Stroke - A Patient Story

Record: 10/19

Published: 10/27

Stanton Shanedling: Hello, everybody! Welcome to health chatter. And today's show is a special show on a stroke survivor, and you'll hear his story. We'll get to that in a minute. Previously, before, before, we had done a show on stroke, and all the information that you, the listening audience, should really know about it, the different types of stroke, how to prevent a stroke, treat a stroke and manage it. But today will be special, because we'll hear from somebody who's gone through it. So stay with us for a second. We've got a great crew as always. That keeps us going, and gives us all the background information we need, does all the technical work for us we have shared and niggard who's doing our recording today. She also does some of our background research for our team and also our marketing. Mattie Levine, Wolf, Erin, Collins, Deandre Howard, also 3 of our researchers, Matthew Campbell, who normally does our production stuff. He's overseas right now. He'll be back, I believe, next week. So, thanks to everybody, you guys are really, really wonderful. It's a pleasure working with this crew because they really know how to do it. And it's really, really nice. And then, of course, there's Clarence Jones, Clarence and I've been doing this for a while. We're great colleagues. We love doing this. We love chatting about different topics in health. And today's topic is no different. So thank you, Clarence. And then also, human partnership is our community oriented group that looks at a variety of different health issues in the community, and they're one of our. They are our sponsor for health chatter. So many thanks to them, you can see. See more information about them at their website. Hueman Partnership.org, so thank you to everybody. Today. We have 2 guests with us, Dr. Haytham Hussein who worked with us on the previous show on stroke and he was one who recommended that we also talk to a patient. So, Hythe, thank you for helping us put this show together. And I'm gonna turn it over to you because I have a sense that you have a nice relationship with our other guests, so I'll let you introduce them.

Dr. Haytham Hussein: Thank you very much, Stan. And hello to everyone. Thank you, Clarence, for having us again here.  I am a stroke neurologist at the University of Minnesota and about a year ago excuse me. About a year ago we had a stroke patient who was very upset with us because he was discharged from the hospital before we talked to him about what exactly caused this stroke and the beginning of the relationship was a little bit rough. but I saw him in the clinic after his discharge and kind of clarified the misunderstanding and we became friends since then. and I like my friend slash patient Because of how eloquent he is and being an African American man, he taught me and also my colleagues and trainees at the University of Minnesota A lot. He taught us a lot about How the African American community views the healthcare system and how we can approach an African American person who is sick in a way to build trust because trust is severely lacking. And I'm also the current Board, President of the American Heart Association. I brought my patient friend to the American Heart Association Meeting, and he shared his story with them. I'm always very pleased and happy to let him talk and tell his story Because there is no way that any of us can really experience and explain as much as he can without further ado. I introduce Tony more to my good friend, and thank you, Tony, for being here and being generous with your time, and I know sometimes this is a little bit traumatic to go over the story of what happened to you, but I see great good come out from you sharing the experience?

Tony Moore - USI: Well, Hello, and thank you. So this is new to me. III have friends that do podcasts. But it's a little bit different because I don't know where to start here. But I wanna say, thanks to everyone for even inviting me to come and share my story in some narrative once again. 

Stanton Shanedling: It's great. It's great having you. And so let's start at the beginning, you know, started at, you know. I suppose, when you started, maybe you were feeling symptoms. That might be. That might be a starting point.

