September 23, 2022 by John Fernandez
Stroke Awareness: When Every Second Counts
You’ve probably heard it before, but it cannot be stressed enough — strokes are dangerous and can be deadly. Stroke is the No. 5 killer and a leading cause of disability in the U.S. What many people don’t realize is that you can prevent, control or treat several risk factors for stroke, said Baptist Health experts during the most recent Resource LIVE: Stroke Awareness: When Every Second Counts.
Those modifiable risk factors include high blood pressure, diabetes, obesity, physical inactivity, high cholesterol and smoking. (May is Stroke Awareness Month.)
“The CDC (U.S. Centers for Disease Control and Prevention) reports that every 40 seconds someone in the U.S. has a stroke,” explains Resource LIVE host, Jonathan Fialkow, M.D., chief population health officer for Baptist Health and chief of cardiology at Miami Cardiac & Vascular Institute. “While it’s not exactly an exhilarating topic to talk about, knowing the warning signs of a stroke can help victims or those around them.”
Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke, the most common) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). When a stroke occurs, part of the brain cannot get the blood (and oxygen) it needs, so brain cells die.
Joining Dr. Fialkow on the panel: Brian Snelling, M.D., director, Stroke Program at Marcus Neuroscience Institute, part of Baptist Health; Felipe De Los Rios, M.D., director, Stroke Program at Miami Neuroscience Institute, also part of Baptist Health; and Joshua B. Young, M.D., medical director and chief of Emergency Medicine at Baptist Health South Miami Hospital.
Recognizing common stroke symptoms — known by the acronym F.A.S.T. — is vital for getting someone immediate medical help because time is of the essence when it comes to treatment to prevent permanent disability or death. It just takes one of those symptoms — not necessarily a combination of them — to signal that you or someone you’re with is stricken. (See below.)
“There are treatments that we can give, but the effectiveness or how well they’re going to perform in returning a patient back to how they were before this stroke happened, or to minimize injury, really depends on time,” explains Dr. De Los Rios. “Doing something in hours two, three, is much more efficacious than doing something a day or two later. And it all starts with the person realizing, or someone realizing, that there is a problem.”
Here are question-and-answer excerpts from the Facebook LIVE. You can see the full video presentation here.
Dr. Fialkow: Walk us through a little bit what we as the healthcare community do when someone’s having a stroke?
Dr. Snelling: “Once a stroke has occurred, when you call 911 and go to the hospital, there’s also a spectrum of treatments that can range from medications to procedures or surgeries that could be possible to help reverse the symptoms of a stroke that you’re currently having. And then, after a stroke has occurred, there’s a couple different things. There’s rehabilitation to help improve any sort of neurological injury that may have happened during the stroke. In addition to that, there’s also figuring out why the stroke happened in the first place. Medication or something else can be prescribed — a therapy or a surgery that could prevent a second stroke because we know it happened once, and it may likely be able to happen again. So, we want to prevent that from happening in addition to rehabilitation to get someone better.
“There’s a lot of tools in the toolbox, as we say. So, it’s really important to just, as we mentioned, have a primary care physician and then regularly schedule those visits so those prevention things can be enacted. And then if a stroke is occurring, call 911 and get to the hospital. That way, we can deploy all those tools as necessary to help patients.”
Dr. Fialkow: What would predispose someone to have a stroke?
Dr. Young: “Basically we can kind of think of two broad categories that can predispose you to having a stroke. And that would be risk factors that are unmanageable, meaning we’re just kind of born with them, and then risk factors that we can change. The unmanageable risk factors: Age (because) strokes become more common as we get older, although they can happen at any age. Sex is a risk factor. There is an increased risk for strokes among males. Race can play a factor. There are higher rates of strokes among African Americans. But there are many modifiable risk factors that is really what I think we need to focus on. And these are things like hypertension (high blood pressure), diabetes, obesity, lack of exercise.
“Smoking is a huge risk factor, as is excess alcohol. There are other less common things that you may not think about as increasing your risk for stroke — oral contraceptive pills. Some of them, the ones that contain estrogen, can increase your risk for stroke. So, it’s important to have those kinds of conversations with your doctor, especially if you have other risk factors that could increase your risk for stroke.”
Dr. Fialkow: What are the signs and symptoms that someone might be having a stroke?
Dr. De Los Rios: “If you realize that the brain is what really allows you to do everything, as far as movement, thinking, speaking, understanding — and all of a sudden you have a problem with your brain, then that’s exactly what happens. You all of a sudden have that inability to do something, be that speaking, moving, feeling, hearing, balance. It’s that sudden. At one time you were fine and then all of a sudden, out of the blue, you’re not. And you can’t do things. And sometimes the person who’s having the problems doesn’t realize it, but someone else does … So, it’s good for you, for us, to know. But it’s also important for the people around you to understand and know stroke because, otherwise, an opportunity might be missed or delayed.”
Signs of a Stroke
Here are the top signs of a stroke, according to the American Stroke Association:
F – Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
A – Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
S – Speech Difficulty: Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?
T – Time to call 9-1-1: If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.