Whatcom View: FAST response key to saving stroke victims

My friend Eli was one of the world’s experts on the Yiddish dialects of Eastern Europe, and he knew that when he died, some of the stories and secrets of this delightful language were likely to die with him. That was why it was especially tragic when a stroke robbed him of his ability to read and speak years before his death. The last few years of his life his unique wisdom was locked inside, lost to the outside world forever. If we could have prevented Eli’s stroke-related disability, the world would be a richer place.

Stroke is the leading cause of disability in the United States. One in six people worldwide will suffer from a stroke in their lifetime. In the United States, that equates to one stroke every 40 seconds. Most — but not all — people who suffer strokes are elderly. For those people who do suffer from a stroke — like Eli — life may never be the same again.

Many people don’t realize that stroke treatment has greatly improved in the past few years, and if a stroke sufferer can get to the hospital soon after the onset of stroke symptoms, the chances of disability are greatly reduced. That is because medications like tissue plasminogen activator, known as tPA, can help dissolve the clots that lead to stroke if administered within about 4 1/2 hours of the onset of stroke symptoms. The sooner they are given, the greater the benefit. Other interventions such as direct removal of clots are also being increasingly used to prevent stroke-related disability. Not all strokes are amenable to these newer treatments, but physicians can rapidly assess which strokes are — if they can assess the patient in time. Sadly, in Whatcom County only one in 10 stroke sufferers reach the hospital in time to receive optimal treatment.

That is why the Chuckanut Health Foundation is partnering with PeaceHealth, EMS, and other community organizations this year to spread the message: Stand up to Stroke: Act FAST.

FAST stands for Face, Arms. Speech, Time to call 911.

F - Face Drooping: Does one side of the face droop or is it numb? If you aren’t certain, look in the mirror and try to smile (or ask the potential stroke victim to smile) and a deficit will become more obvious;

A - Arm Weakness: Is one arm weak or numb? If you aren’t certain, raise both arms (or ask the potential stroke victim to). If one one arm drifts downward, is suggests a possible stroke;

S - Speech Difficulty: Is speech slurred, are you (or they) unable to speak, or hard to understand? If you aren’t sure, ask the potential stroke victim to repeat a simple sentence like, “The sky is blue.” If the sentence is not repeated correctly, it suggests a possible stroke;

T - Time to call 9-1-1: If you or the other person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Of course, it is best to prevent stroke in the first place, and by some estimates, about three-quarters of strokes can be prevented through lifestyle modification and medications. Never smoking or stopping smoking is a key preventive action. In addition, prevention and treatment of diabetes, high blood pressure, and high cholesterol through diet, exercise and medications not only helps prevent stroke, but also heart disease and some types of dementia. Some patients with heart conditions such as atrial fibrillation can reduce stroke risk through the use of anti-coagulants (“blood thinners”) such as warfarin. Some young adults (by my standards that means less than age 50) suffer strokes from using cocaine or methamphetamine.

Recent studies have linked the Mediterranean diet to all kinds of healthy outcomes, including a lower risk for both stroke and cognitive decline. While there is no single Mediterranean diet, in general, the diet emphasizes lots of fruits and vegetables, beans, nuts, whole grains, fish, olive oil (up to a liter a week), small amounts of meat and dairy, and — my favorite — red wine.

If you are interested in doing more to help prevent stroke or improve stroke treatment, contact Heather Flaherty at the Chuckanut Health Foundation. To learn more, go to chuckanuthealthfoundation.org/chf-homestand-up-to-stroke/.


Dr. Bree Johnston is director of palliative care for PeaceHealth and president of the Whatcom County Medical Society.