hospital and michael de firefighter and paramedic with the belmont fire department good morning and thank you so much for being here so our topic today is stroke awareness so marie could start us off with what to look for what things can cause stroke what things to look for and but definitely want to know exactly what to react how to react ok so stroke is a medical emergency and some of the warning signs for stroke are we use the acronym fast so facial cemetery facial an even ness sometimes  patients will ask them to look at america to see if when they smile at both sides of their face so the same both sides go up on arm weakness if you can hold your arm up we ask you to hold your arm out and if it drifts down that's  a cycle be a sign of a stroke leg weakness or inability to move your leg heaviness speech speech difficulty maybe patients to say the sky is blue in boston and ask them to repeat  it sometimes there's their speech is slurred gobbled sometimes it doesn't make any sense at all just they're not words or understanding language so we would ask them a question like can you say the sky is blue in boston and they can't say anything so it's understanding language so we use the acronym fast face on speech in time and time is to call nine one one it's important to get to a hospital especially a primary stroke hospital who treats patien quickly assesses them and can provide medical care to them immediately so time is of the essence in stroke world we say time is brain and every second that your brain goes without oxygen brain cells die while thank you are there any things that you can avoid that contribute to to being susceptible to a stroke both some of the some of what  patients work with their primary care doctors with are if they have hypertension or high blood pressure diabetes if they smoke these are all risk factors high cholesterol over being terribly overweight puts a tremendous strain on all of your vascular system as does but diabetes and hypertension so we ask you to work with your doctors about some of those risk factors a fibrillation it's an irregular beat of your heart and so patients who are diagnosed with that they usually go on a medic patients some type of an eighty coagulation which will help keep their blood thinner help them to prevent from having a stroke and so it's very important for them to work with their doctors in regards to that take their medication regularly and that's that's one of the biggest risk factors hypertension keeping your blood pressure down taking your medicine watching your diet your weight all are contributory to stroke risk factors yes and in terms of watching your diet and what true eating is it is salt intake are risk factors were also salt intake actually increases your blood pressure ok so it would if you had hypertension or high blood pressure increase having a high salt diet would actually make your blood pressure higher so we want to try to avoid that usually with hypertension your doctor will or one of the nutritionists will work with you in regards to what's ok to eat and what's not ok to eat and sometimes patien are on what they call a sodium restricted diet or a low salt diet so it's just an awareness of what foods have a lot of salt in them and it's also good if you do have high blood pressure to take your medication and keep an eye on your blood pressure every once in a while you know you go to the doctor maybe once a year twice a year every three times you know three times a year but in between those times you should be taking having your blood pressure taken at the senior center it was you know walgreens at somewhere where they can take your blood pressure you can go in independently kind of sit down for a few minutes take your blood pressure if you think it's higher than normal going to keep an eye on that and report that back to your physician because maybe you're not taking your blood pressure i mean your medication correctly or maybe you need an adjustment in your medication or you need to lower your salt intake different things like that and it's always a good idea to have a baseline idea of what your blood pressure is normally yes or when you first wake up or after activity it's great to have a baseline idea of what your numbers should be normally so that you can know when something is wrong is there a general what your blood pressure should be what is that what is a good person is different so everybody's going to have their own normal yeah right so that's that's the big thing is so that's why we want every person to monitor their own blood pressure a little bit so that they have an idea of what their normal is and that's a bigger key especially if there's an emergency to find out that they're outside their normal range because some people run high all the time and so if they're high and we find them to have a high blood pressure then we're going to be nervous but if they know that's their normal then that's good for us to know yeah i mean i wouldn't expect you know say potentially one hundred twenty pound woman to have the same blood pressure as a two hundred fifty pound man so everybody's norm is a little bit different depending on height weight and you know their history their medical history yeah absolutely yeah and just it doing your blood pressure was like at the jam and probably isn't the best know i do it because you you know i think they're right but that's not what the norm it would be so your blood pressure is going to be a little bit elevated after working out or doing any sort of exercise so that they actually give you a range of when something's wrong yes so if your blood pressure is matching you know after you just walked a mile when you're sitting on the couch then you know have been many going on oh yeah absolutely yeah all right well we have here which has been clear i went on that a little bit of it which gives you the things to look for when you suspect that someone is having a stroke and this is vast time look at their face can they get their