At the first signs of a stroke: Act F.A.S.T.!

New research from the American Heart Association/American Stroke Association shows that although 35% of Americans experience warning symptoms of a stroke, only 3% seek immediate medical attention.

And ignoring any symptoms can be deadly.

Maybe you’ve heard of a ‘TIA’? Transient ischemic attack is also known as a ‘mini-stroke’ ­– ‘mini’ sounds kind of innocuous, but don’t be fooled. Health experts have stopped using this diminutive to describe a potentially serious event…a full, far more serious stroke may be imminent.  A TIA is a warning stroke.

A TIA means that blood flow to the brain stops for a short period of time, and symptoms appear and last less than 24 hours before disappearing…often they last just for a few minutes.  It’s estimated that 15% of severe stokes are preceded by a warning stroke and people who suffer just one TIA are at significant risk for a stroke within three months.

What’s a ‘real’ stroke?  When blood supply to the brain is blocked or when a brain blood vessel bursts. A loss of oxygen to the brain means brain cells become injured and die, and can kill you or leave you permanently disabled.

There are three types of strokes: we’ve covered TIA, or ‘warning stroke’: The other two types are:

1. An ischemic stoke, accounting for about 80% of strokes, occurs when an artery to the brain is blocked, and within a few minutes, brain cells may die.
2. Hemorrhagic stroke is caused when an artery inside the brain bursts. There are two main hemorrhagic strokes:

–  Intracerebaral hemorrhage (bleeding) is when a blood vessel in the brain leaks blood.
– A subarachnoid hemorrhage is responsible for only 5-10% of all strokes, but is fatal in 50% of cases and happens when blood leaks into the space between two of the membranes that surround the brain: it’s usually caused by a ruptured aneurysm.

Don’t Ignore Warning Signs of Stroke

It’s not just seniors who are at risk. Although strokes are more common among older adults, more adults under age 55 are having stokes.

Researchers surveyed more than 1,000 adults under 45 years old to see what they would do within the first 3 hours of experiencing numbness, weakness, or difficulty speaking or seeing — all common symptoms of a stroke.

Shockingly, 75% of the respondents said they’d wait to see if their symptoms improved.

If you have symptoms, do NOT wait! There is a 3-hour “golden window” where, if the stroke is addressed, there’s a better chance of surviving and avoiding permanent injury.

As the American Stroke Association chair Dr. Mitch Elkind stated, “Only a formal medical diagnosis with brain imaging can determine if you’re having a TIA or a stroke.”

People who experience stroke symptoms should seek treatment immediately. As reported in the journal Neurology, “thrombolytic therapy is the injection of a medication—tissue plasminogen activator (tPA)—that breaks up a blood clot (“clot buster”). tPA can be injected with a needle into a vein (intravenous [IV]), an artery (intra-arterial [IA]), or both (IV/IA)—one after the other. It is like liquid “Drano” for the blocked sink.”  About 35% to 50% who received this treatment had relatively good recovery.

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Remember FAST!

The National Stroke Association writes, “FAST is an easy way to remember and identify the most common symptoms of a stroke. If you recognize any of these symptoms, call 9-1-1 and get that person to the hospital ASAP.

F: FACE: Ask the person to smile: Is it crooked? Does one side of the face droop?

A: ARMS: Ask the person to raise both arms: Does one arm drift downward? Are they unable to lift one?

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

T: TIME TO CALL! Call 9-1-1 immediately if you observe any of these signs.

Duke University does it two symptoms better in their acronym “BEFAST”:

B for BALANCE: does the person have a loss of balance?

E for EYES: has the person lost the vision in one or both eyes?

In addition, a sudden and severe headache with no known cause is symptomatic of a stroke.

Women may have unique symptoms from men:

• Fainting or loss of consciousness
• General weakness
• Difficulty or shortness of breath
• Confusion, unresponsiveness or disorientation
• Sudden behavioral change, agitation, hallucination
• Nausea or vomiting
• Pain
• Seizures
• Hiccups

What you can and cannot control.

There are three primary risk factors that we just can’t control: age, gender, and family history.

Age: stroke risk increases with age: at younger ages, men are more likely than women to have a stroke.

Gender: Women are more likely to die from strokes than men.  Women are more likely to live alone when they have a stoke, are more likely to live in a long-term health facility after a stroke, and have a worse recovery compared to men.  Stroke kills twice as many women as breast cancer. In fact, heart attacks and stroke kill twice as many women as all cancers combined — throughout the world.

