One American dies from a stroke every four minutes. That’s 15 deaths every hour, 360 deaths each day. Only heart disease, cancer and lower respiratory diseases claim more American lives than strokes and the National Institute of Neurological Disorders and Strokes estimates that as many as 800,000 people will suffer a stroke this year.
Gloria Teff, registered nurse, nurse instructor and stroke clinical coordinator at the Indian River Medical Center certainly sees more stroke patients than she’d prefer.
“About 40 patients a month come to the hospital with stroke symptoms,” she says.
Strokes attack the brain and they attack quickly. The most common form of stroke occurs when the arteries that connect the brain to the rest of the circulatory system become blocked and suddenly reduce or even stop blood flow to part of the brain. These blockages are usually caused by blood clots or by the buildup of “plaque” or cholesterol in the arteries. “Ischemic” strokes, as they are called, account for about 85 percent of all strokes.
However, as Teff knows all too well, there’s another kind of stroke that presents with very similar symptoms – a major problem because what might be a reasonable treatment for one can be catastrophic for the other.
Hemorrhagic strokes are caused when arteries in the brain start leaking blood or burst open altogether. These ruptures can be caused by hypertension, blood-thinning medications, trauma or aneurysms (weaknesses in the blood vessel walls).
Whatever the cause, the bleeding puts intense pressure on individual brain cells and can severely damage them. So, while aspirin may be good treatment for an ischemic stroke, used to thin the blood so that it can flow around an obstruction, that same little white pill can be deadly for someone having a hemorrhagic stroke.
According to the Harvard Medical School, aspirin interferes with blood’s ability to clot so using aspirin on a hemorrhagic stroke can make matters much worse by allowing more blood to flow into the brain.
“You don’t ever want to take aspirin while waiting for an ambulance to bring you to the hospital if you think you’re having a stroke,” Teff says.
On the other hand, taking appropriate action quickly is crucial when a stroke occurs. Hoping stroke symptoms will simply pass means losing precious time. Attempting to drive yourself to the hospital or asking a friend or relative to drive you are even worse ideas, according to Teff.
Should you pass out while driving you might well cause a fatal accident involving yourself and others. Asking a relative to drive is almost as bad because it is unlikely that relative will be able to initiate emergency medical care in route if needed.
The best thing to do if you think you are having a stroke, Teff says, is to call 911 immediately and go to the hospital in an ambulance manned by professional paramedics.
So what are the symptoms of stroke? The American Heart Association has come up with the F.A.S.T. acronym as a way to remember the signs:
– The “F” stands for face drooping. Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?
– The “A” is for arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
– The “S” stands for speech difficulty. Is the person’s speech slurred? Is he or she 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?
– Finally the “T” is for “time to call 911.” If someone shows any of these symptoms, even if the symptoms go away, call 911 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared and be able to relay that to the ambulance and medical teams.
Once at the hospital, a patient’s odds of survival increase exponentially. Here in Vero Beach, the IRMC stroke team was awarded the Stroke Gold-Plus quality achievement award from the American Heart Association this past November for its aggressive use of medications and risk-reduction therapies aimed at reducing death and disabilities from strokes.
The American Association of Neurological Surgeons says ischemic strokes are best treated by removing any obstructions (clots) and restoring blood flow to the brain.
The only FDA-approved medication for ischemic stroke is tissue plasminogen activator (tPA), which must be administered within a three-hour window from the onset of symptoms, which, again, reinforces the gravity of Teff’s warning about not waiting to seek medical attention.
Hemorrhagic strokes usually require surgery in order to relieve the pressure caused by internal bleeding.
The risk of having a stroke more than doubles each decade after the age of 55 and three-quarters of all strokes occur in people over the age of 65.
There are other stroke risk factors, however, that can be addressed. “Knowledge is power,” says Dr. Natalia Rost, associate professor of neurology at Harvard Medical School, “If you know that a particular risk factor is predisposing you to a higher risk of stroke, you can take steps to alleviate the effects of that risk.”
Here are seven ways to start reining in those risks:
– First, lower your blood pressure. High blood pressure is a huge negative factor that doubles or even quadruples the risk of stroke.
– Second, if you smoke, stop.
– Third, lose weight. Obesity raises the odds of having a stroke. Losing as little as 10 pounds can have a real impact on stroke risk.
– Fourth, exercise more.
– Fifth, drink only in moderation. While two or fewer drinks a day actually reduce the risk of stroke, the risk goes up sharply when more than two drinks are consumed daily.(Red wine might be a good choice for those two drinks because it contains resveratrol, which is thought to help protect both the heart and brain.)
– Sixth is an admonition to treat diabetes if you have it. High blood sugar can damage blood vessels and make clots more likely to form inside them.
– Finally, as you grow older, keep in regular contact with your primary care physician and keep those appointments for regular checkups so your doctor can spot risk factors and help you reduce them.
