heat stroke - JASE Medical

Staying Safe in the Summer Heat: Tips to Beat the Heat and Avoid Heat-Related Illnesses

Summer- a time of long, endless days of warm weather that children across the country look forward to when school lets out. Swimming, hiking, bicycling, and even setting up camp and stargazing in the backyard are the stuff that fond memories are made of.

All these fun activities, however, can pose potential illness or danger, especially when its hot outside.

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Heat wave sweeps the country

Record breaking heat was recorded in Miami, Austin and Phoenix over the past few days. Even Portland Oregon, usually known for its cooler weather broke daily records.  You don’t have to have record breaking weather to suffer overexposure to sun and heat. One recent and very heartbreaking story  out of Vancouver was of a one-year-old child that died from heat stroke in a car while the outdoor temperature was only 70-75 degrees. The inside of the car reached 110 degrees.  According to the National Safety Council on average more than 38 children from the ages of 1-15 die from heatstroke, mostly from being in a hot car. July is the month that most of these deaths occur, according to the website.

That quick trip into the store for a quart of milk could prove dangerous, even fatal to a young child left unattended in a vehicle.

Populations most at risk for heat related illnesses
Heat related illnesses can affect anyone but certain populations are more prone than others. These include:

Age: Infants, young children, and elderly individuals are more susceptible to heat related illnesses. Both children and elderly have a reduced ability to regulate body temperature.

High heat exposure: High temperatures for extended periods, especially during a heat wave, can put anyone at risk for heat related illness.

High humidity: When the humidity is high, the body’s ability to cool down through sweating is reduced, increasing the risk of heat-related illnesses, including heat stroke.

Chronic health conditions: Certain medical conditions, such as heart disease, lung disease, obesity, and diabetes, can reduce the body’s ability to handle heat stress, making individuals more susceptible to heat stroke.

Medications: Some medications can interfere with the body’s ability to regulate temperature, leading to heat exhaustion or heat stroke. Take precautions if on any medications. The following is a brief list- check your specific medication for more information:

Anticholinergic drugs: These medications block the action of acetylcholine, a neurotransmitter that plays a role in various bodily functions, including sweating. By reducing sweating, these drugs can hinder the body’s ability to cool down effectively. Examples include certain antihistamines, tricyclic antidepressants, and medications for overactive bladder.

Diuretics: Diuretics, commonly known as water pills, increase urine production, which can lead to dehydration. Dehydration impairs the body’s ability to regulate temperature, making it harder to dissipate heat. Some diuretics cause electrolyte imbalances which can further compromise health.

Beta-blockers: Beta-blockers are used to treat various conditions, including high blood pressure and heart conditions. They can reduce the heart rate and limit the body’s response to heat, potentially interfering with temperature regulation.

Psychotropic medications: Certain medications used to treat mental health conditions, such as antipsychotics and mood stabilizers, can affect the body’s heat regulation mechanisms, leading to increased heat sensitivity. This is an often-overlooked class of drugs. Be sure to check with pharmacist or read side effects of these drugs before heading off into the heat.

Antidepressants: Some antidepressants, especially those that affect serotonin levels, can impact the body’s thermoregulatory systems, potentially causing an increased risk of heat-related issues.

Antihypertensive medications: Some medications used to lower blood pressure, such as alpha-blockers, can impact the body’s response to heat and affect blood flow to the skin.

Alcohol and drug use: Alcohol and certain drugs can impair the body’s ability to regulate temperature and increase the risk of heat stroke.

Physical activity:  Physical activity, particularly in hot and humid conditions, can raise the risk of heat stroke, especially if adequate hydration is not maintained. If not acclimated to the heat this can pose a serious health risk.

Lack of acclimatization: Individuals who are not accustomed to hot weather or are not acclimatized to the heat may be more susceptible to heat stroke. This is especially true for those living in or working in air-conditioned buildings.

Heat exhaustion and heat stroke- know the signs and what to do

Heat exhaustion and heat stroke are two distinct heat-related illnesses, with heat stroke being the more severe condition.

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CDC excerpt on heat exhaustion and heat stroke:

Avoid

When the temperature is very high stay indoors. If you must go outside, dress properly and take breaks often. Know who is at high risk for heat stroke and heat exhaustion.

