Stroke

Showing a woman who might have had a stroke.
In the hospital after a mild stroke

How to Tell if a Person Is Having a Stroke

Since the important part of helping a person having a stroke is knowing right away that he/she IS having a stroke and getting help, at the top of the list when starting to talk about stroke is how to know one when you see one.

Stroke Signs You Can See

There are signs that a person is having a stroke that you can see. For example:

  • If he/she falls, passes out, and has an arm or a leg or other body part jerking or twitching. (But, this one is dramatic and easy to spot.)
  • Has a sudden loss of balance or trouble walking, or appears dizzy.
  • Or, suddenly has trouble talking, or seems not to understand what people are saying, or is suddenly confused and can’t recover.

Stroke Signs You Can’t See

Then there are stoke signs you can’t see until the person complains about them. For example:

  • If he/she suddenly has trouble seeing out of one or both eyes.
  • Is stricken with a sudden severe headache.
  • Or, complains of numbness or weakness somewhere, such as in the face, or with an arm or a leg, or maybe on one whole side of the body.

With these, unless the person says something, you can’t see what’s happening. Except maybe the part about weakness in an arm, a leg, or one side of the body. This problem would likely be obvious because of a change in their behavior, as in, they might fall down.

A Cute, Easy to Remember, and Often Quoted Acronym: FAST

Doctors in England made up the FAST reminder acronym in 1998. It’s an easy way to remember the symptoms of a stoke as the stroke is happening. The first 3 letters of FAST are each a reminder of a stroke sign.

  • The “F” stands for face drooping on one side. If one side of a person’s face suddenly looks limp and is not right, or if the person complains that half their face feels numb, it a problem. Ask him/her to force a smile. If only half their mouth smiles, call 911.
  • The “A” is for arm weakness. It also reminds you to ask about arm numbness, which you might not know unless the person tells you. Ask him/her to raise both arms in the air. Can they do it? Does one arm only go up a bit, or go up and then drift down and they can’t keep it up? Call 911.
  • The “S” stands for speech. Has their talking suddenly changed, for example, gotten hard to understand or slurred? Or, the person might not even be able to talk at all. Ask him/her to say some short sentence and see if they can do it, can speak clearly. If not, call 911.
  • The “T” gets us back to the hard fact that the clock is ticking. T is for time. Don’t wait and wonder what to do to help the person. If you think someone is having a stroke, call 911.

Call 911 Right Away, Now, If Someone is Having a Stroke

The most important “take-away” of this page is to call 911. (In the UK, call 999.) Remember the “about stroke” TV ads showing a snake wrapping around a woman’s leg or a woman’s hair on fire. These ads were useful to show stroke as a “right now” emergency. If stroke treatment is going to work it has to be started quickly, as soon as is possible after the stroke starts. This 911 call needs to be immediate, with no hesitation, no lost time. It’s off by ambulance to the nearest Specialized Stroke Center Emergency Department for the stroke victim. Those first minutes are super important to keep brain alive. The person could even die if too much brain is lost.

Why the Signs of a Stroke Look the Way They Do

Each area of your brain connects to parts of the body. For example, one small area in your brain makes your right leg move. Another little part is the feeling in your left hand. Every part of your body is electrically connected by nerves into some area of your brain. So, what a stroke looks like or feels like depends on which areas of the brain are dying. That’s why the person might feel a sudden weakness in one arm or leg. Or they can’t talk or they get confused. It means the connected part of the brain is in real trouble.

Strokes Are Common

Strokes are common. In fact, and sadly, they are too common. There’s nothing unusual or rare about a stroke. In every country around the world stroke is a major cause of disability. And a major cause of death. Of the millions of people worldwide who have a stroke, a 1 out of 3 die and another 1 out of 3 are left permanently disabled.

Are Strokes Just Bad Luck?

