Dr. Juan Gallego walks listeners through the signs and symptoms of a stroke.
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B.E. F.A.S.T.: Stroke Signs, Symptoms and Risk Factors
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Dr. Gallego became the Director of the hospital-based ED Observation Unit in 2017, Associate Director of the Emergency Department in 2018, and was appointed as the Emergency Department Medical Director and Chief of Department in January 2020. He has worked for the NFL as an unaffiliated neurotrauma consultant since 2013. He is an active member of several hospital committees and has chaired the BayCare Emergency Department clinical pathways committee since 2019 and was appointed to EMA’s Board of Directors in 2021.
Learn more about Juan Gallego, MD
Juan Gallego, MD
Juan E. Gallego, MD is a Board-Certified emergency medicine physician, licensed in the state of Florida and working at BayCare's St. Joseph’s Hospital in Tampa, Florida since 2007. Born in Grand Forks, North Dakota and raised in South Florida, Dr. Gallego graduated from Florida State University with a Bachelor of Science in Psychology and obtained his medical degree from Saba University. He completed his residency training in Emergency Medicine at the highly regarded Wayne State University/Detroit Medical Center/Sinai-Grace program where he was selected as Chief Resident his third year. He joined EMA in 2007 and became the chair of the Evidence-Based Medicine Committee in 2008.Dr. Gallego became the Director of the hospital-based ED Observation Unit in 2017, Associate Director of the Emergency Department in 2018, and was appointed as the Emergency Department Medical Director and Chief of Department in January 2020. He has worked for the NFL as an unaffiliated neurotrauma consultant since 2013. He is an active member of several hospital committees and has chaired the BayCare Emergency Department clinical pathways committee since 2019 and was appointed to EMA’s Board of Directors in 2021.
Learn more about Juan Gallego, MD
Transcription:
B.E. F.A.S.T.: Stroke Signs, Symptoms and Risk Factors
Intro: Here's another edition of the BayCare Health System's podcast series, BayCare HealthChat
Tony Martinez (Host): You're listening to BayCare HealthChat. I'm Tony Martinez. This is important. Now listen to this in its simplest terms, a stroke occurs when blood flow to the brain is interrupted. And did you know that every second is so incredibly important when you or someone you know is experiencing a stroke? First of all, you have to dial 9-1-1 immediately. But now the good news, getting fast medical treatment lowers the risk of disability or even death. And the doctors at BayCare require only a tiny hole, one sixth the size of a penny, if you can believe that, to treat most strokes. And joining us now to discuss the importance of early recognition is Dr. Juan Gallego, MD Medical Director and Emergency Department Chief at BayCare's St. Joseph's Hospital. Dr. Gallego great to have you on HealthChat.
Juan Gallego, MD (Guest): Thank you, Tony. Very good to be here as well.
Host: Such an important topic for us to talk about. I'd say this is more than a chat, a serious conversation really. Take me into your emergency room and tell me why recognizing stroke symptoms early is just so important.
Dr. Gallego: Yeah. So, as you mentioned, I'm the Director of the St. Joseph's Main Emergency Department and we're a comprehensive stroke center there. So, I'm keenly aware of how important it is to educate our community on the signs and symptoms of stroke. Most folks have heard that old saying that football is a game of inches. Well with stroke, it's a game of seconds. Every second that a major vessel is blocked causing stroke symptoms, 32,000 brain cells or neurons die. That's 2 million neurons dead every minute that passes. And although the brain adapts very well, the sooner the stroke is treated, the better the chances for patients to recover with sometimes little or even no disability. So, like I said, it really is a game of seconds.
Host: Well, BayCare has an amazing and wonderful way really to remember the keys to early detection. What is this acronym? BEFAST?
Dr. Gallego: Yes. So BEFAST is an acronym, which of course it's a word formed from the initial letters of a longer word or phrase. ASAP or as soon as possible is a good example. But BEFAST is what we use in the neurological world. And the B stands for balance. So, if you're having any difficulty walking, if you're feeling unsteady on your feet, or if your coordination is off. That might be a sign of a stroke. So, that is really important to recognize these symptoms and call 9-1-1 in a timely fashion. The E in BEFAST stands for eyes. And if you're having any change in your vision, any double vision, blurriness, loss of vision in one or both eyes. That's extremely important to identify because you've heard the saying that the eyes are the windows to the soul, but for physicians, the eyes can be the windows to the brain. So, any vision problems at all, we're encouraging patients or family members to call 9-1-1 immediately. The F in BEFAST stands for face. And if there's any new facial droop or weakness noted, if there's any numbness, one way to identify this is to try smiling. If one side doesn't look like the other, or if it's uneven, then that could be a stroke.
