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Illness prevention and treatment

August 10, 2015

Would you know if you were having a stroke?

The first few hours after you have a stroke are crucial. Knowing the signs and acting fast could help save your life.

One morning last May, Olga Wiseman, a retired nurse living in Deer Lake, NL, woke to the sound of her phone ringing. She was too weak to get up to answer it, she was seeing double and felt almost semi-conscious. She thought it was low blood sugar, but she had a gut feeling something wasn't quite right. "I could pick up the phone, but I couldn't see the numbers to dial for help," she says.

Wiseman, 66 at the time, never thought for a second that it was a stroke. She was physically fit, a recreational swimmer and a daily walker. She wasn't overweight and she didn't smoke.

Fortunately, two of her sons phoned shortly after, and a third son recognized her symptoms as a clear indication of stroke and immediately called 911. Tests showed she had suffered a transient ischemic attack (TIA), or mini-stroke. Her doctor changed her blood pressure pills and prescribed a daily aspirin. In the end, she had no permanent damage, and her vision and speech returned to normal.

Wiseman's experience is a stark reminder that a stroke can happen to anyone, even if they don't fit the typical risk profile. And, as Wiseman discovered, time is of the essence when it comes to diagnosis and treatment.

What is a stroke and how is it treated?

A stroke occurs when the brain is starved of oxygen and nutrients by a clot, blockage or rupture of a cranial blood vessel, resulting in the death of the affected brain cells. If, like 80% of strokes, it's caused by a clot, it's called an ischemic stroke. (A mini-stroke is caused by a temporary clot.) If a blood vessel ruptures, it's a hemorrhagic stroke.

Statistics Canada estimates that strokes kill over 14,000 Canadians every year, making it the country's third-leading cause of death. Many more are left permanently disabled: 315,000 Canadians, not counting those in continuing care facilities, are living with the effects of a stroke, according to a report by the Public Health Agency of Canada.

When a stroke is caused by a blood clot, you must get to a hospital set up for emergency stroke care within 4.5 hours of onset to be eligible for clot-busting drugs. When administered within the first critical hours after a stroke, these drugs can significantly reduce brain damage.

"Time is brain," says Teresa Roncon, senior manager, communications, at the Heart and Stroke Foundation of Ontario. "The faster you get medical intervention, the more of the person you save. That's why it's so important to recognize the signs of a stroke as soon as they appear, and call 911 or your local emergency number for immediate medical assistance."

The 2015 Stroke Report also revealed that most Canadians don't recognize the signs of a stroke, or know what to do if one happens. Last year, the Heart and Stroke Foundation launched the FAST campaign to teach an acronym that could help save someone's life:

  • Face: Is it drooping?
  • Arms: Can you raise both over your head?
  • Speech: Is it slurred or jumbled?
  • Time: Call 911 right away

Quick action and early stroke treatment are crucial to recovery, yet many people still wait too long to seek medical attention, including calling an ambulance. According to the 2015 Stroke Report, 77% of Canadians said they would call 911 first if they thought someone was having a stroke. But only 59% of stroke patients arrive at the emergency department by ambulance, which is the best option (despite the cost, which varies from province to province, but can be covered by supplemental health insurance). The rest come by car.

People who suddenly experience the signs of stroke shouldn't wait to see a family doctor, they shouldn't try to "sleep it off' and they shouldn't drive themselves to the hospital. Paramedics are trained to assess and give intravenous medications to stroke patients within the "golden hour" during which treatments are most likely to help patients survive and avoid debilitating, long-term neurological damage. The paramedics can also let the emergency department know they are on their way with a suspected stroke patient, so treatment can start right on arrival at the hospital.

Risk factors for stroke

The more risk factors you have, the more likely you are to have a stroke. Some are treatable or controllable, such as high blood pressure and smoking, but others, such as family history, are not. They include:

  • High blood pressure and cholesterol
  • Atrial fibrillation (irregular heart rhythm)
  • Sedentary lifestyle
  • Diabetes
  • Smoking
  • Obesity
  • Excessive alcohol consumption
  • Stress
  • Personal or family history of stroke or TIA
  • Being a man over 45 or a woman over 55 or postmenopausal
  • First Nations, African or South Asian background

Women share many of the same risk factors for stroke as men, but their risk is also influenced by gender-related factors such as being pregnant or taking birth control pills or hormone replacement therapy.

Prevent a stroke before it strikes

You can reduce your stroke risk with a healthier lifestyle. Start reining in your risks today, before a stroke strikes, with these tips from the Heart and Stroke Foundation:

  1. Lower your blood pressure. High blood pressure is the biggest contributor to the risk of stroke. Monitor your blood pressure and, if it's elevated, have it treated.
  2. Eat a healthy diet. Fill your plate with lower-fat, higher-fibre food from each of the four food groups in Canada's Food Guide.
  3. Manage stress. Identify the source of your stress, talk to friends, family and your healthcare provider. Be sure to take time for yourself.
  4. Lose weight. Obesity and the complications linked to it (high blood pressure and diabetes) raise your odds of having a stroke. If you're overweight, losing as little as 10 pounds can have a real impact on your risk.
  5. Exercise more. Exercise contributes to losing weight and lowering blood pressure, but it also stands on its own as an independent stroke reducer.
  6. Limit alcohol. Women should have no more than two drinks a day, to a weekly maximum of 10; and men, no more than three drinks a day to a weekly maximum of 15.
  7. Treat atrial fibrillation. Atrial fibrillation is an irregular heartbeat that causes clots to form in the heart. Those clots can then travel to the brain and cause a stroke.
  8. Treat diabetes. High blood sugar over time increases the risk of high blood pressure, atherosclerosis (narrowing of the arteries), coronary artery disease and stroke.
  9. Quit smoking. Smoking increases blood pressure and accelerates clot formation by increasing the amount of plaque build-up in the arteries.

Assess your risks with the Heart and Stroke Foundation's Risk Assessment tool. Risks, signs, treatment – with stroke, knowledge is your best defence.

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