May is Stroke Awareness Month in the United States. It's a great opportunity to learn about stroke from survivors and to share your own experiences with the world. Many of us never gave much thought to stroke until it happened to us. Then one day you can use your arm, and the next day, you can't. And it stays like that for months or years. Suddenly you have to learn a whole lot about the brain in a very short amount of time, while your brain is taking damage.
So give yourself a head start with this primer on stroke.
Stroke an incredibly common medical condition, yet folks outside of "stroke world" (Worst. Amusement. Park. Ever.) generally don't give it much thought. And that's a shame, because knowing just a little bit about stroke can save their lives, the lives of their loved ones, and reduce their chances of major disability.
Here are 10 things everyone should know about stroke.
Now let's explore those items in more detail. To share this article with someone you know, give them the link https://Strokecast.com/10Things
A quarter of the US population will experience a stroke according to a worldwide study from 2018. Every year in the US, roughly 800,000 people have a stroke. It's the most common reason people live with significant disability. Odds are you are related to someone who has had a stroke, are friends or coworkers with someone who has had a stroke, or have had a stroke yourself.
That's why it's so important to know the signs of stroke, its common causes, and what to do when someone displays symptoms.
Yes, even kids.
We often think of stroke as something that affects only older people, but that's not the case. More than 1/3 of all stroke patients are under the age of 65. I was 46 when I had mine.
Many well-known actors have experienced stroke in their young lives, including:
Just this year, we heard of Hailey Bieber's stroke experience and ensuing heart surgery.
The tragedy of Luke Perry's death from stroke at just 52 years old reminds us that it can happen to anyone.
I've also had the honor of interviewing many young stroke survivors, including:
Maggie Whittum (stroke at 33)
and the list goes on.
Dr. Heather Fullerton is a neurologist at University of California San Francisco. She specializes in pediatric stroke. She reported, "Strokes will happen in as many as 1 in 2200 live births." Dr. Fullerton further explains that more than 5,000 kids under 18 have a stroke every year in the US.
The point is stroke can happen to anyone at any time. You don't need to be scared; you do need to be prepared.
The most common cause of stroke is high blood pressure. High blood pressure damages the blood vessels in the body making them less flexible, narrower, and more prone to clot formation (ischemic stroke) or rupture (hemorrhagic stroke).
The tough thing about high blood pressure is that it generally has no symptoms and doesn't hurt while it does more damage every minute of every day. To find out if you have high blood pressure, you need to get it checked. Your doctor and their team can do that. Inexpensive home blood pressure monitors are also readily available.
The American Heart Association recommends a blood pressure of 120/80. Be sure to check with your doctor before making any changes.
Other common causes of stroke include smoking, diabetes, high cholesterol, obesity, excessive alcohol consumption.
There are lots of other causes of stroke, too, including some birth control pill, surviving a COVID-19 infection, chiropractic neck adjustment and other neck traumas, unusual blood vessel formations in the brain, and plenty of others,
Addressing the common conditions through lifestyle changes and/or medical care can reduce (but not eliminate) your chances of having stroke.
Making these general improvements to health also reduces your chances of experiencing a heart attack or other medical condition.
120/80 is the magic number for blood pressure.
Stroke kills brain cells. It literally starves them and crushes them. In fact, 2,000,000 brain cells die every minute a stroke cuts off blood flow in the brain. Fortunately, there are treatments to restore the flow of blood in the most common ischemic strokes.
That's why we say, "time is brain." Every moment that passes means more brain cells pass away. The faster we get treatment, the more brain cells can survive. More dead brain cells means more stroke damage. So time lost is brain lost is function lost. Rapid treatment is essential to reducing damage from ischemic stroke.
This treatment involves a clot busting drug called tPA and a surgical procedure called mechanical thrombectomy. They work well, and many patients can leave hospital care within days, instead of weeks or months.
The problem is they typically must be administered within 3-4.5 hours after symptoms begin. So someone has to recognize the stroke, get to the right hospital, get a diagnosis, and then get treated. That's why getting treatment promptly is so important. The window is limited.
Other treatments for other strokes may also be available. Regardless, the goal is to stop any bleeding and/or restore blood flow as quickly and safely as possible, if it is possible. The key to making that happen is timely treatment.
If you can get to the hospital faster by driving than by waiting for an ambulance, should you? Probably not (unless 911 tells you otherwise).
If you're experiencing a stroke, driving is a terrible idea. Stroke will impact your decision making, response time, ability to communicate, and physical ability to operate a vehicle. That's not to say no one tries. Some people do drive while having a stroke and are horrified later when they reflect on their experience.
