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Health care providers debate need for stroke screenings

October 13, 2008

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Vascular ultrasound technicians Kerri Jilka, background center and Donna Hamm, foreground right, perform a carotid artery and abdominal aortic aneurysm screening on Mark Johnson, Lawrence, Oct. 2 at a Life Line Screening clinic. Life Line Screening, a mobile health screening service was offering four screenings that can alert people to their risk of strokes.

Vascular ultrasound technicians Kerri Jilka, background center and Donna Hamm, foreground right, perform a carotid artery and abdominal aortic aneurysm screening on Mark Johnson, Lawrence, Oct. 2 at a Life Line Screening clinic. Life Line Screening, a mobile health screening service was offering four screenings that can alert people to their risk of strokes.

Health screenings

Stroke Detection Plus will provide screenings from 9 a.m. to 4:30 p.m. Wednesday at Hy-Vee Food Store, 4000 W. Sixth St. To make an appointment, call (877) 732-8258. For more information, visit www.strokedetectionplus.com.

Life Line Screening will offer screenings from 10 a.m. to 4 p.m. Oct. 27 at Lawrence Free Methodist Church, 3001 Lawrence Ave. It also will be in town Nov. 20 at the Union Pacific Depot, 402 N. Second St. To make an appointment, call (877) 237-1377 or visit www.lifelinescreening.com.

"We can help you avoid stroke."

"Detect your risk for stroke in less than 10 minutes."

These are the claims on fliers recently distributed by two companies that provide health screenings in the Lawrence community and elsewhere.

These companies say they will use ultrasound technology to test your risk level for:

¢ Stroke. They check the carotid artery in the neck for blockage of blood flow to the brain.

¢ Abdominal aortic aneurysm. They check the lining of the major blood vessel to see whether it is enlarged, which could lead to rupture.

¢ Peripheral arterial disease. They check the blood vessels in the legs for plaque buildup.

¢ Osteoporosis. They check for abnormal bone density.

One company also tests for atrial fibrillation, or irregular heart beat. Both companies charge about $130 for the package of tests or about $40 for individual ones.

Is it worth the expense? It depends on whom you talk to.

The companies back their claims.

Officials with Ohio-based Life Line Screening and Iowa-based Stroke Detection Plus said doctors often can't order these tests for patients and have their insurance cover it because they aren't exhibiting signs or symptoms.

"The scary thing about the conditions that we screen for are they are considered silent conditions, so they don't have a lot of signs or symptoms until you're experiencing the heart attack or stroke," said Katherine Hagge, wellness coordinator with Stroke Detection Plus.

They recommend screenings for anyone with these risk factors: age 40 and older, family history of strokes, high cholesterol, smoking, diabetes, high blood pressure, inactive lifestyle, heart disease or more than 20 pounds overweight.

'Firm believer'

Wallace Ala, 77, of Leavenworth, was screened for his risk of a stroke in April by Stroke Detection Plus, and he said it saved his life.

"If I hadn't done it, I would probably be dead," Ala said.

The screening detected that he had only a trickle of blood flow through his right carotid artery. After further testing with his doctor, he had surgery two weeks later. Now he is doing fine.

"I am a firm believer," he said.

Ala, and his wife, Frances, 70, both get tested every year. Frances said the tests are worth the money.

But some doctors urge caution. They are concerned about the technology, the expertise and value that patients might place on such screenings.

"I think the important thing is when people have this done even if it looks OK, they need to share this information with their physicians," said Dr. Stephanie Lawhorn, a Lawrence cardiologist. "No test is ever 100 percent foolproof as far as I am concerned, and so this is a type of a screening, but it is only a screening. ... If someone is having symptoms of a potential stroke, I don't think that is the place they need to go to see if they have a problem or not."

'No benefit'

Dr. Gary Gronseth, medical director of the stroke program at Kansas University Hospital, doesn't recommend the screenings for two reasons: First, the tests can have false positives. They cause the patients to worry and require additional tests, only to find out that there wasn't significant blockage. Second, the surgical procedures can put the patient at more risk than the potential for stroke.

"There's really no benefit to it and there's potential harm from it," Gronseth said.

