Return to Transcripts main page
CNN LARRY KING LIVE
Stroke Survivors Share Stories
Aired January 28, 2005 - 21:00 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
LARRY KING, HOST: Tonight, Dick Clark just survived America's number three killer, and its leading cause of serious long-term disability, strokes. They can hit anyone at any age, even children. In an average hour, more than 60 Americans have strokes, 20 of them fatal. In this hour, stroke survivors, from an actor to a beauty queen to a senator's wife share stories that could save your life. Cindy McCain, the wife of Senator John McCain. She suffered a stroke nearly a year ago. James Woods, the Oscar-nominated actor directed a series of powerful stroke awareness spots. His stepfather suffered a stroke during open heart surgery, eventually died from that stroke. Leean Hendrix, Miss Arizona, 1998. Suffered a debilitating stroke at the age of 26. Robert Guillaume, the beloved star of TV's "Benson." The actor suffered his stroke six years ago. And Dr. Larry Goldstein, M.D., former chairman of the American Stroke Association Advisory Committee. They're all next on LARRY KING LIVE.
Let's begin with the obvious, and go to Dr. Larry Goldstein, who's director of the Duke Center for Cerebral Vascular Disease and professor of Duke University School of Medicine. We might say at the outset that we're dedicating this show tonight to the memory of Russell Walker. Russell was the father of Wendy Walker Whitworth, the senior executive producer of this program. He died of a stroke when he was 68 years old, 21 years ago -- 22 years ago, in 1983. This show is dedicated to him and his memory.
What, Dr. Goldstein, is a stroke?
DR. LARRY GOLDGSTEIN, FORMER CHAIRMAN, AMERICAN STROKE ASSOCIATION ADVISORY COMMITTEE: Well, a stroke is a problem that occurs in the brain, and there are two main types. There's one type that we call ischemic stroke, and that occurs when a blood vessel is closed off. It can be closed off either because of a problem in the blood vessels within the brain or leading to the brain, or it can be closed off because of a clot that travels to the brain from somewhere else in the body, most commonly the heart.
The second major type of stroke is a bleeding type of stroke. We call those hemorrhagic strokes. And those come in two types also. They can be bleeding within the brain itself, or bleeding around the outside of the brain.
The treatments of these, the approaches to them and the risk factors for them are all quite different.
KING: Do we know why Bill gets one and Joe doesn't? GOLDSTEIN: Well, there are a lot of risk factors that we know about stroke that put some people at higher risk. Some are risk factors that we can do things about, some risk factors that we can't do things about. But even the ones that we can't do things about are important, because they alert the people that they may be at higher risk and have to take -- become more aggressive.
Things that we can't do things about; one is age. The risk of stroke doubles for every decade of age over age 55. But as you said, from the guests that you have with you tonight, stroke can also happen in younger people. About a third of strokes happen in people under age 55.
Race, ethnic group is another risk factor for stroke. African- Americans have about double the risk of stroke as compared to non- African-Americans. Another very important risk factor.
Also, family history. If you had somebody in your family that had a stroke, particularly at a young age, that puts you at higher risk.
So those are things that we can't do anything about.
There are a variety of other risk factors that are related to lifestyle. These are things that we can do things about. One example is cigarette smoking. Smoking cigarettes about doubles the risk of stroke. If you stop smoking, your risk decreases dramatically over about the first two years, and goes back to having never smoked after about five years.
Exercise. We know that people who have -- are on a regular exercise program have a lower risk of stroke.
KING: All right. Let me find out -- I'll get back to you, doctor. I just want to get the overview. Let's discuss -- James Woods, you did not have a stroke. What got you interested in this?
JAMES WOODS, ACTOR: I actually was invited by the American Stroke Association to direct some spots that were public awareness spots, public service announcements, PSAs as we call them. And in the process of trying to get a cast that reflected the demographic of stroke, rather than a politically correct cast I had what I called the medically correct cast. I had Michael Clarke Duncan, for example, who's a great African-American actor who represented that particular group who is at risk.
One of the people that I had, who reminds me of Leean, a beautiful young woman, was Sharon Stone, who was incredibly gracious. She came down from San Francisco. And each of these people actually plays a stroke, it's a kind of conceit in the spots, where they talk about their personalities. And it's the personality of the stroke, that it's cold, it's calculating, it doesn't care, et cetera.
And Sharon, as she came down, was watching me direct a sequence with Don Rickles, who is wonderful in it. And as he did his scene, she burst into tears. I mean, it was actually incredibly moving to me, because I didn't know if she would even actually commit to doing it, even though she was still on the soundstage, because she hadn't done her part yet. And she just started sobbing and I said, what? She said, I didn't realize how seriously you were going to do this and how devoted everybody was to it. And she said, you know, I'm -- this is my debut to talk about my stroke. And in fact, of course, Sharon had had a terrible stroke, and survived it.
