On June 1, 2023, Evan Parker woke up feeling uneasy and with a slight headache. He brushed it off and went to work at an agricultural retail firm in Lafayette, LA. However, when he arrived, his boss noticed that his face was drooping, a telltale symptom of a stroke. Parker dismissed her concern, but his boss persisted and called an ambulance for him. The time from his onset of symptoms to the arrival at the hospital was only one hour, but it made a pivotal difference.
According to research published by the American Heart Association, intracerebral hemorrhage (ICH) stroke is on the rise. A study over 15 years found an overall increase of 11% nationwide, with a 38% increase in the 18 to 44 age group. Yet nearly 30% of U.S. adults younger than 45 are unaware of common stroke symptoms, according to a survey from the association.
“We are seeing a larger incidence of stroke in younger persons,” said Sheryl Martin-Schild, MD, stroke medical director for the Louisiana Emergency Response Network. “We think that it’s at least in part due to younger age at development of risk factors for stroke specifically: high blood pressure, high cholesterol, obesity, smoking. And those things over time can lead to stroke long before the usual age.”
There are two types of stroke: ischemic stroke – blockage or blood clots in the blood vessels to the brain, or hemorrhagic stroke – an artery leak or rupture in the brain.
To raise awareness about stroke symptoms and improve early detection, Intermountain Healthcare in Utah built on the American Stroke Association’s FAST model to create the acronym BE-FAST: Balance, Eye, Face, Arm, Speech, and Time for stroke symptoms and awareness:
B: Balance – sudden dizziness or loss of balance or coordination
E: Eyes – sudden trouble seeing in one or both eyes
F: Face – sudden weakness of the face (Does one side of your face droop?)
A: Arm – weakness of an arm or leg
S: Speech – sudden difficulty speaking
T: Time – time the symptoms started.
“BE-FAST now captures those vulnerable symptoms that have been underrepresented in social media, like the sudden problem with balance and the sudden problem with eyesight,” Martin-Schild said. “It improves the sensitivity of that screening tool to about 95% instead of 89%.”
Martin-Schild specializes in neurology at both Touro and New Orleans East Hospital and said the three often misjudged signs of stroke are sudden problems with balance, sudden problems with eyesight, or a sudden, terrible headache.
A stroke can show itself as a visual disturbance, such as double vision caused by problems with eye muscles, an effect of nerve malfunction due to stroke.
“When I say that, I mean your ability to walk and stand and speak, and think, and have your cognition and memory,” said Meghan McKee, a physical therapist of 14 years living in North Carolina, who had a stroke at the age of 31 due to patent foramen ovale (PFO), a hole between the left and right upper chambers of the heart.
McKee informed her husband of the possibility of stroke and the signs of BE-FAST symptoms she read on StrokeAwareness.com. When she was watching a movie with her husband, she had difficulty reaching for a water bottle. Her left hand flapped the desk. McKee then grabbed the bottle with the right hand and choked on the water. Her husband noticed that her walk was strange when she got up and called 911.
“The faster you can get adequate treatment, the faster you can be on the road to recovery, and the better recovery you can have,” Parker said. “It’s important to live life prepared and not scared,” Martin-Schild said. “And being prepared means that you do everything within your power to lower your risk.”
Martin-Schild said early treatment and access to critical rehabilitation services result in good stroke recovery. However, she said disparities exist in patients’ access to both.
“We need more public health work and more resources devoted to that. That’s going to be where we have the biggest impact,” Leslie-Mazwi said. He recommended a diet minimizing salt and sugar intake, animal products, and avoiding smoking.
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