On the morning of June 1, 2023, Evan Parker woke up feeling uneasy. Despite experiencing a mild headache in the preceding days, their symptoms worsened that morning after having a cup of coffee around 9 am. Parker described the sensation as if “a wave had just washed over” them. While at work at a retail agricultural company in Lafayette, LA, Parker’s boss quickly noticed the signs of a stroke and urged them to seek medical attention. Parker, however, dismissed their concerns because they were only 27 years old and never knew anyone their age who had experienced a stroke. Nevertheless, Parker’s boss called an ambulance, which promptly took them to Rapids Regional Hospital. The quick action taken by everyone involved, from Parker’s boss to the hospital staff, was crucial to their recovery. However, Parker’s stroke highlights a concerning trend of an increased incidence of stroke in younger people. A report by the American Heart Association found that ischemic stroke, the blockage or blood clot in the blood vessels leading to the brain, has seen an overall increase of 11% across the United States in the last 15 years, with a 38% increase seen in the 18-44 age group. Shockingly, nearly 30% of American adults under 45 years old are unaware of common stroke symptoms, according to an association survey. Stoke symptoms can often go unnoticed, but it’s vital to know what to look for and act fast. There are two types of stroke, ischemic stroke and hemorrhagic stroke, and both require different treatments. To combat confusion in identifying stroke symptoms beyond the standard facial drooping and slurred speech, Leslie-Mazwi, a national volunteer expert for the American Stroke Association, recommends BE-FAST (Balance, Eye, Face, Arm, Speech, and Time) to improve the chances of identifying stroke symptoms by 95% from the previous 89%. Parker was fortunate to receive quick medical attention and has since recovered from their stroke. They now advocate for a healthy lifestyle, including maintaining low cholesterol levels and healthy blood pressure levels, to prevent future incidents. Surviving a stroke is also about timing – the faster one can receive the correct treatment, the better the chances of recovery. For example, Meghan McKee, a 14-year-old physical therapist living in North Carolina, noticed the BE-FAST symptoms when she suffered a stroke at 31 years old. She had a patent foramen ovale, a hole between the left and right upper chambers of the heart, and underwent surgery to close the hole after spending four days in the hospital. Surviving a stroke is about reducing risk factors, receiving early treatment and, most importantly, being fearless in living life while also being prepared.
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June 1, 2023 – The morning of his stroke, Evan Parker woke up feeling uncomfortable. He remembers that he was having a cup of coffee around 9 am. He had been experiencing a slight headache for the past few days, but now it was much worse. He felt that “a wave had just washed over him” and he went to get a glass of water.
When Parker arrived at work at a retail agricultural company in Lafayette, LA, her boss immediately noticed the telltale symptom of a stroke. “And she was like, ‘Oh my gosh, Evan, your face is falling off.'” Parker dismissed her concern. She was only 27 years old at the time and having a stroke was almost the last thing on her mind.
“I had no idea because I had never known anyone my age to have something like this happen to them,” Parker said. “Older people I’d known had strokes, it happened in their sleep and things like that. Many older people I had known had died as a result of that.”
But Parker’s boss insisted and called an ambulance for him. The time from symptom onset to hospital arrival was only 1 hour, but it made a critical difference.
Intracerebral hemorrhage (ICH) stroke is on the riseaccording investigation published by the American Heart Association. A study over 15 years found an overall increase of 11% across the country, with a 38% increase in the 18-44 age group. Yet nearly 30% of American adults under the age of 45 are unaware of common stroke symptoms, according to an association survey.
“We’re seeing a higher incidence of stroke in younger people,” said Sheryl Martin-Schild, MD, medical director of stroke for the Louisiana Emergency Response Network. “We think it is due, at least in part, to a younger age in developing risk factors for stroke specifically: high blood pressure, high cholesterol, obesity, smoking. And those things over time can lead to a stroke long before the usual age.”
There are two types of stroke: ischemic stroke: blockage or blood clots in the blood vessels leading to the brain, or hemorrhagic stroke: a leak or rupture of an artery in the brain.
“It’s very hard to get people thinking about a stroke to be worried enough,” said Thabele “Bay” Leslie-Mazwi, MD, a national volunteer expert for the American Stroke Association. She said patients sometimes dismiss their symptoms as time goes by to get emergency help.
Intermountain Healthcare in Utah drew on the American Stroke Association’s FAST model to create the acronym BE-FAST: Balance, Eye, Face, Arm, Speech, and Time for stroke symptoms and awareness:
- B: Balance: Sudden dizziness or loss of balance or coordination
- E: Eyes – sudden trouble seeing in one or both eyes
- F: Face – sudden weakness of the face (Does one side of the face droop?)
- A: Arm – weakness of an arm or leg
- S: Speech – sudden difficulty speaking
- T: Time – time when symptoms began.