KING: We are going to play those stroke spots, by the way, throughout the show.
What happened to you, Cindy?
CINDY MCCAIN, SENATOR JOHN MCCAIN'S WIFE: I was having lunch with friends. I had returned...
KING: In Phoenix?
MCCAIN: In Phoenix. I was just sitting at lunch. And no pain, I had no warning. I just simply all of a sudden couldn't talk. And I was going for my car keys. I had returned from the night before from a flight from Singapore. So I thought I was jet-lagged. And I was mainly more concerned about being caught in public and not being -- without my full faculties. So I grabbed for my car keys, and fortunately my friends grabbed my car keys away from me, and said, no, there's something wrong with you.
KING: They saw it in you?
MCCAIN: They saw it in me. And I wound up at Barrow Neurological in Phoenix, and had the best of care. But I always thought -- you know, I have seen a lot of television too and in the movies, and I thought there was pain with stroke. I thought there was something, some lightning bolt hits you and tells you you're going to have a stroke. And that's not the case. I didn't know what was going on.
KING: What has been the after effect? I know there's some things, there's paralysis? What's your after effect?
MCCAIN: Now -- I had some speech problems, some paralysis, some difficulty walking, but the most difficult thing for me now is my memory. I have had a pretty good memory loss, and difficulty now trying to pull things together. You know, it's frustrating.
KING: Before we talk with Robert and Leean, last month, legendary TV host Dick Clark had a stroke, just released from the hospital this week. Ironically, he was on this show last April. Stroke is one of the health problems he said he worried about. Take a look.
(BEGIN VIDEO CLIP)
DICK CLARK, TV PERSONALITY: Well, after 10 years, I'm -- this is the first time I've talked about it, Larry -- I have type II diabetes, which isn't earthshaking news, but what gotten me shook up was when I went in 10, 11 years ago, and they told me I had it, I didn't think much about it. Do a little exercise, watch my diet, take medication, if necessary, and all would be well.
And about four or five months ago, they announced that two-thirds of the people with diabetes die of heart disease or stroke. And I, whoa. I better get more serious about this thing.
KING: And that's the type II, like I have, that's where you don't take insulin?
CLARK: It used to be called adult onset.
KING: Adult onset, yeah.
CLARK: And we didn't think much about it. But it is pretty serious now.
(END VIDEO CLIP)
Not kidding. Bob Guillaume, what happened to you?
ROBERT GUILLAUME, ACTOR: Well, I -- overnight, I woke up the next -- the morning of the stroke, I woke up and I had a vague presentment that everything wasn't right. And I can't say what it was or why I felt that way.
The day before I had been on a show -- I worked on the show "Sports Night." And I had had a little difficulty turning a corner. My feet just wouldn't act right. But the next morning, when I woke up, I had this -- as I said, this presentment. And then I was thinking about telling my wife to -- just to take our daughter to school, Rachel. And -- but I decided against that.
So then I went on and took her to school. I came back by my hangout over at Jerry's Deli, and that's where we would sit and...
GUILLAUME: ... kibbitz and trash everybody in the business who was doing better than we were, you know, a profoundly disgruntled group of guys. And I got up, ready to leave, and when I got up, I walked in one direction, and then I realized that my car was in the other direction. So I tried to make an about-face. And when I made the about-face, I must have looked pretty ridiculous, because the guy said, what's the matter, Bob? I said, well, I don't know. And so he said, you want us to help you? I said, yes, you know.
And so I realized in hindsight that it was -- I was gradually losing the strength that I needed to carry on my day.
KING: What has been the after effect to you?
GUILLAUME: Well, I've had spasticity in my left arm, and a limp in my left leg.
KING: I got to get a break. And when we come back, we'll get Leean's story. Then panel discussion, your phone calls.
As we go to break, here is that Sharon Stone spot directed by James Woods.
(BEGIN VIDEO CLIP)
SHARON STONE, ACTRESS: There's something you should know about me. I'm cold. I'm calculating. I get what I want. If you get in my way, I'll wreak havoc upon you. I can leave you weak, limp, twisted, confused. If you want to live to see tomorrow, you answer to me and you answer quickly. I am a stroke.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
SEN. JOHN MCCAIN, (R) ARIZONA: My wife is running and she had a mild stroke about a year ago. And so she'll be in it today in the half marathon. She says next year she's going to do the whole one. I hope so. And we -- of course, have the wheelchairs. You know, it's just a marvelous event. And a beautiful day here in Phoenix.
(END VIDEO CLIP)
KING: Leean Hendrix, you were miss Arizona in 1998, that was five years ago, you were 26. You had a stroke.
LEEAN HENDRIX, FRM. MISS ARIZONA: I sure did.
KING: Where, how, what happened?