So, if the face in the mirror is different than the face you are used to looking at call 9-1-1. The A in BEFAST stands for arms. So, any weakness in one arm, does one arm feel heavy or numb? One technique is to raise both arms up in front of you. And if you notice that one arm sort of falls or drifts downward, then you guessed it. You call 9-1-1. And the S in BEFAST stands for speech. And if you're able to speak, is it difficult or hard to get the words that you want to say? Are you able to speak, but you feel like it's coming out slurred or incoherent? Do the words that you're using makes sense? One technique for the speech is to try a simple sentence such as the sky is blue. If you're able to say the sky is blue and your enunciation and everything sounds like it normally would, that's reassuring, but if there's any abnormalities, like mentioned before, it could be a stroke and we encourage people to call 9-1-1, which brings us to the T. The T stands for time. So, do not let time pass. It's time to call 9-1-1 if any of those BEFAST signs or symptoms are present. Like we said, time is brain. So, the faster you call 9-1-1, the faster you get medical attention. So, just like the acronym says, be fast.
Host: What a great way for those of us to use that acronym, to help us prevent stroke if we have it ourselves, or if we see it in others. And you've talked about the fact that stroke is the fifth leading cause of death in the United States and for people 65 and over who've had a stroke, this is heartbreaking. It's the leading cause of long-term disability. What are the risk factors for stroke? Obviously the age, 65 is certainly one of them as we continue to age.
Dr. Gallego: Yes. And there's a number of lifestyle related risk factors that increase your risk of stroke, such as hypertension, diabetes, high cholesterol levels, and also things like cigarette smoking, excessive alcohol intake, lack of exercise, obesity. These are all risk factors that increase one's likelihood of stroke. And especially once we get past that age of 65, if you've had some of these, what we call comorbidities, these are problems that with time, they increase the likelihood or risk of stroke. So, it is something that is extremely important to be aware of and try to take control of what we can control. Like you mentioned the cigarette smoking, that's something that really needs to be, folks need to quit smoking. They need to cut down on alcohol altogether and exercise as well.
Host: Cut down on alcohol altogether. Hope our listeners heard that one. Because that's so important. And I think some of the hardest disciplines we have to have are regarding our food, our sugar and our alcohol. You know, you see so many patients every day, that have to do this the hard way. What would you tell a healthy 60 year old who's listening to this, someone in that age group who is saying, I don't have anything to worry about?
Dr. Gallego: Well, I think that just being at that age around 60, if you don't have any history of hypertension or diabetes or cholesterol, that's great, but what's really important is having a primary physician that takes care of you and follows you. That's where they can actually do some great risk stratification. Folks might feel great, but they're not aware that their blood pressure's elevated. They're not aware that their cholesterol is abnormal. These are things that the primary physician can really test for and identify early. So, if you are pre-diabetic or pre-hypertensive or hypertensive or diabetic, I mean, those are things that sometimes folks just don't feel until it's too late at times. So, to have a primary physician, one that's established with you that you can see on a regular basis for checkups and blood work, would really go a long way with addressing these risk factors early.
Host: Is there anything else I didn't ask you that you think it's important for our listeners to understand today?
Dr. Gallego: Doing our due diligence and trying to prevent a problem like a stroke is to be compliant. So, not only just seeing your physician, but also being compliant with the treatment regimen. Quitting smoking, cutting down on the alcohol, but also exercising, but also taking the medications that your primary physician has prescribed you on a regular basis. Blood pressure control is extremely important. So, if you take the medication, and you also have to monitor your blood pressure at home and bring it back to your physician, so they know whether or not your blood pressure medication is working well for you because everybody's different, right? What works for somebody might not work for somebody else.
So, that's really important to communicate with the physician and inform them of how your blood pressures are doing. Likewise with diabetes, checking your blood sugars at home on a regular basis, knowing what types of foods to stay away from and what foods are good for you. And following up with your physician and being compliant with all of your medications, whether it's pills or insulin, or what have you, controlling those blood sugars is extremely important and cholesterol, is another one too. You know, if your cholesterol is elevated and you were prescribed a statin or anti-cholesterol type medication, it's important that medication be taken on a daily basis, even if you're feeling good. And make sure that you're following the regimen that your primary doctor has prescribed to you.
