The Scary Truth About Stroke

Intro: This is Weekly Dose of Wellness, brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): Hello and welcome to the show. You're listening to Weekly Dose of Wellness, brought to you by MemorialCare Health System. I'm Deborah Howell, and today's guest is Angie West, a registered nurse who serves as the director of Neuroscience Institute and stroke program at Long Beach Memorial. West is responsible for developing educational programs and stroke competencies to educate staff, patients, and their families about stroke, risk factors, and secondary stroke prevention. In addition to her hospital work, West has spoken for the American Stroke Association on several occasions, presenting on the processes needed to set up a stroke center, and recently launched a division of interventional neuroradiology program at Long Beach Memorial in conjunction with UCLA. West is active in both the Orange County and Los Angeles County stroke program coordinators committees, and she's currently on the board of the Stroke Support Association in Long Beach. Welcome to the program, Angie.

Angie West, RN: Thank you very much for having me.

Deborah Howell (Host): We are calling today's show the scary truth about stroke, and it is scary for a reason, don't we all know it. Let's start from the very beginning. What in fact is a stroke?

Angie West, RN: Well, a stroke is anything in the brain that causes an area of the brain not to get oxygen and glucose. So that area of the brain is damaged and doesn't work, causing the symptoms in your body.

Deborah Howell (Host): Okay. All right. And there are different types of stroke, correct?

Angie West, RN: There are. There are two major different types of strokes, and then they're broke down into several other categories. But the two major types are either an ischemic stroke, which is a blockage of a blood vessel. And it can be blocked by either plaque or otherwise known as atherosclerosis. And that comes from too much sour cream and potato chips, if you will. And then there's another type of blocking or ischemic type of stroke, and that comes from a clot, which usually comes from some sort of cardiac disease.

Deborah Howell (Host): Okay.

Angie West, RN: Second kind of stroke, major kind of stroke, is a hemorrhagic stroke, and that's bleeding either into the brain tissue itself or bleeding around the brain tissue. And that is usually caused from hypertension, untreated or undiagnosed hypertension.

Deborah Howell (Host): Interesting.

Angie West, RN: Or high blood pressure. Sorry.

Deborah Howell (Host): Right, I didn't know that. All right. And then what's a TIA?

Angie West, RN: A TIA is a transient ischemic attack. So it transient, it comes and goes. I like to compare a TIA to like when you're having chest pain before you have a heart attack. People grab their chest and then it goes away after they sit down and relax. With a stroke, the symptoms come on, all of a sudden you can't move one arm or you can't move your leg or you can't speak. And in usually less than an hour, those symptoms go away. The challenge with a stroke is is that a TIA and a stroke, neither one usually hurt. And so people don't call 911 and they sit around and wait. And then they get to the hospital eight hours after the fact and we can't do much to reverse it.

Deborah Howell (Host): There's a couple of phrases that people use about the timeliness of getting people into the doctors. Do you have any you want to share with us?

Angie West, RN: I do. The one that we use most often, and the American Stroke Association has got an initiative to educate the public, using the FAST acronym. So FAST stands for facial droop or weakness in arm or leg or numbness on one side of the body. So F for face, A for arm or leg weakness, S for speech problems, and speech can be either difficulty understanding speech or being able to speak or having very slurred speech. And the T is to call 911. It is considered... stroke is considered a medical emergency. And time is of the essence or time is brain, if you will. The longer you wait to call 911, the less we can do to try and reverse the stroke when you get to the hospital.

Deborah Howell (Host): Right.

Angie West, RN: So you gotta think FAST for stroke.

Deborah Howell (Host): Even if you're a bystander and you're looking at somebody experiencing any of these things, 911 is the way to go.

Angie West, RN: Absolutely. You just, you know, everybody's got a phone in their hand nowadays. Just call 911. Even if it ends up being a TIA, it is very important to follow up on that immediately, because probably 10 to 20% of people that have a TIA will have a stroke within the next few weeks to months after having their TIA. So it's still a medical emergency.

Deborah Howell (Host): What are the risk factors of a stroke?

Angie West, RN: Well, some of the most common risk factors... there's things that you can change and things that you can't change. Obviously, the older you are, the more at risk you are for having a stroke. But I will tell you, I see a lot of stroke patients and we're getting stroke patients that are younger and younger. Even school-age kids and babies are even having strokes.