Tony Moore - USI: Absolutely. So. Was actually on a walk with my significant other. We were going for, you know, hey? We should go for a walk. I was like, I don't want to, and I'm like, maybe I should. So we decided to go for a walk in the neighborhood. And it's about maybe hmm. 5 blocks down the road. So 1015 min down the walkway started filling my left. but kind of going a little bit numb. And you know I was thinking that old athlete, you know it's kind of, you know. Maybe it's one of those kinds of things that your foot just acts up. But you know. And so we continued on, and we crossed the street, and by the time we crossed the street at the corner, that numbness had gone to the bottom of me to the bottom of my knee. And so I felt. instead of walking, I was more like throwing my leg forward and I was telling Julie that no, this is something a little bit different. And about halfway up this, up the next street. it has sort of gotten to my hip level  and at that time I'm thinking about it. Hmm! So this was last year. So 5 years ago, one of my good friends that I play football with. Just a we call them a a fawn, a freak of nature athlete played for Dallas. California. Went to school, ran way more than me, but he ran, could lift at the gym all the things from an athletic perspective that you would just say, this guy is the one. And we were going to go back to our Alma Mater and unfortunately he couldn't make it cause he had a catastrophic stroke where they had to do some surgery, and he's now in a home. So at the time that I started feeling this, I'm thinking, like. Am I starting to have a stroke? So I sat down because I didn't wanna do one of those things where you get full paralysis if it is a stroke and you fall flat. So I sat down and I hold my arms out, you know, doing, you know, trying to move and everything like that. And then once it hit my arm, I told Julie I'm I said, I think I'm having a stroke, and I got to say that maybe about 3 times, and then I lost my tongue in the face group, and everything happened.: and from there that's kind of where a little bit of the panic, and w more the real panic sort of set in and you know, it's funny, because,  the stream of consciousness. What I was thinking about that time is. So I used to have a motorcycle back in the late nineties early 2 thousands stop writing. And then that year I think I just had bought my motorcycle. And so my whole thought process is, I just bought a motorcycle, and I can never ride it again. 

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Stanton Shanedling: So let me ask you something, Tony At that point, do you think? Alright, maybe I should say, prior to you, having that episode? Were you aware of the signs and symptoms of a stroke? Were you knowledgeable  about any of it? Or were you kind of forced into dealing with it because of what was happening to you?

Tony Moore - USI: When you say knowledgeable, I would say that because of my Buddy Rodney, I  sort of verse myself as to what a stroke looks like but I don't really think that I went down into the trenches of salt meat all the other kind of things, and from that standpoint, because they were my lifestyle was one that You know I was pride of myself for my age, for my age I always look better, did everything better than all my peers at that same level. Right? So you know, all my peers typically outweigh me by 30 to 40 pounds. They eat way worse than I do. They drink way worse than I do. So all the things that I've purposely stayed away from

and try to. you know, like I didn't believe in medication. So I wanted to do things, so I didn't have to go on medications right?

Stan: So let me ask you this. You say that you knew about the stroke warning signs.  Did you then call 911 right away? Or there was a little bit of denial that oh, this cannot be happening to me or not. Was there a delay, or you just called right away? 

Tony Moore: Not with me. II was telling Julie once once my arm. Once it hit my hand. I'm having a stroke. I'm having a stroke. We need to call 9 1 one. I'm having a stroke. We need to call 9 1 one, and the conversation was really no, you're really no, you're not. Oh you know those kind of things right. Luckily for me, where I was having my stroke. I was on the corner near a neighbor's house, and we didn't take our phones. I we were both together, so why don't I need a phone, so you know, I wouldn't not be paying attention to, or those kind of things and luckily a lady was coming by on a walking, and she had a phone. And so we called and it seemed like it took forever for help to arrive. So the first thing that happened was, Officer showed up. He had no clue whatsoever in terms of really what to do except like it felt like he was trying to keep the area clear, but there was nobody keep area clear from right off and I did stay kind of calm. But again the things that were going through my head. I was telling you about, you know the motorcycle and some other things, and then I started thinking about the positive things about. You know. I'm grateful. I took care of, you know, my life insurance and all these other kinds of things. And yeah, I mean, I went from not being able to do something to the worst tragedies of the whole thing. And then finally, It seemed like it was 30 min before the ambulance showed up. It seemed like, and in the time from the phone call to them showing up. I started to feel I could close and open my hand again and in the midst of them, coming, getting me off the ground and putting me into the ambulance. Then I could start to get some movement back.

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Stanton Shanedling: So you know, for a listening audience, I'm gonna try to link a little bit between what we're hearing now and what we talked about in our show with you previously. time is of the essence. Okay, if you think you are having a stroke. You call 911, and there's some really good reasons for it, because time is of the essence and hythe them you can. You can talk about that a little bit more in detail. But the truth of the matter is, if you get into an ambulance, and if they think you truly are having a stroke. They can. They can warn the the er and they can get you in immediately without wasting any time whatsoever. So for the list of the audience.

