you it's the fourth leading cause of death in the US and women 45 to 54 are seeing the largest spike in occurrence this week on being well our topic is stroke RN Rachel masse from Paris Community Hospital Family Medical Center will be here to talk to us about the warning signs of stroke the risk factors and preventive measures we've got a lot of great information to share with you so don't go away production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at Sarah Bush Lincoln Health System information available at sarahbush.org additional funding by Jazzercise of Charleston thanks for joining us for being well today Rachel Massey is here she's an RN and specifically works in staff development at Paris Community Hospital Family Medical Center thanks for coming over thanks for having me well our topic today is stroke and this is something that you actually go out to the public and talk about stroke correct yes we do a lot of community health programs where we go out and we talked to different groups of women and men in regards to different health care topics and stroke is always a very popular topic to cover all right so we're going to start first with tell us what do you think is the public's biggest misconception about stroke I think the biggest misconception is the fact that they think that it's not preventable on the front side of stroke the more they know about the stroke the better off that they'll be but a lot of folks don't think that it's preventable like it comes out of nowhere at them and in all actuality eighty-seven percent show that you can prevent the stroke based off of the risks ok so we're going to talk about prevention in just a little bit but first why don't you define actually what is a stroke because i know there's two in there's two different types as well correct stroke is basically a brain attack and I like to refer to it like a heart attack and the National Stroke Association has determined that if we use the words brain attack people may pay more attention to that but what that means is it's a medical emergency is what a stroke is in regards to its a sudden and sometimes potentially hardship on the brain so there could be damage done ok so there's two types can you explain the two types in which one is more common than the other yes there's two types and the first one I want to talk about is ischemic ischaemic stroke eighty-seven percent of all people who suffer from stroke suffer from ischemic stroke and basically what this is is there's a clot in the blood vessel in the brain that sits there and it interrupts blood flow to the brain and that's what causes the stroke to occur in that moment and the medicines that are used for that is what breaks up the clot and that's what recovers in the stroke the other one is called the hemorrhagic stroke and basically what happens is the blood vessel actually ruptures in the brain and that sends blood into the brain and fills it up and those are harder to recover from okay and that but that does happen less often it happened it's rare okay so what are some of the causes of stroke the causes of stroke start with basically you're looking at high cholesterol high blood pressure and again it's those preventable treatments so know your family history and it also has to boil down to diet and exercise everything that you would do for a heart healthy diet you need to have a brain healthy diet as well so it sounds like a lot of the same things that you know with heart disease are also affected you can be affected by stroke absolutely yeah are there certain populations out there that are seeing and that we're seeing an increase in having strokes yes overall anyone is at risk for stroke okay but we do see that women have a tendency to have a more prevailing diagnosis of stroke in actuality the information that comes through the National Stroke Association shows that 55,000 more women are diagnosed with stroke over men and why what accounts for that do you think men or women have higher life expectancy so they live longer than men but in addition to that they also say that women two times as many women die from stroke as they do breast cancer really we don't you know we hear so much about breast cancer and heart disease it seems like stroke is it's starting because we're going to talk about fast in just a little bit but for a while it just seems like something that maybe older people got or had during you heard of people having a stroke during surgery but it's becoming more common exactly and that is another misconception is the fact that a lot of people think that the elderly are more prone to stroke but that's not the case we're starting to see more and more younger victims I was going to say can you have a stroke at neh absolutely it's uncommon that babies can have strokes and children all the way up to the oldest there it really doesn't identify one population in regards to age so we talked about you said women usually the biggest bike women between 45 and 54 are seeing more strokes are there other in general do you see more strokes at a certain by a certain age no there is an influx with that age group and the reason is that they feel like and research is showing that women tend to pacify that part of them so they're not taking care of themselves necessarily they're taking care of families and those kinds of things and they're ignoring their risk factors for stroke in that and during those populations of age so 45 to 54 they're starting to see a spike because of that because the women just aren't taking care of themselves are taking care of everybody else okay so let's talk about these signs that you say a lot of people tend to ignore but they're very