Every year in the US, roughly 800,000 people suffer a stroke — that’s one person every 40 seconds. A stroke happens when a blood vessel in the brain closes off and cuts off blood flow to the brain tissue, which causes surrounding nerve cells to die. Some strokes can be treated with medication, but time is of the essence. The sooner treatment begins, the better the chances of preventing permanent damage.
In this episode of San Diego Health, host Susan Taylor and guest Mary Kalafut, MD, a neurologist at Scripps Clinic La Jolla and medical director of the stroke program at Scripps, discuss who’s at risk for a stroke, the signs, and why it’s important to get help right away. Dr. Kalafut also outlines what you can do to lower your stroke risk because prevention is the best medicine.
If you think you or someone you know is having a stroke, call 911 immediately. Scripps hospitals are taking every precaution to protect patients and visitors from COVID. It’s safe to come to Scripps for treatment. It may save your life or your quality of life.
A stroke happens when there is a lack of blood flow to the brain tissue. One of the blood vessels closes off and blood does not reach the tissue in the brain and causes those nerve cells to die. The type of stroke that you suffer depends on the location and the size of that area.
Symptoms of a stroke include an acute change in your ability to function. Most commonly, it would be weakness on one side of the body, inability to communicate and speak correctly. Sometimes people have numbness as well.
People who are at risk for having a stroke include those with untreated hypertension. If you have a heart condition, sometimes that can pre-dispose you to have a stroke. Other possibilities include people who have diabetes that is not under control, or who have elevated cholesterol.
It is critical to treat a stroke acutely because there's a lack of blood flow. What we need to do is to open up the blood vessel to restore the blood flow, so that the nerve cells can continue to work. There’s a medication called TPA, or tissue plasminogen activator, which is a clot busting medication. That medication has to be given within the first few hours after a stroke, in order to open up the blood vessels and restore the blood flow to the nerve cells.
BE FAST is a great way to remember the acute signs of stroke.
B means balance. If all of a sudden you’re unsteady on your feet, that would be a sign that you may be suffering a stroke.
E means eye, and that could delineate either the fact that you can’t see, or that your vision is distorted, or double.
F means face. You ask the person to smile and they should have both sides of the mouth come up, symmetrically. If one side doesn’t come up and it’s weak, that would tell us that there’s an issue going on.
A stands for arms. You ask the person to extend their arms out. Either their arm may drift down, or they might not even be able to lift their arm up at all, so that would be something concerning and a sign of a stroke.
S means speech, whether the patient’s speech is slurred, or they’re finding the wrong word. That would be important to note.
T means time, which tells us that if you’re having any of these symptoms, you need to call 911 and get treatment immediately.
This is a really an important point because in the time of COVID we have seen a significant decrease in the number of patients that are coming into the emergency department.
We’re also seeing patients who come in but they come in days later. We want to get the word out that it’s important that you come in as soon as you notice the signs of a stroke, that you call 911, and come in immediately because we have lifesaving treatments that can reverse the stroke.
It’s very safe to come into our hospitals. Patients are being tested immediately, and they’re taking every precaution for prevention.
Patients can deteriorate as the stroke progresses. Also, you don’t want to put your loved one, or friend, or acquaintance in the situation of driving you, and then you deteriorate, and they can’t help you. It’s important to call 911.
The other thing that’s also very helpful is that when you arrive by ambulance you’re first in line, because it shows to the hospital staff that there’s an acute emergency going on. For those reasons, it’s important to call 911.
That’s a great question because that’s really what it needs to be about. It’s about prevention. We have great treatments if you have a stroke, but it would be better if we never got into that situation in the first place. So, it’s important to make sure that your blood pressure is under control, to be in touch with your primary doctor to make sure that your blood pressure is under control. We’re talking about a number under 140, that would be the top number, the systolic number.
The other thing is to make sure that your blood sugars are under control or know if you are having problems controlling your blood sugar.
Also make sure that your blood cholesterol level is at a good target. If it’s not, there are medications that can be used to get it under control.
Also make sure your heart is healthy. Sometimes people have irregular heart rhythms that can increase their risk of stroke. Doing things like exercising and having the appropriate diet are things that are important for stroke prevention.
We are definitely set up to do that. It’s really been a great way to interact with our patients. And the reason I say that is because, when you come into the doctor’s office, you have that one on one interaction, but you don’t really get to see the environment that the patient is in and maybe even see family members, or their pets, which is great.
You get a really more rounded view of your patient. It also makes it easier for some patients that really are not as mobile, that have a hard time getting in. It’s an excellent opportunity. That being said, I certainly do see patients in the office and that one on one, seeing people face to face, there is nothing that can take the place of that. It is very safe to come into the offices. In between every patient, the room is cleaned, everybody is wearing their mask. It’s a very, very safe environment.