arm and what their speech is and time is of the essence and we were talking before you said time is so we do explain that one a little bit sure so just it's stroke is similar to a heart attack except it happens in your in your brain heart attack happens obviously in your heart so every second that your brain cells go without oxygen which is supplied by your blood to your brain your brain cells die and once brain cells die they do not regenerate they're gone and and when patients have a stroke and if we can't get that blood supply blood back into the brain as quickly as possible once those cells are gone that's it and that's the sort of the deficit that they're left with so when you have a sudden in the kit the thing with with heart attack but also with stroke is it's a sudden change in what your norm is so sometimes i talk to patients and you know they say well i have this weakness well have you always had that weakness for a long time well you have had a for a few years that's your norm that's your baseline ok when you have a sudden change a sudden change in maybe your vision a sudden change in your balance you kind of you can't stand up straighter you're leaning to the side of your speech is different your weakness your arm your leg it's a sudden change in what your norm is that's when you want to pay attention to that so sometimes patients have these sudden changes in especially maybe diabetics or a patients that maybe have high blood pressure in the morning sometimes for they take the medication they may have a little bit of these effects they need to check their sugar levels that isn't too low is it too high if you correct that and you still have that symptom you have you should call nine one one so patien sometimes wait because they think it's going to get better like we all do we want to stay over trying to get better it's going to go away i'm not really sure what this is so we don't want you to wait a long time we want you to get to the hospital as quickly as possible there is a medication that is approved by the federal government it's called t p a or out to place and it's a medication that we give you in an i v form and it travels up into your brain and it can hopefully potentially remove that clot and open up that vessel so that blood is supplied back out of that area of the brain and it's fairly new new in that in the last ten years or so fifteen years it's a new medication so the longer you wait the less that we can give you that medicine you have a three hour window of the time that this your symptoms started so i know that we're going to talk about you know having some information on the refrigerator and different things like that one of the most important things for stroke is that you want to know when was the last time you were normal at your baseline or well so you got up for breakfast in the morning it's eight o'clock you're having your coffee right and all of a sudden you're holding your coffee cup and  it and you can't lift your arm up so now it's eight fifteen when you call nine one one and the paramedics come they're going to say to you if you can speak or somebody your family or somebody that you're with a little outside that you felt normal or when did the symptoms exactly start a lot of the times it will be somebody somebody will be talking with someone else and they'll just suddenly have garbled speech or slurred speech or just start making no sense whatsoever and we want to know exactly when that started because that allows us to let the hospital know if they're going to be able to give that medication that information available when the paramedics and the firefighters arrive yeah it's of vital importance though one of the most important things is being able to have your medications on there in your medical history  very many things that can mimic a stroke so by are seeing what medications you take diabetic emergency can mimic a stroke very similar but when we see that you're on diabetic medication now we know to check your sugar to see if that is something going on it can let us know if you're on medications for atrial fibrillation if there was any change in medication then we can have an idea that there maybe is a stroke we also want to know what you're allergic previously what medications you're on and they can give us a little bit of insight if you're not able to communicate with us to what what is going on with so this i notice that the senior center in belmont does have some of these on hand in and you can get them there and then it has a magnetic arcing on the back for that you can put it on your refrigerator and it really shows up and it gives an immediate information that they need in order to respond to your emergency so we're really encouraging to make sure that there's something for virtually everybody in the house  can print off the the paperwork right and and fill it all in and just make sure you have it and have it where they can even if you write your own note it's just very helpful especially as it when you're in an emergency situation you may not remember everything that you take or all your medical problems right so having written down ahead of time can really give us some insight to what's going on absolutely one of the one of the things that i want to mention calling nine one one a lot of people don't want to call nine one one and i have heard every reason why i didn't want to call nine one one i don't want to i don't want my neighbors to know that i'm having an emergency i don't want to bother the firefighters of the paramedics i don't want the fire truck to come to the house i don't so there are many reasons why people don't call nine one one right but an important message is that the calling nine one one gets a medical person to your door they come they assess you they treat you they give you medications there are already taken care of you before you come to the hospital a huge thing that they do which can will determine in many levels what happens next when you reach a door they call  