NORTH MYRTLE BEACH, SC (WBTW) – More than 795,000 new strokes are reported across the United States each year, making it one of the top expenditures in health care.
A stroke can happen in an instant. The National Stroke Association defines a stroke as a “brain attack” that happens when blood flow to an area of brain is cut off. Side effects can range from temporary weakness of a limp to permanent paralysis on one side of the body.
But how big of a problem is it in South Carolina? Some experts argue it’s one you need to take seriously.
South Carolina had the sixth highest stroke death rate in the United States in 2017, according to data provided by the South Carolina Department of Health and Environmental Control. Stroke resulted in 16,298 hospitalizations in the Palmetto State that same year, and was the leading cause of 2,690 deaths. According to state data, hospitalizations for stroke cost more than $992 million in 2017.
JERRY’S STORY
Jerry Burkhart had always considered himself healthy, and his wife would agree.
“I could do about anything,” he recalled. “I could drive the motorhome for 500, 600 miles a day. I didn’t have any major health problems. All the time I’d been to the doctor and got check-ups (over) the previous 30 years, the doctors I had said, ‘I don’t know how you do it!'”
Travel, you could say, is one of his passions. Jerry and his wife bought a motorhome in 2002 and have traveled more than 150,000 miles across 48 states.
Something happened, though, during a trip to Myrtle Beach in 2014. Jerry was helping a friend with a house project one day when he started slurring his speech.
“I decided to leave and go back to the motorhome, which was (an) 11 mile, 12-mile drive. So I drove back to the motorhome, got there, got out and I still couldn’t speak,” he remembered. “So Jeri called the neighbor next door for some aspirin and took a couple aspirins. (I) was fine. (I) sat down, talked to people for an hour, hour and a half, and then I went and said, ‘I’m hungry.’ (I) went in, sat down to eat, and when my hand fell down in my mashed potatoes, we knew we were in trouble.”
“I said, ‘Jerry, there’s something wrong. We’ve got to go.’ So we got in the car and I started driving towards the hospital. On the way, he started to take a drink of his drink he keeps with him all the time and he almost choked, and he started coughing. It scared me so badly. So I called 911 and told her that I think he was having a stroke,” his wife emotionally recalled.
It turns out, Jerry says he had a transient ischemic attack, also known as a mini-stroke, and a stroke.
“When you’re used to doing everything and then you can’t – I was so bad I couldn’t even turn my hand over if it was on my leg. I could not even turn it over. I couldn’t touch my fingers with my left had or (anything). It was scary,” he said.
Following his treatment, Jerry went through weeks of physical and occupational rehab.
“He did really well and worked so hard. He worked so hard to recover the use of his left side. (He) did an amazing job. The therapists were amazed at what he was able to accomplish,” Jeri said.
Then in 2017, he had another mini-stroke.
“I walked up and came in (to the dining room) and Jeri was at the table and I started talking to her and she knew all of a sudden I couldn’t talk. I sounded like before,” Jerry explained.
Jerry was taken to McLeod Seacoast, where emergency room physicians sent him to McLeod Regional Medical Center in Florence for additional testing and treatment. Following Jerry’s treatment, he noticed he was still slurring his speech and learned he had a tight stenosis in his left carotid artery. Jerry also underwent an angioplasty for a blockage in his leg.
Fast forward to today, and Jerry is living the good life on the North Strand with his wife. His vibrant laugh is just as contageous as his big smile. As for his health, Jerry continues regular appointments with McLeod Health Vascular Surgeon Dr. Christopher Cunningham.
As far as traveling goes, he and his wife will knock off state number 49 in May with a trip to Alaska.
WHY IS THIS SUCH A COMMON STORY?
There are many answers to this question if you ask Dr. Christopher Cunningham.
South Carolina is located in what is known as “The Stroke Belt.” The name refers to a grouping of states in the southeast that have an unusually high incidence of stroke and other cardiovascular diseases. Both Carolinas are included in this region, in addition to Alabama, Arkansas, Georgia, Kentucky, Louisiana, Mississippi, and Tennessee.
