A stroke can change your life in an instant. When you know what to look for and what to ask, you can react faster and increase the chances of avoiding life-threatening brain damage and long term disability.
We're proud to be the only Stroke Program in the Mid-Ohio Valley that has earned the HFAP Seal of Certification.
The Rehabilitation Center at Memorial Health System is the Mid-Ohio Valley’s only Stroke Specialty Program, leading the way in prevention, treatment and maximizing quality of life for those who have sustained a stroke.
Listen in as Shane Parmer, MD discusses the importance of immediate care if you've experienced any stroke symptoms.
Stroke: Acting Fast Can Save Your Life
From the Show: Memorial Ohio - Memorial Health Radio
Summary:
Air Date: 10/23/16
Duration: 10 Minutes
Transcription:
Melanie Cole (Host): According to the National Stroke Association, each year nearly 800,000 people experience a new or recurrent stroke. Heart disease is the number one health problem in the mid-Ohio valley and is one reason state of the art cardiac care is critical. My guest today is Dr. Shane Parmer. He's a vascular surgeon and Medical Director for the stroke program at Memorial Health System. Welcome to the show, Dr. Parmer. What is stroke? Is there more than one type?
Dr. Shane Parmer (Guest): Thanks for having me, Melanie. Yes, there is. There are primarily two types of stroke. The more prominent stroke that we’re concerned with is called “ischemic stroke”. That’s where the blood is shut off from the brain and then the other kind is called a “hemorrhagic stroke” where, for various reasons, you may have bleeding inside the brain. The ischemic stroke is probably responsible for about 2/3 to 3/4 of the strokes. The typical symptoms from ischemic stroke include such things as sudden onset of weakness on one side or the other, sudden inability to speak or slurred speech. Things of that nature are the most common symptoms. For hemorrhagic stroke, typically, you don’t always present with weakness and speech issues. It often presents, initially, as what is often described as the worst headache of all time--severe frontal headache and progression, eventually, to weakness by symptom.
Melanie: Are there certain risk factors for stroke?
Dr. Parmer: There are. As far as primarily for ischemic stroke, without question, when it comes to all vascular disease and heart disease, smoking is, without question, the strongest risk factor for that. Stopping smoking surely decreases your risk of stroke overall. Other risk factors would be history of heart disease. These are often diseases of blood vessels and all the blood vessels, of course, are exposed to the same blood and risk. So, heart disease is something that puts you at increased risk along with heart disease; a history of a atrial fibrillation, which is a type of irregular heartbeat that some people have which would put you at high risk for ischemic stroke; and then, other things such as diabetes which we can often try to improve and something we can’t improve or change and that is our age. As we get older, our risk for stroke is higher.
Melanie: So, you talked a little bit about the symptoms of stroke, Dr. Parmer, but it’s important that people and even loved ones understand these symptoms. Explain them a little bit more in detail. What people should look for when they think they themselves or their loved one is having a stroke? And then, what they should do about it?
Dr. Parmer: Well, that sometimes is one of the challenges, especially if you’re by yourself. Some people may not notice symptoms if they’re more subtle but nationally, especially as part of the stroke programs, we developed a mnemonic to help the public understand what to look out for. When I see patients in my office I make sure that I give them a pamphlet that describes this and it’s called “FAST”. One of the first things is the “F”. You look at somebody’s face, and if they have a sudden asymmetric smile or drooping and numbness on one side. Typically, these are the issues that are on one side of the body or the other, and that could be concerning for a stroke. The “A” in FAST stands for arms. Basically, if somebody has sudden weakness of one arm. Say, if they’re carrying a coffee cup and they drop it, their arm is slung down. They can’t raise their arms or leg, that could be a sign of a stroke. The “S” in FAST stands for “speech”. So, if the person has slurred speech that is sudden in onset or often an inability to think of a common word and the inability to say what they mean, even though they know they want to say that, that could be a sign of stroke. The “T” in stroke means “time”. You were mentioning what should they or a loved one sees these signs or symptoms in them. Time is critical. The longer these symptoms go without being treated, the greater chances there will be of permanent damage and so, the first thing they should do if they have any of these symptoms, especially if they are concerned about stroke, is they need to call the emergency squad 9-1-1 and have them transport to the nearest stroke center.
