Joshua Anderson/USA TODAY
Joshua Anderson/USA TODAY
When Donna Arnett, current president of the American Heart Association and the American Stroke Association, was just 27 years old, she suffered a stroke.
“I got up in the morning and went to let my dog out, and when I called him back in, the words came out babbly. My speech was strange. I felt fuzzy. I got ready and drove myself to work, and the symptoms kept piling up,” says Arnett, now 54.
At the time she was a nurse and worked for a cardiologist, and she told him she thought she was having a stroke. She started drooling, her speech got more garbled, her left arm became weak, then her left leg got weak. Her mother came and picked her up and took her to the emergency room. “By the time I got to the ER, I couldn’t speak anymore,” Arnett says.
“It was really terrifying being a health professional and knowing this was a stroke.”
Every year, more than 795,000 people in the United States have a stroke, according to statistics from the Centers for Disease Control and Prevention.
A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts (or ruptures), the American Stroke Association says. When that happens, part of the brain cannot get the blood and oxygen it needs, so it and brain cells die, the group says. Stroke is the No. 4 cause of death and a leading cause of disability in the United States, according to the association.
Arnett is talking about her experience now to promote a new initiative called “Together to End Stroke” from the heart and stroke associations to raise awareness that stroke is largely beatable and treatable. It helps people identify the signs of a stroke and encourages them to call 911.
Stroke patients who go to the hospital by ambulance are more likely to get there within three hours of the first symptoms, the critical time period for using clot-busting drugs and devices, says a study published last week in Circulation: Cardiovascular Quality and Outcomes, a heart association journal.
Researchers reviewed the medical records of more than 200,000 stroke patients arriving at emergency rooms. They found that one-third of patients didn’t call an ambulance but drove themselves or had a friend or family member take them there. Minorities and rural residents were less likely to call for emergency medical services at the first signs of a stroke.
If you go to the hospital by ambulance you arrive faster, are more promptly evaluated and are more rapidly treated, says the study’s lead author James Ekundayo, assistant professor of family and community medicine at Meharry Medical College in Nashville.
Jeffrey Saver, senior author of the study and director of the UCLA Comprehensive Stroke Center in Los Angeles, says there are several reasons people don’t call 911. “The stroke itself may make them lose the ability to make the call. They may lose language control, motor control or the ability to recognize what is happening to them.” That’s why it’s important for family members, friends and co-workers to recognize the symptoms and call for help, he says.
Another reason is people may think the symptoms will go away, Saver said. “There is denial. They think if they sleep on it, it will be gone when they wake up. That’s the worst thing they can do because it’s a time-urgent condition where immediate treatment makes all the difference.”
A third reason is financial concerns, he says. “Any stroke symptom is a very reasonable cause for activating the 911 system, and insurance plans will cover any ambulance transport that is done for a reasonable cause. For the uninsured, sometimes financial concerns make them hesitate. It’s unfortunate they have to gamble their brains and their lives.” He says it’s worth the cost of EMS to treat strokes quickly because “the cost of not getting the appropriate care quickly and having a bad outcome is far more than the cost of ambulance transport.”
Arnett, who is chairman of the department of epidemiology in the School of Public Health at the University of Alabama at Birmingham, points out the advantages of calling the ambulance:
The EMS team can do a neurological examination on the way to evaluate the severity of the stroke. Then they can alert the ER that a stroke patient is arriving so the hospital staff members are ready to evaluate and administer the necessary drugs and devices. “The sooner the treatments are administered the less the brain injury. Fortunately, our brain is able to recover and relearn.”
The EMS staff members can take the patient to a hospital that offers comprehensive care for stroke victims.
It’s safer for patients to get there by ambulance than to drive themselves.
Arnett says she had a stroke at such a young age because she has a genetic condition that increases her risk of blood clots, and she is deficient in a protein that breaks down clots. “When you have those two together, it’s really bad news for blood clotting.”
She now takes medication to prevent the formation of blood clots.
After her stroke 27 years ago, Arnett’s speech returned in about three days and the left-sided weakness resolved itself after about a week. Some things are “wiped clean from your memory,” she says. For instance, she had to relearn some work-related skills and how to use a calendar.
She understands how terrifying this experience can be. During the stroke, she says, “I was painfully alert and understood everything going on around me but had no ability to communicate. That part was very frightening and very lonely.”
The new Together to End Stroke campaign emphasizes the acronym F.A.S.T., which are ways to identify if a person is having a stroke:
Face drooping. Does one side of the face droop or is it numb? Ask the person to smile.
Arm weakness. Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
Speech difficulty. Is speech slurred, are they unable to speak or are they hard to understand? Ask the person to repeat a simple sentence like “The sky is blue.” Is the sentence repeated correctly?
Time to call 911. If a person shows any of these symptoms, even if the symptoms go away, call 911 and get them to the hospital immediately.
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