When you're experiencing a stroke, your brain, the very part of you that should be making appropriate decision is the part that's actively failing.
Going by ambulance has additional advantages over getting to the ER by car.
First, an ambulance crew should know the right hospital to take the patient to, or they can check with their dispatch team. Not every hospital has the equipment or personnel to treat stroke. Going to the wrong one during the wrong shift wastes valuable time.
An ambulance crew can also do triage enroute to the hospital, help the hospital get ready for the patient's arrival, and help the patient bypass the ER waiting room.
Some stroke survivors use a wheelchair. Some use a cane. Some use a leg or arm brace. Some will limp. Some will have their hand in a tight fist or will have a bent elbow or have a visible dent in their skull.
Others may "look just fine." They have no outward appearance of disability. That doesn't mean they are not disabled.
Some survivors will have aphasia. It's a communication disability where a person has all the same thoughts and feelings they've always had, and they are as smart as they have ever been, they just can't speak. Or they have only a couple words. It's a frustrating experience.
Other folks make experience sensory overload. The brain is not able to filter out the sounds and sights and smells of the world, and the experience can be overwhelming.
Some may live with chronic pain. Others have significant fatigue. They find themselves needing frequent naps. Depression is a common consequence of stroke. So is brain fog.
There's a wide variety of disabilities possible after stroke; some visible and others invisible.
There is a myth among many people that stroke recovery takes 6 months or 12 months, and the condition the survivor is in at that point is the best they'll be for the rest of their life.
That's nonsense.
Recovery may slow down after 6 months, in the experience of many survivors, but it doesn't stop. As long as the survivor keeps trying recovery years later remains a possibility.
Recovery is very much a marathon. It's not a sprint. And it's a hell of a lot of work.
When someone experiences a stroke, it can impact everyone in their household. The trauma of the event itself is, of course, substantial. If someone is in the hospital for an extended period of time, that can complicate the care of children and pets. Modifying a home or moving to a new one more appropriate to a survivor's disabilities is a big change.
Long term, there can be a huge impact on income. If a survivor was employed or ran a business, they may or may not be able to do that again. And all that income is gone in a moment. If they weren't an income provider, they may no longer be able to provide the logistical support that enables another person to earn income for the household.
It's likely vacation and school plans may need to change. Custody, child support, and spousal support may need to change for folks who are separated or divorced.
Or maybe after a couple months, things mostly go back to normal. The fact remains that every stroke is different because every stroke survivor is different. But the trauma will remain.
The human brain is constantly rewiring itself. We call that practice neuroplasticity. Every skill we acquire, every fact we learn, every memory we form, is the result of changes in the brain. New nerve cells are born; others die. Some grow and form new connections. They stretch out to one another.
This practice is how we recovery from stroke; it just has to happen on a massive scale because of all the cells that died during the stroke. The way to encourage that rewiring is lots of work and lots of sleep.
The principle that underlies neuroplasticity is "nerves that fire together, wire together." The more we do a thing that requires to nerve cells to communicate with one another - the more they fire together - the closer and more connected they become in the brain. They ultimately wire together.
It's why with any skill the more you do it and repeat, the better you get at it. It ultimately requires less thought. You get faster and not as tired. It's because you've built stronger and more powerful connections in your brain.
Muscle memory doesn't exist in the muscles. It exists in the nervous system that controls those muscles.
The process of learning to use an arm again after stroke isn't one of repairing the arm. It's one of repairing the brain. Repeating motions again and again and again for tens of thousands of repetitions is how we drive the neuroplastic change in the brain to one day have the use of that limb again.
Knowing the acronym BE FAST is the most important thing you can do regarding stroke. It tells you how to spot a stroke and what to do when you recognize it. A person may be experiencing a stroke if they have:
B - a sudden loss of or change in balance
E - a sudden change in or loss of eyesight or vision
F - single side face droop
A - in ability to hold both arms up
S - loss of or change in speech, vocabulary, or ability to process language
T - Any of this means it is time to call an ambulance
BE FAST = Balance, Eyes, Face, Arms, Speech, Time to call an ambulance.
This pneumonic device will help you spot most strokes and remind you to call an ambulance.
Other common symptoms of stroke include numbness on one side of your body, nausea, vomiting, and "the worst headache of your life." These symptoms may be more common in women, but can be experienced by men, too.
BE FAST may not be comprehensive, but it is an excellent start. And if you remember nothing else, remember to BE FAST.
Finally, as with all things in life, don't get best.get better.