Caitlin Whyte (Host): Welcome to Hally HealthCast, the wellness podcast from Hally Health, your partner in helping you live your healthiest life. Every episode on our podcast addresses a new topic important to your health and well-being, bringing in expert doctors, therapists, and specialists who offer their advice and answer your most pressing questions. 

Today's episode is all about stroke awareness. May is National Stroke Awareness Month, so it's the perfect time to learn more about this important health concern. Here with us is Megan Brown. She's a Registered Nurse and Quality Nurse Specialist at Carle Foundation Hospital in Urbana. Welcome, Ms. Brown, and thank you so much for being with us today and for sharing your knowledge.

Now, let's begin with the basics. What exactly is a stroke? How does it happen and why? And is there more than one kind of stroke?

Megan Brown, BSN, RN: In short, a stroke is when the blood flow to the brain is disrupted in some way. The brain doesn't store any of the nutrients it needs to survive, like sugar or oxygen. So when the brain doesn't get that nutrient rich blood flow, it results in brain death. And there are lots of different causes of stroke. It can be from a blood clot that forms in the brain or travels from somewhere else in the body. And it can also be caused by bleeding in the brain.

So there's two different types of strokes that we can talk about. There's ischemic and a hemorrhagic stroke. So, first is an ischemic stroke, and that's when the blood flow is completely stopped because a clot has either formed in the brain, like I said, or it's kind of traveled from somewhere else in the body up to the brain, and it kind of blocks that oxygen and sugar and everything that the brain needs to keep surviving. So it's stopping that blood flow from reaching the brain tissue and the brain cells.

So then the second type of a stroke is a hemorrhagic stroke, which is when there's bleeding inside of the brain. So that can be caused by uncontrolled high blood pressures. A lot of people think of like the classic, like brain aneurysm, um, which is a type of hemorrhagic stroke, kind of like the blood vessel wall gets really weak and it kind of starts to out pouch, if you will, and kind of makes this bulb shaped kind of thing.

And there's other blood vessel abnormalities that can cause a hemorrhagic stroke. But the ischemic stroke is much more common. It's about 80 percent of all strokes and, hemorrhagic being the less common one at about 20%. 

Host: Well, thank you so much, Ms. Brown. That was a very thorough, yet very understandable explanation. So now we know about the two main types of stroke, but isn't there also something called a mini stroke? What is that exactly, and how is it different from a regular stroke then?

Megan Brown, BSN, RN: Yes. So there is something called a mini stroke. It's what people commonly refer to it as. In the business, we call it transient ischemic attack or a TIA. Sometimes you'll hear it referred to that. So this is kind of a temporary one of those like mini strokes. It goes away, kind of resolves on its own within the first 24 hours. So that's one kind of clue that we can use to help figure out if it's a true stroke or we're thinking more along the lines of a TIA. So basically, the blood flow is temporary blocked, you know, maybe the clot, like, kind of wedges in there for a second and then dissolves on its own, or maybe it gets dislodged and blood flow is, like, restored on its own.

But the main trigger, warning sign, if you will, of this is that a bigger stroke could happen later down the road. The effects of a TIA aren't really permanent. Like I said, they kind of resolve on their own within less than 24 hours is the time marker we're looking at. But it is, so that being like part of the clue between is it a TIA or a stroke?

So the percentage of people that go on to have a stroke after a TIA can be around 10 to 17%, according to the American Heart Association. So we like to tell people like if they're having any kind of like neurological symptoms like that and they're thinking it could be a stroke, you absolutely want to be seen right away to rule out a stroke.

And if you do get seen right away and we think it could be a stroke, we can, you know, provide treatment to help save any brain tissue that we think might be in jeopardy. So, yeah, getting to the emergency room right away to help save that brain tissue, even if it's TIA. We want to be sure it's not the big bad stroke, you know.

Host: Well, thank you so much, Ms. Brown. Another marvelous explanation. So we've learned a lot about strokes already, but what about how to recognize when we ourselves or someone we love or someone just in the vicinity around us is having one? What are the signs and symptoms of a stroke?

