This is “Healthy Conversations,” a podcast presented by Adventist Health.

Prakash Chandran (Host):  Strokes are the fifth leading cause of death in the United States and today we’ll cover details on what a stroke is, how to recognize one, and the quickest way to get it treated. Let’s talk with Registered Nurse and Stroke Coordinator Michelle Brimer.

I’m Prakash Chandran. So, Michelle, let’s start with the basics. What is a stroke and why is it such a time sensitive disease?

Michell Brimer, RN (Guest):  A stroke is a disease that affects the arteries leading to and within the brain. So, a stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts or ruptures. And basically, a quick stroke treatment can save lives. So, if you are having a stroke, it’s critical that you get medical attention right away. Immediate treatment may minimize the long term effects of a stroke and even prevent death. 

Thanks to recent advances, stroke treatments and survival rates have improved greatly just over the last decade. 

Host:  Talk to us a little bit about what someone goes through when they are having a stroke.

Michelle:  So, the main thing that you want to recognize or look for, for stroke symptoms are sudden numbness or weakness in the face, arm or leg especially on one side of the body, sudden trouble seeing in one of both eyes, sudden confusion, trouble speaking or difficulty understanding speech, sudden severe headache with no known cause, sudden trouble walking, dizziness, loss of balance or lack of coordination. All of those symptoms suddenly appearing should kind of raise a red flag that something is going on. 

Host:  Okay so, these symptoms come out of nowhere and I’ve heard of this acronym and I’m sure people have heard about this it’s called like FAST and that’s like a way to – is it to recognize and to treat a stroke? Maybe talk a little bit about that.

Michelle:  Because stroke is an emergency, we say ACT FAST and call 9-1-1. So, the F in is for face. So, you want to look for an uneven smile. Have the person – say heh mom, can you smile for me? And so you want to have them try and make a big smile and what you will notice is one side of the face may be drooping or not able to produce that smile, an even smile. The A is for arm. So, basically you want to check if one arm is weaker than the other. So, lot’s of time they might not be able to grasp anything, or they can’t raise their arm. The next thing is the S and that’s for speech. So, you want to listen for any slurring of their speech and sometimes they can’t even produce speech. And then T of course is time. Time is call 9-1-1 right away. 

And the faster you can get to treatment, the faster we can provide the care that’s going to limit your disabilities, your death from stroke. We have several treatments that we can start right away and basically time is brain. That’s another thing that we try to push. The sooner you get there, the faster we can save those brain cells that are being starved by lack of oxygen going to the brain because of that clot or that rupture. 

Host:  That’s pretty incredible that you are working on that there. I’ve always wondered this for myself, is it ever possible to know when you, yourself are having a stroke and what might that feel like and what do you recommend that if someone is experiencing this, what do they do?

Michelle:  Well, I think being aware of something has changed, you have a symptom that you have never had before, it’s unusual; that alone should raise kind of a red flag for you. So, the main thing is not to wait. A lot of people tend to think oh, if I just rest or if I take a nap or they want to wait and see if the symptom resolves. Because none of us want to go to the emergency room. Nobody wants to come to the hospital. Everybody wants to just think that it’s not an emergency. But remember, if you have any kind of like I said, difficulty speaking, that’s not normal for us. Confusion and difficulty formulating thoughts and that’s not a normal everyday occurrence. Weakness, for us not to be able to really grasp anything. All of the sudden you woke up and you were fine and then later on during the day you notice I’m kind of leaning to the right and my balance kind of seems off.

They may be sort of subtle or they may actually be very sudden, but seeking treatment is only going to validate that it isn’t an emergency or if it is, then we can do something about it. When you are dealing with the brain and much like when we talk about a heart attack or seeking treatment for chest pain. That’s all caused by that blockage in a vessel which is decreasing that oxygen to the organ and in this case, it’s our brain. So, the sooner we can alleviate that or seek treatment, the better the outcome is going to be and that’s basically the whole goal is to decrease disabilities related to stroke and to get patients to understand that it is important to get care ASAP and 9-1-1 is the fasted way to get that. 

Host:  Yeah, absolutely. I think that especially what you said earlier, it’s something that comes on suddenly. So, if you, yourself are experiencing just something different, something that happens very quickly, it’s important to act immediately because as you mentioned before, time is critical with these types of things. One of the things that I have heard is that – or I think what most people think is that stroke affects only the elderly. But I was wondering if you could talk to that a little bit.

Michelle:  So, it is not just a disease of the elderly. It can happen in the younger population. We don’t see a lot of that in our area, but it definitely can happen. You have to look at your risk factors too and today, right, our obesity rates are going up, higher incidences of diabetes, heart disease. So, all of those cardiovascular diseases put you at risk for having a stroke. So, things that we try to do in prevention is to tell people make sure you are monitoring your blood pressure, controlling your cholesterol, keeping your blood sugars down. And we all hear it all the time for most things what helps right? Being active and a healthy diet. Loosing weight if we need to. And a big one is not to smoke. And basically talking to your doctor about your risk factors. 

Host:  What do you wish that more patients knew that came in with a stroke before they came in? Like is there any best practices around lowering risk factors or just more education around stroke awareness that you wish the general population knew?

Michelle:  You know we all wish we could have a crystal ball. If I would have only known ten years from now, this is where I would be. It’s the hardest thing to do is to change our lifestyle and to modify things. That’s the biggest challenge. But really, smoking, it just shortens your life. Not just with stroke, cancer, other diseases, but the importance of exercise and diet, eating healthy, more fruits, vegetables, grains, things like that; it really does make a difference. 

Host:  That’s Registered Nurse and Stroke Coordinator Michelle Brimer. Thanks for checking out this episode of Healthy Conversations. If you found this podcast helpful, please share it on your social channels and be sure to check out the entire podcast library for topics of interest to you. This has been Healthy Conversations. Thanks and we’ll see you next time.  

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