May Is American Stroke Month

May 13, 2016

Know The Signs

Patty, 56, was shopping online and saw two computer screens instead of one. Then, she saw less on the right side and more on the left. She was confused by this. It was so sudden.

 John, 70, was watching the Pirates on TV and the room felt like it was spinning. He was sitting still. It was so sudden, and he felt fine before he sat down.

 “What is wrong with you?” Angela said to her husband, Dave, age 62. He was stumbling as he walked and unable to keep in a straight line. “If I didn’t know better, I would say you were drunk,” she said. “Why are you suddenly acting this way?”

It was the worst headache Teresa, 68, ever had. It came on suddenly, and she had no clue why. It just hurt. She stopped everything she was doing and sat down.

The key word in these examples is “sudden,” Jolene Barbazzeni, RN and stroke coordinator for The Stroke Center at Penn Highlands DuBois, said. “Those are the not so obvious symptoms of stroke that get missed the most.”

May is American Stroke Month, the American Heart Association/American Stroke Association’s annual campaign to increase awareness that stroke is largely preventable, treatable and beatable. 

Penn Highlands Healthcare joins the AHA/ASA in this mission. Stroke is the number four cause of death and leading cause of disability in the U.S.

What is stroke? According to the American Stroke Association, stroke is a “brain attack” cutting off vital blood and oxygen to the brain cells that control what we do – speaking, walking and breathing. Most strokes occur when arteries are blocked by blood clots or by the gradual build-up of plaque and other fatty deposits. Some strokes can be caused by arteries rupturing when weak spots on the blood vessel wall break.

“Because of time restrictions in stroke treatment, it is important to be able to recognize the signs and symptoms of stroke quickly. Think F.A.S.T.,” said Barbazzeni.

F.A.S.T. stands for:

Face drooping - Does one side of the face droop or is it numb? Ask the person to smile. Is the smile uneven?

Arm weakness - Is one arm or leg weak or numb? Ask to raise both arms or both legs. Does one drift downward?

Speech difficulty - Is the person’s speech slurred? Is he or she unable to speak or difficult to understand? 

Time to call 9-1-1. If the person shows any of these symptoms, call. Get the person to the hospital immediately

Beyond F.A.S.T., there are other symptoms to know. They are:

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

“Always call 9-1-1. Don’t drive yourself to the hospital,” John Bacher, RN and director of Penn Highlands Clearfield Emergency Department said. “Quick treatment can help limit damage to the brain or heart and increase the chance of a full recovery. Care begins when the call is made as a dispatcher will provide pre-arrival instructions until the first responders arrive and gather more information and symptoms. Paramedics and emergency medical technicians are also trained with lifesaving techniques they can use if needed.”

“Also, arrival time to treatment time is significantly reduced by ambulance because first responders have assessed the patient and while in route to the hospital, paramedics alert medical staff to begin preparation for arrival.  The Emergency Department will know to start arranging for medical equipment, specific labs and specialists,” he said.

Even if the symptoms go away, it could be a transient ischemic attack or a "mini stroke" from a temporary blockage. Go to the hospital.

“Although a TIA doesn't cause permanent brain damage, it may cause stroke warning signs, which may last minutes or even hours and then resolve. Think of this as a warning sign you shouldn't ignore and seek treatment immediately,” Amy Powell, RN and director of the Emergency Department at Penn Highlands Brookville, said.

Keep track of when the time symptoms started. Healthcare workers will need to know the time the symptoms began or the “last known well” time. Why?

It is very important that you report to the Emergency Department provider caring for you the time you symptoms began. The only FDA approved treatment for ischemic strokes is tissue plasminogen activator, or tPA, given through an IV in the arm. It works by dissolving the clot and improving blood flow to the part of the brain being deprived of blood flow. If administered within 3 hours (and up to 4.5 hours in certain eligible patients), tPA may improve the chances of recovering from a stroke,” Powell said.

“Every minute matters,” Barbazzeni said. “Time is brain!”

But the hope of Penn Highlands Healthcare is that patients can avoid using our help by decreasing their risks of stroke. Don’t be a statistic. Know your risk. Eighty percent of strokes can be prevented, Barbazzeni said.

Who is at risk? Everyone has some stroke risk. A few stroke risk factors are beyond your control, such as being over age 55, being a female, being African-American, Pacific/Islander or Hispanic, having diabetes and having a family history of stroke. If you have one of these risk factors, it is even more important that you learn about the lifestyle and medical changes you can make to prevent a stroke.

Medical risk factors include having a previous stroke, a previous episode of transient ischemic attack or TIA, high cholesterol, high blood pressure, heart disease, atrial fibrillation and carotid artery disease. These risks can be lessened if you follow treatment options from your doctor.

Lifestyle can also play a role, such as smoking, obesity and drinking too much alcohol. Lifestyle risks can be changed if you set your mind to it. Many factors contributing to a higher risk for stroke are ones which can definitely be controlled, according to Mary Ellen Smith, chief nursing officer at Penn Highlands Elk.

Here are a few tips from the American Stroke Association:

Know your blood pressure. If it is elevated, work with your doctor to keep it under control. High blood pressure is a leading cause of stroke. Your numbers should be evaluated and monitored by your health care professional to determine acceptable numbers.

Find out if you have atrial fibrillation, or a fib. A fib is an irregular heart rhythm that can cause blood to collect in the chambers of your heart and form clots to cause stroke. An irregular heart rate can be detected by carefully checking your pulse; however, it is very important that you seek treatment from a care provider. Penn Highlands Healthcare often has programs regarding a fib at area health fairs.

Ask your doctor if you have circulation problems. Fatty deposits can block the arteries which carry blood from your heart to your brain. This kind of blockage can cause stroke. Sickle cell disease, severe anemia or other diseases can increase your stroke risk if left untreated.

If you use tobacco, stop! Smoking doubles the risk for stroke. Chewing tobacco still exposes your body to chemicals that you don’t need.

If you drink alcohol, do so in moderation. But remember that alcohol is a drug – it can interact with other drugs you are taking. If you don’t drink, don’t start.

Know your cholesterol number. High cholesterol, specifically your bad cholesterol (LDL), can indirectly increase stroke risk by putting you at greater risk of heart disease. 

If you are diabetic, follow your doctor’s recommendations carefully to control your diabetes. 

Exercise daily. A brisk walk, swim or other exercise activity for as little as 30 minutes a day can improve your health in many ways and may reduce stroke risk.

Enjoy a low sodium, low fat diet. If necessary, seek nutritional counseling to become educated regarding following this type of diet. 

If you would like further information regarding stroke risk or to have a speaker present to your group about stroke, please contact Barbazzeni at 814-375-6476.