Stroke is the killer number three and adult disability factor number one in the United States and Europe. It takes away the life of more than 150 000 people every year in the US; and affects some 800 000 new or recurrent stroke sufferers yearly. A definite medical emergency and life-threatening neurological injury affecting people’s health on a global scale, stroke can cause permanent brain damage and death. More than 65 billion USD will be required this year to meet related medical costs.
Tough but possible
If left undiagnosed, stroke will become the leading cause of worldwide deaths. Although the symptoms are not easily identifiable it is vital to recognise, diagnose and treat a stroke victim as quick as possible. Tough but possible, neurologists are optimistic. They say they can reverse the effects completely provided the stroke victim is brought for treatment within three hours. There’s very little hope beyond that time frame.
Scene of stroke
But a stroke occurs suddenly, so fast that it shocks bystanders. It may happen anywhere, at home, on the road, at work; and you may be the only person on site. Imagine yourself with a victim headlong or otherwise, in a weak and confused state. It could be anyone from your close relative to a dear friend, or a fellow worker. What do you do?
Unless you have been trained to deal with emergencies you’ll panic. Won’t you?
But if you know the techniques of recognising a stroke you can make all the difference. You can save a life; you can prevent the victim from getting crippled for life. How? Let us first of all try to find out what a stroke is and how it affects people.
What is a stroke?
A stroke which is also called a cerebrovascular accident (CVA) or cerebral infarction is a cardiovascular disease. There are two ways a stroke can strike.
First when the blood vessel carrying oxygen and nutrients to the brain is blocked by a clot (thrombus). This condition is called ischemia (lack of blood supply).
And, secondly, when the blood vessel bursts and causes hemorrhage. In either case the brain is deprived and starts to die.
It is therefore vital to restore the blood flow as quickly as possible. A long period of blood deprivation to the brain may cause nerve cells to die. The brain can be damaged permanently and irreversibly.
A higher death rate is associated with hemorrhagic stroke. But ischemic stroke, also called thrombotic stroke, is more common and accounts for more than 85 per cent of all strokes. It occurs mostly at night or in the early morning. It is often preceded by what is called a transient ischemic attack (TIA) or a “warning stroke” which lasts only a few minutes. If you identify a TIA victim bring him to immediate medical care.
What are the effects of a stroke?
The effects depend largely on where the obstruction or disruption is located and how much the brain is damaged. The brain is a complex organ and functions such that one side of it controls the opposite side of the body.
A stroke in the right side of the brain will affect the left side of the body and the right side of the face. The left side of the body is paralysed and the victim may experience vision problems and memory loss, and display quick, inquisitive behaviour.
A stroke in the left side will affect the right side of the body and left side of the face. The victim may suffer right side body paralysis, experience memory loss and speech problems and display slow, cautious behaviour.
As a layman it’s not your job to administer treatment. Leave it to the professionals; neurologists and emergency physicians will act according to the type of stroke. For ischemic stroke they’ll usually administer clot-busting drugs while a surgical intervention would be necessary for hemorrhagic stroke. But these medical specialists are not always on the scene of the accident. Can you as a bystander do anything? How will you handle the situation?
What you can do
Well, at least you can START the process of treatment. Note I said “process”, which means there are other things you can do before effective (professional) treatment is available. Fair enough if you know a bit of first aid principles. It shouldn’t be a big deal if you don’t.
The most important thing is to act promptly. Remember every minute counts. Don’t panic. Recognise the problem and call the ambulance immediately. If you are in Mauritius dial 114; in the US it’s 911, otherwise check your country’s emergency number. You are the key person here. You are going to START the treatment. How will you recognise the symptoms? Follow the steps below and give a clear description of your own observations to the emergency team once they are on site:
S – The patient cannot SMILE if asked to; there’s sudden numbness of the face
T – If you ask him to TALK he is incoherent
A – He is not ALERT; has trouble seeing and suffers severe headache
R – He cannot RAISE both arms; there’s loss of balance; he cannot walk
T – His TONGUE is crooked or sways sideways.
Don’t forget you have only three hours for a proper treatment; and the victim needs to be hospitalized within an hour of the occurrence of the stroke in order to allow for appropriate evaluation, diagnosis and treatment.
Learn also to know who are vulnerable to stroke
Basically the risk factors are the same as for other cardiovascular diseases. People with hypertension, diabetes, high cholesterol, migraine with aura, previous history of stroke or TIA; cigarette smokers; cases of atrial fibrillation, thrombophilia (a thrombosis tendency) and older aged persons are most at risk.
Take your health in your hands. Doctors cannot do it all. Once you are aware of the risk factors you can take action to reduce the risk of recurrent episodes of stroke. Cardiovascular complications are the result of unhealthy lifestyle, lack of exercise, improper diet or uncontrolled medication. You can prevent a stroke if you adopt a healthier lifestyle. If you feel you are at risk or you have ever experienced a TIA there’s no better way to keep it under control. Here’s what you can do:
• If you are diabetic and hypertensive try to keep these under control. Very often people are not aware they have diabetes and hypertension until they are diagnosed as a result of an emergency
• Practise physical exercise, control your weight
• Control your diet, eat healthy
• If you smoke, quit.
Alternatively medical specialists may prescribe drugs to “thin” the blood.
If you follow the above carefully you’ll go a long towards keeping the stroke incidence at a low level. Not only you’ll contribute to a healthier world population, you’ll also help save billions of dollars for fighting against this big killer.
Alfa King is a Mauritius-based blogger and emerging copywriter and freelance writer. He is a former editor of trade union newsletter and has contributed articles for various in-house magazines and newsletters. He has written technical papers for trade unions, employers and professional organisations. As a professional in Occupational Safety & Health, First Aider and advisor in Human Resources he has worked with both public and private bodies and conducted training programmes at various levels.
Mauritian residing in Rodrigues, Amanoola Khayrattee (pen name Alfa King) is contributing writer and journalist to La Gazette Mag de l’océan indien and This Week News Mauritius.
Retired, former meteorological cadre, trade unionist and OSH consultant, Amanoola has written for in-house union and other journals, publications and magazines. He runs two blogs since 2007: “Alfa King Memories”, and “Le Journal d’Alfa King”. When he is not reading or writing, he is on a 10+ km daily hike in anticipation of his monthly trails.
Amanoola may be reached at [email protected].