THE VIRGINIAN-PILOT
Copyright (c) 1995, Landmark Communications, Inc.
DATE: Monday, May 29, 1995 TAG: 9505270079
SECTION: DAILY BREAK PAGE: E1 EDITION: FINAL
SOURCE: BY PAM STARR, STAFF WRITER
LENGTH: Long : 143 lines
JEAN MAHONEY WAS gardening in the back yard of her Virginia Beach home last September, six months pregnant, when suddenly spots appeared before her eyes.
The right side of her body started tingling and became numb. When Mahoney sat down to steady herself, a splitting headache pierced the top of her head.
A neighbor saw what had happened and rushed her to the hospital. But doctors found nothing wrong and sent the Navy wife home. Tests at the obstretician's office the next day revealed the 31-year-old Mahoney had suffered a stroke.
Mahoney is still stunned by the diagnosis, considering her youth and healthy lifestyle. Fortunately, her pregnancy progressed normally, and Mahoney gave birth to a healthy baby three months later.
But she still experiences tingling in her right hand and leg and takes a baby-sized aspirin every day to thin her blood.
``Doctors don't know what caused it,'' says Mahoney over the phone. ``I've asked my doctors what I can do to prevent another one, but there's nothing I can do. I am worried about having another one, but I just live with it.''
Mahoney is fortunate that her stroke didn't kill her or cause a permanent disability. Former Defense Secretary Les Aspin wasn't so lucky. He died of a massive stroke Sunday at the age of 56.
Stroke is the third leading cause of death (after heart disease and cancer) and the No. 1 cause of disability in the United States. Every year it strikes nearly 550,000 Americans and kills 150,000.
The National Stroke Association aptly describes a stroke as a ``brain attack.'' Stroke occurs when blood flow to the brain is blocked by a clogged or burst artery, causing brain cells to die.
For many years, doctors treated strokes conservatively, with blood thinning drugs and rehabilitation. But venom from the Malayan pit viper may soon be the preferred drug of choice for certain stroke patients. The drug Ancrod is made from purified venom extracted from the snake. Ancrod has been shown to be effective in reducing mortality rates of stroke victims in two recent American clinical trials by increasing blood flow and lowering fibrinogen, a molecule important in blood clotting. The lower the fibrinogen level, the better for the stroke patient. Ancrod has also been shown to break up blood clots.
A much larger study is under way in 35 centers across the country. Virginia Beach General Hospital is the only medical facility in this area participating in this study and has enrolled two patients. Its goal is 20 patients.
Dr. Sidney Mallenbaum, a neurologist who is overseeing the study here, said it's hard to enroll patients in the trial because the drug must be administered within three hours of the onset of stroke symptoms. Most people don't recognize that they have had a stroke until much later, as in Jean Mahoney's case.
Another difficulty, according to Mallenbaum, is anyone on Coumadin (a blood thinner) can't be in the study, nor can someone with liver, kidney or heart failure.
Ancrod is administered intravenously by continuous infusion for three days, then an intermittent infusion for two days. Doctors participating in the study don't know if the patients receive Ancrod or a placebo.
``It used to be the assumption that once the damage was done, there was nothing you could do,'' Mallenbaum says. ``We now know that some brain cells in the central area die (after a stroke), but surrounding that center is a large area of nerve cells in shock, which can be potentially saved. We can minimize the severity of a stroke.''
Although Ancrod is relatively new to the U.S., it has been used extensively in Canada and Europe for 15 years.
Using the venom of a pit viper started in 1963, when a doctor observed that the blood of bitten victims became very thin and wouldn't clot - key factors in treating strokes.
Stroke is one of the most preventable kinds of diseases, as any doctor will tell you. Don't smoke. Eat a well-balanced, low-fat diet. Control your high blood pressure. Exercise regularly. Lose weight if you're obese. Reduce your stress level.
But the majority of us still don't do those things.
The National Stroke Association says stroke deaths are on the rise, after a 35-year decrease. The Centers for Disease Control and Prevention released data this year that shows death rates from strokes rose from 26.2 deaths per 100,000 people in 1992 to 26.4 deaths per 100,000 in 1993.
Although, it doesn't appear to be a major increase, it is the first time the stroke death rate has gone up since 1960.
``When you're talking about 260 plus million people, that is a significant increase,'' says Marjorie Anderson, public relations director of the NSA.
Why stroke deaths are ascending is anyone's guess. Dr. Russell Luepker of the University of Minnesota believes that controlling high blood pressure is no longer a major concern in the national health agenda. He also cites the cost of blood pressure medication. Drugs that used to cost pennies a pill are being replaced by newer drugs that cost as much as $1.50 per pill.
Luepker tracked three groups of 4,000 to 7,000 people from mostly white, middle-class population since 1980 and found that stroke-related deaths have risen.
Mallenbaum, who practices with Dr. Raymond Troiano at Neurological Consultants of Virginia Beach, says one study cannot be conclusive. But he agrees that stroke deaths could be on the increase.
``Maybe people are becoming more lax in their lifestyles,'' he says. ``It seems that the health craze is easing up somewhat. There are a lot of issues. A lot of people can't afford these medications.''
National Stroke Association president Dr. Fletcher McDowell is disturbed by the Centers for Disease Control and Prevention data, particularly the 15 percent rise in stroke death rates among African Americans aged 45 to 64.
However, McDowell is cautious about the Minnesota study.
``The Minnesota study suggests a slight increase, but it's nothing to shout about,'' says McDowell. ``I just think that the most honest thing you can say is it's too early to interpret data. At the least, it should make everybody a little more alert that stroke is still around and is preventable.'' ILLUSTRATION: [Color Photo]
Dr. Sidney Mallenbaum is overseeing the local study on using Ancrod
on stroke victims.
Graphic
JANET SHAUGHNESSY
Staff
SOURCES: AMA Encyclopedia of Medicine, Mayo Clinic Family Health
Book, Knight -Ridder News Service.
MORE INFO
National Stroke Association - Provides stroke prevention,
treatment, rehabilitation and research information. Provides
information on obtaining support for stroke survivors and
caregivers. Free stroke prevention brochure available.
8480 East Orchard Road, Suite 1000, Englewood, Colo. 80111-5015;
call toll-free (800) STROKES
American Heart Association - Offers information on support groups
and stroke prevention; (800) HEARTLINE
National Institute of Neurological Disorders and Stroke - Offers
free information on stroke prevention, research and treatment. P.O.
Box 5801, Bethesda, Md. 20824; (301) 496-5751
KEYWORDS: STROKES STUDY SNAKES VENOM by CNB