Stroke Awareness and Action to Save Lives
Speaker 2: 00:07 Good day everyone. Hey, thanks for listening and tuning into the May edition of our best health podcast. We hope that everyone is enjoying the first part of spring and April showers or should I say January, February, March and April. Showers are gonna bring may flowers here to, to our area. And we're very excited to have a special guest with us. Miss Rayetta Johnson, who is a registered nurse and the stroke program manager here at Wake Forest Baptist health. Welcome Rayetta.
Speaker 1: 00:43 Welcome. Thank you very much. I'm so excited to be here. How's it going today? It's going great. It's a beautiful day here in Winston-Salem.
Speaker 2: 00:49 That's right. That's right. So we're gonna talk about a really important topic for May maze, you know, stroke awareness and prevention month. So we're going to dive into some key facts and information, bullet points about stroke awareness here in a minute. But before we do, just tell us a little bit about, about yourself. Are you, are you from around here or how'd you land at Wake Forest Baptist?
Speaker 1: 01:12 He came to North Carolina Baptist Hospital School of nursing from the western part of North Carolina in 1970. Wow. So I've been here ever since. So, you know, it just felt like the place to be, to learn and grow and be the best that you can be in your field. I've always been in neurosurgery and neurology. So presently I am working in the stroke center. We have a tremendous program. We offer the latest and greatest treatments for stroke. We're very involved with stroke prevention and as well as emergency treatments. We have one of the most dynamic treatments available now at Wake Forest Baptist where it's called a thrombectomy procedure that previously we've only been able to treat patients three to four and a half hours with a medicine called a clot buster. It's called TPA. But that treatment window has expanded up to 24 hours that we can help people. Now we can only help people like between that three and a four and a half hour window from onset of symptoms, but now we can treat people up to 24 hours, which is tremendous.
Speaker 2: 02:36 Yeah. Speaking of growing, and if you've been here since 1970, I can imagine you've seen not only physical growth but just the advances in technology over the last few decades. That's pretty incredible. So so we're gonna get into some of that here in a minute. Which is some of it's just really interesting and fascinating to learn about how far we've come in in stroke treatment. But let's just start kind of I guess at a baseline. You know, there's a wide range of people listening to our best health podcasts. And so just I guess talk about real quickly, what is a stroke? How Wa, how does a stroke affect our body? What happens in our body when we're having, when someone's having a stroke?
Speaker 1: 03:14 Okay. Justin, that's a great question. Actually. stroke affects the brain. It sometimes we call it a brain attack cause most people are familiar with heart attacks. Sure. And symptoms of a heart attack. So we like to compare a stroke as a brain attack and that it's an emergency. People need to realize they're having a stroke immediately and get the emergency room. So stroke is basically just a blockage of blood flow. There's a blood clot that gets trapped in a blood vessel and doesn't allow blood to flow anymore. So that can cause a stroke. 85% of strokes are caused by blood clots or blockage of the artery in the brain. Gotcha. The other 15% of strokes are caused by hemorrhage. Like someone might have a little weak spot in the vessel of their brain blood vessel and all of a sudden that that little weak spot will just kind of a rupture and you will have this massive hemorrhaging in your brain. So that's called a hemorrhagic stroke.
Speaker 2: 04:18 Okay. Gotcha. So in preparing for the podcast, I was interested to look at some of the statistics in our country for how prevalent stroke is. So if I'm not mistaken, it's the fifth leading cause of death in the United States. It is, it is. So you have, we have millions of people who suffer each,
Speaker 1: 04:38 We do about 800,000 people every year. 100,000. Yes. Yes. Suffer from a stroke. And it is like you said Justin, it's the fifth cause of death in United States, but is the first cause of disability. Gotcha. I say so stroke is more of a disabler if he will have been a killer kind of. Sure. so it causes people to be paralyzed, unable to speak possibly. And if they do not receive emergency treatments that we have available, then they may be, you know, totally disabled for the rest of their life. So that's why it's so important, especially now that we have all these great treatments available that we didn't use two years ago. For everyone to understand the basic symptoms of a stroke, to identify them, call nine one one immediately and get to the nearest emergency room.
Speaker 2: 05:29 Glad you brought that up. So that leads into a great acronym that we've been trying to get the word out about fast. Yes. Not talking about me and my my,
Speaker 1: 05:39 My 40 yard dash speed. It's an acronym
Speaker 2: 05:43 That we'll use here in, in the medical arena. So f a s t m is a great little nugget that people can remember. So walk us through what fast is and how people can, can remember that.
