FEBRUARY 2025
Khaas Baat : A Publication for Indian Americans in Florida
Health & Wellness

STROKE

Dr. M. P. Ravindra Nathan

By Dr. Venkit Iyer, MD, FACS

Stroke, also known as cerebrovascular accident (CVA), occurs when blood supply to part of the brain is reduced or interrupted, preventing the brain cells from getting the necessary oxygen and nutrients to maintain function. Brain cells are so sensitive compared to other organs that they tend to die within seconds, with irreversible damage setting within four minutes, to result in sudden paralysis or collapse.

After heart attack, it is the second most common cause of death in the Unites States. It is estimated that 15 million people die from stroke every year worldwide. Disability from paralysis, loss of speech, inability to move or eat leads to more devasting sequel such as malnutrition, contractures, bed sores, urinary infection, personal care issues, emotional trauma, depression, or pneumonia, eventually a slow miserable death.  

Most common cause of stroke is atherosclerosis or plaque buildup and hardening of the arteries to result in blockage of circulation, called ischemic stroke. Obstruction of the arteries can also occur from an embolic episode, when a fresh blood clot that originates elsewhere floats up into the brain vessels. Another cause is bleeding into the brain tissue called hemorrhagic stroke. This can happen from hypertension, head injuries, falls or rupture of blood vessels (aneurysms). Other triggers are aging itself, cancers, metabolic problems or severe infections.

Risk factors for causation of stroke include smoking, alcoholism, obesity, diabetes mellitus, hypertension, cardiac problems, irregular heartbeats, or atrial fibrillation, myxoma of heart, septal defects, high cholesterol levels, poor quality diet and genetic factors. There is a higher chance among males and African Americans.

Symptoms can be sudden onset of a fainting episode, paralysis of one side of body or limb, slurring of speech, drooping of one side of face, loss of consciousness, confusion, loss of balance, drooling, sudden visual problems in one eye, severe headache, difficulty in swallowing, or vertigo. Stroke can affect one half of the brain, a brain stem or just a small patch of brain.

Recovery from stroke depends to some extent on how quickly the problem is diagnosed and treated. Hence, it is up to every citizen to be aware of the above symptoms, call 911 immediately and have the patient taken to a hospital emergency room quickly. Many hospitals have a stroke team on call who specialize in providing instant management. If a stroke is properly diagnosed and treated within four hours of onset, there is better hope for full or partial recovery.

This involves immediate confirmation of diagnosis by CT or MRI scans of brain, blood tests and EKG. Carotid ultrasound/angiogram may be done, with intention for endovascular interventions. If it is confirmed to be an ischemic stroke, with no evidence of intracranial bleeding, then immediate administration of thrombolytics such as TPA can be lifesaving. In selected cases, carotid artery embolectomy can be done. Anticoagulation is administered to follow.

If the stroke is due to intracranial hemorrhage, then urgent neurosurgical intervention is requested to decompress the brain, evacuate the hematoma and stop the bleeding. Thrombolytics and anticoagulants are contra-indicated here.

Once full stroke has set in, the above procedures are of no use. Various supportive measures are planned for slow recovery. This involves physiotherapy, speech therapy, swallowing studies, and intense personal care. If there is difficulty in swallowing, then nutritional care may be provided via tube feeding such as gastrostomy or jejunostomy. Care is taken to prevent decubitus ulcers, urinary tract infections, aspiration or pneumonia. Occupational therapy, psychosocial support and cognitive therapy are initiated. Durable medical equipment such as a wheelchair or walker may be needed. Often left with permanent disabilities, some individuals may recover over time.

Prevention of stroke is done by avoiding atherosclerosis. This is possible through healthy diet, regular exercise, stoppage of smoking or alcohol, control of obesity, hypertension, renal diseases and diabetes mellitus. Regular doctor’s visit and blood tests are conducted to ensure cholesterol, blood sugar and renal functions are maintained at normal levels.