Melanie: And, can 911 do some pre-advance work on the patient? Is that the reason you want 9-1-1 called as opposed to someone trying to drive that person to the hospital themselves?
Dr. Parmer: Absolutely. One of the things we do as a stroke center is coordinate the care and that care starts with helping patients, their loved ones, our neighbors in the public, understand the early signs of stroke so that they can seek care early. That includes working with our EMS or emergency medical services and helping them understand quickly how to diagnose or recognize, I should say, a stroke because it will be important in the kind of care that they provide. There are certain lab values, like a blood sugar they can check, to rule those out before they get to the hospital. If they suspect a stroke, they’ll notify the stroke center, such as our hospital, immediately so that we have mobilized our services and they are ready as soon as they arrive. Most importantly, is they recognize stroke. It’s critical that they transport that patient to the nearest stroke center, even if may not necessarily be the closest hospital, because the strokes centers have been ramped up and trained in the expertise of treating stroke. It follows that, if it’s possible, to be at a place that can treat you best, even if that is further away.
Melanie: What happens in the ER when someone is having a stroke? What are some of the treatments that you use and can they reduce the disability that result from stroke?
Dr. Parmer: Well, as a stroke center, our ER is, for the most part, the front door for most of the strokes that come to our facility. So, when a patient comes in with a presumed stroke, we have what is called a “stroke alert” that mobilizes multiple facets of our hospital to greet them and, primarily, initially diagnose what the issue is and then move with early treatment. So, it's a very intense time for the patient. There are some treatments that will critically reduce your long-term disability from a stroke. And that’s primarily the use of thrombolytics or what we call “clot busters”. Much like the heart, the goal is to get rid of the clot that is blocking the blood flow to the brain. And now, I’m primarily talking about the ischemic stroke that I mentioned earlier. Once that is recognized, getting these clot busters to the patients in a very timely fashion will decrease their overall and long-term disability and when it comes to stroke, certainly, it is one of the most common causes of death in this country. It is, without question, the most common cause of disability in this country. So, even those who survive have often long-term disabilities and decreasing that is a huge benefit to the patient.
Melanie: And, if someone's had a stroke, Dr. Parmer, are they then in increased risk of another one?
Dr. Parmer: Absolutely. I didn’t mention that necessarily as a risk factor but, without question, if you’ve had a stroke, especially an ischemic stroke, again, when the blood flow is cut off to certain parts of the brain, your risk is higher. It’s because of atrial fibrillation, which is an irregular heartbeat. One of the things that we do at the stroke center is to identify that and make sure you receive the treatment that will decrease that as long as possible. If it is, say, from blockages in your carotid arteries, which primarily supplies the blood to the brain and the heart, we make sure that the patients are treated either medically, if indicated, or, if more advanced, a vascular surgeon such as myself may offer an operation that will decrease their overall risk. Without question, if you’ve had a stroke, you’re at risk for another one.
Melanie: Then, tell us about the telemedicine program with Ohio Health and the benefits being instantly connected to their program.
Dr. Parmer: Well, we are a primary stroke center here at Memorial Health System. And, as far as that, we partner with a large facility and our facility is the Ohio Health System. They provide services, some of which are much advanced services than we offer in our smaller facility, and, primarily, we use them for their telemedicine capabilities. So, when that patient comes in with a presumed stroke, we have the capability of contacting them immediately. They will have their stroke-trained neurologist essentially interact with our patients, examine them remotely through a computer kiosk that we have that will be in the patient's room; help us rapidly diagnose what the issues are and then help us make sure that we move in the right direction, be it clot busters here and observation; or be it much more advance techniques where we will only typically find in a very large tertiary health center such as they are.
Melanie: And so, wrap it up for us, Dr. Parmer. What can listeners do to reduce their risk or possibly prevent a stroke? Give us your best advice.
Dr. Parmer: There are several things, especially, here in the mid-Ohio valley where I live, our patients can do. The first and foremost is, basically, diminish your risk factors. If you smoke, you really need consider stopping smoke and work with your health provider, if you need to, to do so. If you have diabetes, you should control your sugar; if you have heart disease or fibrillation, work with your health provider to minimize those risks. Second, as we are working with our neighbors and patients trying to educate them, it’s important that patients and their families know the early signs of stroke so that they know to seek immediate medical attention and so they don’t stay home which I too often see hoping that it will get better because they may lose that critical opportunity to have a treatment that they would otherwise have.