Speaker 1: 05:55 Okay, great. Justin. That's, that's right. That's so easy I think for people to remember. So in the fast acronym, F is for face. So you would, if you were talking to someone and they seemed to all of a sudden change, and you thought they might be having a stroke, you would ask them to smile, just ask them to smile and then one side of their mouth would not be able to go up into a smock. So they kind of a crooked smile. Gotcha. Okay. A is for arms. So you'd ask the person to raise their arms out and if they may be totally unable to raise the effected arm, so, or the weak arm would just kind of drift down, fall down. U and then s is for speech. You would ask the person to say a simple sentence like, it's a beautiful day in Winston Salem for instance.
Speaker 1: 06:47 And if their speech was affected by the stroke, their speech may be very garbled and mumbled and you couldn't even understand that person. Gotcha. Ah, and then t in fast is for time, meaning every minute counts when you're having a stroke. Actually 1.9 million brain cells die every minute after a stroke occurs. 1.9 million points per minute. Yes. Wow. That's a lot. So that t fast has been important the time. Exactly. Exactly. Justin. That's perfect. Yes. That's why it's so important that the person identifies they're having a stroke calls nine one one immediately. And then EMS has been trained. We have done a lot of classes with EMS in our region so they know how to start immediately treating that patient. They'll actually call us in route with the patient to the hospital. So we actually run down to the emergency room. We're waiting at the back door as soon as the patient arrives because we're also trying to save every minute.
Speaker 1: 07:50 So we're right there, you know, waiting for the patient will zap them quickly down the hallway to the CT scanner because that's the first diagnostic test you have to do for the stroke patient. Okay. That's good info. And then we, we want to basically rule out a bleeding hemorrhage. But if the hand, if the stroke is caused by a blood clot, which 85% of strokes are caused by blood clots. So the majority of strokes are of schemic or obstructive strokes. Okay. Then there's a lot we can do for it emergently for that, for that patient. So we can, like I mentioned, we can give the clot busting medicine within three to four and a half hours after onset of symptoms and then we can also now do the, a wonderful procedure called a thrombectomy. Yeah. You mentioned that earlier. So the
Speaker 2: 08:40 Talk a minute about the thrombectomy and just how really amazing that procedure is and kind of what happens and, and how quickly a patient can respond to a, a thrombectomy becoming
Speaker 1: 08:56 Successful. Okay. Sure. Yeah, that's great. I love to talk about that procedure because we've seen such amazing results with that. Yeah. So if we, if the patient gets here in time, of course, within that 24 hour time-frame and they, the patient has significant deficits, we'll call like paralysis on one side or inability to speak or inability to see. And then we do the CT scan like I mentioned, and it does show that the patient has a big obstruction in a, in a large blood vessel in the brain that we can do this procedure for. Then we'll immediately take them up to radiology where we do the procedure. It's not surgery, it's just X-ray, it's just radiology, it's especial radiology suite. So the patient just goes into that suite. Everybody, you know, we, we have a system where we call everybody, everybody's on call for this.
Speaker 1: 09:53 So like we have emergency recall. So everybody gets here very quickly. And so we're, we start immediately preparing and the patient will, will go into the suite, but they probably will not have anesthesia sometimes made, depending on the specific situation. But a lot of times we can just kind of give a little, a little, you know, relaxing medicine if you will. And then of course, just some numbing medicine. We'll just, just kind of put a little catheter into a blood vessel, either in the groin area, the femoral artery and the grow in, or now actually we're doing another procedure where we can just do a, an artery in the wrist, which is pretty amazing. Also, actually Dr Stacey Wolf, one of our, a neurosurgeon and neurovascular surgeons actually has started doing that procedure, which is really phenomenal to be able to do that procedure.
Speaker 1: 10:54 So you just thread the catheter up into the brain under fluoroscopy, this, this special dye that you could say you can, the surgeon can track the the catheter going through all the blood vessels all the way up to the brain. And then you can see where the blood vessel and the brain's totally blocked off. It's not allowing any blood any further than the blood clot. So the catheter just threads up through that little blood vessel. And then when it reaches the book clot, it will kind of emit a little wire cage, if you will, that totally envelops the blood clot. And then you just drag the blood clot. That's amazing. It is. It is totally amazing. And this patient, okay, so let's say I just remember a patient just yesterday, okay. That came in that had an occlusion or blockage of blood flow on the left side of their brain.
