Transcription:

Bill Klaproth (Host): Stroke is an emergency situation in which time lost can mean brain loss and with the recent death of Luke Perry at the age of 52; can strike people at a younger age. Here to talk more about stroke warning signs and prevention is Dr. Howard Sperry, Medical Director, VIP Primary Care at ECMC. Dr. Sperry, thanks for joining me today.

Howard Sperry, MD, MPH, FACP (Guest): Well it’s a pleasure Bill. Good to be with you.

Host: Well thank you. So, let’s jump into this, Dr. Sperry. Many people may think of stroke as something only an older person must be concerned with, but with the recent passing of Luke Perry at a younger age, it seems like that’s not always the case. Is that right?

Dr. Sperry: That’s true. And in fact, if you’re older than 40 and I think Luke just died at the age of 52; that’s one of the risk factors right there.

Host: So, let’s talk about those risk factors. Who is at risk for stroke?

Dr. Sperry: Sure. So, the general risk factors for stroke are usually underlying heart disease. So, for example if you had atrial fibrillation, which is an irregular rhythm in your heart, people who have high blood pressure, if it’s not treated properly, cigarette smoking one of the big risk factors for not only stroke but coronary artery disease, diabetics, especially if their blood sugars aren’t controlled, and especially, high blood cholesterol which usually goes hand in hand with diabetes and underlying coronary artery disease. So, those are the big ones. High blood pressure, cigarette smoking and definitely, elevated cholesterol.

Host: So, as we hear the term Know Your Numbers; this seems like if someone is concerned with stroke, you better understand your blood pressure, you better understand your cholesterol, if you’re a cigarette smoker, you may want to think about quitting and if you have diabetes as well; you should understand that. If you really understand those four things, you can pretty much assess your risk. Is that correct?

Dr. Sperry: Definitely, definitely and what’s important is that you can also help modify your risk and decrease your risk. So, Know Your Numbers. Very, very good, Bill. That’s excellent.

Host: Well thank you Dr. Sperry. I’m a good student.

Dr. Sperry: Yeah, the other things that are really important, we always talk about lifestyle modifications. So, we have people who are overweight or obese, they have an inactive lifestyle, they don’t exercise, there may be also a family history of either heart disease or stroke; so those are other factors to definitely consider.

Host: So, that’s a great point. So, for someone who is concerned with this, if you’re thinking geez, how can I lower my risk for stroke; you just presented the roadmap right there, right?

Dr. Sperry: Yes, yes, the roadmap or the blueprint as we call it here.

Host: The blueprint. Okay, very good, let me write that down. So, when it comes to stroke, Dr. Sperry, how do we know if someone is having one or if we’re having one? Are there signs, symptoms? Help us with that.

Dr. Sperry: Sure. And what’s interesting is that the signs and the symptoms of stroke often develop suddenly, then they can actually temporarily improve or slowly worsen depending upon the type of stroke that you are having and in particular the area of the brain that might be affected. So, the classic symptoms and we’ve seen this in the news now is FAST, the acronym FAST and each one of those letters in the word, stands for one of the things that you should watch for. So, the first is face, that’s your F. so, a sudden weakness or maybe drooping of your face, problems with your vision. Arm, that’s your A. Sudden weakness or numbness in one or both of your arms. Speech is the S. So, difficulty speaking, slurred speech or garbled speech. Sometimes you may have an elder person or elderly person who just looks like they are looking off into space and you ask them a question and they can’t even express themselves. So, that’s another thing to look for in terms of speech. And of course time and we alluded to that just like the heart, where time is muscle for your heart when you are having a heart attack, time is important for your brain because if you don’t act on this very quickly, if you’re having any of the F, A or S symptoms; so think of time is brain. You don’t want to lose brain function.

Host: Okay, so the acronym FAST, face, arms, speech, time. And time is brain. So, why is speed so important when it comes to diagnosis?

Dr. Sperry: Yeah, excellent question. So, because the signs and symptoms of a stroke can be similar to other conditions, the only way to know for sure is to be seen as soon as possible by an experienced stroke team at a stroke hospital. We have that in Buffalo right now, the GVI, the Gates Vascular Institute. So, you want to get to a hospital that has a stroke team present, so you can get the right tests in terms of CAT scans or MRIs, be properly diagnosed and then receive the treatment that’s going to give you the best results in terms of reversing the problems that you are going to have with stroke.

