‘Time is tissue:’ every second counts to recognize a stroke and treat it

VAIL — It’s no secret that life is short and it is important to make every moment count; this is never truer than when someone is having a stroke. A stroke is a “brain attack,” according to the National Stroke Association, when blood flow to an area of the brain is cut off. Brain cells are deprived of oxygen and begin to die; when these brain cells die, abilities controlled by that area of the brain, including memory and muscle control, are lost. A stroke can happen to anyone at any time.

Nearly every 40 seconds, someone in the United States is having a stroke; approximately 800,000 people will have a stroke in the U.S. this year alone. At that time, the saying then becomes “time is tissue” and every second counts. However, by being aware of the signs and symptoms of a stroke, as well as the steps you should take if you suspect someone is having a stroke, it’s possible to win the race against time — and even save a life.

Recognize the signs

In order to help a person receive care quickly, it’s important to recognize the signs of a stroke. Thanks to the National Stroke Association, we now have a mnemonic tool to remember how to recognize stroke symptoms: “FAST.”

Use this acronym when assessing for stroke.

• F is for Face: Can the person smile? Does one side of the face droop, as it would after a dental appointment when your gums are injected with numbing medication?

• A is for Arms: Can the person raise his or her arms? Is one arm drifting downward?

• S is for Speech: Can the person repeat a simple phrase? Is his or her speech slurred or strange?

• T is for Time: If you observe any of these signs, then call 911 immediately.

“(Observing) any of the above-mentioned signs should prompt you to call 911,” Vail Heath Chief Nursing Officer Sheila Sherman wrote in an email interview. “Do not hesitate to call, as access to emergency medical care is key to survival and optimal outcomes.”

Using the FAST acronym is an effective way to help determine if someone is having a stroke, but there are other elements that should be taken into consideration, particularly for women. Stroke is the third leading cause of death for women (as opposed to the fifth leading cause of death for men each year), Sherman said, and 55,000 more women have a stroke than men. Additionally, women may report symptoms that are different than the common symptoms. Some of these symptoms include loss of consciousness or fainting; general weakness; difficulty or shortness of breath; confusion, unresponsiveness or disorientation; sudden behavioral change; agitation; hallucination or pain, seizures or nausea or vomiting.

“Unique symptoms create a problem, as they are often not recognized as a stroke symptom and treatment is often delayed,” Sherman said. “The most effective stroke treatments are only available if the stroke is recognized and diagnosed within the first three hours of the first symptoms.”

A race against time

If you suspect someone is having a stroke, then call 911 immediately. That’s when the medical professionals take over.

“Vail Health’s Emergency Department and Eagle County Paramedic Services approach the recognition and treatment of stroke with the utmost sense of critical responsiveness,” Sherman said. “In fact, (paramedics) will typically call the (Emergency Department) to alert the team that a patient is arriving by ambulance with a suspected stroke. The (Emergency Department) notifies the Stroke Team of an arriving patient with a ‘Stroke Alert.’ This prompts the team to be prepared to direct all resources to the arriving patient.”

After arriving at the hospital, the Emergency Department physician will determine the test needed based on the patient’s presenting symptoms and the timing of when the symptoms first started. Many patients will have a CT scan immediately after presenting to the Emergency Department at Vail Health as a diagnostic test to determine what type of stroke the patient is experiencing. The type of stroke will determine the treatment and next steps.

Vail Health uses a tele-stroke-medicine approach for more complicated cases. Through this technology, the staff at Vail Health is able to consult with physicians at Swedish Medical Center in Denver, where patients are often transferred once their condition is stabilized. Depending on the type of stroke, Vail Health’s emergency medicine physicians may also administer a drug to dissolve any clots and improve blood flow to the part of the brain being deprived.

Vail Health adheres to and follows National Stroke Guidelines, which are proven to improve patient outcomes and care related to stroke, thus ensuring that every patient receives the highest level of stroke care interventions, Sherman said.

‘It could have gone the other way’

Having a stroke is a frightening experience, but Edwards resident Dwane Stover realizes how lucky he was to be surrounded by observant, prepared friends when he had a stroke on May 2, 2018.

Stover, 53, was working out at Inyodo, the jiu-jitsu gym in Edwards, when he said that he felt tired and was planning on going home. However, his teammates at the gym noticed that his speech was a bit slurred and he was looking at them oddly. Instead of letting him go home, his teammates called 911.

On arrival at Vail Health, doctors determined that Stover was experiencing an Ischemic stroke — a total blockage. He was then airlifted to Swedish Hospital in Denver.

Less than five months later, after physical and occupational therapy, Stover is back working, teaching and training. His recovery was fairly quick, which Stover said is due to a combination of his teammates recognizing the situation quickly, getting help and his overall physical health. Though he was timid at first, not wanting to upset anything, he was soon back on his bicycle and in the jiu-jitsu gym.

“I can’t say enough about those guys recognizing the signs and not letting me go home — I was tired and just wanted to get sleep,” Stover said. “I owe a lot to them and their awareness. That was definitely a key factor. If I had gone home, it could have gone the other way.”

After the stroke

Every person and every stroke is different. Stover considers himself lucky and, in many ways, he is: He’s returning to his life, doing what he loves. People who have larger strokes may be permanently paralyzed on one side of their body or lose their ability to speak. And while some people recover completely from strokes, more than 60 percent of survivors will have some type of disability.

And though there is no guarantee that you can prevent a stroke, discussing your risk factors with your health care provider is a good start, Sherman said. Risk factors may include family history of stroke, hypertension, diabetes, hyperlipidemia, medications, lifestyle and other risks. Knowing about the risks can help you take charge of your health.