for stroke (S) and heart attack (HA), which appear as a flow chart. I consider this a new look at old data for addition to future stroke literature if proven true.
One clear message I learned while working at Pfizer was that a research guy is not a welcome guest when entering the domain of a production department. I found out that offering unsolicited evidence for a new understanding of an old production method was a prescription for personal grief and a source of embarrassment for the resident engineers. I am again faced with that potential problem here as well, by entering the domain of highly qualified vascular research talent with a 50-year history, when out of the blue, a nobody from nowhere announces "Hey guys, have you thought of looking at atrial fibrillation (A Fib) in this light? Have you ever considered that A Fib may simply be the way our bodies announce the presence of an inflammatory agent. Is it possible one lesson here is first a plea to not waste science to look for something to mask the symptom, but rather to use science to find out why excess cortisol (as one possible inflammatory agent) became elevated in the first place?"
All I can say is, I am only trying to be helpful, and who knows, maybe there is something here worthy of study. After 50 years of close attention, vascular diseases are still among the top killers worldwide, so it is not as if we have all of the answers. Maybe it will take radical ideas to help reset research objectives.
My approach to uncovering and formulating new ideas about S and HA is one in which I reviewed relevant published reports and showed how some of those reports could be interpreted to support my theory of S and HA mechanisms. As for this book, its backbone consists of showing how S and HA could be related to hydration status. Here a case is made that dehydration, coupled with numerous other possible cofactors could account for clot formation that leads to S and HA. This thesis suggests that atrial fibrillation, while recognized as a risk factor for those diseases, is more likely a statistical matter of guilt by association rather than anything causative when viewed in the context of the schematic shown.
Fire away! Just be fair by remembering, I was only the messenger.
The second important aspect of this book strategy is for the reader to understand how new ideas find their way into the public conscience, which is as follows: It is difficult if not impossible for authors to offer new health-related ideas that have not been subjected to peer review. The escape mechanism for persistent authors is to end up writing a book that can be self-published. The reader can find that many successful authors have taken that path.
Book Structure
Apparently, sustaining an embolic stroke following a thirty-seven-year career with NIH and Pfizer on medically related topics conditions an inquisitive mind to view stroke and heart attack differently from conventional ideas of the diseases. You will find that I have thoroughly endorsed the Einstein quote.
While documenting my stroke experience coupled with intensive literature searches over the past three years, two major departures from usual stroke thinking were developed:
1. A schematic was constructed showing proposed mechanisms explaining how and why blood clots can form in the heart (not relying upon arrhythmia). Why African Americans· will have a higher stroke and heart attack risk than Caucasians. Why TIAs may not be recognized as symptoms of both heart attack and stroke. Why TIA effects are of short duration and without· residual tissue damage. 2. A unique hypothesis for mechanisms of neuropathy is offered.
Here is a brief outline of how this account will unfold: I am going to try to make a rational case for how a state of dehydration coupled with any of a variety of cofactors could together provide the mechanism for clot formation leading to embolic stroke and/or heart attack. Each of the potential co-factors will be separately discussed, to build a plausible hypothesis of stroke mechanisms if possible. There are, of course, the conventionally recognized stroke risk factors to be considered in any comprehensive account—age, blood pressure, lipid profile, etc.
In addition, here is the outline of hypothesized co-factors to be discussed, along with their supporting literature references.
A) Dehydration
B) Arrhythmia
C) Insulin Resistance
D) Fibrinogen
E) Stress Hormones
F) Red Cell Agglutinating Agents 1. Influenza Virus
2. Mycoplasma
3. Sickle Cell Disease
4. Rheumatoid Arthritis
5. Magnesium Deficiency
During the course of my experience with embolic stroke, I formulated these proposed stroke/heart attack mechanisms which seem to lie outside the framework of traditional explanations. Those who are trained in stroke matters may be able to endorse or refute these ideas as subjects of common knowledge, ignorance, or naivety ... maybe all of the above. Readers may decide for themselves.
Not having come across anyone who would or could offer counsel, I leave the test of truth to someone else for now and welcome constructive comment. As I get the picture, I think there are several less-traveled streets within Stroke City that need to be remapped and given new signage. These streets are named Dehydration, Arrhythmia, Insulin Resistance, Fibrinogen, and Inflammatory Agents. Each is reviewed as a separate discussion topic. Additional topics covered are:
A) Brief description of how my embolic stroke made its presence known. (See Chapter 2: How the Odyssey Began) B) Description of the types of strokes that are available, some stroke and heart attack statistics, and the rationale behind the "stroke belt" observed. C) A review of risk factors that stroke and heart attack have in common.
Main Message of Book
While the original intent of the book was an account of how and why I was affected by an embolic stroke and what the reader can do to minimize his or her stroke risk, it became evident that a much greater purpose could be served by showing how stroke (S) and heart attack (HA) have common roots and common causes.
This book is intended to describe in first person what it is like to experience an embolic stroke, and to distinguish it from other types of stroke. It is meant to be a handbook on what to expect after an embolic stroke. It is a who, what, why, when, where, and how type of stroke information. It is a guide for available treatment options I have studied, and my assessment of their utility. The book is strongly committed to offering reasons why my stroke (or your stroke) need never have happened.
While my main focus had been on stroke, coming to my senses on March 24, 2010, I realized that what was really going on within my studies was the revelation that a case possibly could be made that both heart attack and stroke, very likely have common root causes.