His advice: Don't pay for the screenings, see your doctor regularly and get the risk factors - high blood pressure, smoking and high cholesterol - under control.

"They will get much more benefit from that than these screenings," he said.

That's the same stance taken by the U.S. Preventive Services Task Force, an independent panel of experts that reviews evidence of effectiveness.

"They recommend that patients receive screenings in their usual care provider's office, so that they can participate and share in the decision making and really figure out what makes sense for the patient," said Kristie Kiser, spokeswoman for the Agency for Healthcare Research and Quality, which sponsors the task force.

But Scott McGlothlen, president of Stroke Detection Plus, said such screenings are being offered in many hospitals. He also said they use top-notch technology and professionals and the latest research.

He added the screenings are designed to spur those at risk for cardiovascular disease to take action.

"We've been telling people that they have high cholesterol, that they are smoking and going to end up with heart disease, but people won't change. They are like, 'that's 20 years down the road. I am going to enjoy my cigarette today,'" McGlothlen said. "We show them a picture where it looks like you are looking right down a garden hose and you can see that 10 to 30 percent of that is filled up with this plaque deposit. Guess what just happened to their willingness to change?"

During a Life Line Screening clinic on Oct. 2 in Lawrence, several of the day's 48 customers said they were being proactive about their health and wanted to know their potential risk. Some had the screenings because their doctors recommended them; others came on recommendations from neighbors or family.

Carol Hermsen, 67, of Lawrence, had her first screening after talking it over with her doctor, who said the tests would cost about $300 if done at the office, but warned that they might not be as thorough. She wanted to pay for them anyway.

"You may have a problem and not know it. It's a good preliminary thing to do," she said.

Comments

IUS 5 years, 6 months ago

I am a 30 year Cornell Medical Center Graduate with an Associates Degreee in Diagnostic Radiography and Sonography holding registries and credentials in multiple disciplines commenting here.I visited a "BLANKBLANK" screening event locally here in Florida recently and spoke to the staff out of curiosity regarding their credentials. Not only did they all NOT have a Registered Vascular Sonographer performing these exams, none of the "testers" were registered in ANY discipline in the practice of Sonography, nor were they being supervised on site by anyone with ANY credentials from the ARDMS, CCS, or the ARRT as well! It's a true crap shoot getting these tests done by "techs" that haven't even met the MINIMUM requirements for practicing Sonography. And believe me, passing a written credentialing test often means nothing when it comes to proper education and experience. I am glad some are helped by these companies, but the noble effort to find hidden cardiovascular disease is more often than not negated by the means of how they institute their practices to feed their bottom line. $$$$ (cheap labor with official scubs and nameplates)Oh, and by the way, did you all know that HALF of all practicing "Sonographers" in the US are NOT credentialed....AT ALL. This was presented to me in a phone conversation from the president of the preeminent Sonographer's trade organization last year. Makes you feel a bit queasy, eh? Especially considering that the Physician who subsequently reads/interprets the exam will never SEE on the films what the Sonographer MISSES. The depend SOLEY on the skill and experience on the Sonographer. I most humbly agree with the President of Stroke Detection Plus about his comments on screening. I also speak from first hand experience. I saw a COMPLETE regression of a 30-40% "soft" plaque, (and therefore possibly vulnerable for rupture and stroke) in my own carotid artery (discovered by accident at the age of only 42 when auditioning a new ultrasound machine) after 2 1/2 years of mild therapeutic intervention. COMPLETE REGRESSION. No high risk factors at the time or early family history of cardiovascular disease. Go figure!Be healthy, guys!IUS

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pomegranate 5 years, 6 months ago

Wehad this done a number of years ago by LifeLine, and they found a large aortic aneurysm in my husband. He immediately had it treated. Without the treatment, for something we did not even have an inkling that he had, he could have croaked and taken many people with him due to his job. I am all for the test.Although, they told me that I had moderate blockage in my carotid artery, and as it happens,this summer I had a number of various heart related tests and had absolutely no blockage. So they are not always right.

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Lynn731 5 years, 6 months ago

I had the tests last year, approved by my physician. I had no problems. Just knowing that was worth $ 140. Thank you, Lynn

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Keith 5 years, 6 months ago

They create the patients to worry and require additional testsProofreader anyone?

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