ahead to us and they say i have an eighty one year old female who her last known well was eight fifteen this morning she has atrial fibrillation she has hypertension she has left sided weakness with a they're giving us your medical information somebody at the hospital is writing that all down usually a nurse writing that information down they say the word stroke alert that triggers us internally so now nurses assigned you a doctor was assigned to you where waiting at the door for you to come in the many you come in we quickly assess you we get you into a cat scan to take a picture of your brain within minutes well so that we can see what's going on and your brain the neurologist comes to the bedside so we have an internal mechanism for stroke that alerts all of these people across all of these different levels that we're waiting for you at the at the door if you a lot of times patients will get their neighbor to drive the men or they'll wait for someone to come home from work because they didn't want to bother somebody or sometimes many times patients try to drive themselves  patient one time take the m b t a bus to the hospital last she was having a stroke oh my goodness so i've heard many stars you can just imagine dr as i've heard it all so you want to call nine one one because they're already propping us and taking care of you well that's the other thing michael i mean you you're just not providing transportation you're doing a whole lot more than there is still one of the big things that she said is a medication to be a where you will have an i v before you rule out a lot of things on the way to the hospital with the equipment that we have we able to see what cardiac rhythm you're in where we have a set of vital signs to see where your blood pressure is trending upward downward or staying the same and also be able to do a star our own stroke assessment on you we use a master's of stroke skill and we do that on any patient suspected of stroke with any confusion or fish or group or anything like that but we'll be able to alert the hospital like she said a stroke alert and a let them know all of our findings so that they are able to get the cat scan ready to go and communicate with all the doctors so that we have a plan of action before we even get to the hospital usually by the time we're three miles away they already have an idea of that were coming and what we're coming with so wow and time is brain so it makes a huge difference and you are outcome how well you do and it's so amazing to me the things that they can do now you know absolutely they have other procedures besides this particular medication that t p a the out of place where sometimes there's a clot in your brain and maybe you're too late for the t p a because it's only within three hours right so they can put a catheter into you into your vessels either in your growing or your arm and it goes up into your brain and it can literally suck of your brain and open up that passageway again so once again don't wait there are many things now with stroke that we can do hemorrhagic stroke and i'll just talk a little bit about hemorrhagic stroke because there are two types of strokes there's a scheme extract which is that clo type which means maybe you you had a little blood clot traveled through your vascular system and sort of gets stuck in your brain usually it comes from your heart there's also another type where it's atherosclerotic type of stroke it's a piece of cholesterol that kind of breaks off from your vascular system and it's similar and it kind of goes up into your brain and it kind of causes that blockage also so with ischemic stroke so we can give that t p a medicine but if you have a hemorrhagic stroke which is a bleeding type of to call nine one one p has once again bleeding in your brain is not good for your brain either the brain does not like that now and so we want to assess you quickly for that because there's also medications that we can sort of give you to help with the bleeding type in your brain or potentially a surgical intervention ok and there are some signs and symbols will far and if you're called into and we get there we can associate a little more thoroughly than they'd be able to hope you would do over the phone with yourself and we can sometimes take a guess whether oh most yeah i was tomorrow so that sudden severe headache the worst headache you've ever had all of a sudden unless you've fallen and hit your head then you're going to have probably a headache but just a thunderclap sudden headache out of nowhere warning signs for a potential stroke so you have those stroke symptoms maybe you have sudden weakness or maybe you have a little bit of can confusion as speech changes or visual changes that last maybe five or ten minutes and then they go away those are called t i a s so sometimes those a warning signs for a potential stroke maybe there was a little bit of a blockage that cleared itself for whatever reason if you have those sent yes you've had those s you want to call your doctor and if they go away yes if they go away you want to call your doctor and say well i just had this symptom and i think you know i should be checked out because you want you want to make sure that your doctor is aware of that yeah and also that you your blood pressure ok is share cholesterol ok as you know so there are things that they can do to help with that ok and they use it a t r easily lead to a lot of the time a actual stroke to check though right so one of the things that you should probably look out for also is and i have had this happen if you go out in the wintertime and don't know don't pay attention and there is black ice and you can fall and hit your head or him whatever but it's not just the bruise that i have to be concerned about that could that could be something that could cause a serious head injury to cracked and that's something for your doctors if depending on your medication your doctor should talk to you but if you're on a blood thinner