Tips to Beat the Heat

  • Drink plenty of water! (I will add that electrolyte drinks such as these can replace lost fluids and prevent electrolyte imbalance
  • Check on friends and neighbors at high risk for heat-related illness
  • Find airconditioned places to cool off (shopping malls and libraries)
  • NEVER leave kids or pets in a closed, parked vehicle
  • If you go outside, remember:
    • A hat
    • Sunscreen (spf 15 or higher)
    • Lightweight, light-colored, loose-fitting clothing
    • Water
    • Limit time outdoors. Take breaks often
  • Know who is at high risk:
    • Infants
    • Young children
    • Older adults
    • People with chronic medical conditions

Spot

Know the signs of heat stroke and heat exhaustion.

Heat Stroke

Signs & Symptoms

  • Very high body temperature (above 103°F)
  • Red, hot, and dry skin (no sweating)
  • Rapid, strong pulse
  • Throbbing headache
  • Dizziness
  • Upset stomach
  • Confusion
  • Passing out

Heat Exhaustion

Signs & Symptoms

  • Heavy sweating
  • Paleness
  • Muscle cramps
  • Tiredness
  • Weakness
  • Dizziness
  • Headache
  • Upset stomach or vomiting
  • Fainting

If you see any of these signs, get medical help immediately.

Treat

While waiting for medical attention, you can help someone with heat stroke or heat exhaustion.

Heat Stroke

Move the victim to a shady area or indoors. Do not give the person fluids.

Cool the body by:

  • Placing person in a cool (not cold) bath or shower
  • Spraying with a garden hose
  • Sponging with cool water
  • Fanning

Continue efforts to cool the person until help arrives or his or her body temperature falls below 102°F and stays there.

Heat Exhaustion

Get medical attention if symptoms get worse or last longer than one hour.

Cool the body with:

  • Cool, nonalcoholic beverages
  • Rest
  • A cool (not cold) bath, shower, or sponge bath
  • Moving to an airconditioned room
  • Wearing lightweight clothing

Seek medical help immediately if symptoms are severe or if victim has heat problems or high blood pressure.

Taking just a few precautions will ensure you and your child will have a fun and adventure filled summer.

- Brooke Lounsbury, RN

Medical Content Writer

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Drugs That Affect Blood Sugar and Hypoglycemia- A Medical Emergency

Medications can be lifesaving; however, many have unwanted effects. Almost every drug class has medications that can affect blood sugars and even mask high and low glucose levels. From blood pressure meds to inhalers, steroids, antibiotics, antifungals and diuretics, the likelihood of you or someone you know using a drug that affects glucose levels.  There are too many to list. Below are just a few examples:

A few of the many drugs that increase blood sugar (hyperglycemia): (NIH database)

  • Alcohol (decreases blood sugar after several hours of excessive intake)
  • Antibiotics (Dapsone, Rifampin)
  • Antidepressants (Zyprexa, risperdal, Clozaril, Seroquel, Abilify, Geodon, lithium)
  • Beta-2 stimulators (Proventil, Alupent, Serevent, Foradil, Brethine, Theo-Dur)
  • Corticosteroids (Prednisone, Decadron, DepoMedrol)
  • Dilantin (phenytoin)
  • Estrogens (Premarin, hormone replacement therapy)
  • Fluconazole
  • Heart and blood pressure medications (amiodarone, beta blockers(non insulin dependent diabetics), calcium channel blockers, catapress, diuretics)
  • Oral contraceptives (Birth control pills)
  • Niacin or nicotinic acid
  • Thiazide diuretics
  • Thyroid hormones (Synthroid, Levothroid)

If on a continuous glucose monitor acetaminophen (Tylenol) interferes with sensors resulting in a false low glucose reading and should be avoided.

A few of the drugs that decrease blood sugar (hypoglycemia): (NIH database)

  • Alcohol (acute excess amounts)
  • Aspirin and other salicylates in larger doses
  • Cibenzoline and quinidine (heart arrhythmia drugs)
  • Indomethacin (Indocin)
  • Levofloxacin
  • Trimethoprim-sulfamethoxazole
  • Metformin when used with sulfonylureas
  • Heart and blood pressure medications (ACE inhibitors, beta blockers, Norpace, Quinidine)

One common drug that masks low blood sugar

If diabetic (especially insulin dependent) and taking beta blockers the symptoms of low blood sugar may not be apparent. Beta blockers block the effects of norepinephrine. Norepinephrine, along with epinephrine are released into the bloodstream during hypoglycemic episode. In turn the release of these hormones causes the early symptoms of hypoglycemia such as tremor, sweating, rapid heartbeat, and anxiety. If diabetic and taking beta blockers monitor glucose levels closely even when you don’t have signs of low blood sugar.

