STROKES: ACT FAST!



Several of my friends have experienced strokes this past year. While each one has either wholly recovered or is well on the road to recovery, they all made poor decisions when the symptoms appeared. Many of us suffer from denial when symptoms of serious illness occur. I am one of those stubborn people who refuses to accept that I'm getting older with each passing day. As we age, this type of behavior can lead to severe consequences. The risk of death or permanent damage is very possible the longer we wait to seek treatment.


Nearly 800,000 people in the United States have a stroke every year. It is the 5th leading cause of death, killing approximately 130,000 people annually.


Most of the symptoms occur suddenly. One easy way to learn the signs of stroke is to think "FAST" and do the following:


Face.  Ask the person to smile. Does one side of the mouth droop?


Arms.  Ask the person to lift both arms. Does one arm drift downward? Or, does is one arm unable to rise up?


Speech.  Ask the person to repeat a phrase. Is the speech slurred or garbled?


Time.  If the person exhibits one or more of the symptoms above, call 911 immediately.


EMS personnel are trained in the identification of strokes. They can make a determination regarding transportation to the appropriate hospital. They will alert the hospital that a stroke patient is arriving, thus mobilizing the stroke team with protocols to treat the patient appropriately.


Baylor Scott and White (BSW) Medical Center in Marble Falls is certified as an "Acute Stroke Ready Hospital." They can determine the best treatment for stroke symptoms through testing and observation. Emergency Room personnel at our local hospital can send patients to the nearest Primary Stroke Center in Lakeway (BSW) or the two Comprehensive Stroke Centers in Austin (Seton and St. David's).  


Approximately 80% of all strokes are ischemic, which occurs when the arteries to the brain become narrowed or blocked. The blockage or narrowing of arteries creates a severely reduced blood flow. Fatty deposits in the arteries can break away as clots and lead to the brain. A blood clot can also break away from the heart and lodge in the narrower brain arteries. Comprehensive Stroke Centers have the equipment and personnel to retrieve the clot through a mechanical retrieval procedure that can now be used up to 24 hours post-stroke. Many rural ERs are trained in giving tPA (medication to dissolve the clot) and have neurologists available via telemedicine 24/7 to direct the treatment of those with ischemic strokes.


A hemorrhagic stroke occurs when a blood vessel in the brain ruptures or leaks. There are two types of hemorrhagic strokes--intracerebral and subarachnoid. Intracerebral hemorrhagic strokes occur when the blood vessel bursts in the brain and damages the surrounding tissues. The bursting of an aneurysm in the brain causes subarachnoid hemorrhage. Bleeding in the brain is often accompanied by a sudden, severe headache.


A transient ischemic attack (TIA), sometimes called a mini-stroke, is caused by a temporary decrease in blood flow to the brain from debris or a clot. Even though symptoms may seem minor or are improving, call 911! Minor strokes increase the risk of major strokes.


Risk factors for strokes include high blood pressure, obesity, smoking, diabetes, physical inactivity, heavy drinking, high cholesterol, obstructive sleep apnea, cardiovascular disease, and a family history of strokes. People over 55 have a higher risk of stroke than younger people. (The median age in Horseshoe Bay is 67) Men are more likely to have a stroke.


Following a stroke and a course of treatment in the hospital, the person with a severe stroke will be referred to inpatient rehabilitation for intensive physical, occupational, and speech therapy. After discharge, the patient then undergoes outpatient therapy. The most significant gains in recovery are in the first few months following the stroke. Improvement will continue for an extended period, but there may be permanent movement or speech difficulties. Lifestyle changes are needed for the best outcomes--exercise, smoking cessation, medication, controlled blood pressure, controlled diabetes, eating healthy foods low in fat and cholesterol, etc.  


Time is of the essence, as specific life-saving medical interventions are time-limited. YOU or your loved one is your best advocate. Call 911 when signs of a stroke occur.

(The above essay was published in The Beacon, a weekly newspaper located in Horseshoe Bay, Texas)

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