May was Stroke Awareness Month, a moment to teach and raise awareness around the illness. Dr. Michael Dunn from WellMed at Sinton explains early detection, common risk factors and how to reduce serious injuries.
June 5, 2024
Docs in a Pod focuses on health issues affecting adults. Providers and partners discuss stories, topics and tips to help you live healthier with hosts Ron Aaron, Dr. Audrey Baria and Dr. Tamika Perry.
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Show transcript
Podcast transcript
INTRO
Welcome to Docs in a Pod, presented by WellMed. Over the next half-hour, Docs in a Pod will educate you about the health and wellness of adults everywhere. Co-hosts Olivia Rahman and award-winning veteran broadcaster Ron Aaron will share information to improve your health and well-being. And now, here are Ron Aaron and Olivia Rahman.
RON AARON
Thank you so much for joining us today on the award-winning Docs in a Pod. Our podcast is available wherever you get your podcast. We also are on the radio in a number of markets in the state of Texas and in Florida as well. So pleased to have you joining us today. Our co-host today is Olivia Rahman. Olivia works at the WellMed at 9th Avenue clinic in St. Petersburg. She's a nurse practitioner. Olivia earned her nursing degree from Florida State University in Tallahassee. Also earned her master's degree with honors in nursing at the University of South Florida in Tampa. She is board certified in family practice and Olivia is a 2018 Daisy award winner. Daisy award recipients are registered nurses who exemplify the nursing values. When she is not playing nurse practitioner, Olivia has a delightful couple of dogs she hangs around with. And she also is a singer. Olivia, delighted to have you with us.
OLIVIA RAHMAN, NP
Glad to be here, Ron.
RON AARON
I nominated a nurse, this is a couple years ago, for a Daisy award, so I'm familiar with that.
OLIVIA RAHMAN, NP
Amazing.
RON AARON
I was a patient at the time, and she just went above and beyond, way beyond what you'd ever expect from a health care professional in that context. And that's pretty amazing, so congratulations to you.
OLIVIA RAHMAN, NP
I appreciate that. My friends and I call it the Heisman of nursing, so if you have a nurse you like, please nominate them. They will appreciate it.
RON AARON
That's cool. Well, we're going to be talking with Dr. Michael Dunn who is in Corpus Christi, talking about stroke 101. This is such an important topic. Let me introduce him and we can kick the conversation off. Dr. Dunn is a family physician at WellMed at Sinton, as well as the medical director of patient support programs for the greater Texas and southwest New Mexico region. Earned his Doctor of Osteopathic Medicine and Master of Science in primary care clinical research at the University of North Texas Health Science Center, as well as a master's in business administration from Texas Christian University. Prior to medicine, he had a career designing fighter planes as an aerospace engineer with Lockheed Martin up in Fort Worth, Texas. I'm talking to a guy who really had an interesting career before this interesting career. Dr. Dunn, thanks for joining us.
MICHAEL DUNN, DO
It's a pleasure to be here.
RON AARON
I'm assuming you were an engineer working on some of the most recent high-tech fighter planes in the world. How do you then end up going to medical school?
MICHAEL DUNN, DO
That's a great question. I do get asked that a lot. It was a very long process. Basically in a nutshell, I had two dreams. I did have a dream that I remember from very early age of wanting to be a physician and a doctor but as I got into my teen years, I really got drawn into engineering and was able to have a dream job designing, as you said, designing fighter airplanes and it was great, I loved it. But I just got to a point where there was something missing, and it was a very long process. It took many years, but essentially, what I determined was that on my deathbed, at the end of my life, if I didn't attempt to go to medical school and become a physician, I would always regret it.
RON AARON
Wow.
MICHAEL DUNN, DO
I was like, well, that's my answer. I was the only one that was putting myself in the way, so I had to do quite a lot at that point to do all that pre-medical stuff you have to go through, all those classes you need and then apply for medical school. So, it was a very long journey, but I do not regret it one bit. I've essentially had two separate careers. Two full careers because I was an engineer for 15 years and I actually now just hit my 15th year as a physician. I've done both for 15 years at this point.
RON AARON
That's way cool. Now, did you get to fly in some of the aircraft you helped design?
MICHAEL DUNN, DO
No, I did not. I worked on F16, did something for that, the F22, the F35. But like you said, you're high-tech, so it's very limited to who gets to go up in those airplanes.
RON AARON
Well, they let Tom Cruise fly them.
MICHAEL DUNN, DO
Yes, I know. He came to the plant in Fort Worth, Texas and got to fly on the F16 when I was there.
