FOR IMMEDIATE RELEASE
Contact: Stephanie Petta
Director of Marketing
(941) 798-6056

Bradenton, Florida—(AUGUST 31, 2010)—Blake Medical Center announced today that they have hired a new trauma medical director, Dr. Brian Kimbrell. Dr. Kimbrell comes from St. John’s Regional Medical Center in Oxnard, California, where he served as the trauma medical director and surgical critical care director.

Kimbrell’s appointment is the next step in the hospital’s plans to develop a Level II Trauma Center. The hospital filed a letter of intent with the state on September 30, 2009 and in early April 2010, filed an application with a request for an extension which was granted.

The hospital plans to file their completed application in early 2011, with the hope of being granted provisional trauma center status by October 2011. At that point the hospital will begin to operate as a trauma center providing local access to trauma care for residents of Manatee, Sarasota and Desoto counties.

In the meantime, the hospital continues to prepare for provisional status by recruiting specialists, developing trauma protocols and training staff.

“Blake is committed to continually elevating the level of care for our community,” said Daniel Friedrich, chief executive officer of Blake Medical Center, “and the Manatee/Sarasota/Desoto area is need of a trauma center to ensure that critically ill or injured patients have access to local trauma care.”

“I am both honored and excited to be involved in the development of this greatly needed and extremely important service for our community,” said Dr. Brian Kimbrell newly appointed trauma medical director at Blake Medical Center, “Having a trauma center in the local community will save precious time in critical situations and ultimately save lives.”

“Countless studies indicate that trauma mortality decreases with proximity to a trauma center,” explains Michelle Bryskiewicz, RN, vice president of trauma services at Blake Medical Center, “Having a local trauma center will not only benefit trauma patients, but also keep their families closer to home.”

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About Blake Medical Center

Blake Medical Center is a 383-bed, acute-care, full service hospital and a leading provider of quality, affordable healthcare serving our community since 1973. Blake offers a wide range of healthcare services including: 24-hour emergency care, open-heart surgery, cancer care, joint replacement, back surgery and rehabilitation among many others. Blake is pleased to provide free health education, screenings and support groups to improve the health of our community. For information about hospital services or events or to receive a free physician referral, call 1-888-359-3552.

Blake is proud to be recognized by third party reviewers and accrediting bodies with the following awards, designations, and certifications:

· Primary Stroke Center, Joint Commission

· Acute Myocardial Infarction Center, Joint Commission

· Laboratory Accreditation, Joint Commission

· Total Knee Replacement, Joint Commission

· Total Hip Replacement, Joint Commission

· Sleep Center Accreditation, Joint Commission

· Chest Pain Center with Percutaneous Coronary Intervention, Society of Chest Pain Centers

· Accredited Cancer Program with Commendation, American College of Surgeon’s Commission on Cancer

· Certified Inpatient Rehabilitation Center, Commission on Accreditation of Rehabilitation Facilities

· Accredited Radiology Services, American College of Radiology

· Get With the Guidelines Gold Plus Performance Achievement Award, American Stroke Association

· Blue Distinction Center for Knee and Hip Replacement, Blue Cross Blue Shield

· Blue Distinction Center for Spine Surgery, Blue Cross Blue Shield

· Recognized Diabetes Self Management Education Program, American Diabetes Association

· 100 Top Hospitals, Solucient (now Thomson Reuters) – A winner 9 Times!

· 100 Top Cardiovascular Hospitals, Solucient (now Thomson Reuters)

Your lower back has a dull ache you can’t seem to shake. Or you have shooting pain between your shoulder blades. What medications can help?

As you research, you’ll find a host of options to try. Talk to your doctor about what suits your condition best.

• Acetaminophen This medication is probably the most effective nonprescription remedy for back pain. It actually works with your brain to turn off the perception of pain. A common brand of acetaminophen is Tylenol, and it’s safe for you to take 1,000 mg every four hours, but no more than 4,000 mg within a 24-hour period.

• NSAIDs Non-steroidal anti-inflammatory drugs (NSAIDs) combat the inflammation that often contributes to back pain. Some specific names are ibuprofen (such as Motrin and Advil) and naproxen (such as Aleve). You’ll find that they work like aspirin but don’t cause the stomach issues that aspirin can. Be sure to read the labels for dosage information.

