by VEJAY STEEDE
A stroke is a life changing event. An event that, if you’re fortunate enough to recover from, you will always carry with you. For many, a stroke is fatal, indeed it is the second leading cause of death in Bermuda between 2009 and 2019 (Institute for Health Metrics and Evaluation, cited on www.healthdata.org).
Many of us still don’t really know much about stroke, however, choosing to focus on more “sensational” afflictions like heart disease, cancer, and diabetes. While those are serious conditions, and life-changers in their own right, they have no real claim to be more dangerous than stroke.
The National Health Service (NHS) in the United Kingdom describes stroke as: “A … serious life-threatening medical condition that happens when the blood supply to part of the brain is cut off.”
The NHS continues: “There are 2 main causes of strokes: ischaemic – where the blood supply is stopped because of a blood clot, accounting for 85% of all cases; and haemorrhagic – where a weakened blood vessel supplying the brain bursts.”
This hurts to think about, to be fair, and just writing this gives me a dull pain in the side of my head. This is, of course, a psychosomatic phenomenon, but would I really know the difference? Well I did some research, asked some questions, and found quite a bit of information about stroke that really should be general knowledge for all; read on if you want to avoid the life changes, and challenges, that come with having (and surviving) a stroke.
Response time is critical for surviving a stroke, so the sooner a patient receives treatment for a stroke, the better chance they have of making it through without massive life-altering damage to the brain. This, then, makes knowing the symptoms of stroke vital; vital enough to be taught in schools as a regular part of the health curriculum I’d say!
The NHS provides a description of stroke symptoms: “The main symptoms of stroke can be remembered with the word FAST:
• FACE – the face may have dropped on 1 side, the person may not be able to smile, or their mouth or eye may have dropped.
• ARMS – the person with suspected stroke may not be able to lift both arms and keep them there because of weakness or numbness in 1 arm.
• SPEECH – their speech may be slurred or garbled, or the person may not be able to talk at all despite appearing to be awake; they may also have problems understanding what you’re saying to them.
• TIME – it’s time to dial 999 [911 in Bermuda] immediately if you see any of these signs or symptoms.”
The Bermuda Hospitals Board (BHB) adds the word “BE” to the acronym, making the phrase to remember when identifying stroke symptoms, a very apropos, “BE FAST.”
The BHB’s Primary Stroke Center literature is saturated with the “BE FAST” mantra, wherein B stands for Balance, and E stands for Eyes. Loss of balance, headache, or dizziness is an initial sign of stroke, and may be accompanied by blurred vision and/or any of the symptoms described in the Face, Arms, or Speech sections above.
The most crucial letter, of course, is T, as time is of the essence if any of these symptoms are noticed in yourself or someone you love; call an ambulance post haste! The American Heart Association reminds us that, “It’s very important to take immediate action. If given within 3 to 4.5 hours of the start of symptoms, a clot-busting drug may improve the chances of getting better faster.”
Prevention, as is often the case, is also very important. Although there’s nothing specific that one can do to avoid a stroke, such is the sudden and unpredictable nature of the affliction, there are some things all of us can do to lessen our risk of stroke.
Clean living is always a good idea; cutting out alcohol, tobacco, and ingesting moderate amounts of salt, sugar, and cholesterol will go a long way toward reducing your risk of stroke. Regular exercise will provide a heaping helping of stroke prevention as well, along with ensuring that conditions like hypertension, high cholesterol, and diabetes are kept in check. It’s also important to lessen stress in your life; stress is the silent killer!
Stroke survivor and founder of the Bermuda Stroke and Family Support Association (BSFSA), Mr Mark Selley speaks to the importance of having regular bloodwork done once you turn thirty as a vital part of stroke prevention:
“Get to the doctor in your early thirties to get a base rate on how everything is working. Stroke has all to do with blood, so it’s important to be cognizant of that and get your blood checked early and often so that your doctor has prior knowledge of what is going on. Annual physicals should start at 30 as far as stroke is concerned. The longer you have this relationship with your doctors, the better chance you have of getting through a stroke.”
Mr Selley is the current Chairman of the BSFSA, which has helped over 10,000 patients during a period of roughly 30 years, and needs to be supported urgently during these tough financial times. Mr Selley is passionate about public education on stroke, and the association has always done a super job getting literature to the public, but more needs to be done.
Mr Selley ponders some numbers and reflects on some frustrations that he has had to deal with over the years: “Bermuda averages 6-7 strokes a week with a 40-55% recovery rate, and we need to maintain a helping organization for victims. Our team is limited, but we offer counselling, home visits, and evaluation for referrals to Mass General Hospital in Boston for overseas rehabilitation.
“Rehab in Bermuda is inadequate and local insurance companies don’t take stroke as seriously as they should; they think that stroke recovery is like a spa treatment, but it’s far from that! Stroke recovery can be a very grueling, onerous affair that often involves relearning how to do basic bodily functions like walking, eating, and standing. Everyday life skills and body functions are all compromised with a stroke, and many things will never fully recover without proper treatment and effort.”
Mr Selley is the only non-medical person who has the authority to refer patients to Mass General Hospital in Boston, which speaks directly to his experience and expertise on the topic, as well as his standing in the stroke treatment community.
Mr Selley closes by outlining the grim reality for stroke victims in Bermuda and beyond: “One third of victims will die, another third will recover fully, the last third will be dependent upon help from outside sources. Recovery depends on you! You must do the work assigned in rehab or you will never recover fully.”
The NHS echoes Mr Selley’s assertions when it comes to recovery: “People who survive a stroke are often left with long-term problems caused by injury to their brain.
“Some people need a long period of rehabilitation before they can recover their former independence, while many never fully recover and need ongoing support after their stroke.”
The recently formed Primary Stroke Center at the King Edward Memorial Hospital is a step forward for stroke prevention and treatment in Bermuda, but public education on stroke needs to improve. This is a serious, incapacitating affliction, and the more you know, the better prepared you’ll be if you’re struck with sudden dizziness and blurred vision.