1 00:00:01,040 --> 00:00:04,680 From Indias largest newsroom, I'm Arun George and this is the 2 00:00:04,680 --> 00:00:16,720 Times of India podcast. On Monday the 26th of February, 3 00:00:16,720 --> 00:00:20,400 the Co founder of Zeroda and CEO Nitin Kamath wrote in a social 4 00:00:20,400 --> 00:00:23,800 media post that he had suffered A mild stroke six weeks ago out 5 00:00:23,800 --> 00:00:25,840 of the blue. In his post, he said that his 6 00:00:25,840 --> 00:00:30,240 father passing away poor sleep, exhaustion, dehydration and 7 00:00:30,320 --> 00:00:33,920 possibly overworking out any of these could be possible causes. 8 00:00:34,400 --> 00:00:37,240 Kamat said he had noticed his face drooping and had struggled 9 00:00:37,240 --> 00:00:40,400 with reading and writing. He wrote that he expects to make 10 00:00:40,400 --> 00:00:43,280 a recovery fully in the next three to six months. 11 00:00:43,840 --> 00:00:46,400 My colleague Lata Misha in Mumbai and I spoke with two 12 00:00:46,400 --> 00:00:49,600 neurologists who are specialists on strokes to try and better 13 00:00:49,600 --> 00:00:52,560 understand who is at risk of a stroke and what can be done to 14 00:00:52,560 --> 00:00:55,040 prevent one. Doctor Sherish Hastak is the 15 00:00:55,040 --> 00:00:58,760 Regional director, Neurology, Stroke and Neurocritical Care at 16 00:00:58,760 --> 00:01:02,000 Global Hospital in Mumbai. He's been working in this field 17 00:01:02,000 --> 00:01:05,360 for over 35 years. Doctor Sherish says that while 18 00:01:05,360 --> 00:01:07,960 it's sad that someone as young as Kamath has suffered a stroke, 19 00:01:08,160 --> 00:01:11,720 he's not surprised since he has patients across age groups. 20 00:01:13,640 --> 00:01:17,160 You know, this is a very sad thing for a young, active person 21 00:01:18,080 --> 00:01:21,200 to have and of course I wish him a speedy recovery. 22 00:01:21,200 --> 00:01:23,840 That's the first thing. I have quite a number of 23 00:01:23,920 --> 00:01:28,560 patients of young stroke. So I'm not surprised that he's 24 00:01:28,560 --> 00:01:32,600 young and he's had a stroke. So my thinking is that stroke 25 00:01:32,640 --> 00:01:37,240 can happen from 1:00 to 2:00. I mean, it's something that 26 00:01:37,760 --> 00:01:40,520 happens at all ages and at all times. 27 00:01:40,520 --> 00:01:44,360 So yes, of course it's much more common in the older age group, 28 00:01:44,360 --> 00:01:48,920 but but it doesn't mean that the younger people are completely 29 00:01:48,920 --> 00:01:52,320 immune to stroke. Doctor Shirish praised the Zero 30 00:01:52,320 --> 00:01:55,440 Das CEO for speaking up about suffering from a stroke. 31 00:01:55,880 --> 00:01:59,000 He says this helps raise awareness about something that 32 00:01:59,000 --> 00:02:01,080 doesn't typically get as much attention. 33 00:02:01,720 --> 00:02:06,320 Mostly celebrities will try to, you know, not talk about their 34 00:02:07,000 --> 00:02:10,919 the negative side of their life and stroke is a negative side of 35 00:02:10,919 --> 00:02:14,640 your life, so to say. And it's a disabling negative 36 00:02:14,640 --> 00:02:18,360 side sometimes. Of course, I think Nitin is 37 00:02:18,360 --> 00:02:22,200 recovering fairly well and I'm happy about that, but it can be 38 00:02:22,200 --> 00:02:26,400 a disabling disorder and so celebrities will mostly hide 39 00:02:26,800 --> 00:02:31,400 these disorders. And so I think I salute Nitin or 40 00:02:31,400 --> 00:02:34,920 having come out in the open. So I think it's something that 41 00:02:35,720 --> 00:02:42,320 will help create awareness about stroke and and create this idea 42 00:02:42,360 --> 00:02:46,160 that stroke is recognizable and treatable. 43 00:02:47,000 --> 00:02:49,320 That's something even Doctor Pavanuja has praised. 