Workforce Wellness – Bon Secours

Get Stroke Smart

May is recognized as American Stroke Month to promote public awareness of stroke. Stroke is the number five cause of death in the United States, but it is the leading cause of disability in adults. Knowing the warning signs of stroke can alert you to seek emergent medical attention. The sooner treatment is initiated, the better the chances for recovery. Knowing one’s risk factors for stroke allows for modification of them to help reduce your chances of having a stroke. Our goal is to have our community be stroke smart and to BE FAST* if stroke symptoms occur.

Stroke Smart- Know your Risks
Risk factors for stroke are divided into those an individual can control and those he cannot. Those that cannot be controlled are age (higher risk with advancing age), gender (male higher risk than female), race (African-American higher risk), and family history of stroke. You should be aware of these risk factors but these are not able to be changed.
Risk factors that can be modified or controlled are:

• Smoking– Quitting smoking will reduce stroke risk by about half.
  Sedentary lifestyle- Get at least 30-45 minutes of aerobic exercise 3-5 times weekly.
• Hypertension– Keep your blood pressure under control. If you do not know your blood pressure (BP), get it checked. Purchase a home BP cuff and check your BP regularly and report your readings to your doctor. If you are prescribed medication for elevated blood pressure, take it every day.
• Cholesterol– Know your numbers and get them checked regularly. Aim for an LDL (bad cholesterol level) that is well under 100. If you are told you have “borderline high” cholesterol, speak with your doctor about how to address it. If you institute lifestyle changes to bring your LDL in line, make sure your numbers are re-checked to ensure you are achieving your goal. Many times, cholesterol levels are influenced by genetics/heredity, and no matter how much you change your lifestyle, your numbers won’t decrease. Again, if you are prescribed medication to lower your cholesterol, take it every day.
• Blood sugar– If you have diabetes, keep your blood sugar well controlled. Work with your doctor to determine the best medications and diet to keep blood sugars in as close to normal range as possible. Speak with a dietitian/nutritionist and learn the best foods to eat and the foods to avoid or to use sparingly. As with cholesterol, if you are told you are “borderline diabetic,” ask what that means and what you need to do halt or reverse the process.
• Diet– Eat a diet that is rich in fresh fruits and vegetables. Aim for at least 5-6 servings of fresh fruit and vegetables daily. Limit fried food and red meat. Aim to have more beans/legumes, whole grains, and fish/seafood. Limit added fats such as butter and oils. When you do use oils, use olive oil. Try to use “white foods” sparingly-white potatoes, pasta, white rice, white bread, etc. Try whole-wheat bread and pasta or multigrain breads. Substitute brown rice for white rice. You don’t have to eliminate white foods, but try to substitute healthier options as often as possible. Again, we all can benefit from the assistance of a dietitian or nutritionist to give us good tips and advice. Some of the local grocery stores (Martin’s) now have nutritionists on staff to discuss food options and this is provided as a service to customers.
• Alcohol consumption– A limit of two drinks daily for men and one for women is considered not harmful. Stick to appropriate portion sizes to measure this. Excessive alcohol can be harmful.
• Have regular checkups with your doctor– This goes for men as well as women. Many men avoid the doctor or just go when there is a problem. Many issues can be detected early and preventive care is the best course of action. If you do not have a primary doctor, get one-ask a friend or relative who they see and make an appointment. Ask the staff in your employee health and wellness center for recommendations. Call the physician referral line 804-359-WELL (9355) or visit www.goodhelpdocs.com for suggestions near your home or office. Regardless of how you get there, you need to see your personal physician for routine wellness examinations before you have a problem.
• Atrial Fibrillation– This is an abnormal heart rhythm where the chambers of the heart beat out of sync. Because of this, blood tends to pool in areas of the heart and a clot can form and be pumped from the heart into the blood vessels that supply the brain. This causes them to become obstructed, cutting off blood supply to an area of brain and hence causing a stroke. If you have atrial fibrillation, speak with your cardiologist about the appropriateness of taking a medicine to thin your blood to prevent clots from forming and thereby reducing your risk of stroke.

BE FAST to Recognize Stroke Symptoms
The acronym BE FAST is a good way to remember stroke symptoms. Stroke symptoms typically come on suddenly, without warning. Many people awaken with stroke symptoms after going to bed completely fine. NEVER ignore symptoms suspicious for stroke as there are treatments available but one has to get to the hospital as soon as the symptoms are recognized in order to be eligible for treatment. The sooner a stroke is treated, the better the potential outcomes. Also, waiting will make you ineligible for some treatments. Strokes typically do not cause pain and therefore people will tend to ignore the symptoms.

• B- Balance difficulty. Trouble walking, dizziness, or spinning of the room.
• E- Eye trouble. Difficulty with vision, double vision, losing vision in an eye, or losing vision for part of the world (i.e., cannot see the right side of the room, or cannot see all of the television or newspaper).
• F- Face. Drooping of a side of the face.
• A- Arm. Weakness or numbness of an arm, leg, or side of the body.
• S- Speech. Trouble speaking such as slurred speech, inability to say the appropriate word, or difficulty with understanding what people are saying or what you are reading.
• T- Time. Time is brain. If you suspect you or someone you are with is having a stroke, call 911 immediately and be taken to the nearest stroke center. Even if you live close to the hospital, stroke treatment begins with EMS. EMS will quickly identify a potential stroke in progress and call ahead to the hospital emergency department. This advanced warning allows the ED and other staff to be ready and waiting for you to expedite your treatment. The most effective treatment for stroke begins as soon as possible after symptoms are recognized. 1.9 million brain cells are lost every minute during a stroke. Tissue plasminogen activator (TPA) is a clot-busting drug that has been shown to improve the outcome in stroke patients when given within 3 hours of symptom onset. In some cases, it can be given up to 4.5 hours after symptom onset, but the earlier the better. This is why getting to a certified stroke center as soon as possible after symptoms are recognized is important. Additionally, in some cases, it is possible for our interventional radiologists and endovascular surgeons to pass a catheter into the blocked artery and evacuate the clot, restoring blood flow. There are times when patients get both TPA through the IV and endovascular treatment. All of our Bon Secours facilities are certified stroke centers and are capable of providing this rapid, state-of-the-art treatment for stroke.

By Stacey Epps, MD
Executive Medical Director, Bon Secours Neurosciences Institute
Bon Secours Neurology Clinic
11601 Ironbridge Rd., Ste, 207, Chester, VA 23831
804-285-6880
601 Watkins Centre Parkway, Ste. 250, Midlothian, VA 23114
804-325-8750