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Tony Moore - USI: 9, 1, one emergency pay. Don't wait. If you. This is the opportunity to really, hopefully save lives.

 Stan: Quickly review the stroke, warning signs for the audience.

Dr. Haytham Hussein: Sure, we could do that, and then I want them. We'll circle back to Tony. Go ahead, weakness! Where of one of the arms, one of the legs, one side of the body. drooping of one side of the face. numbness or loss of sensation in one side of the body, or one of the extremities. Difficulty speaking, either the words are slurred, or a person is unable to express themselves in words, or having difficulty, understanding difficulty with vision. Either one eye goes blind without pain, or both eyes cannot see one half of the visual feel sudden loss of balance and coordination, and we call them there's a mnemonic be fast BEFA, ST.

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Stanton Shanedling: B stands for balance, E is for eyes, F means face, A identifies arm, S stands for speech and T means time is of the essence,

Tony: I don't like needles. Right? So first start poking me with not just the small needles, but the big ones right? And I'm like, Do I need to go through that and everything? Hey? I can move my arm now, you know. Don't poke me. But they said, well, you know, this is the protocol you I was kind of, you know again. A lot of things going through my brain is you don't need to have medical personnel unless you know that you had a bad issue like you're having a bad issue, and then, therefore you need to have something, so don't poke a hole in me if I don't know that what you're doing is a necessity to be putting holes in me.So after going through that, because I'm kind of standoffish, and there's some history behind that all, and I'll unpack that a little bit later. But so I get you know the needles and everything. They rush me to the hospital and they're having conversation with me, and then from there they take me into a room, and so there I go into a room  and meet with a couple of doctors, and then they do. They sent me in to get an MRI.

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Stanton Shanedling: Hmm!

Come back from the MRI, and then I go back to the room, and then from there it's well. We'll have somebody come back and explain to you what's going on from that standpoint. But

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Tony Moore - USI: I didn't have what my buddy had, which is like a blockage that they had opened up and going and and and get that moving some kind of way, cause if you don't have oxygen or something like that for a long enough time. Then that's the issue. So that's kind of where things were left.

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Stanton Shanedling: So Haytham , let me ask you. from what you just heard. Is that typical as far as emergency initial emergency care for potential stroke patient?

Haytham: So when someone comes with stroke symptoms that are ongoing. we activate something called a stroke code and that means that the emergency doctor, the neurologist on service, the pharmacist, the geologist. interventional radiology. Lab. Everybody becomes alert that there is a potential stroke case that might require emergency treatment. However, if someone comes with stroke symptoms that subsided. : and we think that person might have had a transient ischemic attack or tia it's you know. Many people feel that just getting an MRI, will give us all the information we need beyond what a Ct scan would do. And I'm not really. I don't really remember if Tony went for Ct first, and then MRI, or went to MRI right away. I think we have both images. I think I did. I did both. I think the Ct is the first one. And then I went later on that evening for the MRI. MRI, right? Yeah. But you know, there is, of course, a lot of work, Clarence and Stan, that we do to speed up the stroke code process. and we calculate the time from the per. The patient coming to the hospital, to the patient getting treatment in minutes. We call it the door to needle time. And you know, there are a lot of resources that are utilized to just shorten the door needed time by 5 min or something, and that would count as great success. So what we struggle with is when people are late coming to the hospital. and we really want to avoid that. And I just did an analysis of our data looking at white versus non white And we have about 6 or 7 h. Difference in the Median time from stroke. Symptom onset to arrival to the hospital. 7 hour difference between the 2 groups. So I can talk about this later. But I want Tony to tell us you spend the entire night in the hospital, and then the next day you saw a a doctor, a hospitalist, and you were discharged.

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Tony Moore - USI: Yeah, so cut to I can move. I'm not really getting a lot of  information per se but I did go through some testing all the tests sort of came back a little bit negative and after I had my Ct. Scan, they said, well, you have a little bit of a blockage.