44 00:02:49,680 --> 00:02:52,560 Dr. Pavan is a neurologist practicing in multiple hospitals 45 00:02:52,560 --> 00:02:54,880 in Mumbai and is on the executive committee of the 46 00:02:54,880 --> 00:02:57,840 Indian Stroke Association. Doctor Pavan says that given 47 00:02:57,840 --> 00:03:00,600 many celebrities choose to not talk about suffering a stroke, 48 00:03:00,880 --> 00:03:03,920 Nitin Kamal's choice to go public with it will only help 49 00:03:03,920 --> 00:03:07,640 people at large. My salutations to him that at 50 00:03:07,640 --> 00:03:09,240 least he's talking. Mithun Chakravarthi had a 51 00:03:09,240 --> 00:03:11,800 stroke. He's not ready to talk people 52 00:03:11,800 --> 00:03:15,160 who have a voice they should discuss so that the all those 53 00:03:15,160 --> 00:03:18,280 lay people out there they become more aware. 54 00:03:18,680 --> 00:03:22,760 Suppose a doctor now start, you know discussing about. 55 00:03:23,040 --> 00:03:26,240 They see some different angle. They say that you know this is a 56 00:03:26,240 --> 00:03:29,320 business talk, but someone who has already suffered it. 57 00:03:29,800 --> 00:03:32,800 If he talks then you know it is a community which gets more 58 00:03:32,800 --> 00:03:35,640 awareness and so many people will be benefited. 59 00:03:36,480 --> 00:03:39,680 So what is a stroke? Doctor Shirish says there are 60 00:03:39,680 --> 00:03:41,720 two types of strokes that people can suffer. 61 00:03:42,640 --> 00:03:46,520 I think I need to make the people aware that there are two 62 00:03:46,520 --> 00:03:49,920 types of strokes. One is where the blood vessel in 63 00:03:49,920 --> 00:03:53,680 the brain is blocked and this is called an ischemic stroke and 64 00:03:53,680 --> 00:03:57,040 the other type of stroke is when the blood vessel in the brain is 65 00:03:57,040 --> 00:03:59,320 ruptured and that's called a hemorrhagic stroke. 66 00:04:00,240 --> 00:04:03,120 Doctor Pavan says data for India shows that there are particular 67 00:04:03,120 --> 00:04:05,160 patterns when it comes to who suffers a stroke. 68 00:04:05,400 --> 00:04:08,280 He also explains that in 15% cases of people who suffer a 69 00:04:08,280 --> 00:04:12,000 stroke there is a high possibility of death and in 20% 70 00:04:12,000 --> 00:04:15,280 of the cases there is a chance of lifelong disability. 71 00:04:16,240 --> 00:04:19,200 In general, the incidence of stroke, that means how many 72 00:04:19,200 --> 00:04:24,320 people will get a stroke in India is roughly about 125 73 00:04:24,640 --> 00:04:27,480 people per lakh. There are variations. 74 00:04:27,480 --> 00:04:31,240 So some states where lot of, you know, unhealthy eating habits 75 00:04:31,240 --> 00:04:34,040 are there, especially northern states, they have a higher 76 00:04:34,040 --> 00:04:36,400 burden. So there are few states in which 77 00:04:36,760 --> 00:04:38,760 the hemorrhagic disease burden is higher. 78 00:04:39,360 --> 00:04:42,440 So they are towards the West Bengal, eastern part of the 79 00:04:42,440 --> 00:04:44,280 country where there are more hemorrhages. 80 00:04:44,280 --> 00:04:48,320 Kerala has more hemorrhages like even in Punjab the hemorrhagic 81 00:04:48,320 --> 00:04:50,840 strokes are quite high here in Maharashtra, the hemorrhagic 82 00:04:50,840 --> 00:04:53,440 strokes are less now the disability part. 83 00:04:53,680 --> 00:04:55,400 So how many of them are disabled? 84 00:04:55,400 --> 00:04:58,760 So in general moderate to severe disability. 85 00:04:58,760 --> 00:05:02,200 As we say that you know person is out of his previous 86 00:05:02,200 --> 00:05:07,280 functionality job or you know responsibility at home, that 87 00:05:07,280 --> 00:05:11,000 same function person cannot do needs assistance that is to the 88 00:05:11,000 --> 00:05:14,560 tune of 20%. So 20% people have lifelong 89 00:05:14,560 --> 00:05:18,240 disability and out of that at least half they are having 90 00:05:18,240 --> 00:05:21,160 spasticity also. So that means that their limbs 91 00:05:21,160 --> 00:05:23,920 are rigid and not in the proper position. 