stroke

Leave a comment Posted on December 17, 2017December 18, 2017 Cardiovascular disease

Carotid endarterectomy – will you need one?

Carotid endarterectomy

[Original article on NHS Choices website]

Carotid endarterectomy is a surgical procedure to unblock a carotid artery. The carotid arteries are the main blood vessels that supply the head and neck.

Carotid endarterectomies are carried out when one or both carotid arteries become narrowed because of a build-up of fatty deposits (plaque). This is known as carotid artery disease or carotid artery stenosis.

If a narrowed carotid artery is left untreated, blood flow to the brain may be affected. This is usually because a blood clot forms and a piece breaks off and goes to the brain. This can result in either:

a stroke – a serious medical condition that can cause brain damage or death

a transient ischaemic attack (TIA) – sometimes known as a “mini-stroke”, a TIA is similar to a stroke but the signs and symptoms are temporary and usually disappear within 24 hours

Each year around 110,000 people have a stroke in the UK and around a quarter of these are caused by a narrowing of the carotid arteries. More than 5,000 carotid endarterectomy procedures were performed on the NHS between 2011 and 2012.

Carotid endarterectomy can significantly reduce the risk of a stroke in people with severely narrowed carotid arteries. In people who have previously had a stroke or a TIA, their risk of having another stroke or TIA within the next three years is reduced by a third after surgery.

It’s now thought the operation should be performed as soon as possible after symptoms appear. It’s important to seek immediate medical advice if you experience symptoms such as:

numbness or weakness in the face, arm or leg

speech problems

loss of vision in one eye

Read more about when carotid endarterectomy is needed.

About the procedure

Carotid endarterectomy can be carried out using either local anaesthetic or general anaesthetic. The advantage of local anaesthetic is it allows the surgeon to monitor brain function while you’re awake. However, there’s no evidence that either is safer or better.

During the procedure, a 7-10cm (2.5-4 inch) cut will be made between the corner of your jaw and your breastbone. A small cut is then made along the narrowed section of artery, and the fatty deposits that have built up are removed.

The artery is then closed with stitches or a patch and your skin is also closed with stitches.

What happens after the procedure

You’ll usually be moved to the recovery area of the operating theatre for monitoring. Most people are well enough to go home within about 48 hours of the procedure.

In most cases, the only problems experienced after the operation are temporary numbness or discomfort in the neck.

However, there’s a small risk of more serious complications, which can include stroke or death in around 3% of cases. Nevertheless, this risk is much lower than in people with carotid artery disease who haven’t chosen to have the operation.

Are there any alternatives?

Carotid endarterectomy is the main treatment for narrowing of the carotid arteries, but sometimes an alternative procedure called carotid artery stent placement may be available.

This is a less invasive procedure than a carotid endarterectomy because it doesn’t involve a cut being made in the neck. Instead, a thin flexible tube is guided to the carotid artery through a small cut in the groin. A mesh cylinder (stent) is then placed into the narrowed section of artery to widen it and allow blood to flow through it more easily.

Carotid stenting is currently thought to be associated with a higher risk of stroke during the procedure, especially if it’s performed in the first few days after symptoms appear. However, it’s a useful alternative for people who may be at a higher risk of complications from an operation.

Read more about carotid artery stent placement.

Leave a comment Posted on June 10, 2017June 10, 2017 Multiple Sclerosis, Patient Talk

Pseudobulbar Affect – a possible symptom of multiple sclerosis

Pseudobulbar Affect

As regular readers know we try to look at rarer signs and symptoms of multiple sclerosis.

You might be interested in this video on lesser known symptoms of multiple sclerosis.

Pseudobulbar affect ( also known as emotional incontinence) can occur with multiple sclerosis, strokes and Parkinson’s for example. It is medical condition characterized by sudden and uncontrollable episodes of crying or laughing.

The American Stroke Association have produced and excellent video on Pseudobulbar Affect. We really recommend you watch.

Thanks in advance!

Leave a comment Posted on May 19, 2017May 19, 2017 A to Z of Medical Conditions

Essential tremor – what it is and why you need to know

Essential tremor

[Original article on NHS Choices website]

Essential tremor is a type of uncontrollable shake or tremble of part of the body.

Most people with essential tremor experience a trembling, up-and-down movement of the hands.

