[The Epoch Times, July 09, 2022 New York Business News]During the epidemic, many people are worried regarding contracting the virus and reduce the frequency of going out, so more patients who only take medicine and do not return to the doctor.one hadstrokeof Chinese elders take the anticoagulant drug aspirin on a regular basis, but fail to go to the clinic for follow-up in time, resulting in a cerebral hemorrhage that almost caused blindness.New York neurosurgeonLu ZhihaoIt is appealed that patients should not neglect follow-up visits during medication to help reduce the side effects of the medication and slow down the deterioration of the condition.
Lu ZhihaoThe doctor said that since the epidemic has been raging for more than two years, some patients ignored the follow-up during treatment. Even though they were repeatedly contacted and urged by the clinic, they still refused to show up, resulting in an accident.
For example, he gave an example of a Chinese man in his 70s who had lived before the epidemic.strokeaccompanied by headache symptoms, need to takeaspirinFor control, the drug is prescribed every three months. But every time the clinic called to urge a follow-up visit, he would not show up. One day, he finally came to the clinic for a follow-up visit, but he came with a referral form from an ophthalmologist. It turned out that because he might not see the right side of the object, he sought an ophthalmologist because he thought there was something wrong with his eye, and was referred to the neurology department.
Dr. Lu’s careful inspection found that the real reason that he might not see the right field of vision was not in the eye itself, but because of taking the medicine.aspirinThe resulting intracerebral hemorrhage compresses the nerve bundles of the left optic nerve and beyond. He suggested that the patient stop taking aspirin immediately, and insist on multiple follow-up observations. Finally, he found that the blood clots in the brain gradually decreased, the blood clots basically disappeared, and most of the right visual field was restored.
Physician Lu analyzed that although the aspirin taken by the patient is the minimum daily dose of 81 mg, it still has the side effect of causing cerebral hemorrhage. During taking it, it is necessary to follow up the doctor’s order for regular follow-up and examination to track the latest condition. Especially when the patient has high blood pressure at the same time and is not taking antihypertensive drugs, the risk of cerebral hemorrhage increases. Fortunately for this patient, following losing part of his visual field, he was referred by the ophthalmology department for a follow-up consultation to find the cause and treat it symptomatically, and basically reverse the condition, otherwise the consequences may be unimaginable.
He admitted that he does not recommend taking aspirin for ordinary patients with high blood pressure and diabetes without stroke. For stroke patients, following weighing the pros and cons, it is recommended to take it as needed, and the patient needs to cooperate with regular inspections to prevent the risk of side effects. In addition, he also reminded that the anti-stroke effect of aspirin is only 35% to 40%, and everything will be fine if you take aspirin.
Another elder with Parkinson’s disease was able to walk by himself when he visited the doctor two years ago. He went home to take medication following going back and forth for several times. 2 years later, when she was revisited, she was pushed into the clinic by her family in a wheelchair. It turned out that during the epidemic, he kept himself at home and rarely exercised. It is now necessary to start from scratch, and also to introduce new treatment options to prevent possible strokes.
As a result, Dr. Lu further reminded patients and their families that although the epidemic still exists, while treating the disease, it is still necessary to cooperate with a healthy diet and active exercise. Regular follow-up visits can help control the progression of the disease, not only for stroke patients, but also for other diseases, so as not to delay the disease.
The latest literature favors drug therapy
In addition, Dr. Lo Chi-ho shared the recommendations of a new document released in April at the 2022 American Academy of Neuroscience (AAN) Annual Meeting. In this paper, patients with potential stroke caused by vascular blockage are more inclined to use drug control than surgery or bypass vascular treatment.
Different ethnic groups have different stroke locations. Asians and blacks have more common cerebral vascular blockages, while whites are more common with neck artery blockages. Although the two may also cause stroke, the large neck arteries of white people are blocked by more than 70%, and the blood vessels can be opened by surgery.
Dr. Lu said the latest recommendation from the American Academy of Neuroscience is to take medication for control. The normal dose of aspirin for adults taking the anti-stroke drug is 81 mg per day, but in order to quickly control the disease in the initial stage of stroke, it is recommended to use a dose of 325 mg, plus cholesterol drugs, to reduce blood pressure to 140/90, low density Cholesterol drop to less than 70 target.
In this regard, as a member of the Neuroscience Society, Dr. Lu believes that because the goal of reducing LDL cholesterol to 70 is difficult to achieve, it is necessary to increase the frequency of taking cholesterol-lowering drugs. Patients with new strokes caused by occlusion of blood vessels in the brain should take 75 mg of Clopidogrel (Clopidogrel, or clopidogrel) in addition to 325 mg of aspirin. But stop aspirin at 90 days, or 3 months, because taking the two together increases the risk of bleeding.
Cranial Neurology Specialist, MD from State University of New York, Department of Neurology at New York University, with nearly 20 years of clinical experience, former attending physician at Upstate New York Veterans Hospital (VA) and New York Hospital Queens Medical Center (NYHQ), specializing in neurological diseases : Headache, dizziness, stroke, epilepsy, Parkinson’s, Alzheimer’s and metabolic neuropathy, etc. The clinic provides electroencephalogram (EEG) and neuroelectromyography (EMG). ◇
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