Cunningham says common risk factors for stroke fuel the number of cases in South Carolina:
- High blood pressure
- High cholesterol
- Diabetes
- Poor diet
- Low physical activity
- Smoking
- Age
- Gender
- Genetics
South Carolina, he’s quick to point out, is a tobacco-producing state where smoking is common. According to the South Carolina Department of Health and Environmental Control, about 1 in 3 South Carolinians have also been told by a doctor that they have high blood pressure. Both are factors in stroke risk.
We asked Dr. Cunningham to rate the Grand Strand and Pee Dee’s stroke risk.
“A big F. A big fail,” he said. “First of all, you have to understand the demographic of stroke in the United States. If you look at stroke in the U.S., we are by far and away in the stroke belt. The highest stroke rates in the nation are right in the southeast. We are in the area for concentration of stroke and there are reasons for that. Some of the reasons have to do with risk factor and modification.”
SCDHEC has ranked the state’s 46 counties for chronic diseases, risk factors and health behaviors in this interactive map.
In our area, Marion County ranks number 40 for percent of strokes between 2015 and 2017. Marlboro County is ranked Number 34, followed by Darlington County (No. 32), Florence County (No. 27), Dillon County (No. 25), Horry County (No. 18) and Georgetown County (No. 15).
Cunningham says the region is one that “most needs stroke prevention, stroke education, and stroke care.”
“I would argue strokes are probably the Number 1 major health problem we have in terms of expense in the United States. The more important issue is what do these strokes cost? They cost productivity. They cost ability. They cost loved ones the need to care for you. They are the Number 1 expenditure in health care,” he said.
HOW CAN YOU REDUCE YOUR RISK AND HELP SAVE A LIFE?
Cunningham says while 80 percent of strokes can be prevented, it’s important to know how to reduce your risk. Among SCDHEC’s recommendations:
- Get your blood pressure checked
- Stay active
- Eat a healthy diet
- Use less salt
- If you drink alcohol, drink in moderation
- Get your cholesterol levels checked
- Don’t smoke
It’s also important to know the signs of a stroke. Cunningham says you should “Think FAST” – face, arm, speech and time.
“What you’ll often see is the smile go up on one side and the other side will hang and that is a very telling sign,” he said. “Ask someone to stick their arms out and if this arm can’t be held up or isn’t doing it, that’s a very telling sign. Ask them to repeat a simple phrase like ‘My name is John’… People get that wrong, that’s a big deal and then you know you or someone is experiencing a stroke. And T for time means time counts and it’s time to call 911.”
STROKE SUPPORT IN LOCAL HEALTH CARE
“The advancement in the care and treatment of stroke has advanced greatly,” Cunningham said.
Cunningham currently serves as the director and founder of the Heart and Vascular Institute at McLeod Loris Seacoast. The hospital, Cunningham says, is currently pursuing its stroke center certification, which would reflect its quality and care of major stroke events.
“Honestly, the vision for McLeod Loris Seacoast is to actually be the major cardiovascular hospital in the Grand Strand and to be a hospital that people will actually journey distances from to receive their care,” he explained.
While McLeod is pursuing that goal close to the coast, McLeod Regional Medical Center in Florence currently offers a specialized stroke unit. The 14-bed unit is what McLeod describes as “the first in the region dedicated exclusively for the treatment and rehabilitation of people who have suffered a stroke.” McLeod Regional’s stroke center was also the first in the Grand Strand and Pee Dee to receive its Primary Stroke Center certification in 2014.
A web-based telemedicine system is also making it much easier and faster for emergency department physicians to diagnose a stroke and begin treatment. “REACH” allows instantaneous consultations between doctors and neuroscience specialists around-the-clock. New treatments and procedures performed at McLeod Seacoast are also helping to advance the quality of stroke care on the Grand Strand.
“It’s a bold and a big plan and it’s a plan McLeod Health really has the team to achieve,” Cunningham said.
In addition to advances in stroke care pursued by McLeod Seacoast, Grand Strand Medical Center received its certification from DNV GL – Healthcare as a comprehensive stroke center.