Speaker 1: 11:46 So they had right sided weakness and inability move the right arm. Their right leg also was unable to speak. Okay. Okay. So Dr. Wolf was able to grab a hold of that blood clot and drag it out. Like I said, renewed the blood supply to the brain. That person actually reached up with what was previously their paralyzed arm and like tapped her on the shoulder. I mean like, and right there in the room right there in the room. Right. So it's dramatic. It's dramatic results. It's pretty amazing. So, you know, if, if that patient had not recognized they were having a stroke and had not called nine one one immediately gotten to the march hearing very quickly you know, there may be the results wouldn't have not been so great, you know, but so it's, I can't impress the importance of everyone in the community recognizing the symptoms of stroke calling nine one immediately and getting to the emergency room that that is just major.
Speaker 2: 12:49 Yeah, that's a great story. Thanks for sharing. So we've talked about a couple of different pieces of our comprehensive stroke program here. We talked about the medicine, the medical part the surgical piece. But for some people who suffer a stroke they have to participate in rehabilitation. Yes. So would you mind talking just briefly about the stroke rehabilitation program that we have here at wake forest baptist and how patients can progress through that?
Speaker 1: 13:19 [Inaudible] Yeah, absolutely. So after the patient receives all the treatments we have available and that they are eligible for, and then they get, they kind of go through that, what we call the acute phase of a medical treatment after a stroke in the hospital. Then if they still have some difficulties with movement or, or speech problems or vision problems or you know, mobility issues if they have any deficits at all they may be a candidate to go to rehabilitation for a little while. So, and we have a wonderful rehab unit. It is called the stick center. Yes. And so patients may go over to our sticks center for rehabilitation where they get intensive therapies like physical therapy, occupational therapies, speech therapy. So, you know, it's a, it's a wonderful program to really help people continue to get better. So if they're not completely better then they can go to rehabilitation to continue to recover and get better and hopefully, you know, reach their maximum ability to to perform normal daily activities. Sure.
Speaker 2: 14:41 So our therapists over there work with them and follow them, kind of that the continuum of progression, right?
Speaker 1: 14:46 Yes, exactly. Exactly. They'll get three hours of therapy every, every day. Okay. Yes. So it's very intensive. Yeah. Therapy. It shows positive results. Yeah, it does. It does. It does. And I would just like to interject also, even after rehabilitation and the patient goes home, they can continue to recover though after a stroke. So that's real important, I think because we used to think that you didn't recover maybe a lot after just a few weeks or months after stroke, but you can actually continue to recover up to two years or even beyond that. So, I mean, that's wonderful. So that, that thing that gives all stroke patients hope you know that, okay, this is it. Oh, I'll never get any better, but you, you can get better after, after even a few weeks. So that's important piece, I think. Sure.
Speaker 2: 15:37 I did have another question too. And you know, our people they might just think that my risk for stroke is what it is. I'm born, it's genetically prone to have a stroke or I'm not. So I'm either gonna have a stroke or I'm not. So talk about who's at risk maybe for a minute. And then what things we can do some things that we as humans do to increase our risk sometimes. But then stuff like that we can do to reduce our risk of stroke. [inaudible]
Speaker 1: 16:08 Okay, that's great. I love that. Because I'm at at wake forest baptist, we also would truly just like to prevent strokes. You know, we just want to go out of business and not have any strokes happen. But so the number one cause of strokes is hypertension, high blood pressure, high blood, high blood pressure is the number one cause of strokes. So we absolutely encourage everyone to know their blood pressure right there, what their blood pressure is. And a lot of people really don't know that, what their blood pressure is. You know, maybe they don't go to the doctor. I've, I've heard that a time or two. Yeah. Right. So but it's really important to know what your blood pressure is. So, and now the American Heart Association says that our blood pressure should be around 120 top number one 20 over one of over 80.
Speaker 1: 17:01 So one 20 over 80 is our target blood pressure, if you will. It used to be just a few years ago, it used to be one 40 over 90, but they, the r word association kind of keeps creeping down. So so really the optimal blood pressure if you will, is around one 20, over 80. That's kind of our goal. But everyone's different. You have to look, you know, everyone individually. So the physician may not suggest that your best blood pressure, but just, you know, generally we'll, we'll go with what the heart association says that. Sure. You know, our goal is one 20 abrading
Speaker 2: 17:37 Sure. So what can we do to help keep our blood pressure in check if that's the number one risk factor?