92 00:05:23,920 --> 00:05:27,400 So they don't derive much benefit from even physiotherapy. 93 00:05:27,400 --> 00:05:30,560 They need to go for higher treatments like sometimes you 94 00:05:30,560 --> 00:05:34,480 know, Botox injections or brain stimulation techniques. 95 00:05:34,720 --> 00:05:38,720 So this is the burden and the death rate is about 15%. 96 00:05:39,120 --> 00:05:42,840 So all those people who will suffer a stroke out of that 15% 97 00:05:42,840 --> 00:05:45,840 will die because of the stroke or its complications. 98 00:05:46,680 --> 00:05:49,560 A recent AIM study showed that the age group of those suffering 99 00:05:49,560 --> 00:05:52,680 a stroke has been changing. Basically, the Indian Stroke 100 00:05:52,680 --> 00:05:56,120 patient is getting younger. Doctor Pavan tries to decode why 101 00:05:56,120 --> 00:05:59,120 this shift in the demographic seems to be taking place. 102 00:06:00,000 --> 00:06:02,000 The Causeway is basically of two types. 103 00:06:02,560 --> 00:06:06,320 You can divide these younger people into less than 30 and 104 00:06:06,320 --> 00:06:09,360 more than 30. If it is less than 30, then we 105 00:06:09,360 --> 00:06:12,560 typically get all the factors which are associated with the 106 00:06:13,200 --> 00:06:16,720 poor development of the heart or the cerebral circulation. 107 00:06:17,000 --> 00:06:20,600 So someone who's got a, you know, valvular heart disease, 108 00:06:20,760 --> 00:06:23,600 the valves are not functioning properly, they are generating 109 00:06:23,600 --> 00:06:26,000 clots. So there are many reasons which 110 00:06:26,000 --> 00:06:28,320 are developmental anomalies in the younger people. 111 00:06:28,800 --> 00:06:33,600 But it is very interesting to know that above 30 what trend we 112 00:06:33,600 --> 00:06:37,080 are seeing is not of these younger people, same causes. 113 00:06:37,560 --> 00:06:40,240 In fact what we are seeing is the older people's Causeway 114 00:06:40,240 --> 00:06:42,480 coming here. So cholesterol deposition in the 115 00:06:42,480 --> 00:06:45,760 arteries, in the carotid arteries, in the brain arteries. 116 00:06:46,000 --> 00:06:51,320 So I think these are the younger people by age, but biologically 117 00:06:51,320 --> 00:06:54,320 they are older, their behaviors are older, they are drinking, 118 00:06:54,680 --> 00:06:58,120 they are smoking, not exercising, you know, eating all 119 00:06:58,120 --> 00:07:00,240 junk food, not sleeping properly. 120 00:07:00,240 --> 00:07:04,760 So they are, they are getting atherosclerosis blockage much 121 00:07:04,760 --> 00:07:09,360 earlier and I think that is the most, you know, important thing. 122 00:07:09,360 --> 00:07:14,680 One message we should spread is that don't get the stroke 123 00:07:14,680 --> 00:07:18,160 earlier by inviting it. Doctor Shirish points out that 124 00:07:18,160 --> 00:07:21,160 another factor that has been noted in studies is pollution, 125 00:07:21,440 --> 00:07:24,600 particularly air pollution, which may be contributing to the 126 00:07:24,600 --> 00:07:27,960 higher number of strokes. In the recent times there's been 127 00:07:27,960 --> 00:07:33,000 a lot of thought about pollution and stroke, and pollution seems 128 00:07:33,000 --> 00:07:35,920 to be a very important factor and probably pollution. 