Stroke Symptoms and Recovery: Recognizing the Signs FAST

One minute everything feels normal. The next, you can’t speak, move, or think clearly.

That’s what having a stroke can feel like—and recognizing the signs quickly can save your life.

In this episode of Baptist HealthTalk, we hear from stroke survivor Meisha McIntosh, who shares her real-life experience of having a stroke while at work, and how fast action helped save her life. Dr. Guilherme Dabus, interventional neuroradiologist at Baptist Health, explains what happens in the brain during a stroke, the different types of strokes, and why every second matters.

You’ll learn:

• The most common stroke symptoms and how to recognize them
• What the FAST and BE-FAST acronyms mean and how to use them
• Why calling 911 immediately is critical
• What causes a stroke and the most important risk factors
• What recovery can look like after a stroke
• Why strokes can happen even in younger, otherwise healthy individuals

The longer a stroke goes untreated, the more brain damage occurs. Acting quickly can mean the difference between full recovery and long-term disability.

Host:

 David Jeannot

 Guests:

Guilherme Dabus, M.D., Co-Director of Interventional Neuroradiology at Baptist Health Miami Neuroscience Institute

 Meisha McIntosh, Stroke Survivor

Transcript

David Jeannot: 00:00

One minute you and a friend are talking about your weekend plans, and the next thing you know, you feel confused and have trouble speaking and start slurring. That's what having a stroke feels like.

PreProduced VO: 00:12

Welcome to Healthy Living, Wellness and Prevention, Medical Innovation, the informed side of care. Welcome to Baptist Health Talk.

David Jeannot: 00:23

Hi everyone, I'm your host, David Jeannot, coming to you from the Baptist Health Newsroom. If treated fast, and we'll get to what fast means in just a little bit here, a stroke can be reversed. The longer it lasts, the more brain you damage. The faster you treat it, the more brain you protect. Here to tell us more about her scary experience is stroke survivor Misha McIntosh, a Baptist Health employee who suffered a stroke while at work. And also here to discuss what happens when a stroke strikes is Dr. Guilherme Dabus, co-director of interventional neuroradiology at Baptist Health Miami Neuroscience Institute. Thank you both for being here today. Thanks for having us. Now, uh before we get started here, I want to remind our viewers to send in your questions and comments in the comments section throughout this discussion. Remember that we are here for you and happy to answer any questions that you may have. Okay, so Misha, let's start with you. Tell us about the day that you had a stroke. What were you doing? Were you doing anything strenuous or did it just strike out of nowhere?

Meisha McIntosh: 01:24

Um, well, actually, it was just kind of a normal day at work. Um, I had gotten breakfast, I spoke with my mother, um, then I was documenting on patients. Um, I remember that someone came to me and said one of my patients was getting out of bed. So I walked to my patient room, and then the next thing I know, I was on the floor.

David Jeannot: 01:42

Was there a moment where you felt kind of woozy or w what did you feel?

Meisha McIntosh: 01:46

No, not at all, actually. Um, from what I've heard, um, someone actually caught me and she was trying to talk to me. She kept calling my name and I wasn't responding. So she came and I started to fall back and she managed to catch me.

David Jeannot: 01:60

And how long did like an ordeal like that last?

Meisha McIntosh: 02:03

Honestly, I don't know. It's all such a blur. It happened so quickly. Um, from getting from collapsing on the floor to getting the intervention, it all happened so fast.

David Jeannot: 02:13

Wow. And your your your coworkers, your colleagues, how what were the some of the first things that they may may have seen?

Meisha McIntosh: 02:21

Um, well, I know that I had something that was going off my eyes and I had a facial droop, um, according to some people, and I wasn't able to lift my arms. Um, but yeah, that's pretty much what they saw. I felt I don't know. I can't really describe how I felt. It was scary for sure.

David Jeannot: 02:41

It definitely sounds scary. Well, now, uh doctor, the signs uh can vary on what events you know turn out to be. But what are some of those symptoms that everyone should be cautious about in regards to uh stroke warnings?

