B.E.F.A.S.T. New Jersey, you can save someone having a Stroke
It's always important to know the signs, what to do when or if something happens, and how to prevent a Stroke if possible.
During Stroke Awareness Month in May, education and awareness take center stage and we all need to take a few moments out to learn more about a Stroke so we can do everything we can for our families, friends, and ourselves.
What are the early signs of a possible stroke?
Some of the early signs are things that you can clearly tell are wrong, while others may appear more subtle.
As a way of breaking down these early signs, Dr. Pinakin R. Jethwa, Neurosurgeon and Spine Surgeon, Director of Cerebrovascular Neurosurgery, at Jersey Shore University Medical Center Comprehensive Stroke Center, uses the acronym B.E.F.A.S.T.
"B stands for Balance -- any sudden problems with your balance or coordination or dizziness, E is Eyes -- so any problems with your vision or inability to move your eyes in one direction, F is Face -- if you see any weakness on one side of the face or drooping of one side of the face, A is Arm -- so if you see your arm, usually one or the other arm, having weakness, that would be a sign of a stroke, S is Speech -- that would be any difficulty either understanding or producing speech, and then T is Time -- which means that if you exhibit any of those symptoms, you need to call 911 and get to the hospital right away because this is possibly a stroke," Dr. Jethwa said. "If you don't get treatment, it could lead to really permanent damage for the patients."
If you or someone is experiencing the symptoms of a possible stroke, it's important to get to the hospital right away.
When these signs and symptoms present themselves, you'll want to get treatment at the hospital right away so the doctors can find out for sure what's going on and how to get you the help you need right then and there.
"It's a little bit different from a heart attack where there's a really severe chest pain symptom or something like that where people really can understand that 'hey, something feels wrong'," Dr. Jethwa said. "Oftentimes, patients who are having a stroke aren't necessarily cognizant of the fact that it's actually happening to them, so that's why it's really important if somebody notices -- whose with them -- some of these symptoms to think about 'hey, this could potentially be a stroke, we need to get this person to the hospital right away'. Sometimes the patient themselves will be cognizant of it, sometimes they may not."
How is someone with a stroke treated at the hospital?
There are a few things that need to take place right away to see what's going on and how severe it may in fact be for the individual.
"First thing we're doing, besides doing the basics -- vitals and lab work and things like that -- is getting a CT scan of the brain, that will determine, what are the etiology of the symptoms, meaning is it due to a hemorrhage in the brain which are causing the symptoms or is it due to lack of blood flow to a part of the brain," Dr. Jethwa said. "80-percent of the time, it's due to lack of blood flow if it's going to be a stroke, and 20-percent of the time it could be a hemorrhage in the brain."
Dr. Jethwa explains that the treatment for each cause is different.
"What we're typically looking for are patients who are having lack of blood flow to a certain part of the brain. We want to either get them medications or surgical treatments to restore blood flow to the brain," Dr. Jethwa said. "The primary goal of getting to a stroke center is to determine whether or not the patient is a candidate for typically something called TTA or, basically, a clot-busting medication and if they are, we want to get it to them within 3-hours, obviously the sooner you get it in the better but up to 3-hours is the time frame."
After getting tests or treatment, what do doctors need to see to know if the medicine is working and how well it is and how patients are responding to treatment?
For the obvious reasons mentioned, medication or other treatment methods need to happen right away.
It is the hope that they take immediate effect and that patients and doctors see signs of improvement.
"If it's going to work, meaning that it's a relatively small clot or the clot is able to break up with the medication, a lot of times it'll be miraculous, sometimes you'll see the patients kind of get better almost right away within several minutes of administering the medication," Dr. Jethwa said. "For the other patients who have very large clots or very dense clots where they're not going to break up with the medicines, then that's where they end up calling me to see if it's a patient for whom we can take to the operating room to actually grab the clot with a special device and remove it, either with a suction device or a special kind of stent that grabs the clot and we can extract it from the body thereby restoring the blood flow to the brain."
What is the road to recovery like following a stroke?
Strokes present themselves on multiple fronts with different levels of severity of symptoms, so the journey to recovering and healing could be different for everyone.
Dr. Jethwa explains that there are three different kinds of phases of care post-stroke.
"Number one is when the patient is at the hospital, you want to try and save as much brain as possible. Whenever there's a blockage, there's going to be some area of the brain that's damaged and it's kind of irreversibly damaged, you want to try and limit that area as small as possible by giving the clot-busting medication or doing the procedure to open up the blood vessels and restore blood to the area of the brain," Dr. Jethwa said.
For those types of patients, the recovery is relatively quick if it can be addressed right away and there's not as severe damage.
"For some patients, the next phase of care is what happens in the Intensive Care Unit in a hospital," Dr. Jethwa said. "In that, we want to make sure that we don't have any further issues that are going on like no hemorrhages after one of these procedures or the medication or something like that. We want to make sure that their blood pressure is stabilized, we want to make sure that we are watching to make sure there aren't any changes in them."
Recovery and Prevention are the Third Phases.
"That's understanding what are the underlying risk factors, patients who have high blood pressure, high cholesterol, diabetes, poor diets, lack of exercise -- those kinds of things. We want to fix those so that another stroke doesn't happen in the future," Dr. Jethwa said. "Then there's the recovery part of it which is if you have weakness on one side of the body -- physical therapy to improve that, occupational therapy to make sure they can understand that they can't do their activities of daily living the same way they used to, they may have to make some modifications, speech therapy to address what happened with their stroke."