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Tony Moore - USI: that's about all, that's all. They told me.

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Tony Moore - USI: Right? You have a bit of a blockage, we think, behind your eye, and we think that that's what maybe the cause of what it was. But that's all I was given so the night before I'm in the hospital. They tell me I have a little bit of a blockage. Okay?

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Tony Moore - USI:  Then I go into the hospital. I stay overnight and

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Tony Moore - USI: I see another person that does the echo on my on my chest.

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Tony Moore - USI: and after that it's pretty much, you know. They keep checking on me. But there's not really a lot going on. And so the discharge time is coming up is 30'clock. I'm ready to get out of the hospital, you know. I'm okay. I can move and still have hadn't seen a neurologist. No, I I've seen somebody that was

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Tony Moore - USI: not you could not your team. I, you know they send in the hospital staff. That sort of comes in and do those kind of things. But nobody that was, I guess, part of

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Tony Moore - USI: my actual true care team, or anything of that nature. So about 20'clock, they tell me that they're going to release me for the 30'clock switch over or whatever. And so I pack up my things and

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Tony Moore - USI: Julie and I leave the hospital. and where approximately 20 min from the hospital. when

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Tony Moore - USI: Dr. Hussein's colleague gives me a call.

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Tony Moore - USI: the the neurologist who was on service that week.

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Tony Moore - USI: and at the time, he says, Tony, can I talk to you for a moment, and I will. I was almost even hesitant to answer the phone like, why are they called me? At least I'm at the hospital.

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Tony Moore - USI: and

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Tony Moore - USI: we start having a conversation, and he tells me well, I shouldn't have been discharged.

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Tony Moore - USI: And I said, Well, and then that so that's instantly one of the things that coming from a diverse community that was upset.

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Tony Moore - USI: Then he says, well, we'd like to review all your information, and that's why we want you to come back. And at that time I was. I almost had like an attitude of like, you know. No, not doing it. Don't care what you gotta say. You know all that should have been taken care of. Where were you during the 12 h, or I was? I was at the hospital right?

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Stanton Shanedling: so it was 12 h.

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Tony Moore - USI: Well, I came into the hospital at 9 something that night, and I left at 30'clock the next day. So 12 plus 6 h at the hospital for over 18 h.

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Stanton Shanedling: Wow, okay, alright. I could to a certain extent trying to put myself  in your shoes. I can understand your thought process.

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Tony Moore - USI: It's just like what the heck here it's like you're telling me to come back. Now what's going on here. The the the reason behind that, though, is the worst part is, is my initial  information that was given to me is that I have a little bit of a blockage. Dr. Hussein's : colleague told me that I had a 70% blockage. So there's a big difference between 70% and a little percent of blockage language

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Stanton Shanedling: at least.Yeah. At that point

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Tony Moore - USI: I was thinking that I'm kind of on death's door. And why did it wait till I? Why, why did it take for me to get information about me being that having that much blockage, or or being in that much danger that that wasn't dealt with: between 9 Pm. And 3 Pm. The following day.

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Stanton Shanedling: So let me ask you, Haitham given this time frame that we're talking about here an 18 h time. Frame was the window lost as far as providing necessary medication for an ischemic stroke.

Dr. Haitham: No, we do the intervention when we go with microcutters, thin tubes and wires arteries to open them up when there is 100 blockage. But when there is less than complete blockage, 70 or something like that meet with oral medications most of the time, such aspirin and grill combination which got when he was in the emergency room. But I. He was not seen by the stroke team. He was seen by an internist, and the stroke team has a very long list of patients, and because Tony's case was kind of special, they wanted to have enough time to sit down and talk to him, and they were not aware that he was being discharged. so kind of freaked out and called, they would ask them to come back. But at that point I think in his mind he was thinking, oh, they just let me go because I'm blank and he just was angry. And didn't we tried to rectify that by having him come to my clinic within like a couple of days or something. I don't remember how many days it was And we explained everything. Well, let me back. Let me back up because I want to correct something. So and what's your what's what's your colleague's name again?