Dr. Guilherme Dabus: 02:54

So that's a great question, David, and thanks for asking it. So basically, when you have a stroke, there's a multitude of different symptoms that you can have. So you can have from not being able to speak, not being able to understand, not being able to see, being paralyzed in part of your body, usually like a side, or being having like sensory changes in part of your body, right? So one of the things that we do, which is very easy for the the for people in general to remember, is use like an acronym called FAST, right? You mentioned FAST, and I think it's important to explain why this is so important because it's an easy way and that anyone can do to see if someone, for example, is having a stroke, right? So fast means F for face. So just look at a person's face. One of the things that can have, people when have a stroke, sometimes can have like a facial droop, right? So look at their face, make sure it's symmetric, ask them to smile. When you're having a stroke, sometimes you when you smile, your face gets different, so they're not symmetric. Uh A is for arm. So one thing that you can do is just ask the patient to raise their arms, try to raise their arms. And if you can see if you're having a stroke, a lot of times you're not gonna be able to raise one of your arms, or one of your arms is gonna be weak. The S is for speech. So just have a conversation, ask the patient a question, see how he's answering it, right? So some people will have a slurred speech, basically, like they're gonna be rolling their tongue, they're gonna be very difficult to speak. Some people may not be able to speak at all, and some others will actually not even understand what you're asking them to do, right? So, and the last uh word is actually the last uh letter is T, which is for time. What that means is that the faster you get to act, the faster you call 911, the faster you get to the hospital, the better the chance of you having a good outcome. So that's very why it's very important to this word fast to be remembered. The other thing that actually there are some modifications of the word fast as well. There's something that we use nowadays, which is B fast. So B E, so B fast. And the B means for balance. Make sure some the person actually doesn't have any balance. You should able to walk in a straight line. And the E is for eyes. Make sure again the eyes are not you know, what do you call like disconjugate, basically like point to different directions and uh things like that. So those are very, very important signs if you're having a stroke that you may actually be able to identify it very easily in very simple exam.

David Jeannot: 05:06

So talk a little bit about the uh possible causes of a stroke.

Dr. Guilherme Dabus: 05:11

Yeah, so basically a stroke it's it can have a lot of different uh causes, right? Like any kind of stroke. There's two different types of strokes, it's important to understand that. There's like the ischemic stroke, which is accounts for about 87%. So it's the most common. It's where basically when a vessel in your brain gets blocked, that's what happened with Misha. The other type of stroke is what we call like the hemorrhagic stroke. So basically you have a bleed in your brain, and that can be from different causes, right? So in general, the most important risk factors for having a stroke are the same things that also affect your heart, right? So it's high blood pressure, diabetes, high cholesterol, smoking. So it's very important to have those all like under control. Now, there are other things that can happen that cause some specific types of strokes, which sometimes are very severe for the schemic ones, which are people with like heart problems. Some types of heart problems, including arrhythmia such as atrial fibrillation, where your heart's not beating correctly. Other problems such as carotid stent, uh carotid disease, actually. So basically, when you have blockage in your carotid, that can also cause uh some types of stroke. And basically, when you're talking about the hemorrhagic types, there are other slightly different risk factors, although a lot of them are similar, but you know, high blood pressure is a very important one, of course, to have like a hemorrhage in your brain. The other things such as smoking, uh binge drinking, for example, using illicit drugs, those all favor also like having potentially hemorrhagic types of stroke. So, again, just to summarize, the most common type, 85 to 87% of the cases, are of the ischemic type, when your vessel actually gets blocked and blood flow does not get to your brain, versus hemorrhagic, when basically a little vessel in your brain kind of bursts and causes hemorrhage into your brain. And this hemorrhage can be caused by an aneurysm, can be caused just by high blood pressure, can be caused by other conditions that are very specific, and uh such as arteriovenous malformations, which is something that you're born with, and then can if they bleed, it can cause this type of hemorrhage.