medication aspirin comin and anything like that and you fall and do hit your head it is going to be the safest bet to go to the hospital and go get checked o my symptoms went away or they didn't last that long or well the weakness wasn't that bad and i thought it would get better maybe i slept on it wrong or i did too much work with it or or whatever and i say to them when you want to come to the hospital because we're going to look at you we're going to assess you we're going to take a picture of your brain and we're going to make sure that you're ok and then if there's nothing wrong we're going to say thank you for visiting us and send you home and won't you have peace of mind or feel better knowing that there isn't anything going on and remember nobody wants to go to the halls nobody arrested nobody wants to spend time in the e r but when you need to yes you need to call nine one one and you need to come to the e r yes and you need to have the information there just in case to help them out in case it helps them at the medical provider is it in cuts term or in the time that we're going to be has new same questions over and over if we have a written down then we can yes move forward ye but this is this is so amazing to me are the the the the new things that they happen bailable that they can treat things like this we're there and we should take advantage of that and make sure if we have even any s yes and not have we covered all the symptoms that we pressure high blood pressure that a fed that irregular heartbeat and that the doctor should be aware of and usually they are sometimes  sometimes patients can sort of self diagnose because they all of a sudden they feel like their heart is racing and they don't really know why you know so you want to cut you know you want to have that looked at that would be the atrial fibrillation so high cholesterol keeping your lest managed everybody produces cholesterol in their body but sometimes people prover produce it or sometimes people's diets are not good yes they have maybe potentially fatty type diets things like that you want to keep your cholesterol under control because that's contributory to stress stroke and that and smoking is a huge risk factor for stroke only because smoking actually affects all of your vascular system when you and hill the smoke and if it goes through your bloodstream right it's all right through your bloodstream so that's a huge respect of stroke diabetes sort of the same thing when you have high diabetes it's not controlled people have diabetes and they control it would die and sometimes pills right or sometimes insulin and they have a good sense of what their their norm is they know what to eat sometimes though they can cheat a little bit you know things like that but they keep it under control yes it's when you have very high glucose levels are very high sugar levels that it actually puts a strain on all of your vascular system and that's what is affected by you know a stroke in your heart poor circulation sort of the same thing it's you know all the blood flowing through your important not being active so that sort of ties in with maybe being obese being overweight that puts a risk factor on your on your vessels also and a family history so if your parent had a stroke your siblings have a stroke sometimes grandparents have a stroke it puts you in a little bit of a higher risk for having a stroke so sort of know your family history if you can a little bit make sure your doctor knows that we say that if you keep your blood pressure down you keep your cholesterol down and you stay active that it reduces your risk factors for stroke exponentially while just walking you know you don't have to belong to a gym you don't have to think about lifting weights you don't have just walking maybe potentially a mile a day you know and if you live in a building and it's winter time walk down the hallway walk up a flight of stairs if you're safe walk down the of the hall or you know so just a little bit to go to  are there don't go spending all your money i don't know what the as a great place to walk yeah absolutely especially when the weather's bad yes if you're outside walking is potentially on a very hot day you want to keep some water with you walk early walk late walk safely you know potentially maybe walk with somebody else you know things like that those will help reduce your risk factors for stroke ok well thank you so much you're welcome for all that you do and you're keeping should take advantage of it check with your senior center to see if you can get the file apply if they have it on hand if not create one of your own and make sure that it's available at all banks a big difference does time yes time assia time is of the essence and on that make sure there's a contact person asked if you live alone who to call yes if you create your own yes and an this is dan mccauley of the beaumont police department and emergency can strike at any time when you dial nine one one you are asked to provide information which is difficult to do want to state of panic that is why  now offering smart nine one one nine one one is a national service that allows residents to create a freak safety profile for their homes sold containing crucial information first responders will need to have in the event of my marriage and see such information includes names photos of family members health conditions medications and pets vehicle details and emergency contacts it's strictly voluntary the more information that you and put into the system call taker screen allowing for much quicker response time saving seconds and even minutes a call is made from a cell phone a safety profile can provide an address for first responders to respond to we ask that you when you register for smart nine one one that you register all phone numbers that may be associated with that person or that address in an emergency seconds count set up be a free safety profile today by listening w w w don't smile at nine one one dot com