This book is a product of my research of stroke literature, along with my ideas, revealing what you can do—starting today—to prevent stroke and heart attack. Some are new strategies neither currently recognized/ endorsed, nor refuted by the stroke industry. They simply seem not to have been considered.
STROKE SCIENCE
Types of Stroke
There are five major types of strokes. Two are caused by clots, two by hemorrhage, and one (in theory) by blood vessel spasm (TIA). The two caused by clots, cerebral thrombosis and cerebral embolism, account for 70 to 80 percent of all strokes. Hemorrhagic strokes have a much higher fatality rate than strokes caused by clots (University of Tennessee Medical Center website, Types of Stroke). Strokes caused by cerebral and subarachnoid hemorrhages are caused by ruptured blood vessels. In my opinion, warning strokes are probably caused by a blood vessel spasm.
Cerebral thrombosis: Cerebral thrombosis, the most common kind of stroke, occurs when a blood clot forms in an artery, blocking the flow of blood to the brain. A warning stroke (TIA) often precedes these types of strokes.
Cerebral embolism: This type of stroke occurs when a blood clot forms in other parts of the body and is carried to the brain where it blocks blood flow. A heart disorder called atrial fibrillation is said to be a risk factor for this kind of stroke.
Subarachnoid hemorrhage: This type of stroke is caused when a blood vessel on the surface of the brain ruptures, bleeding into the space between the brain and the skull.
Cerebral hemorrhage: About 10 percent of strokes are cerebral hemorrhages, which occur when an artery in the brain bursts because of a head injury or an aneurysm. An aneurysm is a weak blood vessel that swells out like a balloon. Though they're not always dangerous, the artery wall can weaken and burst.
Warning stroke: A stroke without lasting damage because, in theory, it is caused by a spastic blood vessel (usually called a TIA).
Similarities of Stroke and Heart Attack Risk Factors
Advancing age
Elevated blood pressure
Coronary artery disease
Inactivity
Obesity
Diabetes (HA and S are the greatest cause of death among diabetics.)
Family history
Stress
Tobacco
Blood clots
The crucial fact that emerges from this tabulation is that both of these major killers have the same MO. In both cases, it is a clot that blocks oxygen and nutrients from reaching nerve cells in the brain (stroke) and muscle cells in the heart (heart attack). On the surface, this seems like a pretty simple problem to solve: prevent unwanted clot formation and you prevent HA and S.
Okay, so why have our research centers not been able to solve these problems—given the huge investment in health research made over the years? From my stroke experience, I am going to tell you what I think has been the major mistake and how I think these problems should be approached.
The following pages detail statistical data for heart attack and stroke from the US Centers for Disease Control and Prevention, the American Heart Association, and the World Health Association, respectively.
Statistical Dimensions of Heart Attack and Stroke
From the Center for Disease Control and Prevention 2006
(Prevalence and hospitalizations are computed for 2006 unless otherwise indicated. Mortality data are final for 2005, unless otherwise indicated.)
Estimated Annual Occurrence:
Heart disease: 631,636 cases Cancer: 559,888 Stroke (cerebrovascular disease): 137,119 Chronic lower respiratory diseases: 124,583 Accidents (unintentional injuries): 121,599 Diabetes: 72,449 Alzheimer's disease: 72,432 Influenza and pneumonia: 56,326 Nephritis, nephrotic syndrome, and nephrosis: 45,344 Septicemia: 34,234 Combination of heart disease and stroke: 768,755
From the Centers for Disease Control and Prevention 2010 Update
The following statistics are from the US Centers for Disease Control and Prevention and the Heart Disease and Stroke Statistics—2010 Update published by the American Heart Association.
Stroke is the third leading cause of death in the United States. Over 143,579 people die each year from stroke in the United States.
Each year, about 795,000 people suffer a stroke. About 600,000 of these are first attacks and 185,000 are recurrent attacks.
Stroke is the leading cause of serious, long-term disability in the United States.
Nearly three-quarters of all strokes occur in people over the age of sixty-five. The risk of having a stroke more than doubles each decade after the age of fifty-five.
Strokes can—and do—occur at any age. Nearly one-quarter of strokes occur in people under the age of sixty-five.
Stroke death rates are higher for African Americans than for Caucasians, even at younger ages.
In 2005, among adults age twenty and older, the number of people who had strokes was 6,500,000 (about 2,600,000 males and 3,900,000 females).
On average, every forty seconds, someone in the United States has a stroke.
Each year, about 55,000 more women than men have a stroke. Men's stroke incidence rates are greater than women's at younger ages but not at older ages. The male/female incidence ratio is 1.25 at ages fifty five to sixty-four; 1.50 for ages sixty-five to seventy-four; 1.07 at seventy-five to eighty-four; and 0.76 at eighty-five and older.
Of all strokes, 87 percent are ischemic, 10 percent are intracerebral hemorrhage, and 3 percent are sub-arachnoid hemorrhage.
Stroke accounted for about one of every seventeen deaths in the United States in 2005. Stroke mortality for 2005 was 143,579 (56,586 males, 86,993 females).
From 1995 to 2005, the stroke death rate fell 29.7 percent and the actual number of stroke deaths declined 13.5 percent.
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Excerpted from A Stroke Was My Teacherby JAMES G. CRAWFORD Copyright © 2011 by James Crawford. Excerpted by permission of BALBOA PRESS. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
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