David Jeannot: 06:60

And kind of go back to uh the fast we were talking about, that acronym, uh the it can also mean to literally act fast as well. The faster that you pick up on those symptoms and get that help, the better chances of survival for that patient, is that correct?

Dr. Guilherme Dabus: 07:12

That is totally correct. There is some studies that show that very clearly. So the longer you wait, the more the brain gets damaged, right? So when you have specifically when you have a blockage in your brain, right? So the ischemic type, which again is the most common type, basically immediately after the the vessel gets blocked, your artery gets blocked, parts of the brain start to die immediately, right? So the idea of the treatment is for you to get to the hostel as soon as possible so you can receive the appropriate treatment to unblock that vessel if possible and restore the blood flow to that part of the brain. There's always a small stroke that happens, but what you really want to do is save most of the brain that is around that stroke so that patient can go back to be what we call like functionally independent. So basically go back to do everything that she was doing before.

David Jeannot: 07:56

Now, Meisha, you were extremely lucky that you ended up having your stroke at work at the hospital. Uh, what do you remember from that moment?

Meisha McIntosh: 08:06

Um, well, honestly, I just remember waking up and my coworkers, they all looked very stressed and a little afraid. So I kind of knew it was serious. Um, I remember when they brought over the wheelchair to put me in it. I tried to get up, I couldn't stand. Um, I remember when they asked me to lift my right arm, I wasn't able to. Um when they lifted it, it just kind of flopped down. Um, and one thing that was really frustrating about the whole speech thing. Um, I remember people were asking me questions and I just wasn't able to communicate back with them. I wasn't able to respond. Um, so that was very frustrating. Um, but yeah.

David Jeannot: 08:44

So they instantly recognize the signs, the symptoms.

Meisha McIntosh: 08:47

I actually work on a neurological step-down unit. So it was kind of perfect. I if there was a place to get a stroke, this is what I'm saying. That's what exactly I was just about to say. Yeah. Um, but I am eternally grateful to my co-workers who recognized and acted immediately. Um, and with such like prompt timing as well.

David Jeannot: 09:06

Now, uh doctor, far too many people think that you know something like this could never happen to them. And I'm kind of guilty of thinking that way sometimes. But you know, they'll say that, oh, I'm young, I exercise, I eat right, but um in recent years, strokes have been showing uh up in adults as young as in their 20s. Um, any what are the factors behind this trend?

Dr. Guilherme Dabus: 09:27

So, David, there there's one thing that's very important to understand. I mean, stroke in a young population is still very uncommon, but there's some specific conditions that may facilitate that from happening, okay? There, as I said, there's some congenital problems, hard defects, for example, that can potentially increase your risk of having stroke, independent of your age, right? So that's one of the things. The other thing is that actually there's a big change in our kind of lifestyle, right? People are more sedentary. They're not really exercising as they should be. They're not taking care of their diet. So all those risk factors are getting, you know, unfortunately affecting people younger and younger. So that facilitates uh again or increases the risk of this people also suffering a stroke. The other thing that is important, there are some other types of causes for stroke, which may be more what's more common in young patients. For example, if you have an injury in your vessel, which is not necessarily because you did anything wrong, sometimes just from doing, you know, extraneous exercise, for example, lifting very heavyweights, put a lot of pressure, and sometimes your vessel can get damaged spontaneously on its own. And that's uh one of the important risk factors when you have someone that is young and has a stroke, something that you definitely always should think of. So I think all these factors combined, so there's congenital things, there are things that you're doing normally that may still facilitate you to have, because those are things that younger people do more often than older people. And also, of course, the life uh style changes that unfortunately is affecting more and more young people.

David Jeannot: 10:49

Okay, so here's just a quick uh follow-up for you. You know, every stroke craze, stroke case is different. Um, what I mean, what are the short-term and long-term effects of having a stroke and what's what stroke survivor what can stroke survivors and their loved ones expect after a stroke?