• Muscle relaxants These prescription drugs are available in a wide range, and they are often prescribed only for short-term use. By relaxing your whole body, these medications are helpful for relieving back spasms. Some brand names include Valium, Soma, and Flexeril. Be careful when using them, however, since these drugs can become habit-forming.

• Oral steroids These medications can fight inflammation and most effectively help with lower back pain. Usually, your doctor prescribes a high dose at first and then gradually lowers the dose over the course of several days. You should take oral steroids only on a short-term basis, since they can have side effects. These include ulcers, weight gain, and osteoporosis.

• Narcotic pain relievers These medications are available only by prescription and should be used primarily for sever flare-ups of back pain. Common brand names include Percocet and Vicodin. You should use extreme caution when you take these drugs, since they can be addictive.

Depending on how intense your condition is, a doctor may suggest a day or two of bed rest. However, after the initial rest, light exercise will go a long way in alleviating your pain. Try gentle activities, such as walking, swimming, or yoga. If you have questions about what exercises are safe, talk to your doctor or consult a physical therapist.

To learn more about back pain, contact Blake Medical Center. Visit us online or call Consult-A-Nurse® at 1-888-359-3552. We offer solutions to make your back—and your body—a healthy one.

SOURCES
Spine-Health
National Institute of Neurological Disorders and Stroke

Bradenton, FL – Though still reeling from his own struggle for survival and the unthinkable loss of his wife and brother-in-law, Braulio Pardo, Sr and his family want to find and thank several brave on-lookers who risked their own lives to help rescue he and his family.

The first rescuer was among the victims. Al Pardo, a fire fighter by trade, was able to get a small foothold on a sandbar and call his wife Rochelle, and brother, Braulio Pardo, Jr to himself. Both were extremely fatigued and near drowning, but were able to swim across the rip-tide toward the small patch of sand. “Thank God for that bit of sand,” agreed brother s Gerardo Pardo, also a firefighter, and Juan Pardo, who weren’t with the family at the time of the accident that took their mother and uncle, “It was miraculous that Al found it.”

Once free of the treacherous current, Al swam with his wife and brother toward shore. He found two young girls with a small inflatable boat and told them he needed it. He swam back to his parents with the small floatation and found his father near drowning and his mother face down in the water. He struggled with the raft and his father’s frail grip on it, but managed to turn his mother over and attempt resuscitation.

Braulio Pardo, Sr recalled that he was near death when his son brought the raft. He also recalled two young women, he later learned a mother and daughter, and a young man who came shortly after his son and helped kick the floatation back to shore, “I want to know their names and be able to thank them,” he said from his hospital bed at Blake Medical Center, “they helped saved my life and the lives of my family by their courage.”

“We never would have made it back without their help, and that of the Bradenton Fire Rescue Squad who met us out there with a surfboard” Al added, “we were just too tired by then.”

Tears flow freely among the large family gathered at the bedsides of Braulio senior and junior when talk of the mother they loved and lost begins again. “She was an amazing woman,” Gerardo explains, “She would get up really early to make coffee and breakfast for her sons, and say a blessing for Al and I, and all firefighters, before we went on shift at the fire department. She wanted us to stay connected as a family. We’re still going to do that–go to their house before work and make coffee; she’d want that.”

The other victim, Gerardo Hernandez, a beloved uncle and brother-in-law of the survivors, came to the United States to help support his family in Cuba. He leaves behind a wife, seven children, seven grandchildren, and three great grand-children.

The family also wants to correct some misinformation that’s made it into the media. The family was standing together in waist-high water when the rip-tide drug them under suddenly and rapidly carried them away from shore. They were not out swimming or floating on a raft in deeper water as some reported. “We don’t want people to think, ‘oh they were too far out, that couldn’t happen to me’,” Al said, “It happened so suddenly and there were no signs or postings alerting us to the danger of rip currents in the area.”

As the family grieves the tragic loss of their loved ones, they hope that others can be spared this suffering through posted warnings and public awareness of the dangers of rip tides in this area.

If you have information about any of the Good Samaritans who helped save this wonderful family, please contact Stephanie Petta at Stephanie.Petta@hcahealthcare.com or (941) 798-6056.

