Centered on Health 8-14-25 - Warning signs of a stroke and importance of quick action with Tina Walsh, stroke coordinator, Baptist Health Floyd
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Speaker 1 (00:01):
It's now time for Centered on Health with Baptists Help
on use Radio.
Speaker 2 (00:06):
Wait forty telny WITJS Now, here's doctor Jeff Tubble.
Speaker 3 (00:12):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We are
joined from the studio by our producer, mister Jim Fenn.
He is waiting for your calls this evening to talk
to our guests tonight about warning signs of stroke and
(00:32):
the importance of quick action. Call us at five oh two, five, seven,
one eight four A four and be a part of
the conversation. In Kentucky's stroke is a very real cause
of problems, including both death and permanent disability. Unfortunately, Kentucky
is higher than the national average immortality, and in twenty
twenty one, Kentucky was fourteenth highest in the United States
(00:54):
and stroke accounted for twenty five hundred deaths, not to
mention the disability, making it the sixth leading cause of
death and five percent of Kentuckian's report having had a stroke.
So we're very lucky tonight to have Tina Walsh with
us tonight. Tina is the Stroke program coordinator about This
Health Floyd in New Albany, Indiana, where she has been
(01:14):
since October twenty twenty four. Previously, she was at the
University of Louisville Hospital since nineteen ninety one. She received
her Bachelor of Science in nursing from the University of
Louisville and master's in healthcare Administration also from the University
of Louisville.
Speaker 4 (01:28):
Since July of.
Speaker 3 (01:29):
Twenty sixteen, Tina has had just about any position with
stroke as one could possibly have, so we certainly have
an expert with us tonight. Tina, Welcome to Centered on Health.
Speaker 1 (01:41):
Hi, thank you, I'm glad to be here.
Speaker 3 (01:44):
Well, we're very excited to have you. Such an important
topic for us to talk about and educate, and I
just I actually want to start off by just mentioning
that Baptist Health Floyd is a primary stroke center.
Speaker 4 (02:00):
Tell us what that means.
Speaker 1 (02:04):
Yes, that is correct. So there are accreditation bodies that.
Speaker 2 (02:11):
Hospitals ask to come and check their hospital for appropriate
guidelines to make sure that we're actually following the best
guidelines that have been recommended by the American Heart Association
American Stroke Association for Practice in stroke care, and to
(02:31):
do that, you have to meet certain criteria for how
you care for your patients and you have to be
following the best practice guidelines. And so as a primary
stroke center, there's there's different levels. So there's a prime
there's primary stroke center which can do all of the
basic care for a stroke patient that comes to our facility.
We can give what's called the clock busting medicine, that
(02:54):
is an IV medication that can be given in some
cases when someone is having a certain type of stroke.
What we are not capable to do as a primary
is certain advanced level care that has to be.
Speaker 1 (03:09):
Sent to another facility.
Speaker 2 (03:11):
And we do have a comprehensive center in our Baptist
system that we send those patients to and that those
things consider procedures where there are things that can be
done to actually pull a clot out that might be
causing a blockage, and some of that advanced care for
also bleeding types of strokes that has to be done
(03:32):
on an advanced level hospital.
Speaker 3 (03:36):
And I know that you know this is such an
amazing service that we have in our community, and I
know that you don't want to brag on yourself, So
I'm going to brag on you for you that I
know that the American Heart Association just awarded a Target
Stroke Gold with Honor Elite Plus Award for twenty twenty
five for all the work that's being done at Bauptics
Health Floyd.
Speaker 4 (03:56):
So I feel like that's important for our listeners.
Speaker 3 (03:58):
To know and to congratulate you obviously on all the
work that you are all doing, which we are going
to hear so much about tonight.
Speaker 4 (04:06):
So tell us.
Speaker 3 (04:08):
A little bit about how you got involved in this area.
What were you doing before this became an interest of
yours and how did this become an interest of yours?
Speaker 1 (04:19):
Well?
Speaker 2 (04:20):
As you mentioned, I've been a nurse for many years,
and it doesn't seem that long sometimes that I've been
a nurse.