Dr. Guilherme Dabus: 11:04

So, you know, one thing that you pointed out correctly, every stroke is different, right? Misha here, for example, had one of the most severe types of stroke, which's on a very the main vessel that brings the blood to your brain gets blocked. And these patients, if they're not brought to the hospital immediately and have a a type of catheter surgery to unblock the vessel, the vast majority of the patients will never recover. They will be either dead or severely disabled for the rest of their lives. Um, so you know, it's uh again, it depends on the type of stroke, depends on the stroke was treated. But in general, early on after you have a stroke, there's always some sort of improvement. The question is also how much of that will really improvement be effective and will make you go back to your to your regular life, or it's not really gonna allow you to be independent anymore. And you know, it's important to understand that stroke is a huge burden in terms of like uh our society or even our health system and our society because of the you know of the disability that it causes, right? You know, it's estimated in the United States that approximately like the cost direct or indirect from taking care of stroke is about like $60 billion from like all the disability that it causes, and of course, all the treatments that are performed. So it's important that we all understand, again, that it's very important to take some actions to try to prevent stroke. Make sure you're compliant on your medication, make sure you're going being checked by the doctor regularly. Preventive uh medicine is very important to try to prevent strokes, particularly if you have important family history of diabetes, high blood pressure, right? That's actually my case. So, you know, I know they need to be checked more often or at least, you know, regularly to make sure, you know, if I need to be on a medication, I'm taking the medication correctly, if my blood pressure is, you know, where it should be, normal range, if my glucose is in normal range, if my cholesterol is in normal range, you know, don't smoke, things like that. Because if you don't do that and you, you know, you're increasing your risks of having not only stroke, but also any kind of cardiovascular problem, heart attacks, problems with the blood flow to your legs and everything.

David Jeannot: 12:57

So and Misha, how has your recovery been? And if you don't mind me asking, how are you doing now, uh, mentally and physically?

Meisha McIntosh: 13:05

Um, well, physically, I think that I'm 100%. I'm back at work and it's going great. Um mentally, um, I guess the experience was kind of surreal. I'm still processing it. Um, somehow I managed to be at work when it happened. And I mean, Baptist is a comprehensive stroke center, so I got really lucky.

David Jeannot: 13:27

Are there any symptoms you in in retrospect feel that you may have ignored?

Meisha McIntosh: 13:33

No, not at all. It was just a normal day. I was fine, and then I wasn't. That's a crazy thing.

David Jeannot: 13:40

Just like that.

Meisha McIntosh: 13:40

Yeah.

Dr. Guilherme Dabus: 13:41

It's it's a lot of times that's how it is. I mean, when you have a stroke such as the one that Misha had, basically your vessel gets blocked because the blood flow is normal there. So a clot came, you know, potentially from the heart, from the carotid, we don't know exactly. Goes there, blocks the vessel, and that's when you start to have the symptoms, right? So basically, when the vessel gets blocked, it's when you start having the symptoms. That's why it's like almost like a you know, a light switch, basically. You know, you're totally fine, now you're not anymore. So that's and the other thing that's very important to that brings a very important question to this conversation is a lot of times the person that will recognize that someone is having a stroke is the coworker or the family member, right? So different than when you have a heart attack, for example. You know, I start having like chest pain. I go to the to my telephone or pull my telephone and call 910. So listen, I think I'm having a heart attack, you know, and they will come in, they will assess, take you to the hospital. The person that is suffering a stroke, a lot of times is not able to do that, right? He's not able to even understand what's going on, he's not able to speak, he's not able to move a lot of times. So that's why I think you know, we discussed this before, the acronym FAST is extremely important. Someone, your you know, loved one, family member, or your co-workers will meet will need to be the ones that will recognize that you're having a stroke, and they are the ones that will need to activate 911. And if that's done fast, you know, that that's what gives you the best chance of recovering and going back to your normal life. That's great.

David Jeannot: 15:08

Now, uh, let's go ahead and look at some of the top research questions that we see on the internet. And uh the first one that we have here is what should I do if I think that someone is having a stroke?