HENDRIX: I was at home just like Cindy, doing everyday things. Somebody had came over. Thankfully I wasn't by myself. It was a dizziness, there was no pain associated, no headache, just a very severe dizziness. I tried to shake it off.
It got worse. I proceeded to get up, make my way to the bathroom so I could actually see what was wrong with my eyes. And I started bumping into the walls. Got about two inches away from the mirror and saw the right side of my face was completely droopy. Turned around looked at the person that was with me and said, oh, my God, I'm having a stroke.
KING: You knew right away?
WOODS: How did you know that?
HENDRIX: I don't know. I must have either heard something somewhere along the way. I think people, if you really listen to your body, you know what's going on.
KING: Was there a panic?
HENDRIX: Oh, yes, there was a panic. I hyperventilated. I passed out for a couple seconds. Woke up and told myself to start talking, start talking out loud. I tried to talk, and it was coming out as gibberish.
The person took no an Urgent Care, because I didn't even know where a hospital was at in my neighborhood. I fell unconscious. The ambulance picked me up from the Urgent Care, they took me to the hospital where they left me lying in the hallway for 6 1/2 hours unconscious, unattended because I was young and they assumed that I was either crazy or on drugs.
KING: No kidding?
HENDRIX: No kidding.
WOODS: You brought up one of the most important things. And this is what the Stroke Awareness, the whole campaign, was about. I think Dr. Goldstein will corroborate this. A stroke is, in the simplest terms a brain attack, the way a heart attack is a heart attack, as we know it. The No. 1 thing that you can do for a stroke is to act as quickly as possible. If you think you've had a stroke dial 911. You don't have to be a doctor and say, I know this was a stroke, do I feel a little dizzy, is it a problem? If it seems your body is telling you that something debilitating is happened that could be like a stroke as you understand it, call 911. Time lost is brain lost.
KING: Do you agree, Dr. Goldstein?
GOLDSTEIN: Absolutely. One of the things we can do now, we can intervene, if we can get to people very, very soon after the symptoms begin. It's the symptoms that we were just hearing about, problems talking, problems understanding, weakness on one side, numbness on one side, a severe unexplained headache, that may be a stroke. The message is call 911, because as Mr. Woods just said time lost is brain lost.
KING: Can people get a mild stroke in their life and never know they had one?
GOLDSTEIN: Absolutely. The symptoms of stroke can sometimes be very fleeting. When they are we call these TIA's, or transient ischemic attacks. It can be the same symptoms of a stroke, but it comes and it goes very, very quickly.
The message there, is the response should exactly be the same. Firstly, you don't know whether it's going to turn into a stroke. Secondly, the highest risk of going on to have a stroke is over the next one or two days. For us to treat a stroke, our best treatment is to prevent it from happening. That's a signal, go get help.
KING: What's the best guess, since they're not your patients, why did Cindy, Robert and Leean live?
GOLDSTEIN: Well, the large majority of patients who have had strokes survive. About a third or so can be moderately or severely debilitated after the strokes happened. But that part is not unusual at all.
The thing that we can do now is by intervening is we can try -- we can reduce the amount of damage that could happen. And that's what's particularly important, because the outcome is what we're trying to improve.
KING: You've had heart problems, Jim, I've had them. Do you fear a stroke?
WOODS: I don't fear a stroke now, because I quit smoking 13 months ago, I go to cardiac therapy. I aggressively devoted to preventing problems medically to do with the heart. And the irony is, I'm probably healthier now I ever would have been had I not become aware of this. And I became aware of it by doing the American Stroke Association spots.
And by the way, since we're talking about health, you can go on the American Stroke Association Web sites and you can learn a little bit about strokes. It doesn't take much...
KING: www.strokeassociation.org or Americanheart.org, either one.
WOODS: Right. And I mean, you know, learn a little bit. It's like everybody should know CPR, everybody should know a little something about strokes.
KING: Did you think you were going to die, Cindy?
MCCAIN: I was sure I was going to die. When my friends left the hospital and before my husband was in New York when it happened, and I was alone in the hospital, I was sure. What kept going through my mind was is I hadn't said enough to those that I loved. I just couldn't...
You know, Sharon Stone said to me, I had to ask her, I said, I want to know a little bit about this, because obviously I'm directing these spots. I said, what was it like? She said it was like those horrible dreams when you've fallen into a vast emptiness and you know that life is out there somewhere, but you can't reach it. She said you're in the deepest, darkest well and can't get out.
KING: We'll take another break, be right back. In a while we'll include your phone calls. Don't go away.
BEGIN VIDEO CLIP)
BOB BARKER, PRICE IS RIGHT HOST: I had a minor stroke in 1991. The doctors couldn't explain why I did, because...
KING: Minor stroke meaning what happened?