The arms, head, eyelids, lips and other muscles can also be affected. A tremor in the voice box (larynx) may cause a shaky voice.

Essential tremor is usually more noticeable when you’re trying to hold a position or do something with your hands, such as write. It doesn’t always affect both sides of the body equally.

Essential tremor is a common movement disorder affecting around four out of 100 adults over 40 years of age. Some people only have a mild tremor at first, which usually gets more severe over time.

‘Normal’ tremor

Everyone has a very minor tremor when carrying out daily activities. For example, your hands will shake slightly when you hold them out in front of you. This is normal.

Sometimes, the everyday level of tremor can become more noticeable, particularly in older people. Noticeable tremor is also normal and it’s often caused by a raised level of adrenaline in the body, which can happen when a person is stressed, anxious or angry.

When does a tremor become a problem?

Essential tremor is more severe than normal tremor and it gradually gets worse over time. Eventually, the tremor may become so severe that carrying out normal, everyday activities can become difficult.

Certain things may temporarily increase any tremor, including:

tiredness caused by strenuous activity or lack of sleep

smoking

caffeine – from tea, coffee and some fizzy drinks

being very hot or cold

taking certain medicines – including some antidepressants and treatments for asthma

When to see your GP

It’s important to visit your GP if you experience frequent or severe tremors.

Although there’s no specific test to diagnose essential tremor, your GP can carry out a physical examination and may request further tests to rule out other conditions (see causes, below).

They’ll also ask about your personal and family medical history as part of their assessment.

Treating essential tremor

There’s no cure for essential tremor, but medicines can be used to help improve the symptoms in at least half of people with the condition.

In rare cases, a severe tremor may be treated with surgery if it doesn’t respond to medication.

Read more about treating essential tremor.

Inherited essential tremor

Essential tremor can run in families and research suggests it’s passed on by a faulty gene. At least half of people with the condition have a family member who also has it.

However, the age at which a tremor develops and its severity can vary greatly between different family members. Some people may also develop the faulty gene without inheriting it from either parent.

Other causes of tremor

There are a number of conditions which may cause tremor, including:

overactive thyroid (hyperthyroidism)

Parkinson’s disease, a long-term condition affecting the way the brain co-ordinates body movements

multiple sclerosis, a condition of the central nervous system (brain and spinal cord) affecting the senses and the body’s actions

dystonia, a range of movement disorders which cause involuntary muscle spasms

stroke, which very rarely may result in tremor with few other symptoms

peripheral neuropathy, where the peripheral nervous system is damaged

A tremor can also be one of the withdrawal symptoms for people who are dependant on alcohol and have stopped or reduced their alcohol intake.

Leave a comment Posted on March 4, 2017March 4, 2017 Patient Talk

The top 5 causes of premature death

[Original article on NHS Choices website]

Thousands of people in England could avoid an early death from one of the five most common killers:

cancer

heart disease

stroke

lung disease

liver disease

A child born today should expect to live a longer, healthier life than ever before. Yet, a Government report, Living Well for Longer (PDF, 1.6Mb), blames the top five killers for more than 150,000 deaths a year among under-75s in England alone and the Department of Health estimates two-thirds of them are entirely avoidable.

This chart shows the premature death toll by illness. Heart disease and stroke are together referred to as cardiovascular disease.

Reduce your risk of cancer

More than one in three people will develop some form of cancer during their lifetime. Although there are more than 200 different types of cancer, lung, breast, prostate and bowel cancer account for more than half of cases.

According to Cancer Research UK, an unhealthy lifestyle is the root cause of about a third of all cancers.

Smoking causes almost all lung cancer. Poor diet has been linked to bowel cancer, pancreatic cancer and oesophageal cancer. And heavy drinking has been implicated in the development of breast cancer.

While healthy lifestyle changes can prevent many cases of cancer, screening aims to drive down cancer cases even further.

National programmes for breast cancer screening, cervical screening and bowel cancer screening help identify cancer at an early stage when it’s more treatable.

make sure you know the key symptoms of the main cancers

take up the offer of cancer screening. Find out more about the NHS screening programmes for breast cancer, cervical cancer and bowel cancer

lifestyle changes to reduce your risk of cancer

Prevent heart disease

Experts say most cases of premature death from heart disease are completely preventable.

Smoking, being overweight, having high blood pressure and/or high cholesterol, heavy drinking and physical inactivity are all key risk factors.