RON AARON
Tom Cruise did?
MICHAEL DUNN, DO
Yes.
OLIVIA RAHMAN, NP
Oh, that's cool.
RON AARON
Were you there the day he came in?
MICHAEL DUNN, DO
Yes, but they didn't tell us ahead of time. They have a company newspaper that comes out, I think every two weeks. So, after the fact, they had pictures and the story that he had been there and got the fly.
RON AARON
Oh, that's funny. Well, talk to me about what, what is a huge, huge problem for so many people, almost no matter your age, but the older you get, you may be at more risk. What is it about stroke? Give us the 411.
MICHAEL DUNN, DO
My two big takeaways on stroke are that the first thing is there is much that you can do to help reduce your chances of having a stroke. And then the other big portion is to be aware of the warning signs that you're having a stroke or that someone you're with is having a stroke because the earlier that is identified and you can seek treatment, the better your outcome is going to be. The better the recovery is going to be as well.
RON AARON
Let me just let folks know who may have just joined us know, you're listening to the award-winning Docs in a Pod. I'm Ron Aaron. Our podcast is available wherever you listen to your podcast. We're on the radio as well in a number of markets in Texas and Florida, and we're talking with Dr. Michael Dunn about stroke and the 101, 411 on stroke and Dr. Dunn is giving us an intro. Olivia Rahman, nurse practitioner in St. Petersburg, Florida is with us as well as our co-host. Dr. Dunn, pardon me for interrupting.
MICHAEL DUNN, DO
Going to what you can do to reduce your chances of having a stroke. Stroke is something where there's a decrease in the blood to a portion of the brain, and that's going to cause part of that brain to die because it's not getting the oxygen that it needs. It's going to cause a sudden effect. There's going to be a change that you're going to notice that occurs rather rapidly. But there's a lot we can do to reduce that. The first thing I would recommend everybody do is to have regulars with their primary care provider. They need to be able to be seen by their provider and their provider can know what to look for to reduce that risk.
RON AARON
Like what?
MICHAEL DUNN, DO
A few of the things that are big about this are smoking. If you're smoking, you definitely need to stop smoking. Smoking is going to irritate those blood vessels that go into your brain, and that irritation is going to cause plaque buildup that's going to cause an ischemic stroke to occur over time. The other is blood pressure control. We really need to make sure that our blood pressure is controlled. Normal blood pressure is less than 120 over 80. Someone that's having a stroke, we want to get their blood pressure below 130 over 80. That to me is the cutoff. And when you say blood pressure, that's your resting blood pressure. That's our blood pressure when you're seated, calm, resting blood pressure, because all our blood pressures go up when we stand and walk or run. But it's that resting blood pressure, 130 over 80, that you want to be below that. The other big thing would be, if you have diabetes, make sure your blood sugars are under control because that blood sugar can also irritate those blood vessels. If we can get the blood sugars under control, your diabetes under control, that's going to reduce the risk. The two other big ones are, have a healthy diet, like your Mediterranean diet, which is a diet that's high in fruits and vegetables. You're having seafood, nuts, beans, vegetables. Limiting those processed foods. Limiting sugar. Sugar is very toxic to your blood vessels as well. So, you want to reduce that irritation. We want to reduce the amount of sugar that we consume in the day. And then the last is exercise. Make sure that we're staying active because that's going to help also with our blood pressure, blood sugars with that as well. The one other thing that'll come up with these regular visits is your doctor, your provider, is going to perform some labs and they'll see if you have high cholesterol. So, if you do have elevated, bad cholesterol or elements of that cholesterol, then you can be put on a medication to reduce that, and that'll also help reduce that irritation to those blood vessels, which will reduce that risk of stroke.
RON AARON
Talk to me a little bit about the correlation between something called triglycerides, LDL, and HDL. What are the kind of numbers you need to shoot for, and why is that important?
MICHAEL DUNN, DO
Cholesterol is kind of complicated. Your total cholesterol was made up of the LDL, which is bad cholesterol, your good cholesterol, which is HDL, and then your triglycerides. Those are all different components. There are actually some other components that are part of total cholesterol. The big item is looking at that bad cholesterol. That's the target. So, someone that doesn't have any history of any heart disease, they don't have diabetes, we're shooting for a back cholesterol less than 100. If you do have heart disease or diabetes or other things like a chronic kidney disease, you're going to be looking to be less than 70 from that standpoint. That's really what I'm looking at is that bad cholesterol. However, there are some people that have elevated triglycerides. Anything above 200 really needs to be addressed because sometimes people will have triglycerides of 500 and 1000 in the extreme cases and that can really thicken the blood and cause increased stroke risk.
