Prakash Chandran (Host): When suffering from a stroke, knowing how to act fast could mean the difference between life and death. Joining us today to discuss is Dr. Paul Janda, CEO and Chief Legal Officer of the Las Vegas Neurology Center, the Program Director of Valley Hospital Neurology Residency, and the Director of the Comprehensive Stroke Center at Valley Hospital Medical Center.

 Welcome to Health Talk with the Valley Health System, presented by the Valley. I'm your host, Prakash Chandran. So, Dr. Janda, thank you so much for joining us today. I really appreciate your time. Now, I think everyone has probably heard about the word stroke, but they probably don't know exactly what that means.

Can you start by just giving us a definition?

Paul Janda, MD, Esq, FAAN: Absolutely. So stroke is a nebulous term. It has two definitions because there's two types of stroke. One is an ischemic stroke, in which there's a cessation of blood flow to the brain. The other type is a hemorrhagic stroke, in which there's a rupture of blood supplying the brain as well. So those are the two types of strokes.

Host: Okay. And is one more common than the other?

Paul Janda, MD, Esq, FAAN: Yes, the ischemic subtype is more common. So you can think of that in lay terms as the brain is just not getting blood to one of its arteries.

Host: Are there any like signs or symptoms that you might be having a stroke?

Paul Janda, MD, Esq, FAAN: Absolutely, there are many, and it's important to recognize them quickly. One quick mnemonic that we like to disperse to the general public is something called BEFAST. The B stands for balance, if there's any discrepancy with the balance there. The E is for eyes. Are the eyes deviated to one side? The F is for face. Does the face look like it's drooping on one side? The A is for arm. Is the arm heavy or feeling tingly or numb? The S is for speech. Is the speech slurred? Does it sound like someone has marbles in their mouth? And the T is for time. Because if you recognize any of those signs or symptoms, call 9-1-1 right away.

Host: Okay, understood. So that is BEFAST. That's balance, eyes, face, arm, speech, and time. And time being the most important thing and I've heard of this before. I've heard of like time equals brain. Can you broadly talk about exactly what that means?

Paul Janda, MD, Esq, FAAN: Absolutely. And so the brain is the biggest consumer of oxygen. Arguably we lose about 2 million neurons per every minute that there's no blood flow to the brain. So if the brain is having a stroke, it's important to call 911 right away to get that stroke treated as best as possible.

Host: Who is at most or highest risk for getting or having a stroke?

Paul Janda, MD, Esq, FAAN: Unfortunately, we all are at risk of having a stroke. Our risk certainly increases exponentially as we age, but generally speaking, persons that are at risk of having a stroke are those that have hypertension, also known as high blood pressure, dyslipidemia, also known as high cholesterol, diabetes. Also people that have obstructive sleep apnea that's not treated or not diagnosed and also persons that consume too much alcohol or smoke cigarettes. Those are the people that have the biggest risk of suffering strokes.

Host: Okay, so we talked about this mnemonic, BEFAST if they notice that they themselves or a loved one are experiencing symptoms of a stroke, what should they do?

Paul Janda, MD, Esq, FAAN: Again, call 911 right away. That will get you the best care and the fastest care such that you can be in a position to get treated.

Host: Let me ask you a question. I know that there's going to be people listening to this and sometimes their immediate instinct might be, hey, look, the hospital's just five minutes away. I'm just going to put this person in my car, rush to the hospital. Why is that not a good idea? Why is calling 911 a better idea?

Paul Janda, MD, Esq, FAAN: That is a great question. I'm so happy you asked me that because yes, it does seem like, hey, I could just drive to the hospital and get my stroke treated. No, by calling 911, the paramedics will arrive there. They will start to stabilize the patient and they will already phone into the hospital that, Hey, we have someone coming in with a stroke.

That way the hospital is ready in advance for that patient to come and to try to get them the most up to date and best care possible.

Host: Understood. So, there's kind of like a pre triage that happens in preparing the hospital to receive a stroke patient.

Paul Janda, MD, Esq, FAAN: Exactly. Here in Las Vegas, it's like giving your brain VIP status for that stroke treatment right away in advance.

Host: Okay. So, talking about stroke treatment itself, once the patient arrives at the hospital, what does treatment look like?

Paul Janda, MD, Esq, FAAN: Yes. So the treatment is very fast, but very safe. Vital signs are taken, an image of the brain is taken initially to make sure that there could be nothing else explaining the symptoms. And nowadays, thanks to modern advances in medicine and neurology, there are what are called thrombolytics, or can be regarded as clot busting medications, that can be given to dissolve that stroke, if it's within a certain time window, and also many centers, for example, like Valley Hospital Medical Center, has advanced clot retrieving mechanisms as well, too, to try to pull out that stroke, with all this with the intent to restore blood flow to the brain.

Host: Okay. I've always wondered, you know, I can understand that if you notice a friend or a loved one experiencing some of these symptoms, you can call 9 -1-1. Have you ever heard of a case where someone self identifies that, hey, I might be having a stroke and calls 9-1-1? Do you have recommendations around what people should do if they kind of are feeling a little off?

Paul Janda, MD, Esq, FAAN: Yes, I would say do not delay. We have numerous patients that call 911 themselves. That is the optimal way to treat this because there's nothing embarrassing about being proactive about your own health. Sometimes on the flip side, we do have some patients that say, you know what, I'm feeling these BEFAST symptoms. I'll just sleep it off. Unfortunately, that can lead to a bad result. So if you are experiencing these yourself, by all means call 9-1-1 and get the care that you need.

Host: Okay, super helpful. And as we start to close, you mentioned basically that everyone is at risk and there are things that potentially will make someone more at risk; but how can the average person reduce their risk of having a stroke?

Paul Janda, MD, Esq, FAAN: Yes, so the average patient can reduce the risk of having a stroke by doing some somewhat basic things, but it takes a lot of balance and just repetitive behavior in terms of controlling your blood pressure, controlling your blood sugar and diabetes, controlling your cholesterol, watching what you eat, not smoking, not drinking in excess, and also to overall eat healthily and to exercise regularly. Those are features that one can employ to really reduce their stroke risk.

Host: Okay, and then my final question is given all of your experience and all of the people that you have helped, what is one thing that you know to be true that you wish more people knew about strokes?

Paul Janda, MD, Esq, FAAN: Call 911 right away. Don't delay. Time is brain, and that's the most important feature of this that I would regard. Additionally, take a healthy approach to your own life, so that way you can do your best to avoid having a stroke, just like we mentioned.

Host: Dr. Janda, thank you so much for your time today.

Paul Janda, MD, Esq, FAAN: It's my pleasure. Thanks for having me.

Host: That was Dr. Paul Janda, CEO and Chief Legal Officer of the Las Vegas Neurology Center, the Program Director of Valley Hospital Neurology Residency, and the Director of the Comprehensive Stroke Center at Valley Hospital Medical Center. For more information about Dr. Janda, and surviving a stroke, you can visit valleyhealthsystemlv.com. If you found this podcast to be helpful, please share it on your social channels, and be sure to check out the entire podcast library for topics of interest to you. I'm Prakash Chandran, and this has been Health Talk with the Valley Health System, presented by the Valley. Thank you so much for listening.

Physicians are independent practitioners who are not employees or agents of the Valley Health System. The system shall not be liable for actions or treatments provided by physicians.