Signs of low blood sugar (below 70 mg/dL or less)

Low blood sugar, especially in a diabetic, can be more dangerous and even a medical emergency if not treated in time.

Common signs of low blood sugar are:

  • Fast heartbeat
  • Shaking
  • Sweating
  • Nervousness or anxiety
  • Irritability, anger or confusion
  • Dizziness
  • Hunger

During sleep, low blood sugar symptoms may include sweaty sheets and sometimes nightmares

Signs of severe low blood sugar (below 54 mg/dL or by symptoms listed below)- Medical emergency

  • Loss of coordination
  • Difficulty speaking or slurred speech
  • Blurry or tunnel vision
  • Inability to eat or drink
  • Muscle weakness
  • Drowsiness

If left untreated hypoglycemia can result in coma, seizures and in rare cases, death

Causes of Low Blood Sugar

There are many reasons why for low blood sugar, including:

  • Taking too much insulin and/or not taking it on time
  • Not eating enough carbs after taking insulin
  • Poor diet- not eating a balanced protein, carbs and fat diet
  • The amount and timing of physical activity.
  • Drinking alcohol.
  • Hot and humid weather.
  • Unexpected changes in your schedule.
  • Spending time at a high altitude.
  • Going through puberty
  • Menstruation
  • On medication that causes low blood sugar
  • Severe liver or kidney disease
  • Severe infection
  • Advanced heart disease
  • Pancreatic or adrenal tumors
  • Drinking alcohol at night

What to do if you or someone you know has low blood sugar. The CDC website has tips on managing and treating hypoglycemia:

The 15-15 Rule

For low blood sugar between 55-69 mg/dL, raise it by following the 15-15 rule:

Have 15 grams of carbs and check your blood sugar after 15 minutes. If it’s still below your target range, have another serving. Repeat these steps until it’s in your target range. Once it’s in range, eat a nutritious meal or snack to ensure it doesn’t get too low again.

These items have about 15 grams of carbs:

  • 4 ounces (½ cup) of juice or regular soda.
  • 1 tablespoon of sugar, honey, or syrup.
  • Hard candies, jellybeans, or gumdrops (see food label for how much to eat).
  • 3-4 glucose tablets (follow instructions).
  • 1 dose of glucose gel (usually 1 tube; follow instructions).

Tips to keep in mind:

  • It takes time for blood sugar to rise after eating. Give some time for treatment to work. Following the 15-15 rule helps.
  • Young children usually need less than 15 grams of carbs, especially infants and toddlers. Ask your doctor how much your child needs.
  • You should avoid eating a carbohydrate with lots of fiber, such as beans or lentils, or a carb that also has fat, such as chocolate. Fiber and fat slow down how fast you absorb sugar.
  • Check your blood sugar often when lows are more likely, such as when the weather is hot or when you travel.

Treating Severely Low Blood Sugar- (below 55mg/dL)

Not treatable by 15-15-15 rule

Make sure your family members, friends, and caregivers know your signs of low blood sugar so they can help treat it if needed.

You also may not be able to check your own blood sugar or treat it by yourself, depending on your symptoms.

Injectable glucagon is the best way to treat severely low blood sugar. A glucagon kit is available by prescription. Speak with your doctor to see if you should have a kit. Be sure to learn how and when to use it. Let family members and others close to you know where you keep the glucagon kit and make sure they’ve been trained in how to use it too.

It’s important to contact a doctor for emergency medical treatment immediately after receiving a glucagon injection. If a person faints (passes out) due to severely low blood sugar, they’ll usually wake up within 15 minutes after a glucagon injection. If they don’t wake up within 15 minutes after the injection, they should receive one more dose.

When the person is awake and able to swallow:

  • Feed the person a fast-acting source of sugar (regular soft drink or fruit juice).
  • Then, have them eat a long-acting source of sugar (crackers and cheese or a sandwich with meat).
  • It’s also important that friends, family, co-workers, teachers, coaches, and other people you may be around often know how to test your blood sugar and treat severely low blood sugar before it happens.

