Stroke and heat stroke not the same

Dr. Gott — Wed, 17 Feb 2010 05:01:56 +0000

DEAR DR. GOTT: I would like to know the difference between heat stroke and a massive stroke leading to death.
My friend was out most of the day in 85 F to 90 F heat. He wasn’t sick at all. He went to bed that night and fell on the floor. He couldn’t get up. About a half-hour later, he went into a coma and never came out of it.
I am blaming myself for keeping him outside. He was having a good time, even doing the chicken dance. I am wondering if the heat had anything to do with it. He was 93.
DEAR READER: The main difference between heat stroke and stroke is the heat. A typical stroke results when blood flow to the brain becomes compromised, usually because of a blood clot or bleeding into the brain. A heat stroke occurs when the body is unable to cool itself properly and internal temperatures reach 104 F or higher. At this temperature, tissues and organs can begin to swell and may cause brain damage or even death.
Stroke has warning signs, such as half the body becoming paralyzed, slurred speech, drooping on one side of the face and more. Sometimes no signs or symptoms are present, and in others, the symptoms are mild or occur quickly before the person loses consciousness.
Heat stroke, on the hand, has many symptoms. It is commonly preceded by heat cramps and heat exhaustion. These are usually characterized by fatigue, excessive sweating, muscle cramps, increased thirst, headache, dizziness, nausea, lightheadedness and more. If these symptoms are ignored, the body can become dehydrated, which then results in the inability to sweat, causing the body to overheat.
If your friend was feeling ill prior to collapse, he may have suffered a heat stroke, but you say he was in good spirits and felt normal. This leads me to believe that, if he did indeed have a stroke, it was probably not the result of his outdoor activities.
A final factor is your friend’s age. At 93, our bodies are wearing down. Things don’t always work the way they should. Perhaps he did not have a stroke at all. Often, heart attack can result from strenuous activity and may not present with any symptoms. Did he have any health concerns or medical conditions that would put him at increased risk of heart attack or stroke, such as elevated cholesterol levels, family or personal history of these conditions, or hypertension? Was he on any medication? The list can go on and on, but the result is the same. Unless an autopsy was performed, there is no way to know why your friend passed away in the manner he did.
As for you blaming yourself, this is not necessary. You are not to blame. Even in the event that your friend suffered a heat stroke, he would have had warning signs, which he chose to ignore and not seek help for. I suggest your speak with a therapist to work out your feelings. He or she can help you process what happened to allow you to better cope with the loss of your friend and conclude that what happened was not your fault.
To provide related information, I am sending you copies of my Health Reports “Coronary Artery Disease” and “Stroke.” Other readers who would like copies should send a self-addressed stamped No. 10 envelope and a $2 check or money order per report to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Stroke damage probably permanent after 30 years

Dr. Gott — Wed, 13 Feb 2008 05:00:04 +0000

DEAR DR. GOTT: About 30 years ago, my brother-in-law, while working in extreme heat and consuming alcohol, suffered a heat stroke. He was left with a strong speech impairment where he cannot pronounce consonants and his voice is quite rough. He took speech therapy for a while after the stroke, but it did not help. Otherwise his health is good. He takes no medications and is 74 years old. He has a slight balance problem but can work in the yard, mow with a riding mower, etc. He hasn’t seen a doctor in years. He is quite alert. His wife died two years ago and he is lonely, but he will not go out in public because of years of people making fun of his speech. It has greatly discouraged him. I believe people are more tolerant and understanding today but he doesn’t. He generally doesn’t say anything unless asked a question and he answers in as few words as possible. His grown children are sympathetic but not assertive toward the situation.

Is there a medical procedure or therapy that could help him? Should he see an ear-nose-and-throat or stroke specialist? What about another speech therapist? I don’t want to get anyone’s hopes up and have there be no solution. What is your advice?

DEAR READER: Your brother-in-law may have run out of options. If he hasn’t improved in 30 years, the likelihood of cure or improvement is very remote. However, with modern techniques some of his difficulties may be lessened.

If he were my brother-in-law, I would pull out all the stops and have him evaluated by a neurologist (stroke specialist), an ear-nose-and-throat specialist, AND a speech therapist. This should cover all the bases.

If, as I suspect, your brother-in-law’s damage from the stroke is permanent, at least you can be certain he has been thoroughly evaluated and found to be in otherwise good health.

As a further step, he may benefit from therapy. In this setting he will be able to communicate with someone and not have to fear ridicule. It may give him the confidence to talk with family members in a more meaningful manner. From there a stroke support group, perhaps one geared toward speech impaired patients, is an appropriate step. This should allow him to open up even more because he will be surrounded by individuals who truly know what he is going through. In the best case scenario, he will feel more comfortable in public settings. In the worst, he will have acquaintances (maybe even friends) with whom he can freely talk. Either way, his loneliness will come to an end and he will happier.

Let me know how this turns out.

To give you related information, I am sending you a copy of my Health Report “Stroke”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

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Stroke and heat stroke not the same

Stroke damage probably permanent after 30 years