If you’re over 40, ask your GP about the NHS Health Check, a free five-yearly mid-life MOT to look for things like high blood pressure and high cholesterol.

Exercise reduces your risk of heart attack by 30%. Try to do more exercise, especially aerobic exercise like walking, swimming and cycling. Find out how you can benefit from being more physically active, and try this 12-week exercise plan for beginners combining running and strength and flexibility workouts.

Carrying extra weight puts a strain on your heart. For help losing weight sign up to Change4Life’s healthy eating smart swaps campaigns and the NHS-approved 12-week weight loss plan.

Reduce your risk of stroke

Stroke is the third leading cause of death in England each year and the leading cause of disability.

More than 150,000 people have a stroke every year in the UK but, according to The Stroke Association, up to 10,000 of these could be prevented if more people were aware of the symptoms and sought out emergency treatment.

High blood pressure is the main cause of stroke. Almost one in three people in England have high blood pressure and nearly half of them aren’t receiving any treatment for the condition, says the British Heart Foundation.

watch out for the symptoms of stroke

a good way to reduce high blood pressure is to reduce your salt intake. Find out how to cut down on salt and read articles on how to have a healthy diet

Reduce your risk of lung disease

Respiratory disease covers a variety of conditions ranging from asthma to chronic obstructive pulmonary disease (COPD) one of the most common causes of death.

COPD is almost completely avoidable. Most cases (around 85%) are caused by smoking. The other 15% of cases are triggered by exposure to fumes, chemicals and dusts at work or, very occasionally, because of a rare genetic tendency to develop COPD called alpha-1-antitrypsin deficiency.

find out how the NHS can help you to stop smoking including how stop smoking advisers can help you quit and the benefits of stop smoking treatments

download this free NHS Smokefree app for daily tips and support

read how to stop smoking in pregnancy

Reduce your risk of liver disease

Liver disease is on the increase in England with a 20% increase in cases over the last decade. The disease develops silently and many people have no idea there’s anything wrong until they develop liver failure and it’s too late.

The three main causes of liver disease are heavy drinking, obesity and viral hepatitis (inflammation of the liver).

More than a third of men and over a quarter of women regularly exceed the recommended level of alcohol intake. Find out how to cut down.

Get Change4Life tips on how to take control of your drinking.

Use our BMI calculator to find out if you are a healthy weight and read articles on how to lose weight including the NHS-approved 12-week weight loss plan.

Have a hepatitis B vaccination if you’re at risk of infection.

Leave a comment Posted on September 20, 2016February 18, 2017 Cardiovascular disease

5 great ways to lower cholesterol naturally!

High cholesterol is the bane of the developed world. In the modern world we have more, better and much easier to prepare food than in previous centuries. But, this also means, far too many of us now have the opportunity to overindulge. (I’ll put my hands up here and say I’m one of those guilty of what I have to call greed). The problem with this kind of eating is that it does have the tendency to raise our cholesterol levels.

According to the NHS evidence strongly indicates that high cholesterol can increase the risk of:

narrowing of the arteries (atherosclerosis)

heart attack

stroke

transient ischaemic attack (TIA) – often known as a “mini stroke”

peripheral arterial disease (PAD)

So I think we can all agree that we need a few ideas of reducing our cholesterol levels.

So I thought I would share the following five tips which you can use to help reduce your cholesterol with our recourse to medication.

a) Yes indeed I know healthcare professionals sound like a broken record on the subject of drink. But it is important to cut down (if you do drink) to cut a glass or two a day. Oh and make sure that you have a few drink free days each week including weekends.

b) Smoking tobacco. If you still smoke please please do give up. Please check out a previous blog post with a few tips to help you quit.

c) Now I know that many pixels have died in the cause of lecturing us about taking more exercise. But it also has numerous other benefits as this article shows!

d) Chronic stress can impact on your cholesterol levels. To have a look at these great ideas for reducing stress in your life.

e) Foods fortified with plant sterols and stanols. Foods which contain sterols and stanols include corn, coconut, olive and sunflower oils, beans, corn, peanut butter, almonds, oranges, apples, and avocados. A great way of getting down your cholesterol.

If you do have any concerns about your cholesterol levels please do speak with a medical professional as they are best able to advise on your best course of action!

And if you do have any other tips for reducing cholesterol please do share them in the comment section at the bottom of this blog post.