Yesterday I went to an 80th birthday party for a friend at her board and care or 6-bed care facility. My friend had a stroke when she was 71 years old. Sadly, she was too young and healthy to have considered having a pendant designed to notify others if you fall, and it was before the wide use of Apple Watches by seniors. She only remembers getting ready to have her usual bagel for breakfast and starting to walk to the couch to sit down. Normally she would have eaten at her breakfast bar but remembered not feeling well that day and deciding on the couch. That was her last memory for a long time.
She lived alone in her home with her much-loved St. Bernard dog. Luckily, she was a very regular volunteer at the shop run by a local nonprofit. When she did not arrive for her usual shift and did not answer her phone, another volunteer went to her home. She was found on the floor and taken by ambulance to the hospital. Two days had passed before she got medical treatment, and this delay unfortunately played a critical role in her recovery. Her diagnosis was stroke. Since then I have several friends who have had strokes, but they got to the hospital in time to take advantage of treatments to mitigate lasting physical issues from their strokes.
Heart attacks and strokes have been by far the most common medical issues in my family for decades. After being diagnosed with Atrial Fibrillation in 2023, I have tried to learn all I could about stokes, their prevention, and their treatment.
The following are facts about strokes as of the May 2023 CDC records, some of which surprised me:
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- In 2021, 1 in 6 deaths from cardiovascular disease was due to stroke.
- Every 40 seconds, someone in the US has a stroke. Every 3 minutes and 14 seconds, someone dies of stroke.
- Every year more than 795,000 people in the US have a stroke. About 610,000 of these are first or new strokes.
- About 185,000 strokes – nearly 1 in 4 – are in people who have had a previous stroke.
- About 87% of all strokes are ischemic strokes, in which blood flow to the brain is blocked.
- Stroke-related costs in the US came to nearly $56.5 billion between 2018 and 2019. This includes the cost of health care services, medicines to treat stroke, and missed days of work.
- Stroke is a leading cause of serious long-term disability. Stroke reduces mobility in more than half of stroke survivors age 65 and over.
- Risk of having a first stroke is nearly twice as high for non-Hispanic Black adults as for White adults.
- Black adults and Pacific Islander adults have the highest rates of death due to stroke.
- The death rate for stroke increased from 38.8 per 100,000 in 2020 to 41.1 per 100,000 in 2021.
- Stroke risk increases with age but strokes can and do occur at any age.
- In 2014 38% of people hospitalized for stroke were less than 65 years old.
The leading causes of stroke in the US are high blood pressure, high cholesterol, smoking, obesity and diabetes. One in 3 US adults has at least one of these conditions. Many strokes could be prevented by healthy lifestyle changes and working with your health care team to control conditions that raise your risk for stroke. The CDC makes the following suggestions to avoid strokes:
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- Choose healthy foods and drinks.
- Keep a healthy weight.
- Get regular physical activity.
- Don’t smoke.
- Limit alcohol. Men should have no more than 2 drinks a day and women no more than 1.
- Control your medical conditions. If you have heart disease, high cholesterol, high blood pressure, or diabetes you can take steps to lower your stroke risk.
- Check cholesterol at least every 5 years. If it is high, medicine and diet can lower your stroke risk.
- Control blood pressure. High blood pressure has no symptoms so it should be checked regularly. Medications and lifestyle/diet changes, like lowering sodium, can lower your stroke risk.
- Control Diabetes. Be tested if you or your doctor suspect diabetes and discuss treatment options.
- Treat heart disease. If you have cardiac conditions, such as coronary artery disease or atrial fibrillation (irregular heartbeat), your doctor may recommend medical/drug treatment or surgery.
- Take your medications. If you take medicine to treat heart disease, high cholesterol, high blood pressure or diabetes, it is very important that you follow your doctor’s instructions carefully. Never stop taking these medications without first talking to your doctor.
It is critical to be aware of your risk level for stroke and the signs and symptoms of stroke so you can take quick action that may save a life and maybe your own. The CDC lists the following as stroke signs that require calling 911 immediately.
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- Numbness or weakness in the face, arm or leg.
- Confusion or trouble speaking of understanding speech.
- Trouble seeing in one of both of your eyes.
- Trouble walking, dizziness or problems with balance.
- Severe headache with no known cause.
The stroke treatments that work best are available only if the stroke is recognized and diagnosed within 3 hours of the first symptoms. Stroke patients, like my friend, may not be eligible for these if they don’t arrive at the hospital in time.
If you think someone may be having a stroke, act F.A.S.T. and do the following:
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- F-Face: Ask the person to smile. Does one side of the face droop?
- A-Arms: Ask the person to raise both arms. Does one arm drift downward?
- S-Speech: Ask the person to repeat a simple phrase. Is the speech slurred or strange?
- T-Time: If you see any of these signs, call 911 immediately.
Note the time when the symptoms first appear, which will help the health care providers determine the best treatment for each person. Do not drive yourself to the hospital, let someone else drive you, or drive someone else. The ambulance personnel can begin life-saving treatment on the way to the hospital.
I hope that I never have to recall and use the FAST steps for myself or another, but I know that each moment a stroke goes untreated, the nervous tissue in the brain is rapidly and irreversibly damaged. After watching a friend deal with the life-changing effects of a stroke where medical care was delayed, I realize that recognizing signs of a stroke in yourself or others and immediately calling 911 can save or change a life forever.