Leslie-Mazwi said the most common signs of stroke are speech and facial changes. “Strokes that especially involve the blood vessels in the back of the brain can sometimes go unnoticed. But involvement of the face or speech occurs in about 88% of stroke patients, so it captures the lion’s share of them,” she said.
“BE-FAST now captures those vulnerable symptoms that have been underrepresented on social media, like sudden trouble with balance and sudden trouble with vision,” Martin-Schild said. “It improves the sensitivity of that detection tool to around 95% instead of 89%.”
Martin-Schild specializes in neurology at both Touro and New Orleans East Hospital and said the three signs of stroke that are often misjudged are sudden problems with balance, sudden vision problems or a sudden headache and terrible.
A stroke can manifest as a visual disturbance, such as double vision caused by problems with the eye muscles, an effect of nerve malfunction due to the stroke.
He said people shouldn’t panic if they notice symptoms, but should seek immediate help if the onset is sudden.
When Parker arrived at Rapids Regional Hospital in Lafayette, the hospital staff took him for different tests. After a CT scan, they identified the stroke in his basal ganglia, a region near the center of the brain that controls body movement.
“I think that’s one of the most important things for my recovery; it was such quick action on behalf of everyone involved,” Parker said.
Since her stroke in 2019, Parker has recovered. She dieted for a period of time and lost about 70 pounds. She said that she had stopped eating sugar to maintain her weight and takes a blood thinner every day. She also takes cholesterol medication as an additional preventative measure.
“I tell people all the time to watch your cholesterol and your blood pressure,” Parker said.
When Parker got to Touro Nursing, Martin-Schild narrowed the cause of his stroke down to protein S deficiency, a rare genetic disorder that can cause blood clots.
Parker said knowing the signs of a stroke and acting fast are crucial to surviving a stroke.
“Timing is everything – the faster you can get the right treatment, the faster you can be on the road to recovery and the better recovery you can have,” Parker said.
“It’s important to live life prepared and fearless,” Martin-Schild said. “And being prepared means that you do everything in your power to reduce risk.”
Preventive measures include taking the medications prescribed by healthcare providers and calling 911 if things get worse.
Meghan McKee, a 14-year-old physical therapist living in North Carolina, also caught her symptoms early. McKee had a patent foramen ovale (PFO), a hole between the left and right upper chambers of the heart. So she informed her husband about the possibility of a stroke and the signs of BE-FAST symptoms that she read on StrokeAwareness.com.
“I always knew the possibility, but I also thought, you know, I’m young, active, healthy. I’m doing the right thing so it doesn’t happen to me,” McKee said.
At the age of 31, the stroke came as a complete surprise. When McKee was watching a movie with her husband, she had trouble reaching for a bottle of water. Her left hand shook her desk. McKee then grabbed the bottle with his right hand and choked on the water. Her husband noticed her walking was strange when she got up and called 911.
“In fact, I couldn’t even recognize the symptoms in myself at the time, that my entire left arm was flat, hanging off the side,” she said. “I couldn’t move my left leg. She was dragging him behind me.”
The hospital was only 4 miles away. McKee stayed in the hospital for 4 days and underwent surgery to close the hole in his heart. In her experience as a physiotherapist, she had treated women who suffered a stroke after childbirth, and she knew about treatments such as her surgery focused on avoiding a second stroke.
McKee also received speech, occupational, and physical therapy. Within a week, her symptoms resolved.
“To this day, I have deficits, I have hand and foot strength issues, and then my smile is still not fully symmetrical,” McKee said. “But other than that, you know, I was very, very lucky.”
Seven years after the stroke, McKee has two daughters. Sharing ideas for surviving a stroke, McKee said: “Time is brain. As with each passing minute, there could be more potential damage that could occur to her brain; your whole body is controlled by your brain. And when I say that, I mean your ability to walk, stand, talk, think, and have your cognition and memory.”
A delay, he said, can often lead to a disability.
Martin-Schild said early treatment and access to critical rehabilitation services result in good recovery from stroke. However, he said there are disparities in patient access to both.
“Depending on your insurer, whether they fund your inpatient rehab, for example,” Martin-Schild said. “It depends on your hometown, if there are rehab facilities in your area, or if you are physically separated from your family by hundreds of miles while you are in your key phase of rehabilitation.”
People who can rely on a support team do better at any age when a stroke occurs, he said.
“We need more public health work and more resources dedicated to that. That will be where we will have the biggest impact,” said Leslie-Mazwi. She recommended a diet that minimizes salt and sugar intake, animal products, and avoiding smoking.
https://www.webmd.com/stroke/news/20230601/time-and-support-key-for-younger-stroke-patients?src=RSS_PUBLIC
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