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Tony Moore - USI: Chris? Yeah. So so Dr. Chris was trying to have a conversation with me, and it goes a little something like this. Well, Tony, you know you have the 70 blockage, and we really wanna go back and go through your films. And, by the way, we have a study that we'd like you to do and or be part of right, or be part of yeah. Clarence I'm gonna I'm going to involve you in this portion of the conversation as another minority who is African American

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Tony Moore - USI: Does every black household grow up knowing about the Tuskegee experiment?

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Stanton Shanedling: I guess No, I could tell you that.

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Tony Moore - USI: So so in communities where history has shown that America has done these clandestine little experiments in black communities. I was really angry that I was approached for something left at, so I was discharged under one pretense asked to come back, and then, in the same breath, after participating in some revolutionary new study for black people, a black and brown people, and the only thing I thought about was the results of the Tuskegee experiment, syphilis, and all those other kind of things and simple sale, and everything else that has happened throughout time. When minorities have been,  in terms of my brain, used as a guinea pig to do something, and so without being rude at that time. I said, " I'm not sure I'll have to check with some other people, but as soon as I got off the phone with him. I think that I was. I went. II went forward to Prior in my own car and started having little conversations about how I felt in you know, using language that wasn't appropriate to air in a podcast but we get the gist. So that was the situation. And I had a lot of angst, and about

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Stanton Shanedling: the way moving forward. Yeah, yeah. Okay. So at some point you did move forward. Right? Okay, all right. So let's take it from that point whereby you came to the conclusion that I need some medical attention or further medical attention.

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Tony Moore - USI: Well, I believed I need further medical attention. I just didn't know if I wanted to do this study right. That's the piece. So while I needed that. it became that I finally had a chance to talk, have a conversation and we talked candidly.

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Tony Moore - USI: I think we talked in the office. Okay, so my I have family members that are in the medical field. So as soon as I get off the phone with Dr. Chris, I started making some phone calls and started asking them about what their thoughts are from a professional position and then they were assuring me that where things were 40, 50, 60 years ago are not where things are today and working with medical professionals, so you at least need to go hear them out.So I put on my skeptical hat and went to go see?

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Stanton Shanedling: Dr. Hussein, and we had a good, good decision. Good decision.

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Tony Moore - USI: Yeah. So. And we unpack a lot of historic historic information and dealing with one another to get to a level that to me is missed when minorities have issues, and coming into the hospital, maybe not, stroke related, but hardly all things related. There are a lot of things that if it's not the common cold or broken bone, or something like that, and it gets to these other things that are warranted, where you need to start taking different type of care of yourself and internals that everybody is met with skepticism because there's that innate thing in a person that says I'm the getting pig in this, or I'm not being treated. The way that I need to be treated compared to my contemporaries of a different color. Yeah. how can I word that? He told me once he actually was giving us a lecture at the university. and he said what just give me whatever you gonna give the white guy that was that, or maybe that's in their mind. We don't. There's this mistrust.

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Stan: What? Is there black medication? And is there white medication? No, no, no, it's like, Come on.

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Tony Moore - USI: Well, Stan, here's the situation.There's choices that are typically given out like you can do this or you can do that. I'm not the professional but to me white folks have a better survival rate on things I don't even know if it's a ask. It's more of a you know. What did you do there? Why am I given this choice that I could take a lesser route than go all in Umhm, right? And that was kind of my thought process, what are you gonna do for a Jim Jones, CEO of us bank. That's what I want.

Stan: Yeah, yeah, III totally hear you. And I think it isn't like there is black medicine and white medicine. There is attention to details.

Tony Moore - USI: There is a being you know, providing high quality care. There is spending, you know. Ha! Enough time to really understand what the struggles are. and you know you can. You can imagine if Joe Biden's cousin or something goes to the hospital versus one of our cousins go to the hospital. There is more attention, and there's more time there and then, maybe because of power. But there is also this perceived at least feeling among the minority communities that they are not being given the same quality of care, the same attention, the same understanding of their struggles as white patients. There's no way that we can ignore that or run away from that. And to the point of what hyphen was saying.