- More About the Family –

The Pardo family originally from Cuba, then Spain came to the United States and raised their sons to play baseball hoping they could earn scholarships and get a college education. It worked. Al Pardo became the first Spanish-born person to play Major League Baseball when he joined the Orioles in 1980. He later he played for the Phillies. Gerardo Pardo played for the Tigers, and Braulio Pardo, Jr also played for the Baltimore Orioles. Braulio Pardo, III now plays for the Angels and just flew in to be with the family. Their dad was their coach and their mother was their biggest fan.

You know how it feels. Your back hurts so much that you’re in agony when you sit, reach, or twist. Sometimes the only relief you get is when you lie down. So what can you do about back pain?

If you’re like other people who suffer from back pain—which includes nearly 80 percent of Americans—you may become more and more sedentary, because even fun activities are excruciating. You may feel discomfort in your lower back, as well as your upper and middle back. Sometimes it seems like all you do is ache. So when is spinal surgery a good idea?

Most doctors agree that surgery should be considered only as a last resort. In some cases, they caution, surgery may not even solve the problem. It’s important to consider all courses of action and to get opinions from two or three doctors. However, if any of these statements describe your condition, surgery might help.

• You have a ruptured or herniated disc.
• In your arms or legs, you experience a weakness or tingling feeling.
• You have a bone spur, tumor, or a fracture that’s unstable.
• You suffer from incontinence.
• You have scoliosis, kyphosis, or some other kind of spine deformity.

In the event that your symptoms are not so severe, there are a number of treatments that may help alleviate pain. Give these a try:

• Physical therapy. The exercises and stretches that a physical therapist can teach you will help relieve the stress on your spine.
• Acupuncture. This traditional Chinese therapy has helped many people get relief.
• Chiropractic care. A chiropractor can manipulate your spine and help ease the pain.
• Massage. Especially when used with other therapies, some types of massage have been shown to help relax the back muscles.
• Medication: Ask your doctor about painkillers and other medications that can be prescribed to reduce inflammation.
• Pilates or yoga. These and other practices can strengthen the core, which often takes the pressure off your back.

If you have questions about your spine health, contact Blake Medical Center. Visit us online or call Consult-A-Nurse® at 1-888-359-3552.Your aching back will thank you.

The ability to function independently is often overlooked by those that have it. For those who have lost some ability due to injury or the wear and tear that life puts us through, regaining function may seem like a dream. Advances in medical science have come a long way and the gap between what can and cannot be repaired is getting smaller.

For patients with shoulder problems, simple tasks can be difficult. Some seemingly ordinary, everyday, activities become nearly impossible to accomplish alone. Sadly it seems as if one, if not both, of your arms is unusable and just a source of frustration and pain. Those afflicted with severe arthritis or people who have large tears in their rotator cuff (the group of tendons in your shoulder that help stabilize the joint and allow you to move your arms proficiently) may be candidates for a procedure called reverse shoulder surgery.

Reverse Shoulder Surgery Basics

The procedure has been available in the United States since 2004. It has a longer history in other parts of the world– it has been an accepted practice throughout Europe for over twenty years for instance. The procedure involves replacing the joint in your shoulder with a prosthetic joint. It is called reverse shoulder surgery because the new joint that the patients is fitted with, is designed opposite of the natural one. What this means is that the round or ball shaped end portion of your humerus (upper arm bone) is not round in the prosthetic version. The humerus has indented portions that match up to a round piece attached to your scapula (what you may commonly think of as your “shoulder bone”). In essence the new joint has the same features as your natural joint but they are reversed.

Benefits of Reverse Shoulder Surgery

This procedure is most often recommended for seniors. However there are cases in which younger patients are considered candidates. Some benefits to undertaking this procedure include:

• Regained function of the shoulder- After recovery, most patients who previously had a lack of range of motion, are able to hold their arm up at least ninety degrees. This is shoulder level, if not higher, which makes a lot more activities possible After working with physical therapists many patients can once again:
  • Eat and drink on their own
  • Brush their teeth
  • Comb their hair
• Reduced pain- Many patients who suffer from arthritis report that after a Reverse Shoulder Surgery, the amount of pain they experience on a regular basis is significantly reduced. This alone makes the procedure worthwhile for some as it is easier to enjoy life when your body is not in pain.
• Increased stability- Constant use over the years as well as weakened tissue can lead to an overall weaker and less stable shoulder. With the addition of new prosthetic parts, Reverse Shoulder Surgery, can add strength to the structure of your shoulder. This makes the joint more stable and allows for a better quality of life.

