MEN'S HEALTH MATTERS:Patients with strokes who are treated quickly usually do much better than those who experience a delay
Q My father who is 71 years old had a stroke recently and we brought him to hospital within an hour of developing symptoms.
He was given treatment to dissolve a clot and he improved dramatically over the next couple of days. I was not aware how important a speedy presentation to hospital is.
Can you please explain to your readers why this is so important and what the symptoms of early stroke are?
A One in five Irish people will suffer from a stroke at some point in their lives and unfortunately one in five will die and many more will be left permanently disabled.
Until recently many people, including doctors, believed a stroke was a disease for which little or nothing could be done. We now know that stroke is very treatable and, if the right actions are taken quickly, the patient may not have any long term effects.
Most benefit is seen in patients who are treated immediately after the onset of their stroke symptoms. Many Irish hospitals now administer emergency ‘clot-busting’ thrombolytic therapy if a person presents to hospital within four hours.
Patients treated within an hour or two of the onset of symptoms can expect even more benefit than those patients for whom treatment is delayed by many hours.
In situations where people cannot receive thrombolytic therapy, those attending hospital urgently still tend to have a better outcome.
Some people suffer mini-strokes, sometimes called Transient Ischaemic Attacks (TIA), where they develop a weakness of an arm or leg or develop language or visual problems lasting only a few minutes.
Up to a fifth of such people may go on to suffer a stroke in the following days or weeks with the greatest risk in the first two or three days.
Recent research has shown that if such patients can be seen and started on appropriate treatments by specialist services within a few hours, their chances of suffering another event are reduced by more than 80 per cent.
Several Irish hospitals now run regular TIA clinics and have protocols to urgently investigate and treat such patients, usually on an out-patient basis.
A number of countries have introduced public information programmes to encourage people to recognise stroke symptoms. The UK authorities are encouraging the use of the FAST test with the aid of some very startling advertisements showing people developing stroke symptoms.
FAST stands for Face, Arm, Speech and Time. If someone suddenly develops a weakness or asymmetry to their face, are unable to smile or show you their teeth when asked; if they cannot keep their arm raised, or if their speech becomes suddenly slurred or unintelligible then it’s time to get them to hospital as they may be having a stroke.
In only a few months the UK campaign has increased, by more than half, the number of people reaching hospitals in time for thrombolysis. A similar campaign in Ireland is greatly needed.
Q I am 37 years old and had a vasectomy a few months ago. Do my testicles still produce sperm and if so what happens the sperm that are being produced?
A Vasectomy has no effect on sperm production itself. The testicles continue to generate about 50,000 sperm an hour. These sperm will continue to develop and leave the testicles, but their passage up the vas deferens is blocked at the site of the vasectomy.
Under normal circumstances the body absorbs used and unused sperm – whether or not you have had a vasectomy.
After a vasectomy the testicles continue to produce millions of sperm from the testicles every day and these will accumulate in the testicles, epididymis and vas.
Although the body absorbs the sperm at a considerable rate, the pressure in this closed system may begin to rise due to the continual sperm production.
Rarely, some men experience pain, mild swelling, rupture of the epididymal tubules and infections.
But the vast majority of men have no problems following a vasectomy and, if present, they are usually short-lived.
This week’s column is edited by Thomas Lynch, consultant urological surgeon, St James’s Hospital, Dublin with a contribution from Dr Joe Harbison, Consultant Geriatrician/Stroke Physician, St James’s Hospital, Dublin
Please send your questions to healthsupplement@irishtimes.com