BARKER: Well, I got up one morning and I realized that there was something wrong with my peripheral vision. And I got up very early, I thought, well, I'm going to call the doctor. And I thought, well gee, he's not going to be open yet, I'll go work out. So, I'm out there working out. I was having a stroke.
But I worked out, went over. He sent me to an ophthalmologist. He thought there might be something in your eyes. The ophthalmologist sent me to a neurologist. He said I think you've had a stroke.
So, I went over, and I was in the hospital for a few days. And I got out. And I've never had a recurrence. And I go for a check-up every year.
KING: And no resultant effects?
BARKER: No. No.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
UNIDENTIFIED MALE: Are you her husband?
UNIDENTIFIED MALE: Yes.
UNIDENTIFIED FEMALE: (UNINTELLIGIBLE).
UNIDENTIFIED MALE: Right now, she has an abnormal heart rhythm and we're trying to fix it. We believe something similar may have happened before, that would have allowed a clot to form and move to her brain, causing the stroke.
UNIDENTIFIED MALE: She had a stroke?
UNIDENTIFIED MALE: I need the (UNINTELLIGIBLE) strip.
UNIDENTIFIED FEMALE: Double the dosage?
UNIDENTIFIED MALE: Wait. (UNINTELLIGIBLE).
UNIDENTIFIED MALE: Small IV push.
(END VIDEO CLIP)
KING: That scene is from NBC's "ER," which takes a shot at educating viewers about strokes. It's an episode coming up in February. Cynthia Nixon of "Sex and the City" guest stars as a stroke sufferer. You saw her there in that scene.
Robert, what's it done to your career?
GUILLAUME: Well, I was on the down side anyway, I think. And it's -- I can't say. I've done a lot of things that I had never done before. About two months ago, I directed a play in Nashville, Tennessee, and I made a little independent film, that I like very much. And it's -- I did it out in the desert. So I've done a lot of traveling. And it's part of being in denial.
KING: Have you had memory loss?
GUILLAUME: No, no.
KING: You haven't?
KING: So everybody has different repercussions in a way. What do you live with the worst, Leean?
HENDRIX: Memory loss. Lack of confidence, the same confidence that I had before.
KING: Fear of getting it again?
HENDRIX: Of course. I mean, it gets less and less as time goes by since I've had the stroke, but I think it's only natural to fear having another stroke. And I think also all my dreams that I had before, they changed. I mean, the person I was the day before I had the stroke is non-existent. I'm a totally different person.
KING: You saw the Sharon Stone spot, Jim Woods was telling us an interesting story about -- we're going to see Don Rickles' spot, how he got Don to be serious, which is not easy.
WOODS: Well, you know, he really came across to me like Brando, because, you know, to Don everything is a joke. And when he was there, he was trying to keep the crew happy and so on. And I thought, you know, there's something about Don that I really love. And he has a real depth inside him.
So I walked up to him and I had my hand behind me and I was signaling the cameraman to roll the camera. And I had told everybody on the set, I said, I am going to shoot film when they're not expecting it. The camera is always going to be going, so don't talk. So the crew was very quiet. And I walked up to Don and he says, oh, yeah, with the jokes and this, I said, Don, I said, just one thing before this take. I want to remind you of something. Frank Sinatra is dead, Sammy Davis Jr. is dead, Dean Martin is dead. You're the only one left, you're in your 70s and nobody's laughing at your jokes anymore. Action. He was fabulous.
KING: Let's watch.
(BEGIN VIDEO CLIP)
DON RICKLES, ACTOR: Nobody likes me. Nobody. Maybe it's because I like to attack people. Men, women, kids. I can reduce them to weak, stammering, confused, scared imitations of their former selves. If they don't stop me, I just might leave them that way for life. I am a stroke.
(END VIDEO CLIP)
KING: Whoa. Dr. Goldstein, have we made vast improvements in treatment, prevention, drugs?
GOLDSTEIN: We've made tremendous improvements in all areas related to stroke here over the last decade, decade and a half. We have multiple ways now of trying to prevent stroke from happening. Again, the best way to treat it is to prevent it. High blood pressure, the silent killer is probably one of the most important things that people can do for themselves, get their blood pressures checked. Another important thing is just checking your pulse. If your pulse is irregular, you may have atrial fibrillation, and that's a major risk factor for stroke. Again, we have good medicine for treating that.
The whole reason for trying to get people to the hospital quickly is because we have interventions now, some of which are proven, some experimental, that we can use to try to reverse the effects of stroke if we can get to people fast enough.
Then during the recovery period, there's a lot of experimental work going on to try to improve post-stroke recovery. The advances over the last decade, decade and a half have been tremendous. It's a new world out there.
KING: Is dizziness a sign -- if you're dizzy for a few days, would that be a sign of a stroke?