Some individuals may get a warning signal of impending stroke called transient ischemic attacks (TIA). These are symptoms of mini stroke, when the person experiences a transient weakness of one limb or other, transient blindness of one eye or other, slurring of speech or syncopal episode. The patients are evaluated with carotid duplex ultrasound examination, to be followed by MR or CT angiogram, to identify blockage of carotid artery. At times during a routine physical examination, a bruit is heard over the carotid artery, which indicates narrowing of the blood vessel. If there is more than 70% narrowing of the carotid artery, a prophylactic carotid endarterectomy or angioplasty and stent placement can offset a potential stroke.

Stroke is a devastating condition for both the patient and family. Many people suffer for months or even years and become dependent on caregivers for daily functions. It is a slow painful end to life. At the same time, some patients do regain a good part of their body function slowly with perseverance.

EYE CARE

The Eyes of Love: How Vision Shapes Connection and Life

Dr. M. P. Ravindra Nathan

By DR. ARUN GULANI

By Dr. ARUN GULANI
February is the month of love – a time to celebrate relationships, connections and the beauty of seeing the world clearly, both literally and metaphorically. Yet, how often do we stop to consider how our vision impacts the way we experience life and the people we love?

From the first glance that sparks a connection to the shared joy of watching a sunset or admiring a loved one’s smile, clear vision is at the heart of our most cherished moments. Vision doesn’t just help us see; it allows us to feel deeply, connect meaningfully, and live fully.

As an eye surgeon with a worldwide patient clientele of practically every culture, I’ve had the honor of witnessing how life changes when vision improves.

They may have come to me to get rid of their glasses and contact lenses due to their astigmatism, nearsightedness, farsightedness and even reading glasses or cataracts, and my patients often share stories that are more than medical – they’re deeply personal. One patient who traveled to me from Switzerland recently described the profound emotion of seeing their partner clearly for the first time in years: “It was like falling in love all over again.” Another patient from India talked about the simple but life-changing experience of reading their grandchild’s handmade Valentine – every heart, every word glowing with love.

These stories aren’t unique. For countless individuals, vision is a key part of how they experience the world and express their emotions. Yet, many of us take our eyesight for granted. We adapt to blurry vision or live with discomfort, not realizing how much of life’s vibrancy we’re missing.

Seeing Beyond the Surface
Vision, in many ways, is a metaphor for life. It’s not just about clarity; it’s about perspective. When I work with patients, I see how their journey toward better vision mirrors a journey of rediscovery. Whether they’re regaining the ability to read, drive or simply recognize the faces of their loved ones, the change is profound.

But vision is not just about overcoming problems; it’s also about thriving. In this season of love, consider what it means to truly see – to take in the details, the colors, the expressions and the moments that make life beautiful.
Here are a few tips to keep your vision – and your connection – strong:

  1. Protect Your Eyes: Whether it’s wearing sunglasses to shield against UV rays, using safety goggles during activities, or ensuring proper lighting when reading, small preventive measures can make a big difference.
  2. Stay Hydrated and Moisturized: Winter’s dry air can irritate your eyes. Use humidifiers at home and artificial tears to maintain comfort and eye health.
  3. Prioritize Your Vision: Regular checkups with an eye doctor can catch issues early, preventing them from escalating into more complex problems. Don’t wait until something feels wrong – our eyes deserve proactive care.
  4. Embrace Modern Advancements: Today’s technologies, such as those I have pioneered, can not only correct vision problems from cataract or glasses prescriptions, but even bad outcomes from Lasik or cataract surgery. From laser surgery to personalized solutions for extreme cases, the possibilities for clear vision are remarkable.

The Gift of Sight: A Love Letter to Yourself
Imagine what you could see, feel and experience if your vision weren’t holding you back. Whether it’s reading the fine print on a love letter, watching your favorite film, or seeing the details in your loved one’s face, clarity can transform the way you experience life’s most meaningful moments.

As someone who has spent over three decades helping people achieve this transformation, I can confidently say that clear vision isn’t just a medical outcome – it’s a gift. It’s the difference between living in the shadows and stepping into the light, between missing moments and cherishing them.

This Valentine’s season, as you celebrate love in all its forms, take a moment to consider the gift of sight. Whether for yourself or a loved one, clear vision is an investment in life, love and connection. After all, life is best lived with open eyes and an open heart.

 


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