By Ailin Quinlan
Monday April 26th, 2010
Irish Independent
Two million brain cells can die every minute during a stroke so seek medical help the moment you suspect something is wrong. This is the message of new campaign, F.A.S.T.
WHEN a stroke strikes, the damage spreads like a fire in the brain. Two million brain cells die every minute you stand there wondering if something's wrong. But if you are quick to recognise the symptoms of stroke and get medical help, there is a much higher chance of recovery.
That's the message of the biggest advertising campaign in the history of the Irish Heart Foundation, which kicks off next month.
On May 5, the organisation launches its FAST drive to highlight the symptoms of stroke, a condition which affects up to 10,000 people a year, and kills about 2,000. It has a greater fatality rate than bowel, breast and prostate cancer combined. Around 30,000 people live with stroke-related disability in this country.
"One in five people in Ireland in the course of their lives will suffer from a stroke. It kills twice as many women in Ireland as breast cancer," says Dr Joe Harbison, Consultant Stroke Physician at St James's Hospital and Senior Lecturer in Medical Gerontology at Trinity College, Dublin.
Symptom
Yet, he says, if asked, about 50pc of the Irish population wouldn't be able to name more than one symptom.
"A lot of people will have a vague idea of what a stroke is, but they don't know very much about it. In the case of somebody having one, a lot of people wouldn't have a clue what to do."
It is crucial to be able to spot the signs, hence the FAST campaign, which is part of an overall drive to improve stroke facilities and increase awareness.
The campaign, which will run for at least four years, aims to educate the general public in the symptoms of stroke and highlight the importance of dialling 999 immediately.
A media blitz will be supported by the establishment of local FAST committees, whose aim will be to build awareness.
"Time is of the essence -- the quicker you get in, the more of your brain the doctors can save," says Chris Macey, Head of Advocacy at the Irish Heart Foundation, which works to reduce death and disability caused by diseases affecting the heart or blood vessels -- cardiovascular disease includes both stroke and heart disease.
"Doctors have said to me that if a stroke is not overly severe and you get immediate treatment you can make a very good recovery. Alternatively, a person who does not get speedy treatment could be dependent for the rest of their life and perhaps even have to get life-long nursing care."
However, in 2006, a mere five per cent of stroke patients were admitted to hospital within two hours of the onset of stroke, which results from a blockage of a blood vessel or haemorrhage that stops the flow of blood to the brain.
This can damage or destroy brain cells, which will affect body functions or mental processes. "A stroke is brain damage related to injury to a blood vessel, usually blockage," says Dr Harbison.
There are several causes, including high blood pressure, diabetes, high cholesterol and lack of exercise. A common cause in this country is Atrial Febrillation (AF), a benign heart arrhythmia which occurs when two chambers in the heart are not contracting as they should.
"They fibrillate and wiggle, which forms clots, and these clots are pumped from the heart to the brain," explains Dr Harbison.
Alcohol is a risk factor in the development of AF, he says, adding that although AF is common in Ireland, it is only recognised in about 50pc of cases.
"Every minute your artery is blocked you lose two million brain cells, which may affect anything from movement to language or even your ability to recognise family members. Every single function that makes you who you are can be injured by stroke.
"The message we give out is that 'time is brain'."
Dr Patricia Kennedy, a psychologist in her 70s, understands just how important it is to be treated rapidly. On August 14 last, the grandmother of six from Dublin's Terenure was relaxing after dinner when she had a stroke.
"Within 40 minutes I was in St James's Hospital and I was seen straight away. I'd had a stroke. My right arm and leg had no power.
"For weeks after that I was unable to get out of bed without two nurses and sometimes I felt that I didn't know where my leg was. My language was also affected -- I had difficulty finding words and sometimes I still have to dredge them up when I talk.
"In all I was in hospital for three months getting rehabilitation -- physiotherapy, speech therapy, occupational therapy. I practised my exercises and it paid off -- it's a huge effort but if you persevere it's worth it."
Anybody can have a stroke, though about two-thirds of those who have one are over 65.
"The average age of stroke is about 73 but we'd get 200 or 300 people a year who are under the age of 40," says Dr Harbison.
Stroke can also affect children and pregnant women and hospital staff are seeing an increase in drug-related cases.
"The use of cocaine and cannabis and amphetamines can increase the risk of stroke. We have seen in the past year a number of younger people under the age of 40 with drug-use related stroke."
However, despite the fact that it is so common, only about 11 of the country's 37 hospitals have a stroke unit, according to a HSE survey.
Yet it is believed that up to 500 people a year could be saved if stroke units were introduced to all hospitals.
"If you're living in the wrong area you are going to have a problem. Many of the hospitals in the north-east and south-west either don't have a stroke unit or a well-resourced stroke unit," says Dr Harbison.
He wants to see the introduction of a system allowing GPs to identify people at high risk of developing stroke.
"About one in five people who have a stroke often first experience a mini-stroke as little as 48 hours before a major stroke.
"If you can be investigated for a mini-stroke within 24 hours of having it, your risk of a major stroke is reduced by 80pc."
People who have had a stroke need to be assessed and treated as quickly as possible. If stroke victims can get into hospital for treatment within three-and-a-half hours of the attack their chances of a positive outcome are much higher, he says.
"If you get to a stroke unit, the chance of being either permanently disabled or dying are reduced by 25pc."
When former taxi driver John Daly started getting dizzy spells last September, his doctors initially thought the father-of-three, from Dublin's Firhouse, had a case of vertigo.
Light-headed
"My balance was affected and the headaches were very bad," recalls the 58-year-old. "I couldn't stand up straight and I would have had to crawl to the loo from bed when I got up in the morning. I'd feel light-headed."
Eventually John was admitted to St James's Hospital in Dublin. Tests were carried out and he was told he'd had two separate strokes in the previous weeks.
"I was in hospital for 11 days. My speech, arm and face control were not affected but my balance was. When I left the hospital I was still getting dizzy spells and was a bit light-headed.
"I'm still cagey about going out on my own but the vertigo has subsided. Now and again I'd feel a bit light-headed but nothing too much. The headaches are gone."
John was advised to drink a litre of water a day -- previously he would have drunk just one glass. He now exercises regularly, taking 30-minute walks twice a day.
Although he enjoyed an occasional drink in the past, these days John eschews alcohol.
"I've given up alcohol completely over the last three or four months and I feel better for it.
"I think I've got through it -- I've been very lucky. I got a warning without suffering any paralysis. If I get anything like this again I'll know exactly what to do -- last time I didn't recognise what was happening."
It is important to remember, emphasises Dr Harbison, that stroke is one of the most preventable -- and treatable -- neurological conditions. About 80pc of stroke survivors can walk out of hospital and live independently.
Checking and treating high blood pressure, regular daily exercise, cutting down or cutting out smoking, a moderate consumption of alcohol and a sensible diet all help prevent stroke, he says.
"People are fairly bleak about stroke but if you identify it quickly and manage it properly people do very well."
The Foundation, the fundraising arm of St James's Hospital, is hoping to raise €250,000 for much needed stroke services equipment this year. Upcoming events include a golf classic on May 17 and a liberties fun run on July 22. for more information tel: 01 428 4086
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