And what happens obviously, if you have irreversible brain damage, then that’s not good. So, if you can get to these patients as quickly as possible; not only can you improve the sequalae of the stroke, the end result; but sometimes you can even reverse the symptoms.

Host: And the good news is with time, diagnosing quickly as you said, there are medications and things you can do to lessen the severity of the stroke.

Dr. Sperry: Absolutely. Absolutely correct.

Host: So, important. So, are there any other warning signs and if we see these things happening, it’s an immediate call to 9-1-1. Is that correct?

Dr. Sperry: Yeah, the only thing I would mention besides your acronym FAST, F-A-S-T, is to also briefly mention TIA, which is a transient ischemic attack. So, when you have a TIA, you may be having the same symptoms of a stroke and then they kind of reverse themselves. But the TIA can actually predispose you to having a stroke down the line. So, a TIA, it’s kind of like a type of stroke that can reverse very quickly, but if you’re having that; that’s another reason to get to the stroke center, to get to the hospital as quickly as possible because TIAs can then reoccur and or evolve into a stroke.

Host: So, a TIA has the same symptoms of a stroke?

Dr. Sperry: It can, exactly. Absolutely.

Host: So, you can get the – and you said sudden before, so sudden numbness in an arm you are like geez, what’s wrong with my arm and then after a period of time, I don’t know, it kind of goes away. That’s something to be aware of.

Dr. Sperry: Right. In other words, thing of the same signs or symptoms of a stroke, which can be numbness, and inability to speak like we talked about that, lasts for a short time; but without any signs of a stroke, either on brain scans, MRIs or CTs and these symptoms can last for a few minutes or a few hours, but it’s usually a warning sign that the person is now at higher risk for a real stroke. So, again, if you’re having a TIA, same pneumonic, get to the hospital, time is brain.

Host: So, if someone has experienced that and has not gone to the hospital, as you said, the symptoms reverse themselves and maybe this has happened once or twice, listening to this right now; make an appointment with your doctor. Is that correct?

Dr. Sperry: Definitely because you’ll need to be evaluated but if you’re having a TIA, you want to get to the hospital at that time.

Host: And another quick question, if you are experiencing these symptoms; call 9-1-1. Don’t try to drive yourself. You might think, yeah, my face is drooping, I’m having trouble speaking, I’m just going to hop in the car. Not a good idea, right?

Dr. Sperry: Yup, not a good idea. And the reasons are first, if 9-1-1 is called and EMS arrives at your house, they can quickly begin the evaluation and may even be able to treat you, but more importantly, if you are trying to drive to the hospital, you could have a loss of consciousness or even a seizure as you are driving and something catastrophic could happen. So, it’s better to call 9-1-1, have the rescue people come to your house, do the initial triage at your house and transport you to the hospital as quickly as possible. That was an excellent point, Bill.

Host: Well thank you. See, a good student, Dr. Sperry. And as you said, time is brain. So, getting those paramedics to your house quicker can only help you. Last question Dr. Sperry, -

Dr. Sperry: Crucial. It’s critical.

Host: Crucial. Okay critical, okay, I’m glad you pointed that out. Is there anything else, last question, we should know about stroke?

Dr. Sperry: I would say you pretty much covered it. But what’s interesting not only did we talk about Luke Perry, who I think was 52 and the fact that these occur at younger ages even 30 or 40, but the other thing is it’s really prevalent. We don’t think of – we hear of somebody having a stroke, but if you look at it statistically, there’s about 750,000 strokes each year in the United States. So, that’s pretty significant. And the other thing is that they can cause long lasting disabilities or even death, in the case of Luke Perry. So, bottom line is early treatment and preventative measures can not only reduce the brain damage, but also minimize perhaps the end results of having paralysis and other problems related to the stroke.

Host: That’s a great way to wrap it up. Early treatment and preventable measures. So, think of those two terms.

Dr. Sperry: Right, preventive measures. Yup, early treatment and preventative measures can usually reduce the brain damage that occurs because of the stroke. So, that time is brain, crucial, absolutely crucial.

Host: Well Dr. Sperry, thank you so much for your time today. This has been very informative. I’ve enjoyed speaking with you and for more information, please visit www.ecmc,edu, that’s www.ecmc.edu. This is the True Care Healthcast from Erie County Medical Center. I’m Bill Klaproth. Thanks for listening.