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Know the signs: Recognize stroke and save brain function

Kendra Riley, center, with members of the SNMH Neuro Rehabilitation team that helped her recovery after a stroke: Josh Soria, Physician Therapist and Michelle Sena.
Submitted photo |

FAST

FAST is an easy way to remember the sudden signs of stroke.

F - Face drooping - Does one side of the face droop or is it numb? Ask the person to smile. Is the person’s smile uneven?

A - Arm weakness - Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

S - Speech difficulty - Is speech slurred? Is the person unable to speak or hard to understand? Ask the person to repeat a simple sentence, like “The sky is blue.” Is the sentence repeated correctly?

T - Time to call 9-1-1 - If someone shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get the person to the hospital immediately. Check the time so you’ll know when the first symptoms appeared.

Every 40 seconds someone in the U.S. has a stroke.

In October 2014, at age 37, Kendra Riley didn’t think that could happen to her. While working as the nursing manager at Sierra Endoscopy, she experienced a minor headache, a “fuzzy halo” in her right eye and subtle weakness in her left arm and hand.

“In retrospect, right then and there I should have gone to the ER,” Riley recalled. “But I didn’t because my symptoms weren’t severe, and I was in the healthiest shape of my life.”



Riley didn’t feel she was at risk since she didn’t smoke, use drugs or drink heavily, and she ate healthy foods and worked out five times a week. So she went to bed that night, tossing and turning with a terrible headache.

“When I awoke the next morning to get something for the pain, I collapsed to the ground, paralyzed on my left side,” said Riley.




At that point she noted that all of the acute signs were there: one-sided weakness, facial droop, slurred speech. (See sidebar.) Riley was taken directly to the hospital.

“If you’re having a stroke, it’s critical that you get medical attention right away. Dialing 911 and getting immediate treatment may minimize the long-term effects of a stroke,” said Marie Daly, BSN, RN, Stroke Program and Readmissions Coordinator at Dignity Health Sierra Nevada Memorial Hospital (SNMH).

Stroke occurs when a blood vessel to the brain is either blocked by a clot (ischemic stroke) or ruptures (hemorrhagic stroke). When that happens, part of the brain stops getting the oxygen and nutrients it needs, and brain cells die.

In fact, nearly two million brain cells die each minute a stroke goes untreated, which is why it is essential to recognize the signs early, even in someone who may not appear to be at risk. Certain stroke risk factors are unavoidable, such as age, heredity, race or gender. (Women are more likely to die or suffer serious disability due to stroke than men.)

Other risk factors can be treated or controlled, such as high blood pressure, cigarette smoking, diabetes, atrial fibrillation, high cholesterol, poor diet and physical inactivity and obesity.

“The good news is that 80 percent of all strokes are preventable,” Daly said.

This was not the case for Riley. When she arrived at SNMH, doctors used the hospital’s telemedicine technology to enable a neurologist in Sacramento to examine her. The neurologist made the quick decision to have Riley flown by helicopter to Mercy San Juan Medical Center in Carmichael — the area’s only certified Comprehensive Stroke Center.

“They discovered that my stroke was the result of a right carotid artery dissection I had suffered, unbeknownst to me, when I injured myself at the gym about 10 days earlier. I had no symptoms of the dissection at all,” Riley said.

Riley wasn’t a candidate for the powerful clot-busting drug tPA (tissue plasminogen activator) because she waited too long to be treated. It’s most effective within the first few hours following the onset of stroke symptoms.

According to Daly, medical advances have greatly improved survival rates from stroke treatments during the last decade. But the chances of survival are even better if the stroke is identified and treated immediately.

Riley underwent months of treatment and therapy at SNMH Neuro Rehabilitation to regain mobility and be able to live independently after her initial paralysis. 

“It took me almost a year, but through hard work, patience, the tremendous support of friends and family and the expertise of my therapists at neuro rehab, I regained the ability to walk without assistance,” Riley said.

Less than one year after her stroke, thanks to the help and encouragement of physical therapist Josh Soria, Riley completed a half marathon.

“Because the stroke took so much away from me, I wanted to do something that I had never done before the stroke,” Riley said. “It was my way of choosing to be a survivor, rather than a victim.”

Now 38, Riley is still seeing physical, occupational and speech therapists. She returned to work in a modified role. Due to her physical limitations, she is no longer able to provide patient care.

“That broke my heart. The loss of my career in nursing was, to me, the biggest casualty of my stroke,” Riley said.

She is currently working to attain a master’s degree in counseling, to create a new career where she can continue to help people heal in a way her physical limitations will allow.

May is Stroke Awareness Month and Riley encourages everyone to take the opportunity to learn to recognize the early signs of stroke. “Pay attention to any unusual symptoms you are having and don’t be afraid to seek expert consultation. With a stroke, time is brain function!”

All physicians providing care for patients at SNMH are members of the medical staff and are independent practitioners, not employees of the hospital.


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