Melanie: Thank you so much with being with us today. It’s such important information, Dr. Parmer. You’re listening to Memorial Health Radio with Memorial Health System. For more information, you can go to www.mhsystem.org. That's www.mhsystem.org. This is Melanie Cole. Thanks so much for listening.
Melanie Cole (Host): According to the National Stroke Association, each year nearly 800,000 people experience a new or recurrent stroke. Heart disease is the number one health problem in the mid-Ohio valley and is one reason state of the art cardiac care is critical. My guest today is Dr. Shane Parmer. He's a vascular surgeon and Medical Director for the stroke program at Memorial Health System. Welcome to the show, Dr. Parmer. What is stroke? Is there more than one type?
Dr. Shane Parmer (Guest): Thanks for having me, Melanie. Yes, there is. There are primarily two types of stroke. The more prominent stroke that we’re concerned with is called “ischemic stroke”. That’s where the blood is shut off from the brain and then the other kind is called a “hemorrhagic stroke” where, for various reasons, you may have bleeding inside the brain. The ischemic stroke is probably responsible for about 2/3 to 3/4 of the strokes. The typical symptoms from ischemic stroke include such things as sudden onset of weakness on one side or the other, sudden inability to speak or slurred speech. Things of that nature are the most common symptoms. For hemorrhagic stroke, typically, you don’t always present with weakness and speech issues. It often presents, initially, as what is often described as the worst headache of all time--severe frontal headache and progression, eventually, to weakness by symptom.
Melanie: Are there certain risk factors for stroke?
Dr. Parmer: There are. As far as primarily for ischemic stroke, without question, when it comes to all vascular disease and heart disease, smoking is, without question, the strongest risk factor for that. Stopping smoking surely decreases your risk of stroke overall. Other risk factors would be history of heart disease. These are often diseases of blood vessels and all the blood vessels, of course, are exposed to the same blood and risk. So, heart disease is something that puts you at increased risk along with heart disease; a history of a atrial fibrillation, which is a type of irregular heartbeat that some people have which would put you at high risk for ischemic stroke; and then, other things such as diabetes which we can often try to improve and something we can’t improve or change and that is our age. As we get older, our risk for stroke is higher.
Melanie: So, you talked a little bit about the symptoms of stroke, Dr. Parmer, but it’s important that people and even loved ones understand these symptoms. Explain them a little bit more in detail. What people should look for when they think they themselves or their loved one is having a stroke? And then, what they should do about it?
Dr. Parmer: Well, that sometimes is one of the challenges, especially if you’re by yourself. Some people may not notice symptoms if they’re more subtle but nationally, especially as part of the stroke programs, we developed a mnemonic to help the public understand what to look out for. When I see patients in my office I make sure that I give them a pamphlet that describes this and it’s called “FAST”. One of the first things is the “F”. You look at somebody’s face, and if they have a sudden asymmetric smile or drooping and numbness on one side. Typically, these are the issues that are on one side of the body or the other, and that could be concerning for a stroke. The “A” in FAST stands for arms. Basically, if somebody has sudden weakness of one arm. Say, if they’re carrying a coffee cup and they drop it, their arm is slung down. They can’t raise their arms or leg, that could be a sign of a stroke. The “S” in FAST stands for “speech”. So, if the person has slurred speech that is sudden in onset or often an inability to think of a common word and the inability to say what they mean, even though they know they want to say that, that could be a sign of stroke. The “T” in stroke means “time”. You were mentioning what should they or a loved one sees these signs or symptoms in them. Time is critical. The longer these symptoms go without being treated, the greater chances there will be of permanent damage and so, the first thing they should do if they have any of these symptoms, especially if they are concerned about stroke, is they need to call the emergency squad 9-1-1 and have them transport to the nearest stroke center.
Melanie: And, can 911 do some pre-advance work on the patient? Is that the reason you want 9-1-1 called as opposed to someone trying to drive that person to the hospital themselves?