GOLDSTEIN: Dizziness can be. It's mainly the type of dizziness where the room is spinning around or turning around. General lightheadedness usually isn't. The major symptoms -- loss of vision, trouble speaking, trouble understanding speech, weakness on one side, numbness on one side. A severe unexplained headache. Those are major warning signs of stroke. And...
KING: I'm sorry. Go ahead, doctor.
GOLDSTEIN: And it's also important, by the way, not only for people who are at risk to know about these, but for the people around them, their friends, their family know it. I think that some of the guests that you had have said that they didn't realize what was going on. And it took other people seeing them to know what was going on. Their response should be the same, call 911.
KING: Cindy, what made you recover? What did it for you?
MCCAIN: Just the will to live. I have four children. I mean, I had to pull myself together. You go through such a phase where you're confused and then you're scared, and then you're in disbelief, and all the things that occur. My family was in disbelief. So, mainly, you just -- you turn inside for me. And I turned to my friends, also. That worked.
KING: Did you think more of stroke with aging?
MCCAIN: Oh, yeah. I mean, that was something my grandmother would have or my grandfather. Not me.
KING: Leean, how you knew you had one is amazing at 26. Who at 26 thinks they're having a stroke?
HENDRIX: I don't know... KING: People didn't believe you.
HENDRIX: No, no. And as a matter of fact, I still get people to this day, I tell people, if I had a nickel for every time somebody said to me, I never would have known, there's no way somebody your age could have had a stroke, I'd be very rich living on an island somewhere.
KING: We'll be right back, we'll include your phone calls. Our discussion is stroke. Again, for more information, www.strokeassociation.org, or AmericanHeartAssociation.org. We'll reintroduce the panel, including your phone calls right after this.
(BEGIN VIDEO CLIP)
KING: What happened when you have a brain hemorrhage? What happens?
STONE: Your head hurts. And I've done a public service announcement for the Stroke Foundation, because I really want to remind people that if you have what you think is the worst headache you've ever had, go directly to the hospital. Don't wait an hour. Don't wait for it to get worse, and don't wait to see if it goes away, because it's very, very important to go immediately.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
UNIDENTIFIED FEMALE: I want something good to happen before the day is over, and I'll be the judge of what's good! One good thing before the day is over. I swear, that's all I want.
GUILLAUME: Hey, lady, are you thinking about getting my show on the air any time soon?
UNIDENTIFIED FEMALE: Isaac!
(END VIDEO CLIP)
KING: Our guests are Cindy McCain. She suffered a minor stroke in April, 2004. She was 49 years old, the wife of Senator John McCain. James Woods is the two-time Oscar-nominated actor, who has directed a series of stroke awareness spots for the American Stroke Association. We've seen two, with Sharon Stone and Don Rickles. His stepfather suffered a stroke during open heart surgery, spent months struggling to survive, eventually succumbed, and James underwent emergency heart surgery last year.
Robert Guillaume, the Emmy-winning actor, suffered a stroke in January of 1999, while starring as Isaac Jaffe on the acclaimed TV series "Sports Night." The producers wrote the stroke into his show, enabling his character to return. You just saw the scene.
Leean Hendrix was Miss Arizona in 1998. Suffered a debilitating stroke in 2002 at age 26. And in Durham, North Carolina is Dr. Larry Goldstein, director of the Duke Center for Cerebral Vascular Disease, professor, Duke University School of Medicine, and former chairman of the American Stroke Association's Advisory Committee.
We'll include your phone calls and we start with Indianapolis. Hello.
CALLER: Hi. Yes. At 34, I woke up with what I thought was a migraine headache. And I wonder if you could just touch on the importance of women knowing the risks with the birth control pill.
KING: What is the birth control pill risk, Dr. Goldstein?
GOLDSTEIN: Well, there probably is an increased risk with oral contraceptives in young women, but mainly if they have additional risk factors. The additional risk factors are cigarette smoking and having high blood pressure.
KING: So you have that, though, it wouldn't be just birth controls in and of themselves?
GOLDSTEIN: In general, the risk seems to be very low if you don't have additional risk factors.
KING: Any association between migraine and stroke?
GOLDSTEIN: There is an association, again, predominantly in young women. Again, it's not entirely clear, but there does appear to be an increased risk. And in young women, the risk may be about double.
The thing is that we also have no evidence that reduction of the frequency of migraine necessarily decreases risk. And migraine may also be associated with other conditions that can increase the risk of stroke.
KING: Louisville, hello.
CALLER: Yes. I have had, they say, a mini stroke. Hello?
KING: Yeah, go ahead.
CALLER: They tell me that I have had a mini stroke, but I did not -- I was not aware of it. Can you have one right after the other and still not be aware?
GOLDSTEIN: Yes. A mini stroke is not really a medical term that we use. TIA, a transient ischemic attack, means having the symptoms of a stroke that are temporary and then go away.