129 00:07:35,920 --> 00:07:40,680 If you see you know the low and middle income countries have a 130 00:07:40,680 --> 00:07:45,120 much higher risk because a is there, pollution is higher, 131 00:07:45,360 --> 00:07:48,520 their population density itself is high, and because you have a 132 00:07:48,520 --> 00:07:51,800 high population density the pollution is higher and 133 00:07:52,040 --> 00:07:55,240 pollution will make you predisposed to strokes. 134 00:07:56,080 --> 00:07:58,800 Doctor Pavan says that when it comes to strokes, there are risk 135 00:07:58,800 --> 00:08:01,600 factors and then there are triggers which result in a 136 00:08:01,600 --> 00:08:06,280 person suffering a stroke. So risk factor means whatever 137 00:08:06,280 --> 00:08:09,640 are the factors which are there in the general population also. 138 00:08:10,040 --> 00:08:14,400 But if you have them more than one together, then you are 139 00:08:14,440 --> 00:08:16,520 having a higher chance of having a stroke. 140 00:08:16,840 --> 00:08:20,760 So let's say someone who is like 65 years old, has high blood 141 00:08:20,760 --> 00:08:24,080 pressure, diabetes, cholesterol and is smoking. 142 00:08:24,400 --> 00:08:26,600 He has four risk factors for having a stroke. 143 00:08:27,040 --> 00:08:30,120 It doesn't mean that he smokes a cigarette and he gets a stroke. 144 00:08:30,800 --> 00:08:35,440 So this is not a trigger, but having all four, he has about a 145 00:08:35,440 --> 00:08:40,520 two and half times lifetime risk more than a person who is not 146 00:08:40,520 --> 00:08:43,480 having these risk factors. Now what are these triggers? 147 00:08:43,799 --> 00:08:47,160 So very commonly we see the strokes coming up, you know in 148 00:08:47,160 --> 00:08:52,680 the winters or in Octobers where there is a change in weather 149 00:08:53,000 --> 00:08:55,000 where there can be viral infections. 150 00:08:55,120 --> 00:08:58,840 So people who are typically have had suffered viral infections, 151 00:08:59,280 --> 00:09:01,720 they are prone to having a stroke because of coagulability 152 00:09:01,720 --> 00:09:03,600 in the blood. So blood is generally more 153 00:09:03,600 --> 00:09:08,440 thicker, easily clotting. Similarly, there are other 154 00:09:08,720 --> 00:09:12,200 triggers that we know. Among the potential causes that 155 00:09:12,200 --> 00:09:15,280 Nitin Kamath listed for his stroke were lack of sleep and 156 00:09:15,280 --> 00:09:18,120 other aspects like dehydration and excessive working out. 157 00:09:18,480 --> 00:09:20,240 We asked the two specialists about these. 158 00:09:20,520 --> 00:09:24,040 Doctor Shirish says sleep apnea is a major factor when it comes 159 00:09:24,040 --> 00:09:28,040 to people who suffer a stroke. Sleep deprivation, and 160 00:09:28,040 --> 00:09:31,960 especially if you have a sleep disorder called obstructive 161 00:09:31,960 --> 00:09:35,880 sleep apnea and obstructive sleep apnea is, is fairly 162 00:09:35,880 --> 00:09:37,760 common. I mean, even in the young age, 163 00:09:38,280 --> 00:09:41,520 it's not necessarily that you have to be old in order to 164 00:09:41,520 --> 00:09:44,960 suffer every disorder. So obstructive sleep apnea I 165 00:09:44,960 --> 00:09:48,320 have seen in a number of young people and it's fairly often 166 00:09:48,320 --> 00:09:52,760 missed because it happens at night and you're sleeping. 167 00:09:53,360 --> 00:09:57,560 And So what I do is to all my young stroke patients and even 168 00:09:57,560 --> 00:10:00,800 otherwise to my stroke patients, I will ask them that. 169 00:10:00,800 --> 00:10:05,360 Do they do they snore heavily? And this is a question I'll 170 00:10:05,360 --> 00:10:09,440 usually ask the partner Does this person snore heavily at 171 00:10:09,440 --> 00:10:11,240 night? Does he wake up? 172 00:10:11,840 --> 00:10:14,840 You know, because of snoring heavily and choking sensation 173 00:10:15,240 --> 00:10:21,160 and is asleep at night Poor. And also you know, watch and ask 174 00:10:21,160 --> 00:10:24,520 if there is a history of headache early in the morning 175 00:10:25,000 --> 00:10:28,760 and an exhaustion in the day. Especially obstructive sleep 176 00:10:28,760 --> 00:10:33,080 apnea can be linked to stroke and stroke risk. 177 00:10:33,080 --> 00:10:36,680 And of course, obstructive sleep apnea also produces blood 178 00:10:36,680 --> 00:10:40,840 pressure or hypertension, and that's another link to stroke. 