If you have questions about reverse shoulder surgery or orthopedics, please contact us at Blake Medical Center. Visit us online or call Consult-A-Nurse® at 1-888-359-3552.

Online news site Health News Florida published an article recently about how often hospitals in the state have performed four common diagnostic imaging tests. The article referenced data collected and analyzed by the federal government. Based on this data, some hospitals were determined to be ordering too many tests, and others, not enough tests.

The four tests are:

• Mammogram
• MRI scan for lower back pain
• CT scan of the chest
• CT scan of the abdomen

Last week, the Bradenton Herald ran a story about recall rates for mammograms at Manatee and Sarasota county hospitals. This is how often a woman was asked to come back following an initial or diagnostic mammogram, for a second visit.

The Herald article noted that the federal government guidelines indicate that a mammogram recall rate under 8% is considered too low, putting a woman at risk for cancer, while a recall rate above 14% is regarded as too high, indicating that women are having unnecessary exposure to radiation.

Blake’s point of view

Robert Stouffer, director of the radiology department at Blake Medical Center, is concerned that women will read these articles and conclude that they should avoid mammograms. Blake has a mammogram recall rate of 8.2%, which is within the federal guidelines.

“For individuals who are hesitant to have a mammogram, they may see this as a reason not to,” says Stouffer, who has worked in the radiology field for nearly 35 years.

While mammograms do expose women to radiation, physicians and radiologists agree that the benefits of the test far outweigh the risks. (We receive radiation daily from the sun and from some of the minerals on the earth.)

It’s up to you

Instead of using news reports to make health decisions, Stouffer suggests a woman have a conversation with her physician, because the physician knows her and her medical history.

Based on his decades of experience, Stouffer feels it’s important for a woman who is 40 and up, or who has a family history of breast cancer, to get a baseline mammogram. If that mammogram shows possible evidence of cancer, she should not wait to make a follow-up appointment.

“That’s very basic medicine in my world, in diagnostic imaging,” he says.

Know where to go

Stouffer recommends that a woman get mammograms or other imaging tests at a facility with a reputation for quality.

At Blake Medical Center, mammograms are read quickly, and follow up appointments scheduled promptly. Not all hospitals or outpatient diagnostic centers have the resources to do this, Stouffer notes.

For more information about mammograms, or to obtain a physician referral, contact Consult-A-Nurse^® at 1-888-359-3552, or visit us online.

Has the pain in your knee joints reached a point where it negatively impacts your quality of life? Do you have trouble walking, doing routine tasks, or enjoying recreational activities?

If so, it’s probably time to see an orthopedic specialist. Physicians generally try non-surgical treatments for a time before considering knee surgery. But depending on the results of his or her physical exam and/or tests such as x-rays, CT scans and MRIs, your doctor may recommend either a knee resurfacing, or a partial or total knee replacement.

In knee resurfacing, healthy bone is kept and only damaged bone is reshaped. During knee replacement, damaged parts are replaced.

According to the American Academy of Orthopedic Surgeons (AAOS), about 270,000 Americans have total knee replacement surgery every year. The American Academy of Hip and Knee Surgeons estimates that by 2030, about 3 million people will need knee surgeries each year.

Blake has the resources

At Blake Medical Center, a professional team of physicians, nurses, therapists, technicians, case managers, dietitians and office staff work together to help Joint Care Center patients achieve an improved quality of life.

The center is designed to be comfortable to patients and their families, with amenities such as a patient/family member lounge, cybercafé and coffee.

For patients who need physical therapy after their orthopedic surgery, the Blake Rehabilitation Center provides the ideal place for them to get back on their feet.

Know your knees

There are three bones in the leg: the femur (upper), the tibia (lower) and the patella, or kneecap. Our knees allow us to bend and flex our legs. Ligaments, tendons and connective tissue bind all these structures together and provide cushioning, while cartilage helps protect the kneecap.

Joint forces

Because the knee joint is a complex and delicate structure, it can be severely damaged. Some of the more common knee problems requiring treatment are:

• Osteoarthritis (occurs in older adults)
• Rheumatoid arthritis (affects people of all ages)
• Sports injuries (can be caused by running, jumping, cycling, squatting, etc.)