RON AARON
Hold that thought. We're going to come right back to you. I don't want to go down a rabbit hole, but I want to find out a little bit, can't you just drain off the triglyceride, for example, and maybe a simplistic question. You're listening to the award-winning Docs in a Pod. I'm Ron Aaron, along with our co-host today, Olivia Rahman. Olivia is a nurse practitioner in St. Petersburg, Florida. She's with the WellMed at 9th Avenue Clinic, and our special guest, Dr. Michael Dunn. We're talking stroke 101. Dr. Dunn can be found at the WellMed at Sinton in Sinton, Texas Clinic near Corpus Christi. You're listening to Docs in a Pod.
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RON AARON
We're so pleased you're sticking with us right here on the award-winning Docs in a Pod. Our podcast is available wherever you listen to your podcast. We're also on the radio in markets in Texas, as well as in the great state of Florida. I'm Ron Aaron, along with our co-host today, Olivia Rahman. She's a nurse practitioner at WellMed at 9th Avenue in St. Petersburg. And our guest is Dr. Michael Dunn. He is a primary care physician, and you can find him in Sinton, Texas, near Corpus Christi. We're talking about stroke 101, everything you need to know, and a whole lot more. We were talking a moment ago about LDL, HDL, and triglycerides, and you mentioned if you've got very high triglycerides, just asking for a friend now, can't you just drain it off somehow?
MICHAEL DUNN, DO
I wish it was that easy, but no, the really high triglycerides are tricky. It's a tricky type of condition. Sometimes it's hereditary, it's genetic. You get it from your parents, your grandparents, but the best thing to do is to see your primary care provider. They can do those tests to see if you're one of those that has high triglycerides and get on medications to help reduce that. The other is that it is associated with those high sugars. So, patients that do have diabetes, some of them, a percentage of them are going to have high triglycerides and the best way to reduce is to reduce the sugar, is to reduce the blood sugar level with diabetic medications, but also with diet and exercise. That also helps reduce that. There's no real easy solution to this, except for taking care of yourself, eating well, taking care of your medicines.
RON AARON
Somebody said to me, when you think of the Mediterranean diet, think of eating what they cut off in the middle of the interstates across this country. Eat that mix of grass and weeds and flowers and you'll be in good shape.
MICHAEL DUNN, DO
It's a little more than that. It's about those healthy foods. Healthy vegetables, healthy fruits, eating nuts, the tree nuts. Beans, multiple types of beans are really good as part of the Mediterranean diet. And then seafood. Seafood has these omega 3 fatty acids in it that also help reduce your LDL, help improve your total cholesterol and that's why it's thought that that's what allows it to help reduce risk of stroke and heart attacks in people.
RON AARON
If we come back to stroke, you had mentioned earlier something called an ischemic stroke. As I understand it, there are two different kinds. None are great to have. Can you run through the two different kinds of stroke and how perhaps you'd know what the symptoms are?
MICHAEL DUNN, DO
Sure. So, there's two different types. Most of your strokes are going to be ischemic. About 85 percent are ischemic strokes. That's when there's a blockage to the blood vessel, to the artery, that goes to part of the brain and you're going to have plaque buildup, you can have a blood clot. But it's blocking blood flow to the brain and that's what causes that ischemic stroke to occur. It's stopping the blood flow.
RON AARON
And blood carries oxygen.
MICHAEL DUNN, DO
Yep. The blood carries oxygen. The brain needs to stay well and to function properly. The other is your hemorrhagic stroke. In a hemorrhagic stroke, you have that artery, that blood vessel, and it will either rupture or it leaks, so you're having a bleed in the brain. Your hemorrhagic stroke is about 15 percent, and it actually causes a bleed to occur in the brain, which will have the same type of symptoms that you have in both types of strokes, but the immediate treatment of one versus the other is completely different and once you get to treatment and they work you up for what type of stroke you're having, they can determine that and then you get the appropriate treatment at that point.
RON AARON
As I understand it, Olivia, time is of the essence. If you're feeling or showing symptoms of a stroke, the sooner you get to the hospital, the better your chances of successful treatment and recovery?