But what the other thing is that we're finding is that many people have had strokes and never knew anything about them. We call those silent strokes. And we can find those if we do a brain imaging test, such as an MRI scan.
KING: But if you didn't know it and it didn't affect you, so?
GOLDSTEIN: Well, the thing about is that even though it may not have affected you in terms of the usual type of stroke symptoms, it may over time create additional problems. For example, in people who may also have Alzheimer's disease, it may increase the risk of having memory problems and the effects of Alzheimer's disease. Also, vascular dementia is a major cause of thinking problems as we age.
The business about -- also about having a warning stroke or a mini stroke, again, that should not be ignored. That's a warning sign that someone may be at risk for having a major stroke. It means that you should be evaluated aggressively to try to understand all the potential risk factors and treat them.
WOODS: Is the TIA a stroke itself, doctor, or is it just -- has the symptomology of a stroke, but thank God nothing has happened, it's just an indicator you should be looking into? Or are there actual physical consequences?
GOLDSTEIN: Well, there can be. About 30 percent of people who have -- who fulfill the definition of TIA, which traditionally has been having those symptoms going away within 24 hours -- about 30 percent of them, if we do an imaging test, has actually had brain damage, but they've just recovered very quickly from it.
We've actually revised the definition recently. The new definition of TIA is that it has to last usually less than an hour, usually on the order of just minutes, without brain imaging evidence of brain damage.
KING: What does that stand for, TIA?
GOLDSTEIN: Transient ischemic attack. Transient meaning it's temporary. Ischemic, that's the first type of stroke that I mentioned when we began the hour, the type of stroke where a blood vessel is closed off and then reopens.
KING: What's the most common stroke?
GOLDSTEIN: The most common type of stroke is the ischemic type, when the blood vessel closes off. That's about 80 to 85 percent of the strokes. The second type, the bleeding type, is about 10 to 15 percent of all strokes.
KING: So the former is what our guests have had?
GOLDSTEIN: Well, not necessarily. One of the things that is important to know is that we can't tell just listening to a history very often what type of strokes somebody has had. We may have a lot of clues, but we may not know. An imaging study is absolutely required, which is why when somebody has the symptoms of a stroke, it's important to get to the hospital very, very quickly, because there are a number of tests that need to be done for us to be able to understand the best way to treat someone.
KING: In Leean's case it happened, can a hospital misread it?
GOLDSTEIN: That can happen. The symptoms, especially when one's not looking for them, can sometimes be very difficult to pick out.
The other thing that we also believe now, is that it's very important to get to a hospital that is organized to deliver acute stroke care. And organized to deliver stroke -- the delayed (UNINTELLIGIBLE).
KING: How do you know that?
GOLDSTEIN: Well, there are a number of ways now. One way is that the American Stroke Association, working with the Brain Attack Coalition, developed a series of criteria for hospitals to fulfill to deliver state-of-the-art stroke care. The Joint Commission for the Accreditation of Health Care Organizations just began a program of voluntary accreditation, or voluntary certification of hospitals to deliver primary stroke care. In addition, some states are doing exactly the same thing. The state of Massachusetts, the state of Florida have enacted statewide legislation for designated stroke centers.
KING: Peoria, Arizona, hello.
CALLER: Yes, thank you, Larry. Two questions for the doctor. One, does taking a baby aspirin daily can in any way prevent or help in the prevention of a stroke? And two, if there is a family history of strokes, is there any annual screening other than blood pressure awareness, et cetera, that can be done through your medical doctor?
GOLDSTEIN: Well, to answer the first question about aspirin. Aspirin, believe it or not, is an incredibly powerful drug. The current recommendations are you shouldn't be taking aspirin unless your 10-year cardiovascular risk is at least 10 percent, because aspirin does have side effects. And you should discuss that with your doctor.
In terms of having a family history of stroke, yes, there are many things that you should be thinking about that might increase your risk if someone in your family has had stroke. The thing to do is to become educated about it. One place to get education is to go to the American Stroke Association Web site. You can also call 188-4-STROKE, which is a telephone line to get information about stroke from the American Stroke Association.
Getting educated is incredibly important, because then when you go to your health care provider, who is under incredible stress now in terms of time, you're going armed with information and questions.
KING: Robert, did your family have a history?
GUILLAUME: Yes. My brother had had a stroke, and he lived for 10 years afterward. And he had it at age 52.
KING: Are you aware that it's more common among black than white?
GUILLAUME: Well yes, of course. But I must say, this whole thing of denial, my whole life has been denial. Yes, I'm going to get that job. Yes, I'm not too dark. This is going to happen, that's going to happen. It's always been denial. So, when the stroke struck, if you will...
KING: When the stroke struck...