Dr. Guilherme Dabus: 15:19

So as we discussed now, I mean, the first thing, if you think someone is having a stroke, call 911. 911 knows where to take these patients. The there's some procedures that would take place in some specific hospitals. So if you just drive your loved one to a hostel, you may take him to a wrong hospital, a hospital that does not provide stroke treatment, for example. So that's why it's important. Call 911. EMS knows which hospitals provide stroke treatments. They have like a very specific guidelines where to take these patients. So again, you suspect the patient's having a stroke, don't hesitate, call 911 and let them do their job.

David Jeannot: 15:54

The second question that we have are strokes hereditary? And and for you, Misha, as well, after after he answers, maybe, do you have any family history of this?

Dr. Guilherme Dabus: 16:06

So stroke is not necessarily hereditary per se, right? But the risk factors are. Doesn't matter if it's schemic or hemorrhagic, there's a lot of risk factors that run, you know, in families, right? So you have increased family history of having high blood pressure, if you have family history of diabetes, if you have high blood pressure, uh high um family history of high cholesterol, all these kinds of things do increase your risk of having a stroke, and they are hereditary, a lot of them. So it's important, for example, that if you do have those risk factors run in your family, that you go look for, no, go for your primary care, get checked, get tested, make sure your blood pressure is under control, make sure your glucose and your diabetes is under control, make sure your cholesterol is where the levels that are recommended them to be. So it's important to get that done because again, there's a lot of things that you cannot control, but those things that you can control, taking your right medication, make sure everything is under control, is your obligation to do it to decrease the risk of you having a stroke as much as you can.

Meisha McIntosh: 17:02

Um, well, actually, my family doesn't have a history of stroke, but they do have a history of high blood pressure, and that's something that I've been dealing with for about 10 years.

David Jeannot: 17:10

So And did you ever think to kind of with that high blood pressure thing to look into strokes or whatever may come with that?

Meisha McIntosh: 17:17

Oh goodness, no. I never really like you know, it's just it's funny since I have to deal with patients who have had strokes and stuff like that. I never really thought that it would happen to me.

David Jeannot: 17:28

So I think you're one of the young ones like me who does oh, it's never gonna happen to me. Exactly. Yeah.

Dr. Guilherme Dabus: 17:33

A lot of people think like that. And that's why it's important that people recognize that if you do have those risk factors, you know, you take care of yourself, right? Exercise, don't be sedentary, have a good diet, make sure again, all the risk factors under control, you know, as instructed by your primary care physician. So if you do all that, you decrease significantly the chance of you having a stroke. There's still gonna be some strokes that there's nothing that you can do. Misha actually was one of those. You know, there's nothing that she could have done. And there's a lot of people that are like that. But if you do your part, you do decrease the risk of suffering a stroke.

David Jeannot: 18:09

That's great. And now the third one is can stress, or the the next one I should say, can stress cause a stroke?

Dr. Guilherme Dabus: 18:16

So, you know, that's a great question. Um, a lot of people nowadays have stress, right? I mean, I usually ask my pensions, my patients, right, who are not stressed nowadays? So I think, you know, stress per se, again, it's not that stress cause stroke, but stress can increase your high blood or your blood pressure and cause you to have high blood pressure. And as I pointed out, that's a risk factor for potentially having a stroke. So, you know, it's important to understand that, you know, again, it's nothing that you can do or it's not a lot that you can do for having a stress. I mean, again, life nowadays is stressful. We have a lot of obligations, a lot of responsibilities, you know, everything is is um, you know, time dependent and everything. So it's important that you recognize that. But again, the important thing is to make sure if you have high blood pressure, you're taking the medication, your blood pressure is under control, your risk factors are controlled. Um, of course, ideally, if you can live a life without stress, that would be ideal, but I'm not sure nowadays that's possible anymore.

David Jeannot: 19:08

Well, I want to thank you guys both. This has been a great conversation, and thank you for sharing your insights with our audience. And to our viewers, I want to remind you to be sure to hit that subscribe button on our channel here to keep up with all the latest health and wellness information and tips from our experts. Thank you all for watching.

PreProduced VO: 19:26

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