Surgical options

The following types of surgery are used to correct knee problems:

• Total knee replacement involves up to three parts: the back surface of the kneecap, the top surface of the shinbone, and the lower ends of the thighbone. This is the more invasive of the two procedures. (See image here.)

• In partial knee replacement, also called a unicompartmental knee replacement, one side of the knee is healthy, so only the damaged or diseased bone is removed and replaced with artificial parts. This procedure is normally done in patients with osteoarthritis. (See image here.)

• Knee resurfacing is less invasive than knee replacement. The damaged section of the knee is smoothed and only the surface of the joint is replaced, with a cap-like implant. The incisions are smaller for this procedure, and the recovery time much shorter.

If you think you are or might be a candidate for knee surgery, and would like a physician referral, contact Consult-A-Nurse^® at 1-888-359-3552, or visit Blake Medical Center online.

As people age, their joints can break down from years of use. It can be the result of diseases such as rheumatoid arthritis (RA); or because of injuries.

The American Academy of Hip and Knee Surgeons estimates that a half a million hip replacements may be needed and 3 million knee replacements each year by the year 2030. They base these figures on the fact that our lifespans have increased, and as a result, there will be more cases of arthritis.

“Some joint replacements are due to hip fractures, but most are elective,” says Dr. Alan Valadie, an orthopedic surgeon who performs joint replacements and resurfacings at Blake Medical Center.

“People are living longer and living more active lives, which is causing the deteriorating of their joints,” he says.

However, the elderly are not the only candidates for joint replacement. Children and adults with RA can also experience joint deterioration and discomfort; and younger people can suffer joint injury when participating in sports or by being injured in accidents.

Factors to consider

Whatever the cause of joint problems or your age when you develop them, they can hamper your ability to get around and to accomplish everyday household or workplace tasks. Joint damage can also cause considerable pain.

Sometimes, inactivity contributes to a lack of mobility and flexibility, and incorporating a half-hour of exercise can prevent or delay health issues, the American Academy of Orthopedic Surgeons says. As a rule, doctors will usually have their patients try non-invasive remedies such as walking aids, physical therapy and anti-inflammatory medication, before considering surgery as an option.

Types of joint replacement

Joints that can be replaced include those of the knee, hip, finger, elbow, shoulder and ankle.

Knee

There are two types of knee procedures:

• In a partial knee replacement,  one part of the knee is healthy but another part needs replacing. The surgeon removes the unhealthy portion and replaces it.

• In a total knee replacement, the entire joint is damaged and must be replaced.

Hip

Hip joints are the most often affected by age and/or illness. Osteoarthritis, which affects weight-bearing joints, is usually the reason for hip replacement, according to the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Most people receiving total hip replacement are over 60 years of age.

• In a total hip replacement, a prosthetic joint is used. It has four parts: a hip socket, a liner, a ball, and a stability rod.
• With a hip resurfacing, a cap is put over the existing hip ball, and it is fit into a new socket.

Knee and hip joint surgery can take anywhere from one to four hours.

After the surgery

The majority of people who undergo joint replacement surgery are able to function normally, without chronic pain. Physical therapy is an important part of the recovery process.

“We push people pretty hard,” Valadie says. “Patients take six weeks to six months to regain mobility.” Exactly how quickly they recover, he says, depends on the person and the type of procedure they undergo.

If you do not have an orthopedic surgeon and would like a referral, contact Consult-A-Nurse^® at 1-866-4-HCA-DOCS, or visit Blake Medical Center online.

Cancer patients never face their condition alone. From diagnosis through recovery and remission, a team of experts is there to provide care every step of the way. Each person has a specialized role in ensuring that patients receive the right treatment.

Diagnosis

Identifying cancer may occur with your primary care doctor, but it is usually done by a specialist. Dermatologists, for instance, are often the ones to spot skin cancer, while gynecologists find ovarian or cervical cancers. A urologist generally diagnoses prostate cancer, while a pulmonologist would identify lung cancer.

The second step in diagnosis is to determine exactly what kind of cancer the patient has. It’s important to remember that there are many different types of cancer, and each requires a unique treatment. That’s where pathologists come in. The doctor provides a sample of the cancer tissue (obtained during a procedure called a biopsy), which the pathologist uses to determine the specific kind of cancer cells.