A medical ID, usually a bracelet or necklace, can be critical in keeping you safe and healthy. Emergency medical technicians are trained to look for a medical ID when caring for someone who can’t speak for themselves.

When To Call 911

If any of the following happens, your friend, relative, or helper should call 911:

  • You pass out and no glucagon is available.
  • You need a second dose of glucagon.
  • You had glucagon but are still confused.
  • Your blood sugar stays too low 20 minutes after treatment or doesn’t respond to your usual treatments.
  • Or call 911 anytime you are concerned about your severely low blood sugar.

After You Have Low Blood Sugar

If your low blood sugar was mild (between 55-69 mg/dL), you can return to your normal activities once your blood sugar is back in its target range.

After you have low blood sugar, your early symptoms for low blood sugar are less noticeable for 48 to 72 hours. Be sure to check your blood sugar more often to keep it from getting too low again, especially before eating, physical activity, or driving a car.

 

If you used glucagon because of a severe low (54 mg/dL or below), immediately call your doctor for emergency medical treatment. If you have had lows several times close together (even if they’re not severe), you should also tell you doctor. They may want to change your diabetes plan.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

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Popular Pesticide That Was Recently Banned Associated With Type 2 Diabetes

(This is part 1 of a series on diabetes, other parts will delve into labs, testing, prevention and management of diabetes)

A recent study revealed that Thai farmers exposed to different pesticides found an association between 3 different pesticides and onset of type 2 diabetes.

According to the study, a population-based case-controlled study was conducted among residents in the Bang Rakam district of Phitsanulok Province in Thailand. Lifetime pesticide exposure and other relevant data were collected from 866 participating cases with diabetes mellitus and 1021 healthy controls. Among 35 individual brand-named pesticides investigated, they found statistically significant occurrences of type 2 diabetes with three insecticides.

3 Pesticides

A popular insecticide, trade name Sevin, (carbaryl) recently banned for homeowner use but still available for commercial application was found to have a casual association to the onset of type 2 diabetes, along with other health issues. This insecticide was pulled from consumer shelves mid 2020 but is still used on industrial crops. Another insecticide, mevinphos has been on the EPA restricted use list, but is banned in the EU, and endosulfin whiles still being used on U.S. crops is being phased out globally.

In addition, another popular pesticide, Roundup (glyphosate) may also contribute to type 2 diabetes according to a 2022 study titled “Impact of Glyphosate on the Development of Insulin Resistance in Experimental Diabetic Rats: Role of NFκB Signalling Pathways”.

What is diabetes?

Diabetes is a chronic, serious health issue facing over 10 percent of the U.S. population, and one in five people with diabetes don’t even know they have it. It is a leading cause of death due to complications, such as heart disease, stroke, blindness, kidney failure and lower limb amputation. Depending on the type of diabetes, insulin and glucose metabolism are involved.  While the link between pesticide use is a contributing factor, many other life choices and genetics play into the development of diabetes.

All diabetes is diagnosed through bloodwork, by checking glucose readings- either fasting, after meals or both. A urine dip can show high glucose levels, indicating the need for further testing via bloodwork.

Types of Diabetes

Prediabetes

Prediabetes is a serious health condition where blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Approximately 96 million American adults—more than 1 in 3—have prediabetes. Of those with prediabetes, more than 80% don’t know they have it. Prediabetes puts you at increased risk of developing type 2 diabetes, heart disease, and stroke.

Insulin is key factor

 Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into cells for use as energy. If you have prediabetes, the cells in your body don’t respond normally to insulin. Your pancreas makes more insulin to try to get cells to respond. Eventually your pancreas can’t keep up, and your blood sugar rises, setting the stage for prediabetes—and type 2 diabetes down the road.

