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Every 40 seconds, someone, somewhere in the United States, suffers a stroke.
That’s the same amount of time it takes to reply to an email, reheat a cup of coffee or post a photo to Instagram.
According to the American Heart Association (AHA) and American Stroke Association (ASA), stroke is the fifth leading cause of death and the leading cause of adult disability in the U.S., with nearly 800,000 people suffering a new or recurrent stroke each year.
Even worse, it remains the third leading cause of death in Hawai‘i, with more people dying from strokes than from accidents each year.
A stroke can happen at any time, and when it does, every second counts. That’s why it’s so important to call 911 as soon as you feel like you are having a stroke. Waiting even a few minutes can make a significant difference in how a stroke affects you as well as your recovery.
“For every minute you wait after a stroke has happened, about 2 million brain cells die,” says Dr. David Nguyen, a neurologist and medical director of the Stroke Center at Pali Momi Medical Center.
“Recognizing the symptoms of stroke can be potentially lifesaving,” adds Dr. Beau Nakamoto, a neurologist at Straub Medical Center and Associate Professor of Medicine at the University of Hawai‘i at Mānoa John A. Burns School of Medicine.
“The earlier you can get to the hospital, the better the chances will be of receiving other types of stroke treatment, as well as the chances of recovery,” Nakamoto says.
Recognizing the signs and symptoms of stroke
Some risk factors for stroke can’t be changed, such as your age, race, sex and family history.
However, there are many precursors for stroke within your control.
“The most common risk factors for stroke are high blood pressure, diabetes, high cholesterol and smoking,” says Nakamoto. “These risk factors are common in Hawai‘i, but all of them are controllable with lifestyle changes.
“Eating a healthy diet is probably the best thing you can do to avoid these risk factors,” Nakamoto says. “Quitting cigarettes and exercising regularly are other things people can do to help themselves.”
Even if you lead a healthy lifestyle, stroke still can happen to anyone at any time.
If you ever suspect you are having a stroke, remember that time is imperative to your survival.
“Many times, people will not seek medical attention quickly because they think the symptoms (of a stroke) will go away if they go to sleep. This misconception leads to delay in the diagnosis and treatment of stroke, which often leads to a higher risk of death and disability,” says Nguyen.
“Another misconception is that strokes only occur in the elderly. Unfortunately, we see many people in their 30s, 40s and 50s who have had a stroke. My advice for all patients, regardless of age, is to call 911 if you think you are having a stroke,” Nakamoto adds.
To ensure you get the treatment you need, remember to “act FAST”:
• F = Face. Does one side of the face droop or is it numb?
• A = Arm. Is one arm weak or numb?
• S = Speech. Is the speech slurred, unable to talk, or hard to understand?
• T = Time. Time to call 911.
“When you think you may be having a stroke, call 911,” Nguyen stresses. “Always remember – Spot a stroke, act FAST, save a life!”
New stroke guidelines lead to more lives saved
Earlier this year, the AHA/ASA announced a major update to the guidelines that determine treatment following a stroke.
Based on recent scientific research, the organizations recommended that the window for treating acute ischemic stroke be expanded from six to up to 24 hours in certain patients with clots in large vessels.
According to Nguyen, ischemic stroke occurs when a blood clot blocks a blood vessel and prevents blood from getting to the brain. It is responsible for nearly 87 percent of all stroke cases that occur in the U.S. each year.
This update means that more patients will be eligible to receive a thrombectomy, a potentially lifesaving procedure that removes the blood clot that causes ischemic stroke.
Another new recommendation calls for broader access to the clot-dissolving drug alteplase, a type of tissue plasminogen activator (tPA) that is the only FDA-approved clot-dissolving treatment for ischemic stroke.
“We have experienced a paradigm shift in the treatment of stroke,” says Nguyen, who also is secretary for the Hawai‘i State Stroke Coalition.
“We are now opening a broader treatment window for patients, meaning more patients could potentially benefit and be included in this treatment. Patients who wake up with stroke symptoms could benefit from this as well, as we see more than half of our patients present after waking up with stroke symptoms,” Nguyen adds.
Since the new guidelines went into effect in January 2018, Pali Momi has been able to treat six patients who, prior to the change, would have had very limited options.
“These patients would likely have been disabled or possibly have died had they come in before the guideline changes,” says Nguyen. “Now, we’re seeing patients being discharged within three days almost symptom free, fully independent, walking and returning back to work.”
Both Pali Momi and Straub are certified Primary Stroke Centers, a certification that recognizes medical centers that follow the best practices for stroke care.
For more information, visit HawaiiPacificHealth.org/Stroke.