GUILLAUME: When the stroke struck, I -- my tendency was, the stroke is in that direction, I'm going in this direction. And I fought it as -- I think I fought it, at least I tried. I fought to reverse it, or -- and one morning I woke up and I said, I don't have a stroke. And I got out of bed and of course, promptly fell on the floor.
WOODS: But this denial issue is really important, because when you think about it, I'm sure Dr. Goldstein would agree with this, and I'm not a medical person, but I would love to hear what he has to say, I guarantee you if you could eradicate one thing in this country, you would probably reduce stroke risk more profoundly than any other way and that's to stop cigarette smoking, without a doubt. I'm sure cigarette smoking is one of the most ridiculously horrible risk factors for a stroke. And the fact that we as a people, when I was a smoker, I kept saying, it won't affect me. And we have a government that's in denial. We subsidize tobacco growing in this country, it's ridiculous.
KING: Dr., do you agree on smoking and stroke?
GOLDSTEIN: Smoking is clearly about one of the major risk contributors to stroke, it about doubles the risk of stroke. Another major one is high blood pressure.
GUILLAUME: Talk about a smoking gun.
WOODS: We said it in the break. Nobody ever wants to say it out loud, that the tobacco industry might as well be the arsenic industry. You know, hey, let's make sure our tax dollars support something that kills thousands and millions of people.
KING: We'll take a break and be back with more. Don't go away.
(BEGIN VIDEO CLIP)
GUILLAUME: A stroke can take your mind, your body or your life in minutes. I'm Robert Guillaume, for the American Stroke Association, a division of the American Heart Association. Stroke is a medical emergency. And as African-Americans, we are at high risk. To learn more about the warning signs of stroke for yourself and those you love, call toll-free, 888-4-STROKE.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
BETTE DAVIS, ACTRESS: After the stroke, and they still wanted me to do a book, I thought, what more is there to say? Everybody knows everything about me. And I thought, no. It would be worthwhile to explain what I went through and hopefully give people hope that they really can, they really can get better of a stroke.
(END VIDEO CLIP)
KING: The late Bette Davis.
CALLER: Hi, Larry. Great show. Panel, thank you. I have a CVA in 19 -- in the year 2001. I'm on Social Security, which is scary, because they don't supply good rehab 3 1/2 years later. What would you suggest I do with my general doctor trying to get me to go to a neurologist? Would he help?
KING: Dr. Goldstein?
GOLDSTEIN: Well, it really does depend on a lot of different things. One thing again is once somebody's had a stroke, they're at major risk of having another one. And making sure that you're on all the correct preventative therapies is majorly important. But the point you make about there being limited rehabilitation after a stroke is a major problem.
GOLDSTEIN: There is currently a cap on her Medicaid on the amount of reimbursement for long-term rehabilitation services. And this is something that comes up, the government has release the cap repeatedly over the last few years and we're actually evacuating now for that cap to be released permanently.
KING: Back in August of 2000 doctors told president Gerald Ford that he had suffered a stroke. Just one day before that, we interviewed Mr. Ford about his physical condition. Watch this.
(BEGIN VIDEO CLIP)
KING: How is your health? You're 88.
GERALD FORD, FRM PRESIDENT OF THE UNITED STATES: I should correct you. I was just 87, Larry.
KING: Good. Live longer.
FORD: I'm looking forward it to.
But anyhow, I couldn't be healthier. Betty and I are having a magnificent life. 52 years of married life and 4 great children, 15 grandchildren. Everything is breaking just right.
(END VIDEO CLIP) KING: He had a stroke that night. You could see it, couldn't you?
WOODS: You know what's like? You remember that movie "Deep Impact" or "Armageddon," one of those movies about the meteorite. And the big meteorite is coming, but all the little pieces are coming first. It almost looks as if he were having these slight, tiny little strokes and then the big one happened. I don't know if Dr. Goldstein would have to verify...
KING: Dr., could you sense that coming?
GOLDSTEIN: This is the first time I've actually heard that little piece. And his speech at the time was clearly affected. He's probably had a stroke at least at that time.
Yes, the warning signs are really critical not to ignore.
KING: Now, everyone in that room, at that taping when he finished said, something the matter. Like you're friend said something's the matter.
WOODS: You know, Larry, and I think Dr. Goldstein will verify this. But if a piece of debris gets caught in your heart, there's no oxygen going to that muscle. And that muscle has a few minutes to live and then it's going to start dying and dying and dying and it's going to get worse and worse. And the same with a piece of debris, I'm just saying this very roughly, not as a medical expert, gets caught in your brain, the same thing is going to happen. You can't even begin to stress how important absolute immediate action is. You know, when they say call 911, call it immediately.
KING: Don't say, ah, it's nothing.
WOODS: Don't wait it out.
KING: Leguna Niguel, California. Hello.