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Tony Moore - USI: My thought was, there's no way they would have let a 56 year old white man leave the hospital with 70% blockage without having a conversation

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Stanton Shanedling: absolutely. So, you know. Here's a take partially a takeaway for the audience, too. It doesn't matter if it's a stroke. It could be any, any medical condition here, there should be equity. There should be the same kind of care for one as it is for the other. Okay, it it. It's just the way it should. Okay. we will. We'll get back to stroke in just a second, Clarence, are you there?

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iPhone (2)clarence: I don't know if he can connect the he's having a little bit of problem connecting. But that let me, I just get back into the city and I click in. My Internet. Was not that good? I heard part of that. Yeah, I heard part of that. And I think that part of what I'm glad we're having this conversation is that II recently was working with that Dr. Della Farida, at the University of Minnesota, on the African American Stroke Project, where we're talking about some of the same things is, how do you make people aware? What should people know? And then how do you communicate with your doctor about whatever the condition was, we would just happen to be talking about strokes. But I I'm really glad, Tony, that you're telling your story, because I think that you know, many people don't really understand the the nuances that that happened with these issues and and and why it's so important for us to first of all, to know our sales what's going on, but also to be able to communicate with our doctors.

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Tony Moore - USI: Tony, you also mentioned a really really important aspect here, and then I'll let you take the take the mic here. But is this idea of trust?

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Stanton Shanedling: And fortunately you are able to create trust in frankly a a pretty quick manner with hyphen. Okay, and that but that even took some conversation from what it, from what I understand. In order for you to gain that in order for you to proceed with the care that you needed. Okay, take it from there.

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Tony Moore - USI: So one of the things Clara's I think you might have missed I was. I had asked

folks blacks in general, typicallyunderstanding or hearing the stories of the Tuskegee experiments.

Clarence: Umhm. Right

Tony Moore - USI:  And so when you are raised that your government or institutions do things to minorities that they typically don't, that you don't hear about White America being treated. You broke with sort of a a reservation for anything being introduced new as Hey, we want to try this new thing with you. So

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Tony Moore - USI: cut to me, having my conversations with hype them and moving forward. One of the things about communication and trust was I basically posed. How is this different than anything else in history that has been done for black folks under the guides that is supposed to be better for them, and turns out 2030 years later that it was actually a setup distrust. And oh, there's no accountability for injecting people with something that actually makes them sick, and we can sit back and watch them because it's experiment right? And those were the issues that I was having with this whole thing, along with the fact that if I would have been a Caucasian, male or female. I would not have been released out of that hospital with 7% blockage in my brain without seeing the top neurologist that the hospital had to offer.

iPhone (2)clarence: You know, I wanna say that I wanna say this real quickly, though I've and and and, Tony, II totally understand you, because that's one of the one of the challenges for us, you know, in terms of the work that we do is that there are people that are very skeptical of the of the system. Okay? And I think people like myself who who've had a chance to kind of work with the system. We understand that that's not. That's not always in the majority of the cases, the the issue. Sometimes we just have. We have, as you just said, because of the mistrust, people will not, will not, do a study. But those things are also in the. On the other hand, those things impact us as well. I don't know if you know that I mean, I know you know that, but because we're not involved in this studies. Many times when the medicines come out, they don't necessarily work as effectively for us as they do for other people.

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Tony Moore - USI: Yeah, but I do.: That's part of what Hythem and I had gotten to in terms of lack of information. So we finally but I think that that was the root cause of apprehension for most people. Is exactly what you're saying. We can't get to the solution because they're distrust there, and that's what we had to work on was, how do we gap to to get that trust involved not only with myself, but with others in the community and move forward. And so that was the the phase that we really were talking about working on moving forward.

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Stanton Shanedling: I'll tell you what what, what this disturbs me. And I'm glad you're telling the story behind. It is the fact of taking advantage of a of a medical situation. Okay, where that needed to be foremost dealt with. Okay, as opposed to. Oh, by the way, you know, you should be part of of this of this initiative. No. So what comes out of this? It and and, Tony, maybe you can respond to this is, it's one thing that the care that you got one way or the other. But it's also the mental anguish.

