Derek Burnett
Derek Burnett is a Contributing Writer at Bottom Line Personal, where he writes frequently on health and wellness. He is also a contributing editor with Reader’s Digest magazine.
If you’ve ever had a family member or friend who suffered a stroke, you’re likely familiar with the signs that a stroke can leave behind. Perhaps your loved one was left bedridden or in a wheelchair, unable to walk or use one half of their body. Perhaps their face had fallen on one side into a permanent droop. Maybe their cognitive functioning was never quite the same. Maybe they were newly prone to weeping or to fits of anger. Perhaps they fumbled trying to perform fine-motor tasks, had trouble seeing, spoke with great difficulty, or had difficulty sensing heat and cold.
Those all may be signs that someone has already lived through a stroke. But what were the earliest signs as the stroke was occurring? It’s a worthwhile question to ask, since delivering prompt medical intervention to a stroke victim is the best way of preventing long-term damage. Knowing the stroke warning signs will allow you to act with no delay.
If someone around you is having an episode that could be a stroke, remember the FAST acronym. FAST stands for Face, Arms, Speech, Time.
Face: Look closely at the person’s features. Is one side drooping? If it’s hard to tell, ask the person to smile, which will make any loss of control of the facial muscles more evident.
Arms: Ask the person to lift both arms over their head. Just as with the smiling test, this simple request should reveal whether the person has lost control over their limbs.
Speech: Think of a very basic sentence and ask the person to repeat it back to you. It can be as simple as noting something in your surroundings, such as, “The clouds in the sky are very white,” or, “There’s a lot of traffic on the road today.” Listen to their attempt to respond, both in terms of the words they say and how the words come out sounding. Someone who has had a stroke may not be able to say back such a sentence at all. They may leave out some words. Or their words might come out in an odd cadence or be noticeably slurred.
Time: The “time” element is added onto the end of this mnemonic to remind you how urgent the situation is if the patient has “failed” one or more of these three simple tests. Even if the symptoms appeared briefly and then disappeared, you must call 911 to get the patient to a hospital immediately. Every 30 minutes of delay are associated with a 10% decrease in the probability of a good recovery. Stroke experts speak of “door-to-needle time,” which refers to how much time has passed between the patient entering the hospital and the administration of “clot-busting” medications through an IV. Door-to-needle times of over an hour are associated with significantly higher death rates.
As noted, you may detect early stroke signs beyond the classic symptoms included in FAST. This is especially true when the patient is a woman.
People who have survived strokes sometimes describe highly idiosyncratic and even quirky symptoms. Many describe the experience as surreal, confusing, even otherworldly. Some report feeling like passive observers of their own situation, powerless to act. Some feel drunk, elated, silly, while others are terrified by what’s happening to them. Some wake up to the feeling that a newly paralyzed limb belongs to someone else. Some have such intense vertigo that they clutch their bedsheets because it feels like they will otherwise spin off onto the floor. Still others see double, feel like their heads are being beaten with baseball bats, feel their tongues thicken in their mouths. Some have an irresistible urge to lie down and sleep rather than going to a hospital. Others have the sensation that their limbs are made of concrete.
Such an array of possible sensations and experiences is impossible to memorize or to pin down as positive proof of a stroke. Still, it’s helpful to know that such additional symptoms may be further evidence, beyond FAST, that you are witnessing a stroke.
Non-FAST stroke signs can include any of the following…
However, that doesn’t mean there’s time to dither. As soon as you have detected these signs in yourself or another person, it’s time to call 911. No one who has had a stroke should drive, and an ambulance ride is preferable to having a friend or loved one take you to the hospital, since the EMTs know best where to take you and may begin life-saving treatments en route.
Note, too, that balance issues alone should not necessarily be taken as evidence of a stroke in older patients, who are susceptible to balance problems due to their age or, often, medications they’re taking. However, a sudden onset of balance problems accompanied by another possible stroke symptom, such as weakness on one side of the body or impaired vision, is reasonable cause for alarm.
While age is definitely a risk factor for stroke, the truth is no one is completely safe from experiencing a cerebrovascular event. When a stroke hits, every second counts, with brain cells dying at a rate of nearly 2 million per minute. If the patient receives emergency care in time, long-term damage may be stopped or prevented. That’s why it’s so critical to recognize the signs of stroke, in yourself or in someone else.
In recent decades, there has been growing awareness that men and women are likely to experience strokes quite differently. Signs of stroke in men tend to be those “classic” indicators in the FAST acronym. Signs of stroke in women tend to be on the less distinctive, broader list above. Too often, women’s strokes go untreated because their symptoms do not match the classic signs and are written off as something other than stroke. When in doubt, act as if a stroke has occurred.
Certainly nobody wants to have a stroke. But if you’ve already had one, you probably know that you’re in a very high-risk category. Or perhaps you haven’t yet had a stroke but your doctors have told you that the odds are high that you will. Obviously, you can’t predict when a stroke will hit, but you can make a few simple preparations so that if it does occur, you can give yourself the best chance of getting to a hospital in time to minimize the damage.
One such preparation you can make is to speak with your close loved ones or the people you spend the most time around and explain to them what could happen. Make sure they understand the signs of stroke. Share with them your doctor’s phone number, and post it prominently in your home, along with that of an emergency contact. Impress upon them the importance of calling 911 in case of emergency rather than attempting to drive you to the ER.
Besides your short list of important phone numbers, keep a current inventory of all your prescriptions, as well as a brief medical history so that you, the paramedics, or whoever is helping you can bring them to the hospital to share with the physicians caring for you. Good advance preparation can help your recovery!