important they're very important fast is an acronym that they came up with to help people remember what to do in the event that a stroke does occur f is facial expressions so one easy way to determine if someone is having a stroke is to very quickly look at their face see if it's still symmetrical if everything still looks the same as it did before and if they notice any changes that's part of that facial expression change and one easy way to assess the face estab is to have them smile and when they smile you'll start to see one side of the mouth droop okay so that's F mm-hmm and then a a is arms so you have them stick their arms straight out in front of them and what you'll tend to see whether stroke is that one arm may not be able to be lifted or it may drift a little bit and that's another sign as well okay then we move on to s as his speech sometimes speech is not immediately affected they're unable to put together sentences but the other part of it is sometimes it is grossly affected and they're not able to talk at all or make any sense at all if you feel that it's somewhat affected have them repeat a simple sentence and if they're unable to repeat that simple sentence it's an indicator and then t t is time time is very important with stroke in regards to time the first thing that you do and the initial onset of any sign or symptom is to notify 911 determine whether or not it this is a stroke seek medical attention immediately secondary to that is the timing of when the symptoms actually happened it's important to remember that part for the health care providers and the doctors when you get to the emergency okay because we want to talk about some of those medications that they can give you but I wanted to ask can these signs be mistaken for something else ever like slurred speech could you be having a major migraine just people sometimes maybe pass it off as something else they do and actually a lot of times hypoglycemia which is low blood sugar or if someone has an eaten or even a diabetic sometimes mimic the exact signs of a stroke so yes it is hard to determine but we just ask that you seek medical attention despite if you're having any deficits or difficulty it's better to err on the side of letting a health care practitioner evaluate you so let's talk about that time factor someone maybe come in from mowing the lawn and all of a sudden they've lost a lot of their ability to move their arm when should they call 911 immediately okay again time is a factor what happens is there's a medication that can be hospitals can use very quickly and it's called TPA it's a fancy word for a clot blossom Buster and what this does is because most jokes are scheming what they do is they'll bring them in and they'll do a scan of their head to determine whether or not they can use this massive blood thinner okay and once they determine that they can there's a certain window that it's effective and basically if that medication is delivered within that time frame the patient or the person may never have any symptoms of that stroke so fast is better so what is generally what is that time frame three to four hours okay so if you kind of sit at home and go I'm not sure what it is time is ticking away yeah so the EMTs don't give that correct that is correct ok it's only administered in an emergency room by a physician so again that's determined only after they've been the test which the only test for stroke is the CT and and or an MRI of the brain that's what I was going to ask what can they when they look at it can they tell they can see a blood clot is that what they're looking for they're looking for initially for bleed in the brain okay so they need to rule that out before they actually give that medication because obviously a blood thinner and if they've had a hemorrhagic stroke would make that worse so initially they're looking for that sometimes they don't necessarily see a cot but it's to rule out whether or not they can use that clock bus busting medication okay so why is it that you get this facial drooping or what that things seem to happen on just one side of the body with stroke it determines where the stroke occurs on the brain okay so wherever the clot is it could be right it could be left side and what the amazing part is when you do the fast the same side of the face is typically the same side that you see weakness on ok so it's a good indicator that that's happening on one side of the brain or the other race so do the strokes happen in the brain in common in can they happen anywhere or is it usually one side or the other it can happen anywhere it's a blood vessel in the brain ok and where this occurs so it could be a clot that you know had been forming for a long time typically or it could be in the carotid artery or it could be you know any other vessel this simps the signs and symptoms remain the same no matter where it's at so let's talk a little bit about a mini or a TI a stroke I won't try the house that how is that what is it and how is it different from what we consider like a major stroke or brain attack a TI is a transient ischemic attack and basically the problem with that is is that the signs and symptoms of a TI a especially initially are exactly the same as a stroke the difference is a stroke is a medical emergency and a TI is not okay and the really the only way to tell the difference which you wouldn't initially because you want to seek medical attention is the fact that the ti a this symptoms resolve usually in a couple of hours but no more than 24 hours the deficits disappear with a stroke the deficits remain so if there's speech deficits or limb deficits with the arms or legs those will stay in a stroke