Insulin, Blood Sugar, and Type 2 Diabetes

  • Insulin is a key player in developing type 2 diabetes. This vital hormone—you can’t survive without it—regulates blood sugar (glucose) in the body, a very complicated process. Here are the high points:
  • The food you eat is broken down into blood sugar.
  • Blood sugar enters your bloodstream, which signals the pancreas to release insulin.
  • Insulin helps blood sugar enter the body’s cells so it can be used for energy.
  • Insulin also signals the liver to store blood sugar for later use.
  • Blood sugar enters cells, and levels in the bloodstream decrease, signaling insulin to decrease too.
  • Lower insulin levels alert the liver to release stored blood sugar so energy is always available, even if you haven’t eaten for a while.
  • That’s when everything works smoothly. But this finely tuned system can quickly get out of whack, as follows:
  • A lot of blood sugar enters the bloodstream.
  • The pancreas pumps out more insulin to get blood sugar into cells.
  • Over time, cells stop responding to all that insulin—they’ve become insulin resistant.
  • The pancreas keeps making more insulin to try to make cells respond.
  • Eventually, the pancreas can’t keep up, and blood sugar keeps rising.
  • Lots of blood sugar in the bloodstream is very damaging to the body and needs to be moved into cells as soon as possible. There’s lots of insulin, too, telling the liver and muscles to store blood sugar. When they’re full, the liver sends the excess blood sugar to fat cells to be stored as body fat. Yep, weight gain. And what’s more serious, the stage is set for prediabetes and type 2 diabetes.

NOTE: Type 1 diabetes is different; it’s thought to be caused by an autoimmune reaction (the body attacks itself by mistake). People with type 1 diabetes don’t make enough insulin and need to take it to survive.

Symptoms

(Type 2 diabetics)

  • Urinate (pee) a lot, often at night
  • Are very thirsty
  • Lose weight without trying
  • Always hungry
  • Blurred vision
  • Have numb or tingling hands or feet
  • Fatigue
  • Dry skin
  • Slow healing sores or injuries
  • Have more infections than usual

You’re at risk for type 2 diabetes if you:

  • Have prediabetes.
  • Are overweight.
  • Are 45 years or older.
  • Have a parent, brother, or sister with type 2 diabetes.
  • Are physically active less than 3 times a week.

Treatment

Treatment consists of leading a healthy lifestyle, diet, and sometimes oral medications.

Type One Diabetes

Type 1 diabetes is a disease in which autoimmune destruction of pancreatic β-cells leads to insulin deficiency.

If you have type 1 diabetes, your pancreas doesn’t make insulin or makes very little insulin. Insulin helps blood sugar enter the cells in your body for use as energy. Without insulin, blood sugar can’t get into cells and builds up in the bloodstream. High blood sugar is damaging to the body and causes many of the symptoms and complications of diabetes.

Type 1 diabetes was once called insulin-dependent or juvenile diabetes. It usually develops in children, teens, and young adults, but it can happen at any age.

Only 5-10% of people with diabetes have type 1. Currently, no one knows how to prevent type 1 diabetes, but it can be treated successfully by:

  • Following your doctor’s recommendations for living a healthy lifestyle.
  • Managing your blood sugar.
  • Getting regular health checkups.
  • Getting diabetes self-management education and support.

Symptoms

In addition to the above symptoms listed for type 2 diabetes, type 1 diabetics may also have nausea, vomiting, or stomach pains. Type 1 diabetes symptoms can develop in just a few weeks or months and can be severe.

Treatment

Treatment consists of insulin therapy and sometimes oral medication in addition to leading a healthy lifestyle.

Gestational diabetes

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don’t already have diabetes. Every year, 2% to 10% of pregnancies in the United States are affected by gestational diabetes. Managing gestational diabetes will help make sure you have a healthy pregnancy and a healthy baby.

What Causes Gestational Diabetes?

Gestational diabetes occurs when your body can’t make enough insulin during your pregnancy. Insulin is a hormone made by your pancreas that acts like a key to let blood sugar into the cells in your body for use as energy.

During pregnancy, your body makes more hormones and goes through other changes, such as weight gain. These changes cause your body’s cells to use insulin less effectively, a condition called insulin resistance. Insulin resistance increases your body’s need for insulin.

All pregnant women have some insulin resistance during late pregnancy. However, some women have insulin resistance even before they get pregnant. They start pregnancy with an increased need for insulin and are more likely to have gestational diabetes.

  • Having gestational diabetes can increase your risk of high blood pressure during pregnancy. It can also increase your risk of having a large baby that needs to be delivered by cesarean section (C-section).
  • If you have gestational diabetes, your baby is at higher risk of:
  • Being very large (9 pounds or more), which can make delivery more difficult
  • Being born early, which can cause breathing and other problems
  • Having low blood sugar
  • Developing type 2 diabetes later in life
  • Your blood sugar levels will usually return to normal after your baby is born.
  • About 50% of women with gestational diabetes go on to develop type 2 diabetes. You can lower your risk by reaching a healthy body weight after delivery.

