April 3, 2020 by John Fernandez
Stroke Survival: What You May Not Know About Symptoms, How to Respond
You’ve probably heard about the F.A.S.T. system of recognizing stroke symptoms. But did you know that it just takes one of those symptoms — not necessarily a combination of them — to signal that you or someone you’re with is stricken.
And how should you respond? During a recent Facebook Live session, Baptist Health stroke experts answered many questions about this vital topic, including symptoms and the importance of calling 911 — as opposed to driving yourself or the stroke victim to a hospital.
The featured guests: Felipe De Los Rios, M.D., medical director, stroke program at Baptist Health Neuroscience Center, and Daniel D’Amour, R.N., stroke program manager at Baptist Health Neuroscience Center. Here is Part II of our recap of the Facebook Live session as we mark National Stroke Awareness Month.
Question: How do you recognize, in either yourself or someone around you, the symptoms of a stroke?
“Any acute neurological deficit that you have … it could be anything … we have to be very aware. A sudden incident of something debilitating. So that could be acute confusion, the inability to speak or understand speech. So there’s a lot of different things that going on. We try to bundle them so that it’s easier to digest. F.A.S.T. is one of those acronyms. That’s Face, Arm, Speech and Time. With the face, it would be any kind of facial droop, especially on one side of the body. The arm would be kind of like arm weakness and that’s often depicted as somebody dropping a cup or something like that. Speech could be the inability to produce speech or the slurring of speech. And that means somebody all of a sudden is looking at you and can’t speak. Or they are speaking but what they’re saying is either slurred or it’s gibberish. T is for time and that means it’s time to call 911. Like 80 percent of strokes are covered by that F.A.S.T. acronym. So it is important that we we really focus on on that, recognizing that there could be other kinds of things happening as well.”
Dr. De Los Rios:
“But you only need one (of the four red flags in F.A.S.T.) … actually on one side. That’s what really drives the concern for stroke. The face, the speech, arm — you only need one of those (to have a stroke.) Better to be safe than sorry because time is very important. The brain doesn’t store energy … so whenver it’s not receiving blood supply, it’s not getting any energy and the brain cells don’t survive very long without energy.”
Question: “When someone is having a stroke, does it make a difference if you drive immediately to a hospital or if you call 9-1-1?
“Remember that F.A.S.T. acronym. Yes, it is time to call 9-1-1. There’s a reason for that. Over the last 10 to 20 years, we’ve done a lot of work in stroke centers to be able to streamline the process of identifying a patient and getting them treatment on time. And if you drive to a hospital that’s not a stroke center that could be catastrophic. You go to a stroke center that can handle your kind of stroke. We have primary stroke centers that has handled a certain percentage, and then you have a comprehensive stroke center (such as Baptist Health’s) that can literally treat anything that stroke presents. An ambulance is like a mobile ER. They get to your house. They establish an assessment. They’re looking to stabilize you, and to triage you to get to the right place. An EMS (Emergency Medical Service) crew is also in contact with the stroke center to which it’s going.”
Question: What are the basic things people should know when they’re young to try to avoid problems later on with stroke?
Dr. De Los Rios:
“The American Heart Association has a list of seven healthy habits. In general, they are things like minimizing your alcohol intake. Really, any amount of alcohol will increase your risk of hemorrhage, as well as the risk of cancer. For ischemic strokes (the most common type), you have to drink more regularly. So I think it’s about two drinks daily for women and three for men. So, for the risk of ischemic stroke to go up, you have to drink a little bit more. But when it comes to other health hazards, any amount of alcohol can increase your risk. So decrease your intake of alcohol, avoid tobacco, diet and exercise.
“And for exercise to work, you have to do it three to four times per week. And it has to be moderate intensity. It has to be regular exercise so you can get that cardiovascular benefit. And then make sure that you check your blood pressure. And make sure that you get screened for diabetes. So you have to get your glucose checked, and your cholesterol as well.”
“It’s a challenge getting the younger generation to understand that what you do now is going to have long, lasting effects. How many times do we look at ourselves when we go too long without exercising and then we kind of regret it later. Well, that’s the whole idea — avoid the long periods of inactivity.”
Part I of our recap: Stroke Questions Answered: Why are Rates Rising in Younger Adults and What About Prevention?