okay so if you have a TI a you will recover from some of that you cover fontaine eous okay and you don't need any medications it heals itself okay that's the difference and it the ti a the definition of that basically is that there has been a temporary blockage in the flow of blood to the brain whether that's a spasm of the vessel or maybe there is a small clot in there but it's not big enough to warrant any major strokes at that point now a TI a is it could be a good indicator to a stroke is away so it is a precursor that there could be a stroke impending but not always okay so can anybody get a TI a or do you see that may be happening in younger people TI is anyone can get those as well any age group again because it could be just a spasm of that blood vessel that causes that to occur and it mimics the exact signs and symptoms of a stroke just sometimes I'll have tea is and don't even know it and maybe find out later that they had that yeah yes they actually they do and but then they'll say they didn't feel right and there's some slug enos or you know there maybe they've had a headache with anything if you're experiencing anything out of the ordinary we just ask that you seek medical attention immediately and let them try to help you work through what it is because with the ti a the physicians and the health care practitioners will work with them to develop their plan of care and how to recognize that and when to be worried and what not to but let them help get them on that right track we often hear about people having a stroke during surgery is that a TI a or is that a full full stroke or brain attack it could be either with surgeries what happens is you are messing with blood flow so to speak so clots can occur surgeons take very special precautions to make sure that that doesn't occur but it can occur because are exposing the blood to elements and then clots can occur the other part of that is again spasms you know surgery is a stressful thing to happen to a person's body so it just depends on how that body is going to react to the surgery and most surgeons are aware of those risk in those risks are shared with patients up front ok let's talk about recovery what kind of determines let's talk about recovery percentages because it's actually quite alarming it is only ten percent of all stroke victims fully recover twenty-five percent of those victims have minor deficits but I think what's more astounding is that forty percent actually have moderate to severe deficits meaning that they may have lifelong debilitation treatments therapies physical therapy speech it and it it's limitless space let's talk about what are some of those deficits that people have of those forty percent that don't recover a lot of times it can be speech if it is speech where they're trying to reconnect the brain to learn how to talk again sometimes they have to see a speech therapist and and what's crazy about it is the fact that they think they're saying the right things and it comes out all wrong so they really have to relearn how to talk and put sounds together again if it's a deficit in regards to a limb and arm or leg those are handled with occupational therapy and physical therapy and sometimes they have to relearn how to fold towels or how to put deodorant on or even how to brush their teeth because that arm doesn't remember how to do that so it's that connection in the brain that's confused yes and through therapy they help to reconnect those sign apses basically to remember what they used to do sometimes that comes back sometimes that doesn't it just depends on how long they waited before they notified health where it happened and the treatments thereafter and what their risk factors were as I was going to say the ten percent that do recover what did they do differently than the forty percent who test that's all about that timing that's all about the time it's all about the timing and they were quick to respond and the ten percent usually if it was the scheming stroke obviously they got that TP a very quickly I would have you when you're out talking to people about this and do you often hear people well I don't I would be so embarrassed if I think I'm having a stroke and I get to the ER and yes wow it's that's not what they are and they're very concerned with that perception but again I just I just kick back and say what if it was a heart attack would you feel the same way because the brain is just as valuable as the heart is in fact it's probably more valuable it's a little harder to fix the brain yeah yeah I mean we can fake that and we've had doctors on the show I'm amazed at what can be fixed but without your brain your kind of yeah tough situation you know I think another statistic comes to mind just talking about it Every 40 seconds someone suffers a stroke Wow Every 40 seconds that's a lot 800,000 in one year suffer a stroke so it is that important you know it's the fourth leading cause of death in the United States so attention does need to be paid the same way you know that we finally got attention paid to heart attacks and breast cancer and other leggings yeah are we seeing an increase in stroke we have started to see an increase just for the very reason and they're correlating it with stress they're correlating it with the fact that people suppress and they don't do preventable health maintenance I think we're all a little guilty of that unfortunately taking care of ourselves and that recognition of is this what I really think it is or do I need to be concerned so I think in regards to preventing is making sure you know where you're at understand if you do have any risks particularly with cholesterol or high blood