Who is at risk

  • Have ever had gestational diabetes (diabetes during pregnancy) or given birth to a baby who weighed over 9 pounds
  • Overweight
  • Over age of 25
  • Not physically active

Symptoms

Unlike type 1 and 2 diabetes, there usually aren’t symptoms, it is usually diagnosed by urine and bloodwork.

Treatment

Depending on the severity of the diabetes, medication, lifestyle, and diet changes may be implemented.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

My Reasons for ordering Jase Daily

I recently went through the process of ordering my yearly supply of prescription medicine through Jase Daily. I received my medication over the weekend and am impressed. From the ordering process to communication, every step of the way the process was streamlined and efficient. In addition, I pay out of pocket for my medication (I use a Health share program) and found the price for a whole years’ worth of medicine to be very competitive compared to my usual 90-day supply. In fact, it cost less over the year.

The packaging was secure and tamper resistant.

Once opened, I found the bottle of medication in a waterproof pouch which held the medicine and details of the transaction and prescription.

My medicine came in a clearly labeled, tamperproof bottle.

Why did I feel I needed to get an entire years’ worth of my prescription medicine?

The pandemic is over, so what’s the emergency?

If the pandemic has taught us anything is to not take anything for granted. Disrupted supply chains, medical supplies and medicines were held up in ports, diesel shortages prevented transport from the ports to pharmacies, clinics and hospitals, illness overloaded the hospitals and clinics, and on and on. Hopefully we learned to not take any part of our modern, just in time delivery for granted.

I have been a medical content writer for Jase over the past year and have researched and documented how fragile our healthcare system is. The gradual deterioration of our relationships with countries (China, and India and the threat of the dollar losing world currency status) that supply the overwhelming stock of our medications and medical supplies prompted me to act. This, along with reporting on the historic weather events of the past year-2022 and 2023 so far: record-breaking snows in Sierras, tornadoes, hurricanes, flooding in California, wildfires added to my concern.

It only takes one event, nothing even national or worldwide, to cause your supply of medicine (or even water or food for that matter) to dry up for an extended period. Having a year’s supply of my prescription gives me peace of mind and I can focus on other preparedness projects.

Our world is entering a time of massive uncertainty. Severe weather, layoffs, the pending USP strike(hopefully they will come to an agreement before the deadline of July 31st), the ongoing threat of war, civil unrest, escalating gas prices, food insecurity ( the baby formula shortage is still ongoing) and on are more than enough reasons to be proactive and stock up.

Who is eligible to order a Jase Daily Supply?

To qualify for your years’ worth of medicine, you must meet certain requirements.

  • Must be a preexisting prescription.
  • Must be stable on current medications for at least 6 months.
  • If hospitalized in the last 6 months, you’ll be required to explain during the order process.
  • A Jase physician will determine if your Jase Daily supply will be appropriate for you.
  • To safely prescribe Jase Daily medication, we require that you have been seen by a health care provider within the past 6 months.

Any day, any time even local events can cause shortages. Be proactive, not reactive. If you or your family are on long term medicines, it makes sense to stock up. Get your Jase Daily for you and your loved ones today.

- Brooke Lounsbury, RN

Medical Content Writer

Lifesaving Medications

Everyone should be empowered to care for themselves and their loved ones during the unexpected.

Recent Posts

Keeping you informed and safe.

Join Our Newsletter

Our mission is to help you be more medically prepared. Join our newsletter and follow us on social media for health and safety tips each week!

Medical Emergency – Stroke

(May is stroke awareness month)

Strokes, also called CVA (cardiovascular accident) affect more than 795,000 people in the United States. About 610,000 of these are first or new strokes. A stroke occurs when a clot or plaque forms and blocks blood supply to a part of the brain, or when a blood vessel in the brain bursts. The lack of oxygen to the brain can cause brain damage or death. Brain damage or death can occur within minutes.

Stroke is the number three cause of death in women; 20% of women will have a stroke in their lifetime. Stroke is the number five cause of death in men; 14-17% of men will have a stroke in their lifetime.

For both sexes stroke is a leading cause of disability. Strokes can occur at any age, however the incidence of stroke rises dramatically over age of 65.  Over 50 percent of stroke sufferers over the age of 65 have impaired mobility after the stroke.

