Anthony Bray MD : Hello!
thank you for take my question
Anthony Bray MD : i think that her stroke was most likely associated with her HUGE risk factors of # XXXXX diabetes // #2 high blood pressure// #3 high cholesterol >>> these three in combination would be the MAJOR factors of risk...
Anthony Bray MD : The details of her control of these conditions would be helpful...
well I don't really know the name of the medicine of she takes, but I know are many, like 8 or 10 pills a day plus the insuline
Anthony Bray MD : while there have been alarming studies showing some increase risk of heart attack and stroke with the anti- inflammatory MEDS these seem to be more long term risk with taking such MEDS daily over a long period of time and not that sporadic dosing would be expected to have much adverse effect on risk at all ...
I understand she isn't careful with the time that she has to take them, I mean, she takes the medicine at the time she just remember....
Anthony Bray MD : Her having an argument would not be expected to be any major risk factor either -- an argument may cause a temporary rise in blood pressure and may increase risk some but I think to minimal extent at most ... I think the argument would be more a coincidence in this setting....
I really want to know if this kind of stroke can be cause by an argument that she had, because that is what she said... I don't believe that it can happen, I more realistic, I think the medicine disorder and the Aleve she took cause this effect..... am I right???
ok.... I read the answer.... You got me already
Anthony Bray MD : I understand >>> as I said she has a set of MAJOR MAJOR risk factors and these would probably account for greater than 95 percent of her risk for example .... I think a single or occasional dose if an anti- inflammatory med and her having the argument would NOT be the main culprit in her case at all!!?
Anthony Bray MD : what symptoms if stroke does she have??
well, when they went to ER, she can't walk normally, she had headache and pain on her entire body.... yesterday I saw her in the hospital and she told me she had two blood clods in her head or brain
she point me her head
Anthony Bray MD : I hope this discussion has been helpful for you. She will likely be advised to take Plavix ( maybe plus low dose aspirin = 81 mg ) would be likely to have her decrease risk in the future...( it is important to know if she had hemorragic vs thrombotic type stroke....
actually weeks before a lot of blood came from her mouth and nose.... I remember it can't stop and in the hospital she had a blood transfusion
Anthony Bray MD : OK I see>> it sounds thrombotic in nature then ...
so it is cause by????
Anthony Bray MD : With that added history it sounds more high risk--- she needs to reduce risk if recurrent stroke but also needs care not to unduly increase risk of recurrent bleeding....
Anthony Bray MD : blood clot in brain artery --- clots blocks blood flow to brain segment and this would damage tissue if brain in the distribution of the affected artery ....
what you mean when you said she needs to reduce risk, she has to be careful about what???
Anthony Bray MD : diabetes well controlled >>> hemoglobin A1C controlled to less than 7.0
that is a medicine right???
Anthony Bray MD : Blood pressure needs to be controlled to 135/85 or less ( every 20 point rise in systolic = top number causes a doubling of relative risk over time...
ok.... thank you for help me to be clear about this. I'm pretty clear what was happening now....
Anthony Bray MD : cholesterol needs to be controlled to get LDL less than 70 if possible ... At least LDL less than 100...HDL = good cholesterol should be greater than 50....
Anthony Bray MD : OK. Let me know if you have futher questions and I will be happy to get back with you!
Well I think she has to talk with her doctor and be honest with he/she and obviously with herself...
Anthony Bray MD : If my answer has bee
Anthony Bray MD : been helpful and to your satisfaction then please remember to leave positive feedback. That would be very much appreciated! Thank you and best regards,
Anthony Bray MD : Anthony Bray MD