Host: Well compliant, consistent and disciplined. Dr. Juan Gallego, thank you so much for being with us today. Great information.
Dr. Gallego: Thank you, Tony. It's my pleasure.
Host: BayCare offers a variety of services for stroke diagnosis, stroke treatment, and prevention. The BEFAST acronym that Dr. Gallego mentioned is a tool to assist you in the early recognition of stroke symptoms. Go to BayCareStroke.org to learn more. And if you found this podcast informative, please share it on your social media channels and be sure to check out our interesting and incredibly informative podcasts that are in our library. They are lifesavers there for you. This is BayCare HealthChat. I'm Tony Martinez.
B.E. F.A.S.T.: Stroke Signs, Symptoms and Risk Factors
Intro: Here's another edition of the BayCare Health System's podcast series, BayCare HealthChat
Tony Martinez (Host): You're listening to BayCare HealthChat. I'm Tony Martinez. This is important. Now listen to this in its simplest terms, a stroke occurs when blood flow to the brain is interrupted. And did you know that every second is so incredibly important when you or someone you know is experiencing a stroke? First of all, you have to dial 9-1-1 immediately. But now the good news, getting fast medical treatment lowers the risk of disability or even death. And the doctors at BayCare require only a tiny hole, one sixth the size of a penny, if you can believe that, to treat most strokes. And joining us now to discuss the importance of early recognition is Dr. Juan Gallego, MD Medical Director and Emergency Department Chief at BayCare's St. Joseph's Hospital. Dr. Gallego great to have you on HealthChat.
Juan Gallego, MD (Guest): Thank you, Tony. Very good to be here as well.
Host: Such an important topic for us to talk about. I'd say this is more than a chat, a serious conversation really. Take me into your emergency room and tell me why recognizing stroke symptoms early is just so important.
Dr. Gallego: Yeah. So, as you mentioned, I'm the Director of the St. Joseph's Main Emergency Department and we're a comprehensive stroke center there. So, I'm keenly aware of how important it is to educate our community on the signs and symptoms of stroke. Most folks have heard that old saying that football is a game of inches. Well with stroke, it's a game of seconds. Every second that a major vessel is blocked causing stroke symptoms, 32,000 brain cells or neurons die. That's 2 million neurons dead every minute that passes. And although the brain adapts very well, the sooner the stroke is treated, the better the chances for patients to recover with sometimes little or even no disability. So, like I said, it really is a game of seconds.
Host: Well, BayCare has an amazing and wonderful way really to remember the keys to early detection. What is this acronym? BEFAST?
Dr. Gallego: Yes. So BEFAST is an acronym, which of course it's a word formed from the initial letters of a longer word or phrase. ASAP or as soon as possible is a good example. But BEFAST is what we use in the neurological world. And the B stands for balance. So, if you're having any difficulty walking, if you're feeling unsteady on your feet, or if your coordination is off. That might be a sign of a stroke. So, that is really important to recognize these symptoms and call 9-1-1 in a timely fashion. The E in BEFAST stands for eyes. And if you're having any change in your vision, any double vision, blurriness, loss of vision in one or both eyes. That's extremely important to identify because you've heard the saying that the eyes are the windows to the soul, but for physicians, the eyes can be the windows to the brain. So, any vision problems at all, we're encouraging patients or family members to call 9-1-1 immediately. The F in BEFAST stands for face. And if there's any new facial droop or weakness noted, if there's any numbness, one way to identify this is to try smiling. If one side doesn't look like the other, or if it's uneven, then that could be a stroke.
So, if the face in the mirror is different than the face you are used to looking at call 9-1-1. The A in BEFAST stands for arms. So, any weakness in one arm, does one arm feel heavy or numb? One technique is to raise both arms up in front of you. And if you notice that one arm sort of falls or drifts downward, then you guessed it. You call 9-1-1. And the S in BEFAST stands for speech. And if you're able to speak, is it difficult or hard to get the words that you want to say? Are you able to speak, but you feel like it's coming out slurred or incoherent? Do the words that you're using makes sense? One technique for the speech is to try a simple sentence such as the sky is blue. If you're able to say the sky is blue and your enunciation and everything sounds like it normally would, that's reassuring, but if there's any abnormalities, like mentioned before, it could be a stroke and we encourage people to call 9-1-1, which brings us to the T. The T stands for time. So, do not let time pass. It's time to call 9-1-1 if any of those BEFAST signs or symptoms are present. Like we said, time is brain. So, the faster you call 9-1-1, the faster you get medical attention. So, just like the acronym says, be fast.
