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Awareness vital to stroke prevention

By Don Kirkland

Three years ago, when I first heard about the program scheduled at one of our local churches, it sounded too good to pass up: a series of three, $40 tests that in a matter of  minutes could help assess your risk of vascular disease and, ultimately, stroke.

Although I have no family history of such problems,  my longtime awareness that stroke has gained a reputation as “the silent killer” suggested it might be time for a little preventive maintenance.

So I added my name to the signup list for an upcoming test series being conducted by LifeLine Screening, a company established 10 years ago in Cleveland, Ohio, and now offering its services nationwide.

In fact, I later learned, two out of three people who experience a stroke show no symptoms prior to the attack. Yet more surprising, stroke is the number one cause of nursing home admissions and America’s third leading killer.

Yes, it was definitely time for a look.

The series of exams, held at St. Andrew the Apostle Catholic Church in Chandler, turned up no abnormalities, thankfully. The print-out I received in the mail a week after my exam went into my medical history folder at my doctor’s office, where it has remained since the initial test.

It was a relief to know that, despite not always eating as conscientiously as I should and not getting as much exercise as I’d like, it didn’t appear I was at significant risk for coronary artery disease.

When I received a phone call several weeks ago announcing that another series of tests would be available at St. Andrew’s, I asked the obvious question: Was it time for another look-see.

Depending on risk factors and, of course, the outcome of any previous tests, doctors recommend a re-test every one to three years. Since it had been almost exactly three years since my first test, the timing was right for a repeat performance.

This time I was more familiar with the procedure and had time to learn more about the testing process, how it works and, importantly to me, who does it.

Juan Moncivaiz, the supervising technician on site, explained that the process relies on the familiar technology of ultrasound.

Three tests are available, each one at a cost of $40, or three for $99. Once again, I opted for “the works.”

The carotid vascular test scans the arteries in the neck for plaque buildup. Seventy-five percent of all strokes are linked to carotid artery blockage, according to medical experts.

A second test checks for aneurysm in the abdominal aorta. The majority of people who have an aneurysm have no symptoms, Moncivaiz told me.

Finally, the ankle brachial index test screens for peripheral arterial disease, indicated by plaque buildup in the lower extremities. Peripheral arterial disease is linked to coronary artery problems.

In the first two tests, a tiny glob of acoustic gel is applied to the skin, followed by the a placement of a small, hand-held Doppler ultrasound probe to the test area. The ultrasound transmits wave images and sounds to the connected monitor, giving the technician a preliminary indication of possible irregularities.

In the carotid test, the technician records the velocity of blood flowing through the arteries. The lower the flow, the less likely the possibilities of stroke.

In the aneurysm test, any aneurysm three centimeters or larger warrants further evaluation by the patient’s physician.

In one recent case, I learned from LifeLine’s director of marketing Violet Salinas, a scan caught what appeared to be a life-threatening condition.

“He had an aneurysm the size of a grapefruit,” she said. “We sent him from the site directly to a hospital.”

The ankle brachial test involves the use of blood-pressure cuffs and a Doppler ultrasound probe placed first on the ankles and then on the upper arm. By comparing the systolic pressure of all four locations, it’s possible to determine existing arterial disease or predict its future potential.

While the connected ultrasound monitor allows technicians to gain an advance indication of possible problems, results are screened by a board certified cardiologist prior to being mailed to the patient, said Salinas.

In fact, as other companies have tried to compete with LifeLine’s program, physician review continues to set LifeLine apart from its imitators, she says.

Because many who take the test forward the results to their physician, a doctor’s signature on the final report gives it added authenticity, Salinas suggests.

“When a doctor receives the results and there is no physician’s signature on it, it simply doesn’t carry the same weight,” she says.

In addition to LifeLine Screening becoming the nation’s number one provider of screening services, Salinas says pharmaceutical giant Glaxo Smith Kline is now co-sponsoring the company’s work with an educational video that precedes testing and an informational packet that patients receive afterward.

While LifeLine reminds that the testing doesn’t guarantee all abnormalities will be detected, it can offer an indication of potential problems in advance of catastrophic illness.

In my case, there were no “grapefruit-sized” irregularities and no indication that I need to hustle over to my doctor’s office.

You can be sure, however, that she’ll once again get the print-out of my results, and that my name will be on the list for a repeat test in another couple of years.

LifeLine Screening can accommodate 30 to 50 patients a day at testing sessions throughout the metro Phoenix area. The next session scheduled in the Kyrene Corridor will be held Friday, April 12, at the Parish of St. Benedict, 6400 W. Del Rio St., Chandler. Pre-registration is required. Information is available by calling (602) 230-2633.

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