Dr. Parmer: Absolutely. One of the things we do as a stroke center is coordinate the care and that care starts with helping patients, their loved ones, our neighbors in the public, understand the early signs of stroke so that they can seek care early. That includes working with our EMS or emergency medical services and helping them understand quickly how to diagnose or recognize, I should say, a stroke because it will be important in the kind of care that they provide. There are certain lab values, like a blood sugar they can check, to rule those out before they get to the hospital. If they suspect a stroke, they’ll notify the stroke center, such as our hospital, immediately so that we have mobilized our services and they are ready as soon as they arrive. Most importantly, is they recognize stroke. It’s critical that they transport that patient to the nearest stroke center, even if may not necessarily be the closest hospital, because the strokes centers have been ramped up and trained in the expertise of treating stroke. It follows that, if it’s possible, to be at a place that can treat you best, even if that is further away.
Melanie: What happens in the ER when someone is having a stroke? What are some of the treatments that you use and can they reduce the disability that result from stroke?
Dr. Parmer: Well, as a stroke center, our ER is, for the most part, the front door for most of the strokes that come to our facility. So, when a patient comes in with a presumed stroke, we have what is called a “stroke alert” that mobilizes multiple facets of our hospital to greet them and, primarily, initially diagnose what the issue is and then move with early treatment. So, it's a very intense time for the patient. There are some treatments that will critically reduce your long-term disability from a stroke. And that’s primarily the use of thrombolytics or what we call “clot busters”. Much like the heart, the goal is to get rid of the clot that is blocking the blood flow to the brain. And now, I’m primarily talking about the ischemic stroke that I mentioned earlier. Once that is recognized, getting these clot busters to the patients in a very timely fashion will decrease their overall and long-term disability and when it comes to stroke, certainly, it is one of the most common causes of death in this country. It is, without question, the most common cause of disability in this country. So, even those who survive have often long-term disabilities and decreasing that is a huge benefit to the patient.
Melanie: And, if someone's had a stroke, Dr. Parmer, are they then in increased risk of another one?
Dr. Parmer: Absolutely. I didn’t mention that necessarily as a risk factor but, without question, if you’ve had a stroke, especially an ischemic stroke, again, when the blood flow is cut off to certain parts of the brain, your risk is higher. It’s because of atrial fibrillation, which is an irregular heartbeat. One of the things that we do at the stroke center is to identify that and make sure you receive the treatment that will decrease that as long as possible. If it is, say, from blockages in your carotid arteries, which primarily supplies the blood to the brain and the heart, we make sure that the patients are treated either medically, if indicated, or, if more advanced, a vascular surgeon such as myself may offer an operation that will decrease their overall risk. Without question, if you’ve had a stroke, you’re at risk for another one.
Melanie: Then, tell us about the telemedicine program with Ohio Health and the benefits being instantly connected to their program.
Dr. Parmer: Well, we are a primary stroke center here at Memorial Health System. And, as far as that, we partner with a large facility and our facility is the Ohio Health System. They provide services, some of which are much advanced services than we offer in our smaller facility, and, primarily, we use them for their telemedicine capabilities. So, when that patient comes in with a presumed stroke, we have the capability of contacting them immediately. They will have their stroke-trained neurologist essentially interact with our patients, examine them remotely through a computer kiosk that we have that will be in the patient's room; help us rapidly diagnose what the issues are and then help us make sure that we move in the right direction, be it clot busters here and observation; or be it much more advance techniques where we will only typically find in a very large tertiary health center such as they are.
Melanie: And so, wrap it up for us, Dr. Parmer. What can listeners do to reduce their risk or possibly prevent a stroke? Give us your best advice.
Dr. Parmer: There are several things, especially, here in the mid-Ohio valley where I live, our patients can do. The first and foremost is, basically, diminish your risk factors. If you smoke, you really need consider stopping smoke and work with your health provider, if you need to, to do so. If you have diabetes, you should control your sugar; if you have heart disease or fibrillation, work with your health provider to minimize those risks. Second, as we are working with our neighbors and patients trying to educate them, it’s important that patients and their families know the early signs of stroke so that they know to seek immediate medical attention and so they don’t stay home which I too often see hoping that it will get better because they may lose that critical opportunity to have a treatment that they would otherwise have.
Melanie: Thank you so much with being with us today. It’s such important information, Dr. Parmer. You’re listening to Memorial Health Radio with Memorial Health System. For more information, you can go to www.mhsystem.org. That's www.mhsystem.org. This is Melanie Cole. Thanks so much for listening.
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