Carotid artery blockage one cause of stroke

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DEAR DR. DONOHUE: What are the symptoms of blocked carotid arteries? What treatments are available? How can we avoid having this condition? – B.N.

ANSWER:
There is a carotid artery is on each side of the neck. The two arteries bring blood to the brain. Blockage of a carotid artery doesn’t usually bring on symptoms until the blockage reaches a critical point. Although the process goes on in both arteries, most often one artery is worse off than the other.

A transient ischemic attack is one big sign of carotid artery blockage. “Ischemic” means lack of blood. Such an attack causes an arm or leg to become weak. A person might have difficulty speaking. Vision can become impaired. Or people are suddenly confused. These symptoms disappear in 24 hours, but usually much sooner – in a matter of minutes. People often call these attacks “little strokes.” A transient ischemic attack is a warning that a stroke is in the offing. A stroke can happen within as short a time as two days unless treatment is instituted.

The process that causes carotid blockage is the same process that plugs heart arteries to cause a heart attack – atherosclerosis, the piling up of cholesterol, fat, protein and platelets on and in the walls of the artery. Keeping the carotid arteries clean involves the same things that keep heart arteries clean – no smoking, lowering blood cholesterol, maintaining normal blood pressure, normalizing blood sugar if one has diabetes, drinking alcohol in moderation and exercising to the limits permitted by one’s doctor.

When a carotid artery has reached the critical blockage point or when a person has symptoms but the blockage is not at the critical point, cleaning the artery is the treatment.

That can be done surgically, or it can be done in the way heart arteries are often opened up, with a balloon-tipped catheter. A catheter is a soft tube advanced into the carotid artery. At the point of obstruction, the doctor inflates the balloon and squashes the buildup.

The stroke booklet handles the topic of carotid artery clogging and the other causes of strokes, and describes symptoms and treatments. Readers can obtain a copy by writing: Dr. Donohue, No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6.75 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a recovering alcoholic and have not had a drink in 12 years. I say “recovering” because I fear using the word “cured.” I think, however, I am cured.

I have many friends who used to be heavy drinkers. It seems to me that they have come down with cancer much more frequently than nondrinking people. Is there any validity to this observation? Myself, I had prostate cancer. – G.M.

ANSWER:
Cancers of the liver, rectum, esophagus, mouth, throat and larynx (voice box) show some relationship to excessive intake of alcohol. That by no means is an indication that every person who comes down with one of those cancers was or is an abuser of alcohol.

Prostate cancer doesn’t have a link with alcohol abuse. At least, to date, no relationship has been made between the two.

DEAR DR. DONOHUE: I had severe pain on the left side of my chest and I was afraid that it might be a heart attack, so my husband took me to the emergency room. After hours of tests, they said I didn’t have a heart attack, but I had costochondritis. They put me on Indocin. Would you explain what this is? – C.R.

ANSWER:
It’s an inflammation of the cartilage (chondritis) that attaches the rib (costo) to the breastbone. The pain it causes is often confused with the pain of a heart attack, especially when the pain goes down the left arm, as it can do. Taking a deep breath, twisting the torso or coughing makes the pain of costochondritis worse.

Indocin, one of the anti-inflammatory drugs, can usually relieve the pain and inflammation. If it doesn’t, an injection of a cortisone drug in the area of inflammation almost always does.

DEAR DR. DONOHUE: Thank you for your explanation of LGV (lymphogranuloma venereum) in gay men. The mother, who wrote the letter, feels “all alone.” We would be grateful if you would let her and other readers know about Parents, Families and Friends of Lesbians and Gays (PFLAG). She can obtain information by visiting the Web site: www.pflag.org. She will no longer be alone with her questions. – A.N.

ANSWER:
I am sure this mother will appreciate the information.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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