OLIVIA RAHMAN, NP
That's the number one most important thing to remember about stroke is time is of the essence. There's an acronym from I believe the American Heart Association. It's literally called FAST. So, that's how to recognize it. How to recognize would be face is the F, so facial droop is the most I think common thing we think about when we think of a stroke. It's one side of the face drooping, have the patient you're looking at or your family member smile. It's one side just kind of not doing what it normally does. A in FAST is arm, arm weakness. Personal story, but I remember my grandmother went through this and the EMS people literally were raising her arms in the air and telling her, okay, hold them up, and she couldn't. That would be one of the things you're looking at. The S in fast is speech. So that slurred speech that we think about when we're thinking of people having strokes. And then the last part of that, the T is time. So, immediately call 9-1-1. Don't pop them in the car and bring them. Who knows how far you are. You're going to be stressed. Just 9-1-1 and get the EMS out immediately.
RON AARON
And if you're alone at home, and your speech is not functional, would you know you're not talking properly, or is it something someone else has to tell you?
OLIVIA RAHMAN, NP
That is a great question. I have had patients who've called EMS on themselves because they recognize they're having a stroke. Any sign of you just feeling funny. Maybe you look at yourself in the mirror and you're saying, that doesn't look right. Go to a neighbor, go call 9-1-1 if you can yourself. And if you worry that you won't be able to do that for yourself, then looking into a life alert button might be a great option for you as well.
RON AARON
Dr. Dunn, you mentioned earlier that in talking to your PCP, they can pick up on indications that perhaps you're at risk for a stroke. Talk to me about people who have a temporary kind of two- or three-minutesÂ’ worth of a stroke who just kind of blow it off.
MICHAEL DUNN, DO
Yes, so the technical term, the one that your primary care provider is going to use is called a transient ischemic attack. Sometimes it's called a mini stroke. But that's just a slang way of saying that you had a stroke. Even if you've had one of these transient ischemic attacks, it's still a stroke. It's just that it didn't last longer than a day. So, sometimes you can have a situation where you'll have the same symptoms that Olivia was just referring to. YouÂ’ll have weakness on the left side of the body, but it will resolve. It could resolve in a few minutes. It could resolve in a couple of hours. That still is telling you that you had an attack and it's a warning sign that you need to seek treatment. Just like Olivia said, time is of the essence. So, if you've had a transient ischemic attack, and you're back to normal, you still need to seek care because you're at a higher risk of having a full stroke within the next 7 days to 90 days. That's a warning sign that you're about to have something more major go on and there are medications that you can be put on to help reduce the risk of having a full-blown stroke. We haven't really touched on it, but for those that haven't seen somebody that's had a stroke they can be very debilitating, right? You could lose the ability to move one half of the body, your arm, your leg. You might lose the ability to talk or to swallow. We want you to come see us so that we can get you the treatment that you need to help reduce the risk of having a stroke like that from happening.
RON AARON
And if you get to the hospital for a stroke caused by blood clots, for example, aren't there blood clot busting drugs, but there's a time limit they can be used?
MICHAEL DUNN, DO
Yes. If you go to the emergency room, and they're evaluating you. Maybe you had a TIA, a transient ischemic stroke, maybe you are still having symptoms, they're going to do a CAT scan of your head to see if it's hemorrhagic or if it's an ischemic type of attack. From that they can determine what type of treatment to go forward. If you've had a TIA and you would come to see me in my office the next day, hopefully, you won't wait to see me longer than that, but I would put you on aspirin and a blood thinner for that. You would stay on that for 30 days or 90 days during that period. Like you mentioned, it's like a clock bluster. It's going to help thin out the blood, help reduce that risk of having a full-blown stroke. And then after that period of time, I'm going to continue you on an aspirin to help prevent you from having a stroke. And you'll stay on that for a long period of time.
RON AARON
We are unfortunately out of time, but we there's so much more to cover. We're going to get you back at some point in the future. Dr. Michael Dunn, appreciate you coming on. Sinton, Texas, near Corpus Christi, is where you'll find him. Thanks to our co-host today, Olivia Rahman. Nurse Practitioner, WellMed at 9th Avenue in St. Petersburg. I'm Ron Aaron. Thanks so much for being with us today on the award-winning Docs in a Pod.
OUTRO
Executive Producers for Docs in a Pod are Dan Calderon and Lia Medrano. Associate Producers, Cherese Pendleton. Thank you for listening to Docs in a Pod presented by WellMed. We welcome your emails with suggestions and comments on this program at radio@wellmed.net and be sure to listen next week to Docs in a Pod, presented by WellMed.
DISCLAIMER
This transcript is generated using a podcast editing tool; there may be small differences between this transcript and the recorded audio content.
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