Megan Brown, BSN, RN: Yeah, so they can be pretty easy to remember. There's a mneumonic device that we use called BE FAST. So the symptoms that you have, are kind of like associated with whatever part of the brain is experiencing that stroke. So the interesting thing about strokes is that your symptoms will be on the opposite side of what part of your brain is having that stroke.

So if you're having a right sided stroke, you're going to be having left sided symptoms and vice versa. So the big telltale signs that we look for are the mneumonic device is BE FAST. So B stands for balance. You're kind of looking to see are they feeling off balance, dizzy? Maybe a little bit more clumsy than, you know, I'm a clumsy gal, so, but more clumsy than usual. So we're looking for any kind of like coordination issues. Eye symptoms, a lot of people will have blurred vision or loss of vision in one eye or maybe both. Facial symptoms. This is kind of like that classic symptom of like the droopy one sided face.

So just try to have them smile. See if they're able to on both sides. You always want to look at both sides of the face. Have them raise their eyebrows. See if they can look around the room with both eyes, you know, and they're kind of looking similarly. Arms, we want to assess that by having the patient squeeze your hands and see if they're having one sided weakness.

You can also have them raise both arms out in front of them and see if they're able to keep them up for 10 seconds, or if one arm or the other starts to drift down. But you're really looking at both sides. When you have two of something, you want to assess both things. So, and you can compare which one is maybe weaker or slower or not able to stay up or anything like that.

So the S is for speech. And that can just be best assessed by having the person repeat a simple phrase. Something like, no ifs, ands, or buts. Or, the sky is blue. It doesn't really matter what you have them repeat. You're just kind of looking to see if they're able to speak at all, if they're able to follow a simple command, and if they're speaking clearly or logically.

And then T, T kind of has a few different layers. It used to be T is for time, right? Time to call 9-1-1, time to get help, but, T is for also now terrible headache. So they wanted to also add a way to identify brain bleeds, like our hemorrhagic kind of stroke, right?

So T is for terrible headache. So, you're kind of thinking more along the lines of like maybe a sudden onset, severe, worst headache of your life. That can be a sign of bleeding in the brain. So you can think of T for terrible headache or you can think of T for time to call 9-1-1. Like we need to get help right away because time is brain, right? Like the sooner we get help, the sooner we can save brain tissue.

Host: Well, I'd love to talk more about what you just said at the end there. Time is brain. You know, it's spelled out right there in the acronym, BE FAST. So can you tell us about this time asset and how we need to work fast when it comes to when someone is having a stroke?

Megan Brown, BSN, RN: Yeah. Yeah. So time is brain. Every minute, like literally every minute that we delay seeking care, millions of brain cells are dying. And the more brain cells that you have dying during a stroke, and the longer we leave that stroke untreated, the worse outcome you might have. So, I read one study that kind of equated the loss of brain cells into accelerated aging. So even delaying stroke care by like one hour, it kind of ages your brain up to almost four years. So if you kind of think of it in terms of that, like we want to save as much brain tissue and healthy brain cells that we can to kind of minimize like that accelerated aging of our brain tissue.

So any signs that signs or symptoms of stroke, you need to call right away. Call 9-1-1. Don't try to drive yourself. Get help as soon as possible because those brain cells truly depend on it. And sometimes we can, we can stop that stroke and kind of save some of those viable brain cells that might be at jeopardy of dying.

Host: Well, thank you, Ms. Brown. That is some truly urgent information. You've really helped to make us all more aware and better prepared in the event of a stroke. And yet with all of this information being put out there during Stroke Awareness Month, stroke remains the number five cause of death and the leading cause of serious long term disability in this country. How can this be when a stroke is both preventable and treatable?

Megan Brown, BSN, RN: Yes. So very true. Very true. So modifiable risk factors. We talk about those a lot. So modifiable risk factors are the things that we can control. So meaning that we can either add things to our lifestyle to promote health. And also take things out of our lifestyle that are not healthy. Some things we can't control age, family history, ethnic backgrounds, some of those things, but there's so many things that we can control. So the first one I tell everyone is stop smoking. It is so so damaging to your blood vessels.