If you have a family history of stroke, or if you’ve had a stroke, you’re at higher risk for another one.

A history of migraines is linked to double the risk for stroke, and most people who have migraines are women. Smoking and migraines increase the risk even more.

For younger women, birth control pills increases the risk for stroke, especially if they smoke, and/or have high blood pressure or diabetes. All women should be screened for high blood pressure before starting birth control.

Women using hormone replacement therapy (HRT) to relieve menopausal symptoms (a combined therapy of progestin and estrogen) can be at increased risk for stroke.

What You Can Do To Prevent a Stroke

With obesity comes increased risk for diseases including diabetes and hypertension, and for stroke.

The increase in stroke deaths in Ecuador has increased almost 30% since 1990, and continues to increase about 1.3% each year.

Prevent Strokes

Here in Ecuador, and wherever you travel, wherever you live…you can control many stroke risk factors!

• If you smoke, quit now
• If you are overweight, now is the time to eat to live, not live to eat. Don’t “go on a diet.” It’s time to ‘live it’ every day.
• Control high blood pressure: Here in Ecuador it’s so easy to enjoy fresh, whole foods. Eat real food, in portions that will satisfy instead of stuff you.  Ditch the sodium-saturated, preservative and chemically laden packaged foods and add more potassium-rich fruits and vegetables, known to lower your risk.  Scrap the ‘gringo diet’ of fatty white gravies, deep-fried meats and huge burgers and fries, sugary beverages and daily desserts. Feast on fish, salads, homemade soups (watch out for restaurant soups that tend to be loaded with salt), whole grains, quinoa, and legumes. Keep alcohol moderate if you drink: moderation means one for women, two for men.
• Stress less. Stress is a known risk factor for hypertension, inflammation, diabetes and more.  But, don’t stress about stress…it can be managed. Share your stressors with friends and family; join a support group, try mindful meditation, even simple deep breathing exercises. Most of all, stay physically active.  Daily physical activity promotes health in so many ways, including activating ‘feel good’ hormones that are necessary for maintaining a good mood, and facilitating sleep.  Read more here.
• Have regular medical check-ups and keep current with your doctor. If you have diabetes and/or heart disease, especially irregular heart beat called atrial fibrillation, it’s especially important to take all the steps necessary to control your condition. Medications may be necessary to manage certain conditions such as hypertension and diabetes, but lifestyle is always the first step to wellness! Make each day your healthy day.  Take your lifestyle by the hand and keep moving toward feeling great.
• Keep active. It is so important that I’ll repeat it twice.  Activity any way and every day.  Some people think it’s necessary to “exercise” daily, doing something formal, like going to the gym. That’s great if it fits your budget and lifestyle.  But it’s getting activity every way you can that makes the difference.  Walk with purpose, stretch, bike, jog, or dance. Buy a resistance band and do simple stretches and arm/leg strengthening exercises. If your legs and knees aren’t up to the challenge of vigorous activity, no worries.  Even armchair Yoga is shown to help keep you fit. Read more here.  Take charge, enjoy your health.

Sources

DukeHealth.org. Stroke care. https://www.dukehealth.org/treatments/neurological-disorders/stroke

Medical News Today. What is a Subarachnoid Hemorrhage?
http://www.medicalnewstoday.com/articles/220844.php

National Heart, Lung and Blood Institute. Who Is at Risk for a Stoke? https://www.nhlbi.nih.gov/health/health-topics/topics/stroke/atrisk

National Stroke Association. Four Letters: F.A.S.T. http://www.strokeassociation.org/STROKEORG/WarningSigns/Stroke-Warning-Signs-and-Symptoms_UCM_308528_SubHomePage.jsp

National Stroke Association. Women and Stroke. http://www.stroke.org/understand-stroke/impact-stroke/women-and-stroke

Neurology.org.  Clot-busting therapy helps stroke victims — but only if they get treatment in time. http://www.neurology.org/content/64/2/E1.full

Research Global Disease Burden. Stroke in Ecuador. http://global-disease-burden.healthgrove.com/l/42285/Stroke-in-Ecuador

The Lancet. The greatest threat to women’s health. http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(03)14551-5.pdf

WebMD.com. Stress: How to Manage and Reduce It. http://www.webmd.com/balance/guide/tips-to-control-stress#1

World Heart Federation. Stoke. http://www.world-heart-federation.org/cardiovascular-health/stroke/

World Life Expectancy. Ecuador. http://www.worldlifeexpectancy.com/ecuador-stroke
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