Would You Recognize Stroke If it Happened to You or a Loved One?
Free Seminar Focuses on Acute Care and Rehabilitation Following Stroke
When someone has a stroke, it's usually unexpected. And many times people don't know the signs and symptoms of stroke, which can delay seeking treatment. This is unfortunate, because effective management of stroke requires fast action.
Cardiologist Dr. Ash Jain, Medical Director of the Stroke Program at Washington Hospital, wants community members to understand how to recognize symptoms of stroke, so that they can take immediate action by calling 9-1-1, which triggers the Stroke Program's rapid response.
"Our program is a certified Primary Stroke Center, which means that stroke intervention begins the moment a patient or family member calls 9-1-1," Dr. Jain says. "The program has been designed to expedite treatment at every stage, from the first responders who identify stroke to our on-call neurologists who determine whether a patient is a good candidate for tPA (tissue plasminogen activator)."
Effective treatment of stroke is all about timing, and it's vitally important to take stroke seriously - because even small delays can have heavy costs, according to Dr. Jain. In the same way, the faster a person reaches the ER for treatment, the better the outcome will be in most cases.
"Let's say the patient comes in within four hours of suffering a stroke. At this point, we can get good results with administering tPA intravenously," he explains. "Then, if the patient comes in between four and six hours after the stroke, we would inject the drug directly into the brain and still get fairly good results."
After six hours, patients are no longer good candidates for clot-dissolving medications, Dr. Jain says. However, the Stroke Team at Washington Hospital can still treat strokes for up to eight hours by inserting a catheter through the groin into the brain to remove the clot.
Dr. Jain calls this procedure "riskier" and says the results are not as good, but his team can still in most cases preserve a fair amount of brain function. After eight hours, most of the damage to the brain has been done, and the window for acute treatment has usually closed.
"When it comes to stroke, prevention is ideal, and you can help prevent stroke by identifying your risk factors - like high blood pressure and atrial fibrillation - and seeing the doctor about how to treat or manage them effectively. The next best thing is to know the signs and symptoms and make sure to get to the hospital right away so we can treat the stroke with all the tools at our disposal."
"If people arrive in the ER soon enough, acute management of stroke can help save lives and mitigate long-term disability, but patients and family members first need to recognize the signs and symptoms and call 9-1-1 immediately," he says.
What happens now?
After acute management of stroke inside the hospital comes a very important phase, according to Doug Van Houten, R.N., clinical coordinator of Washington's Stroke Program.
However, before anything else, Van Houten and members the stroke team make sure that patients' risk factors have been identified and are being properly managed.
"Risk of future strokes is one of the strongest reasons for being admitted following stroke, so we always check the carotid artery for blockages, identify diabetes, and measure cholesterol and blood pressure to make sure those things are under control."
Once the team has identified problem areas that need to be addressed in order to reduce the risk of another stroke, the rehabilitation professionals start their work.
Strokes, and the impairment they can cause, vary widely from person to person. In very mild cases, people may recover with very little deficit at all. Stroke, though, remains the No. 1 cause of long-term disability, which means that most people will benefit from acute rehabilitation, which helps them regain lost function, including mobility, speech, and activities of daily living.
"This whole talk is about disability, first how to minimize the disability through acute rehab, and then how you can cope and find satisfaction in life following stroke," according to Van Houten.
One of the most important steps stroke survivors need to take is reorienting themselves to what he calls their "new normal." He says often people have made long-range plans-maybe golfing during retirement or working another 10 years-when stroke gets in the way.
"At this point, you have to find a way to move forward and say, 'Yeah, I sort of planned to have everything one way, and now things are going to be different.' You wouldn't have chosen to have a stroke, but there's no turning back. Now you've got to find a way to live with this."
The stroke survivor is not the only one impacted by stroke, Van Houten adds. The caregiver's role is critical, and is a task that usually falls to the stroke survivor's spouse. This, he says, is a unique challenge, because most spouses are in their sixth, seventh, or eighth decade of life and are not usually health care professionals. These caregivers often 'learn on the job,' and may be completely new to helping someone walk or brush his or her teeth.
Van Houten says recovery from stroke means people have to be open-minded and clever and to take opportunities and be creative in finding ways to get around the disability.
"You treat stroke-related disabilities with rehab, and you get around them with perseverance," he says.
To learn more about acute management of stroke, as well as rehabilitation and chronic care following stroke, make sure to attend the upcoming free Stroke Education Series seminar next Tuesday, August 7, from 6 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium, Rooms A and B, located at 2500 Mowry Avenue (Washington West) in Fremont.
To register for the upcoming seminar, call (800) 963-7070 or visit www.whhs.com and click on Upcoming Health Seminars.
For more information about the Stroke Program at Washington Hospital, visit www.whhs.com/stroke.