DEAR DR. DONOHUE: My father-in-law died at an early age from a stroke. I don’t want the same thing to happen to my husband, but I am ignorant when it comes to recognizing one early on. Would you give me some ideas of what to look for? – D.J.

ANSWER: More than 700,000 North Americans will have a stroke this year. It will be a second stroke for 200,000 of those people. The annual death toll from strokes exceeds 150,000.

Recognizing the early signs of a stroke has assumed major importance. Not so long ago, there were few stroke treatments that could limit the brain damage caused by a stroke. Now, with clot-busting drugs, prompt treatment reduces the grave and permanent impairments that strokes can cause.

At the beginning of a stroke, people often say that they have weakness or numbness of the face, arms or legs on one side of the body. They might complain of blurred or dim vision. Some lose vision in one eye. Mental confusion and memory impairment are common signs. Dizziness is another complaint. All of these symptoms come on suddenly.

The University of North Carolina has devised three tests that can help onlookers judge if they are witnessing a stroke in evolution. The first is to ask the suspected stroke patient to raise both arms and to keep them raised. The second is to get the person to utter a simple, coherent sentence. The third test is to ask the person to smile. If people cannot perform these simple tasks, the probability of a stroke is high. Rapid transportation to the hospital for treatment is critical. The reason is to quickly dissolve the clot that is blocking blood flow to a section of brain before brain cells die.

Strokes are common and often disastrous. The stroke report clarifies what’s happening and what to do about it. Readers can order a copy by writing: Dr. Donohue – No. 902, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I am a 50-year-old woman. Lately a couple of floaters have appeared in my left eye. The eye doctor tells me there is no cure. I cannot live like this. They bother me in my work. How can I get rid of them? – M.F.

A gelatinous material, the vitreous, fills the back two-thirds of the eye. It is a clear gel, and one of its functions is maintaining the eye’s shape. In later life, small particles find their way into the vitreous. They might be tiny dots or ribbons of protein or body cells. As they float in the vitreous, they cast a shadow on the retina, the vision-sensitive layer at back of the eye. Those shadows are floaters.

Floaters happen to nearly everyone as they grow older. People who are nearsighted get them early in life.

They can drive a person to distraction if the person fixates on them. I am not speaking from secondhand information, for I have more than my share of them.

A sudden shower of floaters is an alarm that should send a person to the eye doctor immediately. The shower can be a signal that the retina is detaching from its location at the back of the eye. That constitutes an emergency.

Should the vitreous be filled with blood or some other opaque substance so the eye is blind, then the vitreous can be suctioned and replaced with a clear fluid. This is not a procedure that is done for a few floaters, no matter how annoying they are.

DEAR DR. DONOHUE: I am confused. When the instructions say to take medicine with food, how much food? I can’t get an answer to this question, and I have asked many medical professionals. – D.S.

A small sandwich or its equivalent serves as the minimum amount of food that should be taken with a medicine that carries the instructions to take with food.

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.

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