179 00:10:41,760 --> 00:10:44,520 Doctor Pavan says that while sleep apnea is a major factor, 180 00:10:44,720 --> 00:10:47,760 he says he does see a lot of patients who just have really 181 00:10:47,760 --> 00:10:50,480 bad sleeping patterns. He explains why trying to 182 00:10:50,480 --> 00:10:53,000 stretch your day is always a bad idea. 183 00:10:53,320 --> 00:10:56,320 And even with patients, he explains the one rule he tells 184 00:10:56,320 --> 00:10:59,000 them to stick to. We are not discussing 185 00:10:59,040 --> 00:11:02,960 obstructive sleep apnea. We are discussing a poor sleep 186 00:11:03,440 --> 00:11:07,000 time and poor sleep quality because lot of these people, 187 00:11:07,000 --> 00:11:09,360 they are having, you know, sacrificing their sleep. 188 00:11:10,120 --> 00:11:12,800 Lot of other activities that are supposed to be done in the 189 00:11:12,800 --> 00:11:15,520 daytime. They are doing continuously 190 00:11:15,520 --> 00:11:19,000 working or continuously attending phone calls or you 191 00:11:19,000 --> 00:11:23,440 know, bingeing, binge watching, binge eating, binge drinking at 192 00:11:23,440 --> 00:11:26,480 night. As a outcome of this, there is 193 00:11:26,480 --> 00:11:30,280 no time for sleep or that sleep time is altered. 194 00:11:30,280 --> 00:11:33,480 It is sleep fragmentation. As a result what happens is the 195 00:11:33,480 --> 00:11:35,640 hypothalamus in the brain gets disturbed. 196 00:11:36,240 --> 00:11:40,520 There is a bio clock in the hypothalamus which allows us to 197 00:11:40,520 --> 00:11:43,600 rest at certain times and during the rest there are some 198 00:11:43,600 --> 00:11:48,200 reparative hormones that are released in the body and you are 199 00:11:48,200 --> 00:11:50,840 restored and made healthy once again. 200 00:11:51,200 --> 00:11:55,160 Now imagine that you didn't go through all this every night for 201 00:11:55,160 --> 00:11:58,920 night after night. Then you know you are having all 202 00:11:58,920 --> 00:12:01,040 the bad hormones getting released, all the stress 203 00:12:01,040 --> 00:12:04,440 hormones getting released and lot of inflammatory substances. 204 00:12:04,440 --> 00:12:08,600 So these inflammatory substances also Causeway inflammation in 205 00:12:08,600 --> 00:12:12,680 the blood vessel wall lining and there clotting and you know 206 00:12:12,680 --> 00:12:14,360 blockages of the artery take place. 207 00:12:15,840 --> 00:12:19,920 So this is one reason why we are saying that adequate amount of 208 00:12:19,920 --> 00:12:23,200 good sleep night after night should be taken. 209 00:12:23,280 --> 00:12:28,440 And I typically tell my patients that 11:00 PM to 7:00 AM, no 210 00:12:28,440 --> 00:12:32,720 device you must sleep otherwise medicines will not work. 211 00:12:33,360 --> 00:12:37,000 I think it is all it is all common sense that if you are 212 00:12:37,000 --> 00:12:40,160 challenging your body, going out of the way to challenge your 213 00:12:40,160 --> 00:12:44,040 body then obviously there might be more problems. 214 00:12:44,760 --> 00:12:47,600 Doctor Shirish explains why dehydration may not seem like an 215 00:12:47,600 --> 00:12:50,920 obvious Causeway of a stroke, but how he's seen a case where a 216 00:12:50,920 --> 00:12:52,920 patient who was fasting suffered a stroke. 