There is a common but false belief that strokes come as a surprise to people. Most people feel that strokes come out of the blue, strike with no warning. You’re fine one day, and boom, the next day you’ve had a stroke and you’re in bad shape. People tend to think it’s just bad luck. And the same with getting better. Maybe you’ll be lucky and get completely well, perhaps with some physical therapy help. Or, sadly, luck of the draw, you could be permanently disabled. Or worse yet, dead.

Strokes Are Rarely a Surprise

In 2019 it’s rarely really true that strokes come out of the blue. A stroke only surprises you if you’ve not been watching. Well, maybe at times a stroke is a surprise. For example, if it’s from a little blood vessel bulge that burst. But it’s seldom a real surprise. Long-term smoldering health problems are usually behind the “sudden” stroke, with 85% of strokes due to high blood pressure that has gone on for many, many years. Get your blood pressure checked and, if it’s high, get it treated, get the pressure down, and you’ll dodge 85% of the risk of a stroke. Same story with cholesterol and other blood fats, and with smoking, and with diabetes. More on prevention below.

A Personal Life’s Story About Us

We at the Neuroscience Research and Development Consultancy care a lot, maybe even worry a lot, about stroke. Let us tell you why. Stroke is very personal for one of our company officers. Both of his grandfathers died of a stroke at age 73. His uncle was severely and permanently disabled by a stroke at age 45, and when he died years later he had been deaf and blind for a decade. It was in an era before medicine knew about link between high blood pressure and stroke. And, it was before doctors could easily catch high blood pressure early and treat it. His father started a successful battle with high blood pressure at age 40. He lived to be 96, a healthy, clear-minded, and happy 96. Treating high blood pressure really does make a huge difference.

Kinds of Strokes

There are 2 main kinds of strokes. At least for now let’s stay with 2 main kinds. One kind is when a blood vessel to or in the brain gets blocked by a clot. With the vessel blocked off the blood can’t flow. The other main kind of stroke is a bleed. A blood vessel breaks open and bleeds inside the brain. Blood flows out of the vessel and into the brain tissue. You see, our brain only stays alive because blood constantly brings oxygen to it. Whether a clot or a bleed, some part of the brain does not get the oxygen it needs to stay alive. All brain areas need oxygen every minute to stay alive. Just few minutes without oxygen kills brain cells. The doctors who treat stroke have a saying, “Time is brain.”

Well, Actually, There Are a Couple More Types of Strokes

The strokes caused by a clot blocking the blood vessel can be one of 2 types. One type is a block where the blood clotted right in the vessel in the brain where it was flowing. The other type of block happens when the blood clot occurs at a more distant part of the body, far from the brain. But a chunk of this distant clot breaks off and travels through the blood vessel until it wedges in a small blood vessel in the brain 

In addition, there are 2 types of bleeding strokes, but for now we’ll stop adding types of strokes.

What Causes Strokes and How to Prevent Them

Preventing strokes is better than letting them happen and treating them. A half-ounce of prevention in this case is worth many pounds of cure. This is true because strokes are hard to treat. And, some just can’t be treated. Once some strokes happen the brain damage is done. The disability (or death) is there. Strokes that can be treated have to be treated immediately. And, bad news, luck is there when treating strokes. Who wants Lady Luck involved at a time like this? How many minutes away is the nearest Specialized Stroke Center Emergency Department? How fast can Emergency Medical Services get to the stroke victim? Then, how quickly can EMS get the stroke victim to the best emergency department? How soon after the start of the stroke did someone call 911? As the saying goes, “It’s complicated.”

While getting a stroke treated in time needs some luck, preventing a stroke is much more of a sure thing.

Beating the Devil – High Blood Pressure

High blood pressure causes 85% of strokes. So, it’s easy. See your doctor and have your blood pressure checked. If you don’t have a doctor, find one! If you use the blood pressure machines in your grocery or drug store, okay, but don’t rely on them. Store machines are rarely checked for being right. Your doctor will get the right number. If she/he says your blood pressure is high, get a prescription from her for the medicine to treat it. And, get the prescription filled and take the medicine. It’s amazing how many people get medicine for high blood pressure but don’t take it. Don’t think you don’t need the medicine because you feel fine. You don’t feel high blood pressure. It’s called a silent killer. There are no symptoms. You feel fine until you have a stroke. No warning. And about one-third die. Sudden death.

