You Smoke, You Stroke; The Big NOT Surprise

In the Disney movie Aladdin, the evil Jafar, and his equally nefarious, but much ornerier parrot Lago, were attempting to find that “diamond in the rough”—the only person worthy to enter to retrieve the coveted magic lamp from the Cave of Wonders—and live. After witnessing the unsuccessful attempt of their latest “jewel,” Lago stomps around on the shoulders of his master, sarcastically stating, “WELL, now THAT’S a big surprise! I…I...I think I’m gonna have a heart attack and die from NOT SURPRISE.” I truly believe that this is how most of you will feel when you read about this next risk factor for stroke.

We’re wrapping up our stroke risk factors, and holy smokes! That means May is almost over! Speaking of smokes…that just happens to be our next topic of discussion.

Smoking. For all you Lago’s out there—you may now die of NOT SURPRISE.

I mean, what ISN’T smoking a risk factor for? MULTIPLE forms of cancer—not just lung cancer. The one true surprise to me was when I learned that smoking is the #1 cause of BLADDER cancer. I am encouraging you to research all cancers that smoking can lead to. It’s a risk factor for heart disease and diabetes (hey! There’s another circle forming…) It affects skin, teeth, gums and it can affect one’s ability to get pregnant. Those that smoke are more likely to have broken bones and weakened immune systems. If all this isn’t scary enough, let’s get back to why smoking is a risk factor for stroke.

Cigarettes contain both carbon monoxide and nicotine, as well as thousands of other chemicals, many of them toxic. Carbon monoxide—does this sound familiar? As in…carbon monoxide poisoning? As strange as it sounds, your body’s cells actually LIKE carbon monoxide more than they like oxygen. So, when carbon monoxide is around, the cells let go of the oxygen and pick up the carbon monoxide, which, as you can imagine, doesn’t do your organs any favors. Then there’s the nicotine. This substance makes your heart beat faster and causes your blood vessels to constrict, or narrow, limiting blood flow to your organs and increasing your blood pressure. There is a combination here of oxygen reduction in the blood and narrowing vessels, creating potential for restricted blood flow. And the increased pressure against the vessel walls can cause damage, which encourages clotting, and those clots can break off and block blood flow to the brain.  

If you have a loved one, or even have a friend who has a loved one, that has been or is currently within the grasp of drug or alcohol addiction, you have my heartfelt sympathies and my prayers. I work with this difficult population every day; these are incredible demons to even try to overcome, and I honor those people who set foot through the doors of the Crisis Center where I work, no matter how many times they do it. I want to quickly mention the role that drugs and alcohol play as stroke risk factors.

The liver is responsible for making proteins that aid in blood clotting to prevent spontaneous bleeding. Excessive alcohol can damage the liver and interfere with this protein synthesis, and excessive bleeding can then occur anywhere in the body including the brain. This would fall under the 5-10% that could experience a bleeding (hemorrhagic) stroke.

There are also many drugs in their various forms that dramatically and quickly increase blood pressure or cause narrowing or spasms of the vessels in the brain, both also causing hemorrhagic stroke conditions. IV drug users specifically are at risk for infection, especially in the heart valves, causing a serious heart infection called endocarditis, which is among many heart conditions that can lead to stroke. With endocarditis, small clumps of bacteria can leave the heart and travel to the brain, blocking a blood vessel and blood flow, causing an ischemic stroke.

This is our last week discussing the stroke risk factors. I know it is a lot to take in, but since this is where I started my career, I feel like I am saying goodbye to an old friend. Haha. I hope it means more to you…knowing the “why”. It’s not like your parents (or we as parents) used to say when we (or our kids) asked “why?” The answer is no longer “because we say so.” The answer is, “So we can…”

Be well! 

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