pressure or if that runs in the family right and then just have an open dialogue with your physician and more importantly do preventive health care we're all guilty of not doing that and also doing education so once you know about it then also taking it outside of that and educating everybody that you know because it goes a long way I was going to ask you about stress I mean sometimes in it when we realize now how serious a stroke is we kind of say I'm so stressed out you're going to give me a stroke can stress lead to a stroke like if you are really intense about something it can because you're not taking care of your site so it's not necessarily the stress itself it's sort of the resulting character it is it's beginning to that point it be high blood pressure it's the fact that you're not taking care of yourself and yes it can in a long way to get there yeah but it's kind of like a heart attack stress you know can lend itself to a heart attack it's it's the exact same mechanism it's just in two different parts of the body you know a heart attack is usually a clot in the heart mm-hmm and a brain attack is a quantum brain okay so what can we do we've talked you've touched upon prevention but what what advice do you have for people to reduce for prevention of stroke again I think it's just that recognition I think it's paying attention to your body know your body know where you're at the feelings and if something doesn't feel right or you're struggling with whether or not you know there may be something going on then have yourself checked out you owe yourself at you owe your family that just get it checked out the other thing again knowing your risk factors talking to your physician to even see if you are at risk there is a risk analysis that health care practitioners can do on you and can identify if you are at risk and grade it but just based off of conversation okay and then that way you know what track you're down so that you can lead yourself into more prevention so but it's still healthy diet exercise reducing your stress all the things that we should be doing anywhere for just a healthy lifestyle and heart in general yes yeah same exact thing actually rachel has there anything else we haven't covered that you want to tell our viewers about stroke no other than just fast just you know face pay attention to the face the arms the speech and more importantly is timing and again I can't emphasize it enough that let them determine whether or not you're having a stroke try not you don't need to diagnose that let them diagnose that for you all right Rachel thank you so much for coming over and talking to us about stroke I learned a lot and I'm certainly going to remember fast and they help our viewers will to thank you thanks for all of the high-tech and futuristic technology finding its way into healthcare a Mayo Clinic surgeon proves that old-fashioned common sense has its place too how do you make sure a procedure to restore a musician's wind power has worked before you leave the operating room you just bring a little something extra of all the surgical instruments that come into play in the operating room the oboe may be the last one you'd expect to see or hear but in this case pediatric otolaryngologist Sheila cofer thought it might be the most important she's treating patient married for BPI velopharyngeal insufficiency that's just a fancy word that means some air was escaping out the back of her throat and up and out through her nose when she was playing her instrument Mara's been in the operating room with dr. Cofer before several years ago chronic sinus and throat infections called for the removal of her tonsils and adenoids but not before they had a serious conversation a conversation about the risks for a highly accomplished musician such as Maura there is a risk of developing this difficulty with playing your wind instrument or even with speech if you take out the adenoids and take a look inside the mouth relax your tone the difficulty looks like this the little air bubbles you see at the back of Mara's throat are sneaking through gaps left when the infected tissue was removed so I'd start noticing that my endurance was lower I couldn't play for as long as I wanted to and you'd hear these little audible snorts coming out of my nose which would sometimes interrupt my playing dr. Cole first solution is an injectable solution often used as a cosmetic filler or to resolve urinary reflux and children dr. colfer says it's a safe way to plump up soft tissues bringing in the oboe however was a first what better way to put the full force of the woodwinds air pressure demands to the test so that we can pinpoint precisely where we need to put the filler material to augment the nasopharynx that also meant Mara needed to be awake only mildly sedated but they didn't want to give me too much because they wanted me to be able to play oboe in the operating room because that would give us the best chance of success success is exactly what they got really happy that this all worked out so that I could perform those as well as I can for the Mayo Clinic News Network I'm Dennis Dylan production of being well is made possible in part by Sarah Bush Lincoln Health System supporting healthy lifestyles eating a heart healthy diet staying active managing stress and regular check-ups are ways of reducing your health risks proper health is important to all at Sarah Bush Lincoln health system information available at sarahbush.org additional funding by Jazzercise of Charleston being well is also available online at our youtube channel youtube.com / w EIU TV just look for the being well playlist here you can view current and past episodes you