St. Rita’s health focus: Stroke: Time is key

By Cathy Dodson and Kelli Westlake - Guest Columnists

What is a stroke? There are two main types of stroke. A dry stroke, or an ischemic stroke, is a blockage from plaque or a blood clot in an artery of the brain. A wet stroke, or hemorrhagic stroke, is when an artery within the brain bursts and you have bleeding in the brain.

There are 700,000 strokes in the United States every year. Stroke is the fifth-leading cause of death in the U.S., one person dies every three seconds of a stroke, and stroke is the leading cause of long-term disability in the U.S.

What are some risk factors you could change to decrease your risk of stroke? High blood pressure, heart disease, diabetes, being overweight, high cholesterol, lack of exercise, smoking and alcoholism.

How do I know that I am having a stroke, or if my loved one is having a stroke? Use the acronym BEFAST.

B = Balance. Your balance is off or you’re having trouble walking. You may feel as you are spinning and may have nausea.

E = Eyes. You can have a sudden loss of vision or double vision.

F = Face. Droopy mouth on one side.

A = Arm. Weakness in the arm on one side.

S = Speech. You cannot say a phrase like, “No ifs, ands or buts about it.” You may have garbled speech.

T = Time. Call 911 immediately and make sure they know what time the symptoms started. Time is very important. If you feel like you are having a stroke the hospital needs to know your “last known well.” What does this mean? What time was it when you started to have symptoms? For example: I was cooking lunch at 11:30 a.m., and my right hand dropped the spoon. I could not lift my arm or use my hand. My last known well is right before 11:30 a.m.

What is the good news? At Mercy Health St. Rita’s, we partner closely with first responders. Please, if you have these symptoms, call 911 immediately. First responders are highly trained to recognize a stroke and they will call the hospital ahead of time to get you the fastest treatment possible and to those who specialize in stroke care.

What are the best treatment options for stroke? For dry strokes, or ischemic strokes, if you are brought to the hospital quickly you could receive a drug called Alteplase. This drug is amazing. If your “last known well” is less than four hours prior, you may be able to receive Alteplase.

Mercy Health St. Rita’s has been a Primary Stroke Center since 2013, and if you receive Alteplase, you will be admitted to our ICU unit for the first 12-24 hours of your stay. That’s right, you stay in Lima. Alteplase works very quickly and most patients start feeling symptom relief before they leave the emergency room.

On occasion, patients will have what is called a large vessel occlusion. This is a dry stroke that is resistant to Alteplase due to the large size of the blockage. At Mercy Health St. Rita’s, this patient would be a candidate for an intervention if the last known well is within 24 hours. Dr. Bansal, the neuro interventionalist, can make a small stick in the groin or the wrist and a device is inserted to retrieve the clot and the clot is removed from the artery.

Lastly, a wet stroke or a hemorrhagic stroke, has a few options for treatment depending on the severity of the stroke. If possible, Bansal can make a stick at the groin or the wrist to go to the brain and coil the hemorrhage. At times, the neurosurgeon may have to take the patient to surgery and manually stop the bleeding through surgery.

Please remember, time is everything. Know when you were last well, call 911 and get the treatment you need in time.

By Cathy Dodson and Kelli Westlake

Guest Columnists

Cathy Dodson, BSN, RN, neuroscience manager; Kelli Westlake, RN, neuroscience.

Cathy Dodson, BSN, RN, neuroscience manager; Kelli Westlake, RN, neuroscience.

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