Deborah Howell (Host): Babies, really?

Angie West, RN: Absolutely. Absolutely. For different reasons, but yes, they're still having strokes. So some of the other risk factors are smoking. And smoking is a terrible risk factor that causes your vessels to constrict and puts you at much higher risk for stroke.

Deborah Howell (Host): Including secondary smoke, correct?

Angie West, RN: Including secondary smoke. Absolutely, including secondary smoke.

Deborah Howell (Host): Okay.

Angie West, RN: High blood pressure is another one. And many, many people have high blood pressure. The thing about high blood pressure is if you don't check it, you don't know whether you have it or not. And it's considered the silent killer because it, again, there's no symptoms to having high blood pressure. So you really need to take your blood pressure and make sure that it's under or around the 120 over 80 mark. That's where normal blood pressure is that decreases your risk for stroke. Another huge risk factor for stroke is high cholesterol. And again, if you don't know what your cholesterol is, you don't know whether it's high or whether it's okay and you need to work on it. So we kind of go by a mantra of knowing your numbers, which means you need to know what your cholesterol numbers are, you need to know what your blood pressure is, and you need to know what your glucose is, because diabetes is also a risk factor for stroke. Probably about 40% of our patients have diabetes here at the hospital that come in with strokes. So that's a huge risk factor for stroke.

Deborah Howell (Host): What is that... is that because there's a weakening? What's the predisposition for people with diabetes? Why are they likely?

Angie West, RN: Well, diabetes damages the vessels of the body. So if you think about somebody that's diabetic, they often have sores on their feet that don't heal because there's not good blood supply to their feet. They may have kidney damage, because the kidneys are very vascular. They may have problems seeing, because your eyes are very vascular. So that same damage that is done to those other organs or to the vasculature in the arms and legs, happens in the brain. So it damages the blood vessels in the brain. And then if you partner that up with high blood pressure and smoking or so, it just predisposes you, puts you at very high risk for a stroke.

Deborah Howell (Host): And then of course, if you have sores on your feet, you're not likely to be able to get a whole lot of aerobic activity in.

Angie West, RN: That's true. That's true.

Deborah Howell (Host): Wow. Okay. So it's all the same ball of wax, isn't it?

Angie West, RN: It really is. The same things that cause heart disease, all those risk factors that I just mentioned, also cause stroke. So they're vascular problems. Again, the heart pumps blood to the brain. And so anytime you damage the vessels in your heart, and the vessels, the carotid arteries that go to your brain, or your big toe for that matter, it damages all the vessels in your body.

Deborah Howell (Host): Okay. Now, we've gone over it once, but I think you can't go over it enough times. The way to remember signs of a stroke.

Angie West, RN: The way to remember signs of a stroke are to think FAST for stroke. So facial numbness or facial drooping. Arm or leg weakness or numbness, and it usually occurs on one side of the body. Speech problems, either difficulty understanding speech or being able to speak or having very slurred speech. And the T means to think FAST for stroke and call 911. And when you call 911, tell them you think you're having a stroke and it started 10 minutes ago, because it's very important when you get to the hospital... when you get to the hospital, it's important that we know when your stroke started, those symptoms started, so we know what we can do to treat you.

Deborah Howell (Host): So look at the clock.

Angie West, RN: Look at the clock. Yes, yes, ma'am.

Deborah Howell (Host): Check your watch, check your cell phone, whatever you have on hand. And see your doctor, get your cholesterol count, you know, if you don't want to do it at home, there's somebody who'll gladly do it for you.

Angie West, RN: That's right. Know your numbers.

Deborah Howell (Host): Know your numbers. Where can I learn more about the stroke program at Long Beach Memorial?

Angie West, RN: Memorialcare.org/lbstroke.

Deborah Howell (Host): Fantastic. Thank you so much, Angie, for finding the time to talk to us today about how we can cope with strokes once they happen and even prevent them if we're lucky. It's been a real pleasure to have you on the show, and we definitely learned a lot.

Angie West, RN: Well, thank you so much, Deborah. You have a great day.

Deborah Howell (Host): I'm Deborah Howell. Join us again next time. We'll explore another Weekly Dose of Wellness, brought to you by MemorialCare Health System. We hope that you check out the website, get your numbers, know your numbers, know the signs of stroke, remember FAST, and have yourself a great, safe, wonderful day.