217 00:12:53,880 --> 00:12:57,400 So if you get dehydrated your blood becomes thick and then it 218 00:12:57,400 --> 00:13:01,680 is prone to form clots and because the blood has to remain 219 00:13:02,080 --> 00:13:04,080 in the fluid state in order to flow. 220 00:13:04,480 --> 00:13:08,480 But if it becomes thick then it tends to clog and and that can 221 00:13:08,480 --> 00:13:11,720 of course lead to stroke. But usually dehydration has to 222 00:13:11,720 --> 00:13:14,480 be severe in order to lead to stroke. 223 00:13:14,800 --> 00:13:19,000 And I remember one of my Jain patients, he was only 40 years 224 00:13:19,040 --> 00:13:24,880 old and he fasted for about 5 days with no food, no water and 225 00:13:24,880 --> 00:13:27,760 he developed a stroke. So he was certainly unable to 226 00:13:27,760 --> 00:13:30,520 talk and his right hand and leg became weak. 227 00:13:31,200 --> 00:13:37,200 And of course he did recover the hand and leg power overtime, but 228 00:13:37,200 --> 00:13:41,280 unfortunately his speech did take a long time to recover. 229 00:13:43,040 --> 00:13:46,240 Another factor listed as a possible factor is working out 230 00:13:46,560 --> 00:13:49,000 excessively. We have been hearing about this, 231 00:13:49,000 --> 00:13:51,000 you know, contributing to heart attacks. 232 00:13:51,760 --> 00:13:55,080 Could this contribute person for suffering a stroke as well? 233 00:13:56,320 --> 00:14:02,200 So you want to try to do everything and you know not not 234 00:14:02,200 --> 00:14:04,840 take it down under. Sometimes you have to you have 235 00:14:04,840 --> 00:14:07,800 to be the down under. You say OK, it's a bad day. 236 00:14:08,240 --> 00:14:11,600 I'll take rest, I'll relax. So people who take on lot of 237 00:14:11,600 --> 00:14:15,080 these responsibilities, sometimes you know they they 238 00:14:15,080 --> 00:14:18,160 land into troubles. So we have to accept that you 239 00:14:18,160 --> 00:14:21,000 know, some days you have to relax, take it easy. 240 00:14:21,440 --> 00:14:25,160 So just working out extra that we see all the time that gyming 241 00:14:25,160 --> 00:14:28,240 people or you know the marathoners they workout. 242 00:14:28,680 --> 00:14:31,760 I think if you take adequate rest, do adequate hydration, 243 00:14:31,760 --> 00:14:34,720 then it doesn't matter. But if you get everything wrong 244 00:14:34,840 --> 00:14:36,960 on a particular day, then you land into stroke. 245 00:14:38,440 --> 00:14:41,880 Are there any first aid like tips for people who are dealing 246 00:14:41,880 --> 00:14:46,920 with a person suffering stroke? So the first thing we need to 247 00:14:46,920 --> 00:14:49,720 understand is you should be able to recognize a stroke or 248 00:14:49,720 --> 00:14:52,720 recognize the devil. And unlike a heart attack, the 249 00:14:52,720 --> 00:14:56,040 stroke manifests by different symptoms. 250 00:14:56,440 --> 00:14:58,960 You know, in the heart attack it's pretty simple because it's 251 00:14:58,960 --> 00:15:03,240 either it's pain, pain and pain in the chest, so it's simple to 252 00:15:03,240 --> 00:15:06,600 recognize. But whereas if you have a 253 00:15:06,600 --> 00:15:09,680 stroke, then you need to recognize the stroke. 254 00:15:10,360 --> 00:15:15,560 And for this, I think what you need to do is you need to 255 00:15:15,840 --> 00:15:19,920 remember an acronym and the acronym is called B fast. 256 00:15:20,600 --> 00:15:26,800 So it's BEFASTB fast. And each of this stands for a 257 00:15:26,800 --> 00:15:30,600 symptom. So the B stands for balance 258 00:15:30,600 --> 00:15:33,760 problems. E stands for eye problems. 259 00:15:33,760 --> 00:15:39,320 So if you suddenly lose vision in one eye or if you lose vision 260 00:15:39,320 --> 00:15:43,440 on one side of your eye, you know this could also be a 261 00:15:43,440 --> 00:15:47,440 stroke. Then the F stands for face. 262 00:15:47,960 --> 00:15:51,400 So if your face is deviated to one side it could be a stroke. 