Treatment

The location and type of cancer determine the most effective treatment, including any chemotherapy medications. Multiple healthcare providers work together to coordinate cancer care:

• Medical oncologist: This doctor specializes in all kinds of cancer treatment and usually acts as a sort of team leader for each patient’s cancer care team. The medical oncologist may refer the patient to necessary specialists or other support personnel, such as social workers.
• Radiation oncologist: With special training in radiation therapy, the radiation oncologist oversees the dosage and administration of any radiation treatment.
• Surgeons: If the cancer is operable, the first step may be to remove the tumor during surgery. Surgeons usually specialize in one specific part of the body, for instance the lungs or brain. A plastic surgeon may also be involved, particularly in cases of breast cancer, where the patient may want reconstruction.

Many non-invasive surgical options, such as CyberKnife treatment, require specially trained technicians and doctors. These treatment options have grown in popularity, since they reduce recovery time and hospital stays. At Blake Medical Center, the Cancer Care team includes healthcare professionals who can administer these non-invasive cancer treatment options.

Recovery

During recovery, patients generally follow up with specialists and other members of their medical team. They may also find that extended support from non-medical experts plays an important role in their well-being. Many patients maintain contact with a social worker during and after recovery. They may also continue going to support groups. A social worker or member of the medical team can often recommend support groups that are established especially for cancer survivors.

If you would like more information about cancer care and treatment, please contact Blake Medical Center. Visit us online or call Consult-a-Nurse® at 1-888-359-3352 for free physician referrals and health information.

If you live an active lifestyle, congratulations: That’s one of the best things you can do to prevent a stroke.

Numerous studies have shown that regular exercise is associated with a significant drop in stroke risk for adults. If you are obese and live a sedentary lifestyle, you are more likely to have poor cardiovascular health – putting yourself at greater risk for suffering a stroke.

Stroke is one of the leading causes of death and serious, long-term disability in the United States. On average, someone suffers a stroke every 45 seconds, and someone dies of a stroke every three minutes, according to the American Heart Association/American Stroke Association. May is National Stroke Awareness Month.

Blake Medical Center is a certified Primary Stroke Center, meaning we comply with the highest national standards for safety and quality care in the rapid-response and treatment of acute stroke patients. Stroke accreditation by the Joint Commission is regarded as the “gold standard” for excellence in stroke care, a distinction of which we’re proud.

It’s our job to not only provide top-notch quality care, but also educate the community we serve about strokes. We have articles and much more information for you on our website about our stroke program, strokes, stroke prevention, caring for strokes, and stroke rehabilitation.

We recommend you do at least 30 minutes of moderate to intense aerobic exercise most days of the week to reduce your risk for stroke or a recurrence if you’ve had one (and there is evidence that regular exercise improves stroke recovery and survival rates).

Consult a doctor before starting any new exercise program. If you need help finding a doctor or have any questions about strokes or the recommendations here, contact our free Consult-A-Nurse ® healthcare referral service 24/7. Our nurses will answer your questions.

If you receive the doctor’s approval, begin a gradual, sensible exercise program that’s right for you and your needs. You can break down the exercise into 10 to 15 minute sessions – just make sure to stick to a regular routine. It’s true – you’ll see more benefits being active regularly for longer periods and at greater intensity. Just be careful – do what’s right for you, don’t overdo it.

Aerobic exercise is so good for stroke prevention because it stops clots that can cause a stroke by preventing the buildup of plaque in blood vessels. It increases your endurance and strengthens the cardiovascular system.

Some examples of intense aerobic exercise are: brisk walking, hiking, stair-climbing, jogging, running, bicycling, rowing, swimming, and activities like Ultimate Frisbee or basketball that include continuous running.

Some examples of moderate aerobic exercise are: yard work, housework, dancing, walking for pleasure, and recreational activities like tennis, golf or racquetball.

Symptoms of Stroke

If you notice any of the symptoms below, call 9-1-1 right away. Symptoms occur suddenly and differ depending on the part of the brain affected. Also, multiple symptoms can happen at the same time.

• Sudden weakness or numbness of face, arm, or leg, especially on one side of the body
• Sudden confusion
• Sudden trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden dizziness, trouble walking, loss of balance, or coordination
• Sudden severe headache with no known cause