Which I think kind of is like ignored a lot. I feel it's like, oh, your lungs, your lungs, but it is so damaging to your blood vessels as well. So, all of them in your legs, your brain everywhere. So, your heart, all those places. So there's no, and you know what? There's no conclusive evidence that vaping is any better for you either. It's so, so new that we don't really have the long term data on what it's going to do in the long term. So I kind of think this like younger generation is kind of like really the guinea pig generation of vaping. Kind of like, you know, my parents were the guinea pig generation for smoking.

And it's like, now we're seeing those long lasting effects. So, really, stopping smoking is such a huge, huge, lifestyle modification that we can do. Other than that, really controlling any health diagnosis that you might have, taking your medications as prescribed, controlling your blood sugars if you're diabetic, taking your blood pressure medications as prescribed.

Hypertension, high blood pressure is the number one risk factor for stroke. So really making sure you're keeping your blood pressures controlled. You know, if you have a diagnosis of atrial fibrillation, which is kind of a dysrhythmia in the heart, making sure you're taking your medications and blood thinners for that.

Just really owning your diagnoses and managing them the best that you can. Another good way to kind of try to stay healthy is to increase physical activity. You know, you don't have to like do crossfit six days a week. You can start somewhere small. We can do like a 15 minute walk a few times a week. And I really believe that like people will start to fall in love with moving their body. It's really just that initial like getting over that hump of like that mental block of being like, oh, I'm going to like start to commit to this thing.

But I really think that the more people move, the more they start to fall in love with that. And they're saying like sitting is the new smoking, you know, we have a very sedentary lifestyle between work and going home after work and you kind of just want to chill. And, but it's really important to try to get a little bit of movement in every day.And the last one I want to talk about is eating a healthy diet. The mediterranean diet is really highly recommended for healthy living. Lots of fish, whole grains, fruits, vegetables, nuts. I try to not overthink it and I try to stick to maybe more like an 80/20 healthy diet lifestyle. Like I love salmon, but I really love pizza.

So I you know, yeah, so I really want to try to take care of myself the best way I can but I'm not gonna not enjoy a pizza every now then. So don't overthink it. Just try to eat incorporating more fruits, vegetables, fish, that kind of a thing.

Host: Well, Ms. Brown, thank you so much for that quite literally life saving advice. Which brings us to our last question today, a chance for you to wrap up the whole idea of Stroke Awareness Month in a nutshell for us. If you could communicate one main message about strokes this May, what would you want to make everyone aware of and take to heart?

Megan Brown, BSN, RN: Yeah, I think that my biggest advice in healthcare in general is to advocate. Advocate, advocate for yourself. Advocate for your family. You know when something is wrong within your body, and you know when your family members aren't quite acting right. You know, maybe something is just kind of off with their speech.

You know them better than we do and you know when something isn't right. And so we're seeing a patient in such a brief snippet of their lives, that we really look to the family a lot to help, help us understand when you think something is wrong. Because like I said, we're not seeing them day to day and you really know if something's off. So any of those stroke signs or symptoms, a lot of people can kind of overlook and ignore and explain away, right? We don't want to go to the doctor. We don't want to go to the emergency room. But stroke signs and symptoms are truly something that need to be taken seriously. Call 9-1-1 if you think you're having a stroke if somebody else is like hey, something's up here.

They're not quite acting right. We want to get treatment as soon as possible to save your brain. So, definitely advocate for yourself and your family and don't be shy. Come on out. If you think you're having any kind of stroke symptoms. 

Host: Absolutely. Well, this has been a powerful episode indeed, Ms. Brown, and a terrific way to wrap up an amazingly enlightening conversation. You've been an absolute pleasure to have as a guest. Thank you so much for joining us today and for all you do every day at Carle Foundation Hospital to help so many individuals and families throughout our communities. That concludes today's Hally HealthCast. Tune in next time as we tackle yet another topic important for your health and well being. And remember, Hally Health is your partner in helping you live your healthiest life.

Visit Hally.com. That's H-A-L-L-Y.Com for resources, information, tips, and much more. Help us keep you and your family healthy and well. Thanks for listening. We hope you tune in again.