263 00:15:52,200 --> 00:15:55,600 Then is the arm. So if you develop an arm 264 00:15:55,600 --> 00:15:58,720 weakness, you know. So if your arm starts drifting 265 00:15:58,720 --> 00:16:02,480 down, and the arm of course includes the leg as well, so if 266 00:16:02,480 --> 00:16:05,760 your leg starts giving you trouble, you know then your leg 267 00:16:05,760 --> 00:16:08,200 is dragging, then that could also be a stroke. 268 00:16:08,880 --> 00:16:13,040 And then the S stands for speech and I think again within in the 269 00:16:13,040 --> 00:16:16,560 social post said that his speech was impaired and then the speech 270 00:16:16,560 --> 00:16:20,520 impairment also indicates that this could be a stroke. 271 00:16:21,520 --> 00:16:27,600 And the T stands for time. So be fast and rush in time to 272 00:16:27,600 --> 00:16:31,800 the hospital and rush him tied to a proper hospital is what I 273 00:16:31,800 --> 00:16:34,360 would insist on patients and people. 274 00:16:35,360 --> 00:16:38,080 Doctor Pavan says it's important that a doctor first diagnosis 275 00:16:38,080 --> 00:16:41,040 what type of stroke a patient has suffered, and only then 276 00:16:41,040 --> 00:16:43,840 should treatment be given if it's because of a clot in a 277 00:16:43,840 --> 00:16:46,600 blood vessel, the treatment is very different from what would 278 00:16:46,600 --> 00:16:50,600 be given if there's a rupture in a blood vessel in the brain, so. 279 00:16:50,600 --> 00:16:53,720 Let us decide first whether this is ischemic or hemorrhagic. 280 00:16:54,240 --> 00:16:56,960 So let's say that you have a hemorrhagic stroke in the brain. 281 00:16:57,240 --> 00:17:01,480 You don't want to give a blood thinner, you want to drop the 282 00:17:01,480 --> 00:17:04,680 blood pressure very very quickly to manageable levels. 283 00:17:04,680 --> 00:17:09,599 So if you want to give like some some basic care to this person, 284 00:17:10,440 --> 00:17:12,960 you know let's say that just first aid as you mentioned it's 285 00:17:12,960 --> 00:17:15,839 not definitely not medicine. But if you want to just give 286 00:17:15,839 --> 00:17:19,640 some basic care to this person, please see to it that this 287 00:17:19,640 --> 00:17:23,280 person you you protect his airway, breathing and 288 00:17:23,280 --> 00:17:26,000 circulation. So suppose there is a person who 289 00:17:26,000 --> 00:17:28,880 has had a major stroke and becomes unconscious or he is 290 00:17:28,880 --> 00:17:32,840 like partly conscious or he is vomited and you know his airway 291 00:17:32,840 --> 00:17:35,000 is blocked. Then at least we should try to 292 00:17:35,000 --> 00:17:36,800 clear his airway so that he can breathe. 293 00:17:37,280 --> 00:17:40,960 If he is not breathing, well then we can give him like a CPR 294 00:17:41,520 --> 00:17:43,920 and try to maintain his circulation if he's already 295 00:17:43,920 --> 00:17:46,400 collapsed. So the same rules that follow 296 00:17:46,400 --> 00:17:49,760 for the heart attack, CPR, airway breathing and 297 00:17:49,760 --> 00:17:54,320 circulation, they also are applicable to these people who 298 00:17:54,320 --> 00:17:57,400 have had a stroke. In fact don't even give water 299 00:17:57,400 --> 00:18:00,200 because what happens is sometimes, you know, the 300 00:18:00,200 --> 00:18:03,320 swallowing may be deficient, it may be very defective. 301 00:18:03,320 --> 00:18:06,960 So you give some water and that may go into the lungs because he 302 00:18:06,960 --> 00:18:09,200 is not able to manage the oral secretions. 