Speaker 1: 17:43 That's a great question. So we need number one to know what it is a, of course with, with this everything, it's, it's healthy living. If you will. So, okay. Healthy Diet, you know, low cholesterol, low fat diet, and also exercise. Like the heart association suggests that we exercise at least three times a week for 30 minutes a day. So that 30 minutes a day doesn't have to be all at one time. It could be, you know, 10 minutes of morning, 10 minutes at noon, 10 minutes in the evening, however you want to do it. But so that's, that's kind of the recommendation by the American Heart Association. 30 minutes a day. But, and, and probably I like to say that, you know, the cheapest, easiest exercise is just walking, you know, just walking, walk around the neighborhood, walk around your neighborhood, walk around the mall even, you know, if it's, if it's a rainy day or whatever but just walk, you know, you don't have to go to a special gym just to exercise. You can just walk. Basically. Other fun exercises are like swimming, dancing is even good exercise where you go. So, you know, make it fun. I think it's fun to mix it up. Zumba yeah, do a little Zumba. Yeah.
Speaker 2: 18:58 Well that's good. That's good. Information for helping keep our blood pressure in check and probably the disclaimer too, of no smoking.
Speaker 1: 19:07 Yes, absolutely. Yeah, absolutely. Good, good suggestion. Yes. Yes. Because smoking is one of the risks for, for having a stroke, you know, smoking, excessive alcohol use illicit drug use. We see some young people come in that have been utilizing, you know Meth, say for incense or cocaine or some of the, you know, street drugs, I guess you would call them out there. And, and they can have massive hemorrhagic strokes that other kind of strikes that we didn't talk about a lot yet, but the hemorrhaging kind of stroke. Gotcha. So and that's, that's really devastating because those people can be very, very sick and, and sometimes do not be cover. Well, sure. So, sure. So staying as healthy as you can. That's right. Say, yeah, healthy. You know, everything in moderation, if you will. I think, you know, a moderation in eating and drinking and and also exercising and not sitting on the couch and watching TV all day is, is not good for us. You know, we need to stay active.
Speaker 2: 20:18 Now. The gems have all the flat screens at the gym. We can watch TV even we're on the treadmill or on the elliptical.
Speaker 1: 20:24 Oh, that's great. Justin. Yeah. You so I guess you can watch TV then, but, but just so you're moving right.
Speaker 2: 20:29 I've seen them at the gym. I guess I need to use them. Okay,
Speaker 1: 20:34 Good suggestion.
Speaker 2: 20:35 So we just got a couple minutes left. We actually have a neat tool on our websites. On the best health website. If people go to best excuse me, wakehealth.edu/besthealth. They can take the stroke risk assessment and that's just a quick quick quiz if you will. Just takes a few minutes, about five minutes to complete. And that can give someone a, just some initial baseline information about whether maybe they should, they should seek some additional consultation from their primary care physician or another physician. They can always call seven, one six week if they're you know, want to know their numbers or think they might be at risk for stroke. So I just want to throw that plug in there for our stroke risk assessment because it's a great tool for people just to initially find out where they might lie on, on the, on the, on the field of, of risk or not. So just real quick, I did want to mention so we have a lot of really hardworking providers like yourself that are out helping take care of patients. And this past year we were actually ranked our, in neurology, neurosurgery. We were ranked by US News and World Report, is that correct?
Speaker 1: 21:53 That's correct. That's correct. We were you know, highly ranked in, in that report. So that's tremendous that that gives us Q days, if you will, for, for our great program that we do have. We have seven stroke neurologist. Okay. And also we have three neurosurgeon that are vascularly trained. We have three neurointerventionalists in our program. And then as well as our Rehab physicians specialists. So, sure. So we have a lot of great physicians. We have a lot of you know nurse practitioners, physician assistants are pretty comprehensive. It is, it is actually, we are a comprehensive stroke center, which, which is a huge deal. That means that we are the best of the best of stroke centers in the country. So, so that's really important. So we are, you know, joint commission certified comprehensive stroke center.
Speaker 2: 22:54 Yeah, that's, that's great. Thank you for pointing that out as well. So we're about to wrap up. I just wanna once again, thank everyone for listening to our may edition of the best health podcast and thank you ray ETA for joining us. So much good information. And may is stroke prevention month. So we do encourage everyone to check their numbers, know their blood pressure, and take the stroke risk assessment at wakehealth.edu/besthealth. And people can like I said earlier, seven one six week call and make an appointment. And we'd love to talk with you further. So hope y'all have a great, May I help you get outdoors and get a little bit of exercise and sunshine and we'll talk to you soon. This is Justin Gomez signing off from Wake Forest Baptist Health. Thanks for listening to this episode of the [inaudible], the
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