Types of strokes

There are two types of strokes: one that blocks an artery that supplies blood to the brain (ischemic stroke) or when an artery in the brain leaks blood or ruptures (hemorrhagic stroke).

Ischemic Stroke

(About 87% of all strokes are ischemic strokes)

An ischemic stroke is when a blood clot blocks the artery leading to a portion of the brain, or atherosclerosis, which is a buildup in of fats, cholesterol and other substances in and on the artery walls called plaque hardens and narrows the arteries, which limits blood flow to tissues and organs, in this instance, blood flow to the brain.

Hemorrhagic Stroke

A hemorrhagic stroke happens when an artery in the brain leaks blood or ruptures (breaks open). The leaked blood puts too much pressure on brain cells, which damages them.

TIA (Trans ischemic attack)

TIAs are sometimes known as “warning strokes” which is a warning sign of a future stroke. It is a medical emergency, just like a stroke. More than a third of people who have a TIA and don’t get treatment have a stroke within one year. The symptoms are the same as those of an early stroke. (slurred speech, weakness visual disturbances)

Know the signs and what to do if stroke is suspected

Other signs of a stroke

(Excerpt from American Stroke Association)

  • NUMBNESS or weakness of face, arm, or leg, especially on one side of the body
  • CONFUSION, trouble speaking or understanding speech
  • TROUBLE SEEING in one or both eyes
  • TROUBLE WALKING, dizziness, loss of balance or coordination
  • SEVERE HEADACHE with no known cause

What to do and what not to do if stroke suspected:

What TO DO if stroke suspected

  • Call 911 immediately
  • Note when you first saw symptoms of stroke
  • Perform CPR if necessary

What NOT TO DO if stroke suspected

  • Do not let that person go to sleep or talk you out of calling 911- A stroke is a medical emergency, many feel that if they wait it out the symptoms will pass. Many times, a stroke can make a person feel sleepy, and may try to talk you out of calling 911- that they just need to take a nap and will feel better. This could mean the difference between life and death, and even how much the person will recover. It is always better to err on the safe side and seek medical attention asap.
  • Do not give them medication, food, or drinks- Depending on the type of stroke, medication should never be given unless instructed by medical personnel to do so. A patient can aspirate on food or drinks during a stroke.
  • Do not drive yourself or someone else to the emergency room- unless there is no other way and no help is available, stay with the patient and wait for EMS. They are trained and carry life saving equipment with them to handle emergencies.

Stroke Risks

You are at risk of a stroke if you have:

  • High blood pressure (this is the number one cause of a stroke)
  • Diabetes
  • Heart and blood vessel diseases- (carotid artery disease, atrial fibrillation, heart valve disease)
  • Are a smoker
  • High LDL cholesterol
  • Viral infections or conditions that cause inflammation. Rheumatoid arthritis and systemic lupus erythematosus (SLE) showed an excess risk of stroke over the general population.
  • Age: A stroke can happen at any age, but the risk is higher for babies under the age of 1 and for adults. In adults, the risk increases with age.
  • Race and ethnicity: In the United States, stroke occurs more often in African American, Alaska Native, American Indian, and Hispanic adults than in white adults.
  • Family history and genetics
  • Anxiety, depression, and high stress levels, social isolation
  • Medical conditions- bleeding disorders, kidney disease, sleep apnea, sickle cell disease
  • Sedentary lifestyle
  • Poor nutrition
  • Illicit drug use
  • Overweight

Prevention

Talk to a dietician and care provider about ways to prevent stroke. In addition:

  • Maintain a healthy weight
  • Diet- add colorful vegetables, healthy fats to diet
  • Manage stress
  • Stop smoking
  • Manage blood pressure
  • Get enough sleep
  • Add daily physical activity if you aren’t already

Diagnosing a stroke

Depending on the symptoms, the doctor can diagnose a stroke using the following:

  • Physical symptoms (FAST)
  • CT or MRI imaging
  • Carotid ultrasound
  • Cerebral angiogram
  • Echocardiogram

Treatment- ischemic and hemorrhagic stroke

(Excerpt from National Heart, Blood and Lung Institute)

Treating an ischemic stroke

Treatment for an ischemic stroke or transient ischemic (TIA) may include medicines and medical procedures.

Treatment

The main treatment for an ischemic stroke is a medicine called tissue plasminogen activator (tPA). It breaks up the blood clots that block blood flow to your brain. This medication is injected into your vein. If tPA isn’t an option an anticoagulant or blood thinning medication, such as aspirin or clopidogrel may be given.