303 00:18:09,680 --> 00:18:12,840 So it's better not to do anything just straight away get 304 00:18:12,840 --> 00:18:17,240 the, you know, the vehicle need not be an ambulance unless the 305 00:18:17,240 --> 00:18:21,320 patient is really down and get into the some stroke ready 306 00:18:21,320 --> 00:18:23,480 hospital. There are also plenty of 307 00:18:23,480 --> 00:18:26,720 misconceptions about strokes. We asked Doctor Shirish what is 308 00:18:26,720 --> 00:18:28,440 one of the biggest misconceptions that he 309 00:18:28,440 --> 00:18:32,240 encounters among patients. But are there any misconceptions 310 00:18:32,240 --> 00:18:35,080 about strokes that you'd like to address that you believe that 311 00:18:35,320 --> 00:18:36,920 you see with a lot of your patients? 312 00:18:37,840 --> 00:18:41,240 Yes, I think one of the misconceptions I want to, you 313 00:18:41,240 --> 00:18:45,520 know, very clearly convey to the people is that a stroke is non 314 00:18:45,520 --> 00:18:48,440 treatable. You know that's a misconception 315 00:18:48,440 --> 00:18:52,280 people have because I think a lot of them go to the hospital 316 00:18:52,280 --> 00:18:56,640 too late or go to the wrong hospital and don't see the right 317 00:18:56,640 --> 00:19:00,280 people. Stroke is treatable if you reach 318 00:19:00,280 --> 00:19:03,880 your hospital in time in a fair number of patients. 319 00:19:03,880 --> 00:19:07,280 Not in all, I would never say in all, but they're in a fair 320 00:19:07,280 --> 00:19:10,640 number of patients are treatable, especially treatable 321 00:19:10,880 --> 00:19:15,080 if you rush to your hospital rapidly and in time. 322 00:19:15,960 --> 00:19:19,000 And finally, let us ask Doctor Pavan what advice he had for 323 00:19:19,000 --> 00:19:22,120 those who may believe they're completely healthy and not at 324 00:19:22,120 --> 00:19:26,160 risk at all from a stroke, Sir. What advice would you give for 325 00:19:26,160 --> 00:19:29,920 people to reduce their risk of experiencing a stroke, 326 00:19:29,960 --> 00:19:32,400 especially if they believe that they are fit and healthy? 327 00:19:33,640 --> 00:19:36,880 Everyone should introspect. Even when you call yourself fit. 328 00:19:37,280 --> 00:19:40,200 Are you doing too much? Too much is not good. 329 00:19:40,560 --> 00:19:43,560 I think there is a bell shaped curve so you do too less. 330 00:19:43,960 --> 00:19:46,800 You are not protected and you do too much. 331 00:19:46,840 --> 00:19:49,840 You are overexposed to all the risks and injuries. 332 00:19:50,120 --> 00:19:53,160 So probably somewhere in the we are not going to prove ourselves 333 00:19:53,160 --> 00:19:55,000 to anyone by doing an extra mile. 334 00:19:55,880 --> 00:19:57,640 You have to do it. You have to protect yourself, 335 00:19:57,640 --> 00:20:00,000 right? So first thing is that do some 336 00:20:00,000 --> 00:20:02,520 introspection and think how much is required and how much is 337 00:20:02,520 --> 00:20:05,520 necessary rather than trying to anchor the world. 338 00:20:06,240 --> 00:20:12,280 Second is eat right, sleep right, exercise right, Do 339 00:20:12,280 --> 00:20:14,800 whatever it takes. Do some meditation, do some 340 00:20:14,800 --> 00:20:17,480 exercise so I am not telling any new things. 341 00:20:18,080 --> 00:20:22,360 I am just, you know, revisiting or reiterating whatever we 342 00:20:22,360 --> 00:20:28,360 already know. Today's episode was produced by 343 00:20:28,360 --> 00:20:32,920 Jayaraj Singh and Sahil Gupta. For a daily spotlight on people, 344 00:20:32,960 --> 00:20:35,720 ideas and stories that matter, subscribe to us. 345 00:20:36,080 --> 00:20:40,520 We are available on TOI Plus, Spotify, Apple, Google Podcasts 346 00:20:40,720 --> 00:20:44,000 and all other platforms of your choice for any new steps. 347 00:20:44,240 --> 00:20:47,280 E-mail us. At toipodcast at timesinternet 348 00:20:47,280 --> 00:20:47,960 dot in.