You’re Having a Stroke: The Warning Signs
It was a phone call I wish I hadn’t received. A woman, whom I did not know, said she was a nurse and had accompanied my brother Richard to a hospital emergency room in St. Louis. He was currently being evaluated by the E.R. staff with a CT scan. She sounded very anxious and stated she had to be very “forceful” with the E.R. admission staff when a clerk told my brother to take a seat. “I’m an ICU registered nurse (RN) at this hospital and Richard is having a stroke.” “No, he will not take a seat.” “Get him into the treatment area NOW and call one of the doctors to see him immediately.”
We spoke for a few more minutes and she said “are you coming?” I said “of course” and I hung up and went online to American Airlines to purchase a ticket on the next flight from DFW to St. Louis.
My brother had been attending a party and was speaking with a small group of friends when he began slurring a few words. Our heroine RN immediately noticed and asked my brother if he felt funny. He stated he felt a little “woozey,” and the right side of his face was a little numb. Then she noticed a slight facial weakness and said to everyone and to my brother, “Richard, I think you are having a stroke. We need to go to the hospital now. No arguing.”
We should all be so lucky to have an experienced nurse at our side when an incident like this happens. Immediate intervention by an experienced “stroke team” in an acute care hospital for an impending cerebral vascular accident (CVA) is now as important as immediate intervention by a cardiologist and the “cardiac team” for a heart attack or myocardial infarction. In fact, the time window to intervene with anti-thrombotic therapy tPA or (clot busters) is much shorter to prevent permanent damage from a stroke (CVA) than the time interval needed to prevent lasting damage from a heart attack (Myocardial infarction). If the diagnosis of a CVA can be made quickly and the “clot buster” (tPA) therapy can be given in less than 180 minutes (three hours) the residual neurological damages can be significantly lessened. In fact, 90 minutes to diagnose and treatment with tPA is better than 180 minutes. Immediate recognition of an impending CVA is absolutely necessary for any chance to lessen the devastating effects from a stroke.
Here is a list of the most common signs and symptoms to know if you or a loved one is having an impending stroke event.
- Weakness, usually one-sided in the face, arm or leg
- Numbness on one side of the face or body
- Slurred speech or difficulty understanding someone’s speech
- Aphasia or inability to speak coherently and clearly
- Transient loss of vision either one eye or both eyes
- Double vision
- Acute confusion usually with other symptoms
By the time I arrived at the hospital, my brother had undergone a negative CT scan in the E.R., which had ruled out an acute intracranial bleed. He had been diagnosed with small infarct on the MRI and uncontrolled, high blood pressure. His symptoms had resolved with treatment and his blood pressure was slowly coming under control. Since I identified myself as Richard’s brother and a physician I was allowed into the ICU at 3 a.m. and was able to speak with my brother. He was grumbling that he felt fine and didn’t understand why everyone had rushed around to take care of his little episode and “what was I doing there?” Needless to say I didn’t say much except that he owed his nurse friend “big time.”
Ten years later my brother remains in excellent health with no further symptoms. He now appreciates and knows every warning sign of a stroke.
Learn the signs of an impending stroke. There may not be a trained medical person with you. The time interval for intervention to prevent permanent damage is short! Your life and the quality of your life or a loved one’s depends on knowing when a stroke or transient ischemic attack is occurring. Time to diagnosis and treatment can make an enormous difference in remaining normal or suffering serious neurological damage. The time to intervene is a short 90 to 180 minutes for best results. Don’t wait around to see if you get better. Your life or the quality of your life depends on immediate action.
By: Dr. Michael Stoltz