Dr. Carlye Reichert has seen the difference in outcomes when people receive prompt stroke care versus delayed treatment. As a physical medicine and rehabilitation physician, she works with individuals who have suffered a stroke.
Some people experiencing stroke come into the emergency department unable to move an arm or leg, Dr. Reichert says. After receiving swift treatment — ideally within three hours of symptom onset — they often regain control of the affected limb.
“It can be a pretty significant, dramatic improvement,” she says.
On the flipside, those who don’t receive immediate care can see a worse outcome and a more prolonged road to recovery.
For example, someone might begin to experience symptoms right before bed. Unsure what’s going on, they may go to sleep and then wake up in much worse shape, Dr Reichert says.
“That totally changes our treatment options,” she says. “If you’re having any stroke symptoms, it’s very important to get to care quickly.”
There are two main types of stroke: ischemic and hemorrhagic.
Ischemic strokes are more common and account for about 80% of strokes. They occur when the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients. Brain cells begin to die in minutes.
Ischemic strokes happen when a blood vessel in the brain becomes blocked. Blockages can stem for blood clots or buildups of fatty deposits and cholesterol.
A hemorrhagic stroke happens when a blood vessel in the brain bursts, spilling blood into nearby tissues. With a hemorrhagic stroke, pressure builds up in the nearby brain tissue. This causes even more damage and irritation.
People can also experience transient ischemic attacks (TIAs), sometimes called mini-strokes. TIAs cause stroke-like symptoms but don’t lead to permanent brain damage. They often last less than one hour, but can last up to 24 hours. About one-third of people will suffer a stroke within a year after a TIA.
Ischemic strokes, hemorrhagic strokes and TIAs are all emergencies, and you should seek immediate care.
Remember to ‘BE FAST’
The acronym BE FAST serves as a reminder of what to do if you suspect a stroke.
- B: Balance — loss of balance, headache or dizziness.
- E: Eyes — blurred vision.
- F: Face — facial drooping on one side. You can ask the person to smile to check for this.
- A: Arms — weakness in an arm — or leg. Ask the person to raise the affected limb, and see if it drifts down.
- S: Speech difficulty. Is the person slurring or difficult to understand?
- T: Time — now is the time to call 911. ‘T’ can also stand for terrible headache.
It’s important to call 911 versus trying to take the person to the hospital yourself, says Kristin Randall, manager of the stroke program for ThedaCare.
“EMS personnel are part of our chain of survival,” she says. “They’re there to help us determine when was the last time you were known well, any medications that we should know, and what family members or loved ones we can contact while they’re in route.”
Once the person arrives at the hospital, the medical team will be waiting, Randall says. A physician will come in and take a quick look to see what’s going on. A brain CT scan can then help determine the best treatment options.
ThedaCare Stroke Care
All seven ThedaCare hospitals have received stroke care accreditation from DNV GL – Healthcare. ThedaCare Regional Medical Center-Neenah is the region’s only Comprehensive Stroke Center. This accreditation demonstrates the highest level of competence for treatment of serious stroke events.
ThedaCare Regional Medical Center-Appleton is accredited as a Primary Stroke Center. This certification goes to hospitals that have the necessary staffing, infrastructure and programs to stabilize and treat most emergent stroke patients.
ThedaCare Critical Access Hospitals in Berlin, New London, Shawano, Waupaca and Wild Rose have all earned Acute Stroke Ready certifications. With this certification, smaller and rural hospitals must demonstrate excellence by complying with standards of care for the initial treatment of stroke patients, when rapid action and proper medications can save lives and limit the long-term disabling effects of strokes.
Lifestyle risk factors for stroke include:
- Being overweight or obese
- Sedentary lifestyle
- Heavy or binge drinking
- Cigarette smoking or secondhand smoke exposure
- Use of illegal drugs such as cocaine and methamphetamine
Medical risk factors include:
- High blood pressure
- High cholesterol
- Obstructive sleep apnea
- Cardiovascular disease, including heart failure, heart defects, heart infection or irregular heart rhythm, such as atrial fibrillation
- Personal or family history of stroke, heart attack or transient ischemic attack
- COVID-19 infection
Other factors associated with a higher risk of stroke include:
- Age — People age 55 or older have a higher risk of stroke than do younger people. However, anyone, at any age, can have a stroke.
- Race or ethnicity — African Americans and Hispanics have a higher risk of stroke than do people of other races or ethnicities.
- Sex — Men are at slightly higher risk for stroke than women. However, women are more likely than men to die of strokes.
- Hormones — Use of birth control pills or hormone therapies that include estrogen increases risk.
When it comes to risk factors, some are beyond your control, such as your family history, age, race and gender you were assigned, Dr. Reichert says. However, you can take steps to mitigate many risk factors.
Prevention steps include:
- Controlling high blood pressure
- Lowering the amount of cholesterol and saturated fat in your diet
- Abstaining from tobacco use
- Managing diabetes
- Maintaining a healthy weight
- Eating a diet rich in fruits and vegetables
- Exercising regularly
- Drinking alcohol in moderation, if at all
- Treating obstructive sleep apnea
- Avoiding illegal drugs
Dr. Reichert emphasizes the importance of staying on top of routine care to help you manage and track stroke risk factors.
“We see people come in with strokes due to high blood pressure, and they didn’t know they had high blood pressure because it has not been checked,” she says. “Going to your primary care provider and doing those checks every year can be really important in preventing strokes.”