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Stanton Shanedling: Okay? And and I don't think that that's well. A. A. Obviously I don't. I don't think that's fair. But II greatly greatly appreciate the fact that you're telling the story because you you you get a sense of the mental anguish that you're going through. Besides the actual medical condition that you were trying to to deal with. Go ahead.

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iPhone (2)clarence: Well, let let me say this real quick. II think I think this is really good, that we're entering into this kinda candid, open, honest conversation. And we're being very, very transparent. This is a issue that that you know that many, many many people in our communities face. You know it. It was interesting, you know. Sometimes we take it as as only happening to our people. But it's happened to a lot of folks.

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iPhone (2)clarence: you know, one of the things that. And I'm gonna just say this real quick. It's kind of as a side, but also the you know, we talk about health disparities, and people think that health disparities are only among, you know, people of color health disparities, also rural. There are a lot of things that we don't talk candidly and honestly about. What we think is just, you know, one group versus another group. And III love the fact that we can enter this conversation and talk about all of the myriad issues that we have and why we need to be talking about trust. We need to be talking about transparency. We need to be talking about education, and one of the things for me as a and, Tony, I am totally with you. One of the things for me is that I believe that people from our own communities need to be talking more about these issues so that we don't have this this, this problem that we can kinda begin to minimize this problem as well.

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Tony Moore - USI: yeah, I would totally agree with you on that as I sidebar before I get back. So once I got about 45 right, a lot of the things that start happening are things of, you know, is your, are you where you need to be in your career? Because now you're on the second second half of your life and relationships and everything else. And one of the things that I was raised is you're stoic. You don't talk about, especially in the black household all my life. You know it was, you know we call we would always joke froze that nation right you know. And so that was running joke. Because it's like, Yeah, they're on drugs and volume. And this is that never. But to us. Oh, you gotta be strong austerity. However, I dealt with a lot of things that from a lot of depth was happening between age 45 and 52, and things that were affecting me that eternally.I didn't really know how to deal with, because you're told just to internalize it and move forward sort of suck it up right. And now I'm understanding that that's the wrong thing. But we were taught to do things a certain way, and there's a lot of things about being taught that carry over, which is the wrong thing. We don't have the right conversations at the dinner table, or just in life. Going back to what Clarence was saying to share how to have a better health situation  with being healthy, and what you should be doing, how to eat. You know I grew up eating a lot of fat and grease, and everything else, and all those other kinds of things. And I, you know, maybe I thought working out and being an athlete trumped, dealing with that where you know, my health issues happened in my late 50 s. Compared to my uncles and those guys in their thirties, forties and fifties. So I didn't really think that I ever I thought I was the one that beat the system because I was healthier. Well, if I may interject to to explain to the listeners

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Dr. Haythem Well, if I may interject to to explain to the listeners the study that we're talking about is stroke prevention Study.

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Tony Moore - USI: The stroke that Tony had was caused by a disease called intracranial atherosclerosis, severe narrowing of the arteries inside the head  and we do not have a good treatment for this condition. The risk of recurrence is about 23% in the first year. So a quarter of our patients are gonna have another stroke, and this condition is more prevalent in non-white races black Hispanic Middle Eastern Asian populations.  So we are very much interested in bringing into that. And this is a study funded by the National Institutes of Health, the Nih. It's not by like a drug company or anything. And we want to to study our black patients and our Asian patients. And so I think my colleague is enthusiastic about Tony coming back. And is that first the study offers what we think is kind of cutting edge medicine in terms of stroke prevention so there is a chance that he will be on a combination of drugs that will in the future be shown to be superior and second, that he is part of the community that we are desperately want to understand and so, being a participant in this study, really is a great service to the African American community in general. And I acknowledge that it was just not the right moment to bring it up. And my colleague, as I, as many other doctors really, are not very well versed with the Psyche of the minority groups.  And that's why I brought Tony to our meetings, and he taught us very important lessons. He said that you cannot ignore the elephant in the room. What happened to us over the decades and hundreds of years cannot be ignored. You cannot say I'm blind to color, and I'm just gonna treat everybody the same. No, you have to understand that there is this trust gap, and you have to acknowledge it, and you have to work on fixing it and building that bridge. I agree, I can tell you that Chris, my friend and colleague, used that technique after Tony gave that lecture, and it worked. He was delighted. And I told you, Tony, right, that's what it has to be. We have to respect history.