I am 35 years old and I suffer from very severe frequent migraines. Knowing I am at increased anyway, because I'm a migraine suffer, my question for the doctor is how would I differentiate my regular severe migraine from a stroke headache?
KING: Good question.
CALLER: Which is also very severe? How would I know.
KING: How would she know the difference?
GOLDSTEIN: Superb question. And this is actually something that baffles doctors very often when we have patients that have headaches all the time. If it's a different quality headache, more severe, or different type of headache then the headaches that you normally have, that could be a warning, especially if its associated with other types of symptoms, any of the typical symptoms of stroke.
It can be complicated though, there's no question about it. You should certainly see a neurologist.
KING: Leean, what post reaction do you have? Other than memory loss? Do you have any physical reactions?
HENDRIX: You know, energy. My energy level is definitely not the same. And there are moments where I can feel my brain shutting down and my thought processes much, much slower.
KING: Robert, you have that thing in the hand and the leg, right?
GUILLAUME: Yes, I have spasticity over here. Where the muscle...
MCCAIN: I was the one at home that everyone came to to program their computers, fix their phones, do anything electrical, technical, anything on the computer. I can't get near it now. I'm overwhelmed by it.
And it's weird for me. And I might also say, I suffer from migraines also. And your last caller that called in -- and I just had an episode about a week and a half ago, where I didn't know, I thought I was having another stroke. It was a different kind of...
KING: Has the senator been very sympathetic?
MCCAIN: Yes. And I -- please don't -- let me explain that. He was very confused in the beginning. He didn't -- like everyone in the family, how could it happen to my wife? I'm 18 years older than she is. It doesn't happen to someone that's younger than you are. So on his behalf, I think he's trying to understand all this. It's a lot for him to take in.
KING: We'll be back with our remaining moments. For more information, www.strokeassociation.org, or AmericanHeartAssociation.org. Don't go away.
(BEGIN VIDEO CLIP)
PENNY MARSHALL, ACTRESS: There's something you should know about me. I believe in equality. Regardless of race, gender or age. If you have no voice, I am there. If you cannot stand, I am there. If you are lost or confused, I am there. I am there to hurt, paralyze, or kill. I am a stroke.
(END VIDEO CLIP)
(BEGIN VIDEO CLIP)
KIRK DOUGLAS, ACTOR: My stroke has done so many things for me. It has saved my personality, it has saved my sense of value. And I always think, Larry, no matter how bad things are, they can be worse. So...
KING: Good way to look at it.
DOUGLAS: Yes. And during my stroke, I realized so many things that I hadn't realized before. So I -- when I wrote my book, trying maybe to help other people how to deal with a stroke or how to deal with life.
(END VIDEO CLIP)
KING: Dr. Goldstein, James Woods had an interesting thought. Is there an association between a heart attack and a stroke potential?
GOLDSTEIN: Absolutely. There is the -- the American Stroke Association is a division of the American Heart Association. The diseases carry a lot of risk factors in common. But it turns out that if you have had a heart attack, particular types actually increase the risk of stroke as well.
KING: One more quick call. Grand Rapids, Michigan. Hello.
KING: Go ahead.
CALLER: Yes. This is more or less for the doctor. My son, before he was born, had a stroke. We did not know about it until he was about six months old, when he had his first seizure. And of course, during the MRIs, EEGs...
KING: We have less than a minute, ma'am. I hate to rush. We have less than a minute.
CALLER: That's OK. But what I'm curious about, is for a baby that is not even born, what -- they could not tell me what the cause of it could have been.
KING: Doctor, what could that have been?
GOLDSTEIN: It could have been from a variety of different things. Remember that stroke is within the top 10 causes of death in children as well.
KING: So a fetus can get a stroke?
GUILLAUME: That pretty much puts it in perspective.
KING: I want to thank our panel again. For further information, www.strokeassociation.org, the AmericanHeartAssociation.org.
Before we leave, we want to send our best to a friend of ours, Paul Geragos (ph), who has suffered -- or rather, recovered beautifully from a stroke that he had last month. He's back at work. So, Pops, here's to you. And we've dedicated the show tonight to the memory of Russell Walker, who died at age 68 in 1983 of a stroke, the father of our executive producer, Wendy Walker Whitworth.
We thank Cindy McCain, James Woods, Robert Guillaume, Leean Hendrix and Dr. Robert Goldstein, for appearing with us on this edition of LARRY KING LIVE. I'll be back in a couple of minutes to tell you about the weekend. Don't go away.
KING: Before we leave you, happy birthday to our friend, Oprah, who's 51 tomorrow. Oprah's 51. It's (UNINTELLIGIBLE) hardware store. Happy birthday, Oprah.
Tomorrow night, we'll repeat our tribute to Johnny Carson. Sunday night, we'll be live with the Iraqi election story.
TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com