No Joke! It Could Be a Stroke!

Another part of the ACLS class I am taking involves learning more about strokes. I am refreshing my knowledge about causes, symptoms, diagnosis and treatment. As I do this, I realize that even the best doctors and nurses can't help a stroke patient if they aren't present. It usually falls upon a non-medical person to recognize a problem and to initiate the process of care by calling 911. So...... you guessed it! I decided to post a little education about strokes. Yay! Aren't you excited!?

Strokes are so, so common! People can have strokes and not even realize it. Although the risk of stroke gets higher with age, no one is immune. Watch this young news reporter. She seems oblivious to the fact that she is making no sense. She was having a stroke.

There are two major types of strokes. Basically, a stroke occurs when something happens to impede the blood flow supplying the brain. The two major types of stroke are ischemic and hemorrhagic. It probably isn't important for the average person to know those words but I will tell you what they mean.

An ischemic stroke simply means that a little something interrupts the flow of blood to a part of the brain. This includes blood clots or a little piece of debri that breaks loose and travels, getting stuck in a small vessel.  Brain cells are very delicate. They need constant blood flow to bring nutrients and oxygen to them! When they don't get what they need, they start to die. The symptoms a patient has with a stroke depend upon which brain cells are being deprived, which cells are dying.

The second type of stroke is referred to as a hemorrhagic stroke. Instead of something getting in the way of the flow of blood, this type occurs when a vessel is leaking blood out. When the blood leaks out into the brain, it means the blood cells downstream aren't getting their fair share of the nutrients and oxygen. The leaking blood can also cause damage by pooling where it is not supposed to be. It causes pressure and damages precious brain cells that way.

Have you heard of mini-strokes? A mini-stroke is referred to as a transient ischemic attack (TIA). They are not to be taken likely. A TIA is more than just a warning sign. A TIA is really a narrow escape. Here's an example.... a person may have a piece of plaque (debri) that breaks loose from inside a vessel. It starts flowing along until it travels to a vessel that is more narrow. It gets clogged up there and sticks. Doesn't that sound just like the ischemic stroke I described above? Well, it is. The only difference is that the debri is stuck only temporarily. Whew! The patient lucked out, right!? The thing is, someone who has a TIA may not be so lucky the next time and permanent damage may occur. It is important for them to be treated so as to prevent another, worse event.

To learn more about how to take care of yourself the best you can so as to avoid a stroke altogether, click here. That link will take you to the Mayo Clinic site, one of my favorite places to refer people who want to learn a bit more about any health topic. It is trustworthy and written in words that make sense even if you have no medical degree. And no, Mayo Clinic does not pay me for that little advertisement...although I'd be open to that! Anyway, they will explain to you how to increase your chances of avoiding a stroke. 

So, even if you don't feel you are at risk for strokes, you likely know someone who is. If you are present when someone is having a stroke, the best thing you can do is get emergency services to them as soon as possible. It is sooooooo important to get care quickly because the fewer brain cells that die, the better the chance for a good recovery! The problem is, sometimes people just don't recognize the symptoms of a stroke. Not everyone starts speaking nonsense like the reporter shown in the video above. Sometimes the symptoms are much less dramatic.

Sometimes a person stroking may report that they are experiencing sudden vision changes. Sometimes they complain of sudden numbness or tingling. Maybe you'll just notice they seem to be suddenly confused or suddenly dizzy. Like the reporter above, they may have sudden trouble speaking. Perhaps they suddenly complain of an unbearable headache. Another thing you may notice is they are suddenly having trouble walking or even balancing while standing still. Did you notice that word "sudden" being involved in each of those sentences? Stroke symptoms can occur more gradually if the person has several smallish strokes but anytime any of those symptoms come on suddenly, it warrants an immediate call for 911. Do not hesitate to say you think the person is having a stroke. You want help FAST!

When the paramedics arrive you may notice them asking the patient to do some weird things. For example, they may ask the patient to smile. What?! It doesn't seem the time to check out their pearly whites! What they are doing, though, is a stroke assessment. Sometimes a stroke patient feels like they are smiling normally, but only half of their face is smiling. That's a pretty low tech approach but is strongly indicative for stroke. They may also ask them to raise both arms out in front of them. A stroke patient may be unable to raise both arms equally or, even if they can, one arm may keep drifting downward. They may ask the patient to squeeze their own hands with both of their's. The paramedics are comparing strength. If one hand can't squeeze or does so with a lot less strength than the other, suspicion of a stroke diagnosis is even stronger. Of course, these are tests you can perform as well, but please call 911 first.

If you remember nothing else about strokes, remember that time is important. Wasting time to get help may result in the death of more brain cells! Also, some of the treatments are only helpful if started within a few hours of the first symptoms. It is good to note the time when symptoms began and to report that time to the healthcare professionals. 

I'd like to leave you with some good news... 

I once had the opportunity to spend a couple of months helping a stroke patient. She wasn't just any patient; she was my friend. In the first days after her stroke she could not walk, talk or even recognize many of the people she'd known for years. We were devastated! I was given a front row seat, though, to a wonderful show of recovery! I watched as her brain had to find new routes to access information. It was one of the most incredible things I have witnessed! Her recovery outcome would not have been as good if she had been deprived of early interventions.  As it is, she was able to return to her husband and children, able to care for herself and her family. It was a story with a happy ending.

If you think you or someone else may be having a stroke, call 911 without hesitation.