In Case of Stroke, Timing is everything
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When I was a Naples emergency room doctor, stroke was sometimes one of my favorite issues to deal with, in a way...as long as I was treating the patient within 3.5 hours or so of the onset of symptoms.
In those cases, many stroke victims -- not all, alas -- can be helped with a drug that aids in dissolving blood clots in the brain. I've seen remarkable outcomes, including recovery from paralysis on one side of the body.
The take-home message is plain: if you have or can see the warning signs of stroke, don't second-guess them or take a nap, hoping to feel better. Get to an emergency room as fast as possible.
The CDC's summary of those symptoms is useful: Sudden numbness or weakness in the face, arm, or leg, especially on one side of the body. Sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden trouble walking, dizziness, loss of balance, or lack of coordination. We might be tempted to downplay them, and just wait it out. Don't.
Four out of five strokes are "ischemic" -- caused by the narrowing of brain arteries, or by clots that block blood flow to the brain. They are often preceded by a “warning stroke” or “mini-stroke” that shows similar symptoms but typically lasts less than five minutes and does not injure the brain.
This may occur as early as seven days before an attack, and also requires "urgent treatment to prevent serious damage to the brain," according to a study in the medical journal Neurology. Timing is critical here, too: "....the most effective treatments should be initiated within hours...in order to prevent a major attack,” that study found.
But my favorite stroke, of course, is no stroke at all. The data show that for obvious demographic reasons, around Naples strokes are more common than across Florida as a whole, whose rate is also higher than the U.S. average. A happier data set is that you can improve your odds of avoiding all that. Take as many steps as you can now, away from a possible future stroke, by working closely with your family doctor.
At WellcomeMD here in Naples, we're coaching patients through those important preventive steps. They aren't mysterious, but they're easier to achieve with attentive help from your family physician. Monitoring and reining in cholesterol, blood pressure, and alcohol use. Prescribing medicines as appropriate, but also working on an all-important and achievable program of heart-healthy foods and fun exercise.
Dr. Diana Macian is board certified in Emergency Medicine and has treated a wide range of medical issues, from a bad cough to cardiac arrest and stroke. Before joining WellcomeMD, Dr. Macian worked in the Emergency Department at Naples Community Hospital on the frontline throughout the COVID-19 pandemic.
She attended medical school at the Uniformed Services University of Health Science and completed her residency at the Portsmouth Naval Medical Center. While serving throughout the Iraq and Afghanistan conflict, she developed a passion for veterans’ healthcare issues and providing outstanding medical services to those who have served our country.
