Stroke? Think FAST

Katherine Herczeg, MSN, APRN
Bitterroot Physicians Clinic South
3334 DVN Lane
Darby, MT 59829


Stroke? Think FAST
Strokes are the fifth leading cause of death in America and a leading cause of adult disability. A stroke may also be known as a cerebrovascular accident (CVA), "brain attack", hemorrhagic stroke and/or ischemic stroke. A "mini-stroke" is known as a transient ischemic attack (TIA). All these titles refer to the basic pathology of when blood flow to an area of brain is cut off. When this happens, brain cells are deprived of oxygen and begin to die. This may sound similar to a heart attack to some of you (myocardial infarction). Sudden bleeding in the brain can also cause a stroke if it damages brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control.

Inspiration for this article came from the recent news I read on local rancher, Jim Ellingson. He and his family are all too familiar with strokes and their aftermath. After seeing so many stroke patients over the years, a resounding question I often hear are "how could this happen?" The following statistics come from the Center for Disease Control (CDC):
  1. Strokes kill more than 130,000 Americans each year-that's 1 out of every 20 deaths.
  2. Someone in the United States has a stroke every 40 seconds. Every 4 minutes, someone dies of stroke.
  3. Every year, more than 795,000 people in the United States have a stroke. About 610,000 of these are first or new strokes.
  4. Stroke is a leading cause of serious long-term disability. Stroke reduces mobility in more than half of stroke survivors age 65 and over.
  5. About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked.
Despite advances in health technology and access to care, you can clearly see that based on the above statistics, strokes are still a major medical concern and education to the public is still pertinent to ensure those with symptoms or risks seek medical treatment. Who is at risk for stroke? Risk of stroke is much higher in African Americans than Caucasians. African Americans are also more likely to die from a stroke. Stroke risks rise with age but can occur at any age. According to the CDC, in 2009 34% of those hospitalized with a stroke were under 65 years of age. High blood pressure (Hypertension), high cholesterol and smoking remain the top risks for causing a stroke. There are many other risks as well such as family history of stroke, diabetes, and heart disease and brain aneurysms. Risk factors that are in your control to modify include the following: alcohol and illegal drug abuse, obesity, lack of physical exercise, unhealthy diet and stress.

What do you do if you have any of the risks factors listed? Up to 80% of strokes are preventable. I would recommend you discuss these risks and concerns with your healthcare provider. They can help you develop a plan to monitor ongoing health issues as well as identify and control new ones. This may be done through monitoring your weight and blood pressure or performing blood work to identify presence of diabetes or high cholesterol. If abnormal sounds are heard in the arteries of your neck, an ultrasound may be ordered. Never start an aspirin regimen without first discussing it with your healthcare provider. The best thing you can do for yourself is to get physically active, work on smoking cessation, modify your alcohol intake, aim for a healthy weight, manage your stress levels and eat a heart healthy diet. Healthy weight loss is slow and steady with long-term habit changes. There are no reliable and long-term successful fad diets out there. A diet higher in fresh fruits, vegetables and lean meats are suggested. Eat less processed foods like chips, cookies, ice cream, hot dogs etc. The external aisles of the grocery store are where most of your fresh foods are. Some may lower stress by being physically active, yoga, or even counseling to name a few.

What are the symptoms of a stroke? Stroke symptoms are typically very sudden in onset and may present as:
  • Sudden confusion, trouble speaking, or understanding
  • Sudden numbness or weakness of face, arm or leg, especially on one side of the body
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause

FAST is an easy way to remember and identify the most common symptoms of a stroke.

F: FACE: Ask the person to smile. Does one side of the face droop?

A: ARMS: Ask the person to raise both arms. Does one arm drift downward?

S: SPEECH: Ask the person to repeat a simple phrase. Is their speech slurred or strange?

T: TIME: If you observe any of these signs, call 9-1- 1 immediately.

Note the time of onset of the first symptom. This information is important and can affect treatment decisions.

The public has become more educated in understanding that time is valuable in treating a heart attack. The same applies to a stroke. We have a saying in the healthcare field and that is, "time is tissue." Brain death can occur within minutes from lack of blood flow or oxygen. Treatment of the stroke depends on the cause and other medical conditions you have. I recommend you keep an updated list of your medications in your wallet and perhaps a close family member or friend's as well. This will help determine if you are a candidate for certain stroke treatments. In the event of a stroke, you will be in the hospital to stabilize your condition and often rehab directly afterwards to help you work through any deficits that have been caused by the stroke.

Many resources exist out there to get more information. I recommend the CDC at cdc.gov or the National Stroke Association at stroke.org. Most of all, remember to act FAST if you or someone you are with, are having symptoms. Modify the risks you have control over by making gradual lifestyle changes. Work with your healthcare provider on other risks or perhaps even to prevent a subsequent stroke.

Questions and or comments regarding this week's health column please contact, Katherine Herczeg, MSN, APRN at Bitterroot Physicians Clinic South, a service of Marcus Daly Memorial Hospital, 3334 DVN Lane, Darby, MT 59829, a service of Marcus Daly Memorial Hospital. Working together to build a healthier community!
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