Stroke awareness team at Inova Loudoun Hospital reaches out

Education and risk assessment are the first steps in stopping the ‘silent killer’

The front line in the campaign to prevent strokes is an educated public.

So the Stroke Program at Inova Loudoun Hospitalset up shop every Friday morning in May – Stroke Awareness Month – in the cafeteria and offered free blood pressure screenings and a wealth of information to all comers. Inova Fair Oaks, Alexandria, Mount Vernon and Fairfax hospitals mounted similar outreach programs every Friday in May.

“Stroke is the third leading cause of death in the United States, right behind heart disease and cancer, and the leading cause of adult disability,” said Jennifer Rasmusson, Registered Nurse in Telemetry and chair of the Stroke Program at the hospital.

“Because one of the risk factors is high blood pressure, this is an easy way to check people and to raise awareness.” One of her first subjects May 20 was Beatriz Betancourt, a food service employee. Her blood pressure was fine, at the “low risk” end of the scale, but Rasmusson went over the National Stroke Association’s risk assessment card.

First, Rasmusson said, acknowledge the risks we can’t change – race (more than 40 percent of African Americans have high blood pressure or hypertension), age and family history.

“But we can quit smoking, become more active, control our blood pressure, lose weight, and move the line over to the low risk side of this table. Minimize risk and then go out and live. That’s the best part, just go out an enjoy life,” Rasmusson said.

Outreach and education are a challenge in fast-growing Loudoun County, Rasmusson said. Much of the population is young families, not at high risk for stroke as a rule. But a significant number of Loudouners are retirees and older people. They are at higher risk simply by being older, and the younger segment needs to recognize the symptoms.

The Stroke Program needs to reach both those groups, and it must reach out to the free clinic patients and to the growing Hispanic population. Most of the program’s materials are available in both English and Spanish.

Stroke patients at Inova Loudoun Hospital can be found in the Intensive Care Unit, the Telemetry Unit or the Emergency Room, Rasmusson said, depending on the severity and nature of their stroke. Staff from those three units, plus other volunteers, set up the stroke awareness table in the cafeteria each week. Friday May 27 will be the last appearance there, staffed by the Telemetry Unit. Anyone who wants more information about stroke and its symptoms can call 703-858-600 at any time and ask for the stroke unit.

The other part of the awareness campaign is to get people to take the first symptoms of a stroke seriously. “We tend to ignore it if it doesn’t hurt,” Rasmusson said. Stroke is known as the silent killer.

“The saddest thing is to hear about someone who had numbness, went to bed and woke up the next morning unable to move. They are beyond the time we can intervene.”

Rasmusson, and nurses Alexis McPoland and Mildred O’Meaera-Lett, handed out FAST cards detailing for the layman the symptoms of a developing stroke:

F is for Face. Is the person’s smile lopsided? Is one side of the face immobile?

A is for Arm. Raise both arms. Are they even, or does one droop, sag, or not move at all?

S is for Speech. Pronounce a simple phrase. Is it clear?

T is for Time. If even one of these signs is present, call 9-1-1 immediately.

Strokes come in two categories, McPoland explained to Sandy Frager, a volunteer at the hospital’s main entrance reception desk. Blood clots cause ischemic strokes; bleeding causes hemorrhagic strokes.

Both can be treated, but doctors at the Emergency Room have to determine which type of stroke is occurring. And they need to know, as precisely as possible,the time of the first symptoms.

The window of opportunity to administer TPA, or Tissue Positive Antigen to dissolve a clot, is four and a half hours at the most.

The gospel at the Stroke Program is “Time is brain.” Bleeding can be treated, clots can be removed, but every minute before treatment means lost brain cells.

McPoland recommends a visit to www.stroke.org. “There’s a section there solely for women about stroke, and you can download the whole portfolio. Only 20 percent of men will recognize stroke symptoms in a woman.”

Reducing risk of stroke:

• Know your blood pressure. If it’s higher than120/80, work with your doctor to lower it.
• If you smoke, stop. If you don’t smoke, don’t start.
• If you drink alcohol, do so in moderation.
• Find out if you have high cholesterol. If so, work with your doctor to reduce it.
• If you are diabetic, work with your doctor to control it.
• Exercise regularly.
• Reduce your intake of salt. The American Dietetic Association has lowered its recommendation for maximum sodium per day to 1,500 milligrams. Most processed foods – canned soups, frozen lunches – are high in sodium.

Disclaimer: this post originally appeared in http://leesburg.patch.com, written by Shannon Sollinger and re-posted with permission.