Dear NP

Dear NP,

What are some ways to tell a stroke is coming? And why is it so important to recognize them as early as possible? L. J.

Dear L. J.,

Strokes are the third leading cause of death in the United States. Each year approximately 795,000 people suffer strokes in the world. Many die, and those who don’t often suffer permanent disability.

And the saddest part – many of these strokes are preventable. Not all strokes can be prevented, but there are many warning signs ahead of time that can save a life if recognized. The problem is that people just don’t know what to look for.

Strokes are typically caused by problems in the heart, but the damage that occurs is in the brain. Your brain needs a lot of oxygen to function, which is delivered by your heart pumping oxygen-rich blood through your arteries. If that blood flow is interrupted, the effects can quickly become catastrophic.

When a person has a stroke, an injury or blockage in a blood vessel stops the supply of oxygen to the brain. Brain cells cannot live long without oxygen, so in mere minutes permanent brain damage can occur.

Because brain damage occurs so quickly, it’s critically important to be able to recognize strokes quickly. If the brain’s oxygen supply is restored quickly enough, people can survive strokes with little or no brain damage and continue to live as normal.

People having a stroke have trouble understanding others and forming sentences, struggle with coordination, have trouble seeing and may experience paralysis in parts of the face, arm, or leg. The symptoms of a stroke are distinctive enough to easily recognize in yourself or your loved ones as long as you know what to look for. Here are some of the immediate signs you or somebody you love may be having a stroke:

Slurred speech or confusion

Numbness limited to one side of the body

Sudden vision loss, especially in one eye

Dizziness or loss of coordination

Severe headache

Another way to remember and identify some of the important signs is the acronym FAST (Face, Arms, Speech, Time). This isn’t just something clever to put in a column – it’s one of the standard protocols used by paramedics to identify strokes in the field.

Here’s how the system works:

FACE: Look the person directly in the face and ask them to smile. If one side of their face droops, this is a sign of a stroke.

ARMS: Ask the person to raise their arm. If one arm can’t lift up or droops down, this is a sign of a stroke.

SPEECH: Try to speak with the person or ask them to repeat a simple sentence. Do they slur their speech or fail to remember the sentence? Either of these could indicate a stroke.

TIME: If any of these signs are present, it is time to act. The person is likely having a stroke and needs immediate care.

Recognizing these signs is a critical part of preventing debilitating strokes in yourself and others, but equally important is preventing them from happening to begin with. There are a number of things you can do to prevent strokes:

Manage chronic conditions like high blood pressure, coronary artery disease and diabetes.

Follow the advice of your health care provider and remember to take all your medications.

Don’t smoke, or quit if you do.

Limit alcohol consumption.

Exercise regularly and eat a balanced diet. Consult with your health care provider before physical activity if you are recovering from a previous stroke or heart attack.

Strokes are one of the most time sensitive medical emergencies. Nothing is sadder to health care providers than to see somebody suffer long-term effects from a stroke that could have either been prevented or treated sooner. Everybody, regardless of age, should educate themselves on the signs and symptoms of stroke. It might just save a life.

Dr. Wesley Davis is an Emergency Nurse Practitioner at Crook County Medical Services District and Coordinator of the Family and Emergency Nurse Practitioner program at the University of South Alabama. He encourages readers to send their questions to [email protected]