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Stanton Shanedling: So here's, I think the unfortunate part of this is the context of how it all kind of came together. On one hand, you're dealing with a stroke. On the other hand, you're dealing with somebody who's saying, Come in, come back to the hospital. On the other hand, you're also talking about somebody who's saying, be part of an experiment. And you know what context the contextual framework that surrounded your particular case here, Tony. in my estimation, is unfortunate and and wrong. Okay, but what is really positive about it is how we can learn from it how we can learn as providers of care, how we can learn as human beings, and I don't care what color you are. That's why I really promote Hugh man partnership HUEMAN, it doesn't matter what color we are, it really, when it really comes down to these types of things, Clarence, some, some final thoughts here.

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iPhone (2)clarence: Yeah, I just wanna say that. I hope I'm coming to clear here. But III do appreciate you know, both of you for coming on that program and talking about this issue. And I know that I am working on some stroke issues outside of the health chatter that I will be talking with you up specifically about stroke, and you'll be in contact with me, and I know that there many people that will be interested in hearing this conversation. So thank you both for being a part of us.

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Stanton Shanedling: You know some real clear take aways links back to the first show that we had with you. Hyphen, and that is truly everybody. Be aware of the signs and and symptoms of a stroke.

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Tony Moore - USI: and suspicion is good enough.

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Stanton Shanedling: Yeah, you have, to be sure, suspicion is good enough. Good enough, exactly. Yeah. If you just think you might be having a stroke, call 911, it's better to be safe than sorry, Tony. II don't know how I can underscore my thanks to you. For sharing your story. 

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Stanton Shanedling:  there's good that's come from it, and maybe that's the best I can. I can tell you. People have become more aware. People are becoming more educated, and it's through people that we get better at that.  And I underscore that a lot.

Tony Moore - USI: Thank you, Stan. I know you want to wrap, because this is sounds like the end of the program. So let me just share my points that if nobody can take anything away from this one. Ask the right question to have transparency of your doctors.  I think that's that's probably the biggest thing, too. While we didn't touch on it to the point of had I not entered into this study? The care standard standard standard care is 90 days. While I was back in the hospital in January.  Right? So if standard care is only 90 days because of how things work out there in the world. how people live longer and not go back to their same practices that they were doing that caused them to have a stroke, and most people do. There is no change in their household diets and things of that nature. So then, that becomes an educational piece and on the third portion is, is education to those that can. When you have these types of situations. The elephant in the room to Dr. Hussein's point is, listen. I need to have a conversation with you and the results of what I would like to have the outcome, or is a better outcome for you. But I need to share with you that I understand what I'm about to say. that there's a lot of negative negativity and neg A, and issues that have to be addressed in order for us to get to the right place. So we can have the right conversation, because there's the big picture issues. And there's what I call the immediacy issues and and we're we're trying to create balance here.

Stanton Shanedling:  Thank you so much. You know, what I can't say is that I hope you can use this podcast for further educational purposes. Going forward for our listening audience. I hope you've learned a lot I know I have. This is a dynamic duo that we heard from today that has a very strong message, and I hope you all heard it as a final reminder to our listening audience. Get vaccinated. We're getting into the fall season here, and people are spending more time indoors, which increases community spread of all these different illnesses that we're trying to get a handout. So it's a good time to get vaccinated for flu, for covid, for Rsv. For pneumococcal disease. Check in with your physician to make sure that  you're a candidate in the right timing for those vaccinations for you. Our next show will be on motivation in health. How is it that we get motivated to change our health habits? Do we have to be scared into it before we do it? Or do we embrace prevention? So with that.  keep health chatting away.