Host: What a great way for those of us to use that acronym, to help us prevent stroke if we have it ourselves, or if we see it in others. And you've talked about the fact that stroke is the fifth leading cause of death in the United States and for people 65 and over who've had a stroke, this is heartbreaking. It's the leading cause of long-term disability. What are the risk factors for stroke? Obviously the age, 65 is certainly one of them as we continue to age.
Dr. Gallego: Yes. And there's a number of lifestyle related risk factors that increase your risk of stroke, such as hypertension, diabetes, high cholesterol levels, and also things like cigarette smoking, excessive alcohol intake, lack of exercise, obesity. These are all risk factors that increase one's likelihood of stroke. And especially once we get past that age of 65, if you've had some of these, what we call comorbidities, these are problems that with time, they increase the likelihood or risk of stroke. So, it is something that is extremely important to be aware of and try to take control of what we can control. Like you mentioned the cigarette smoking, that's something that really needs to be, folks need to quit smoking. They need to cut down on alcohol altogether and exercise as well.
Host: Cut down on alcohol altogether. Hope our listeners heard that one. Because that's so important. And I think some of the hardest disciplines we have to have are regarding our food, our sugar and our alcohol. You know, you see so many patients every day, that have to do this the hard way. What would you tell a healthy 60 year old who's listening to this, someone in that age group who is saying, I don't have anything to worry about?
Dr. Gallego: Well, I think that just being at that age around 60, if you don't have any history of hypertension or diabetes or cholesterol, that's great, but what's really important is having a primary physician that takes care of you and follows you. That's where they can actually do some great risk stratification. Folks might feel great, but they're not aware that their blood pressure's elevated. They're not aware that their cholesterol is abnormal. These are things that the primary physician can really test for and identify early. So, if you are pre-diabetic or pre-hypertensive or hypertensive or diabetic, I mean, those are things that sometimes folks just don't feel until it's too late at times. So, to have a primary physician, one that's established with you that you can see on a regular basis for checkups and blood work, would really go a long way with addressing these risk factors early.
Host: Is there anything else I didn't ask you that you think it's important for our listeners to understand today?
Dr. Gallego: Doing our due diligence and trying to prevent a problem like a stroke is to be compliant. So, not only just seeing your physician, but also being compliant with the treatment regimen. Quitting smoking, cutting down on the alcohol, but also exercising, but also taking the medications that your primary physician has prescribed you on a regular basis. Blood pressure control is extremely important. So, if you take the medication, and you also have to monitor your blood pressure at home and bring it back to your physician, so they know whether or not your blood pressure medication is working well for you because everybody's different, right? What works for somebody might not work for somebody else.
So, that's really important to communicate with the physician and inform them of how your blood pressures are doing. Likewise with diabetes, checking your blood sugars at home on a regular basis, knowing what types of foods to stay away from and what foods are good for you. And following up with your physician and being compliant with all of your medications, whether it's pills or insulin, or what have you, controlling those blood sugars is extremely important and cholesterol, is another one too. You know, if your cholesterol is elevated and you were prescribed a statin or anti-cholesterol type medication, it's important that medication be taken on a daily basis, even if you're feeling good. And make sure that you're following the regimen that your primary doctor has prescribed to you.
Host: Well compliant, consistent and disciplined. Dr. Juan Gallego, thank you so much for being with us today. Great information.
Dr. Gallego: Thank you, Tony. It's my pleasure.
Host: BayCare offers a variety of services for stroke diagnosis, stroke treatment, and prevention. The BEFAST acronym that Dr. Gallego mentioned is a tool to assist you in the early recognition of stroke symptoms. Go to BayCareStroke.org to learn more. And if you found this podcast informative, please share it on your social media channels and be sure to check out our interesting and incredibly informative podcasts that are in our library. They are lifesavers there for you. This is BayCare HealthChat. I'm Tony Martinez.