Come On, People, Quit Smoking Already!

Don’t smoke. It really is that simple. Smoking cigarettes, cigars, or a pipe damages blood vessels. Your inside plumbing goes from nice, solid, like-new pipes to rusty, corroded pipes ready to burst at any time. We don’t yet know about vaping (electronic “cigarettes”). However, it does much less damage than any kind of burning-tobacco smoking. Inhaled nicotine is probably not the problem with vaping. If you have other junk in your vape juice/e-liquid, especially oils, it can kill you. Smoking, in addition to aging your plumbing, also gives a person high blood pressure. Double whammy, here.

Nicotine Helps Stop Depression – Take a Depression Medicine Instead

But, you see, here’s the problem. The nicotine from smoking feels good. It treats a down mood. And, nicotine is addictive. If you get depressed, angry, and irritable if you don’t smoke, ask your doctor for a medicine for depression. If you’re really not depressed but you can’t stop smoking, you’re addicted to the nicotine. So, find a safer source for your nicotine hit. Smoking is the most dangerous way to get nicotine. Stop smoking and use nicotine patches. Or, stop smoking and chew nicotine gum.¬† Maybe even stop smoking and start vaping (just no junk or oil vape juice). Do whatever, but stop smoking. It might not feel like the best answer to you right now, but you’ve got to stop smoking.

Shortened Lives – A Case Example

When our CEO was treating patients at Scripps Clinic, an older guy from Montana came to see him. He said that it was so obvious that smoking was shortening the lifespan of his brothers and sisters. His mom and dad, and his aunts and uncles, all lived into their mid-90s, ranchers in Montana. None of them smoked. But, his brothers and sisters (and cousins) were all cigarette smokers. And they were all, one by one, dying in their early 70s. From the old guy’s point of view, this information told the story. And, the message was clear. Smoke and you die 25 years too soon. He had stopped smoking.

Those Fats in Your Blood

LDL cholesterol, and triglycerides, the fatty lumps floating in your blood. While your doctor is checking your blood pressure, have her draw some blood to measure your cholesterol. High cholesterol is another way to ruin your body’s plumbing. It weakens the walls of your blood vessels and sets the stage for a stroke. If your cholesterol is high, there are now great medicines to treat it, to lower the level. Get a prescription, get the medicine, take it, and live 10 extra years.

The Sugar in Your Blood

Too much sugar in your blood, that is, high blood sugar, called Type II diabetes. Maybe “lifestyle changes” will help. Healthy foods, exercise. Maybe not. If not, get back to your doctor again and get the right medicine to treat it. There are great, easy-to-take medicines for diabetes. Your doctor can also check for early diabetes, or “pre-diabetes”. She has tests and will get your medical history, and can tell you whether you might become diabetic. Diabetes is much easier to prevent than to treat. You might be able to “dodge the diabetes bullet” altogether.

Are You Healthy?

If so, great. If not, do whatever you need to do to become healthier to help prevent strokes. Eat healthy foods. Things like vegetables and fruits, whole grain breads and cereals, chicken and especially fish, and healthy oils like olive oil and canola oil.

And exercise. Get yourself moving. Any exercise! Physically getting in gear and getting going is much, much better than sitting. Walk. When going up two or down three floors in a building, take stairs rather than just hopping on an elevator and pushing a button. Swim. Bicycle. If you can and want to do more, go for it. But while you’re sitting there and thinking about it, about what exercise to do, about how to get started, take a walk.

Helpful links:

The National Institute on Aging on stroke

National Institute of Neurological Disease and Stroke – Stroke Information Page

Or, try the National Institutes of Health, National Heart, Lung, and Blood Institute on stroke

National Library of Medicine’s Medline Plus on stroke

Center for Disease Control and Prevention (CDC) on stroke

The National Stroke Association – About Stroke

The Mayo Clinic on stroke

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