Do not take aspirin unless directed by your care provider.

Medical procedures

A procedure to open up blocked arteries and restore blood flow to the brain may be needed. This can be done several ways.

Depending on the location, age and overall health the surgeon may perform a thrombectomy. The clot is removed from the blood vessel using a catheter inserted intd the groin and threaded to the blocked artery in the neck or vein. From there, the surgeon will use angioplasty and stenting or a device called a stent retriever to open up the blocked artery.

Angioplasty and stenting procedures use a thin tube to deliver a balloon or small mesh tube into the artery. Inflating the balloon or expanding the mesh tube clears space for blood to flow more easily to the brain.

The stent retriever is a wire mesh inside the catheter that traps the clot. The stent retriever and the blood clot are then pulled out through the tube.

If carotid artery disease caused the stroke, the doctor may perform a carotid endarterectomy, a surgery to remove plaque from the carotid artery in the neck.

Treating a hemorrhagic stroke

(Excerpt from National Heart, Blood and Lung Institute)

Hemorrhagic stroke can happen suddenly and grow worse quickly. Just as with an ischemic stroke, getting treatment as quickly as possible is essential for a full recovery. The type of treatment depends on what part of the brain is bleeding and how severe it is.

Treatment

Sometimes blood pressure medicine is given to lower the pressure and strain on blood vessels in the brain. Anticoagulant medicines are discontinued and sometimes vitamin k is administered to help coagulate the blood.

Medical procedures

Procedures may include:

Aneurysm clipping to block off the aneurysm from the blood vessels in the brain. This surgery helps stop bleeding from an aneurysm. During the procedure, a surgeon places a tiny clamp at the base of the aneurysm.

Coil embolization to block blood flow to or seal an aneurysm. The surgeon will insert a tube called a catheter into an artery in the groin. The doctor will thread the tube to the aneurysm in the brain. A tiny coil will be pushed through the tube and into the aneurysm. The coil will cause a blood clot to form, which will block blood flow through the aneurysm and prevent it from bursting again.

Rehabilitation

Rehabilitation following a stroke can take days, months or even years. The road to recover depends on many factors, such as type of stroke, if diagnosed and treated promptly, overall health, age and sex and race.

After a stroke, you may need rehabilitation to help you recover. Rehabilitation may include working with speech, physical, and occupational therapists. Your care team may also recommend medicines to manage pain, muscle spasms, or other problems as you recover. In addition, recovery can be frustrating and emotionally challenging. Be sure to talk with your care team about your feelings. The sooner you receive care, the better the outcome.

Language, speech and memory:

Language, speech and memory are often affected by a stroke. Many times, you may have words you want to speak but are unable to. Or you may be able to speak but not be able to put words together that make sense. Speech and language specialists can help you adjust and learn how to effectively communicate again.

Muscle and nerve :

A stroke may affect only one side of the body or part of one side. It can cause muscle weakness or paralysis, which can put you at risk for falling. Physical and occupational therapists can help you strengthen and stretch your muscles. They can also help you relearn how to do daily activities, such as dressing, eating, and bathing.

Bladder and bowel:

A stroke can affect the muscles and nerves that control the bladder and bowels. You may not be able to get to the bathroom in time. Medicines and a bladder or bowel specialist can help with these problems.

Swallowing and eating:

 You may have trouble swallowing after a stroke. Signs of this problem are coughing or choking during eating or coughing up food after eating. Working with a speech therapist can help overcome some of these difficulties. In some instances, a modified diet may be prescribed.

Mobility affected:

Canes, braces, grab bars, special eating utensils, wheelchairs, and other devices can make it easier to keep doing your regular activities after a stroke. Working with a physical and occupational therapist can help you achieve the optimum level of recovery you had before the stroke.

Learning how to adjust to life after a stroke can be challenging. Patient support groups provide a valuable resource that can offer not just support but can connect you with services to help you with recovery and adjusting to changes you may experience.

Talk with your doctor about local support groups for both you and any family members or caregivers that will be helping you. In addition, let your care provider know if you are experiencing depression or are having frequent mood changes (both are common). Your care provider may recommend a course of antidepressants, counselling, or other therapies to help you cope with your new way of life.

- Brooke Lounsbury, RN

Medical Content Writer

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