Speaker 3 (04:27):
For thirty nineteen ninety one was only ten years ago, right.
Speaker 2 (04:31):
I know, right? And so initially, you know, I worked
in critical care and then have the opportunity to become
interested in the neuroscience area, and so I did work
in that area for starting in two thousand and one.
(04:52):
Then my grandmother had a stroke and that is what
piqued my interest because I saw what happened heart and
her story. I tell when I do seminars. I talk
about how you know her sittings were a little bit
atypical and she was able to recover. However that did
(05:14):
I saw her through that pathway in the hospital, and
so that made me get interested in wanting to try
to learn the signs and symptoms and how to treat
people in the cute phase so that we can help
prevent that disability.
Speaker 3 (05:29):
Well, I am sure that your grandmother would never have
wanted to have a stroke, but having had one, it
was a chain of events that appears to have led
to you helping countless numbers of patients with strokes.
Speaker 4 (05:41):
So what a what a great story.
Speaker 3 (05:45):
I want to know a little bit about the role.
Speaker 4 (05:49):
Of a coordinator. What what does a coordinator do?
Speaker 2 (05:55):
So a stroke program coordinator is the person that's respect
possible for not only collecting the data and the performance
measures to make sure that we are following those special
requirements for primary Stroke Center and for the American Heart
(06:15):
Association get with the guidelines registry.
Speaker 1 (06:19):
We also are involved with.
Speaker 2 (06:23):
Teaching in the hospital, helping to teach providers, helping to
teach staff about current guidelines. Basically kind of making sure
to act as an expert in the hospital setting to
make sure that we are doing the best possible current
practice and best care, and with stroke that is constantly changing.
(06:46):
There's always there's new research coming out for better practice,
guidelines and things that we can do differently. You know,
years ago, many years ago, some certain types of symptoms
we're not really paid much attention to, and now that
we have certain research that's been done, we know that
(07:07):
when patients are having those symptoms, even if they go away,
so that's a very high chance that those symptoms may
come back and actually cause a stroke the next time.
Speaker 3 (07:17):
Yeah, and we're gonna we're gonna get into some of
that too, to educate our audience of how many coordinators
are there?
Speaker 4 (07:24):
Are you?
Speaker 3 (07:24):
Are you the one? Are there multiple stroke coordinators? What's
the sort of team.
Speaker 2 (07:31):
Yeah, at a facility the size of Baptist Health Floyd,
we have one coordinator. In most hospitals there there is one.
There's one coordinator there. There are at times in larger
facilities that maybe two. One may focus more on the
bleeding type strokes and procedures and one may focus.
Speaker 1 (07:54):
On more of the blockage type strokes.
Speaker 2 (07:57):
It definitely is a a role that uh involves.
Speaker 1 (08:04):
A lot of many hats, as I said, not.
Speaker 2 (08:07):
Only being acting as an educator, acting as a resource,
acting as a data expert, guideline expert, but also pulling
a lot of that data and then sharing it back
with the team in a meaningful way that can help
us be able to make improvements where we need to.
There has been you know, some uh information out about
(08:30):
this role because it is such a busy role and
and quite honestly doesn't get a lot of other help
as far as data and things like that. Right, So
oftentimes the burnout for this role is oftentimes around three
years for positions, and so there is sometimes a high
turnover rate at some facilities for this role. But that's
(08:54):
kind of there's there's more and more information being shared.
Speaker 1 (08:58):
And stroke is still also compared to heart.
Speaker 2 (09:03):
Treatment and trauma treatment, stroke acute treatment is still kind
of new. People have been treating trauma and heart as
emergencies for a long time now, but treating stroke is
an emergency is still relatively new.
Speaker 3 (09:19):
Well, that is fantastic introduction to what we're going to
delve into. We're going to take a very quick break tonight.
We're talking with Tina Walsh about the stroke signs and
symptoms and the importance of a rapid response to it.
I am doctor Jeff Tublin. You are listening to Centered
on Health with bout his Health here on news radio
eight forty whas. Our phone number five oh two, five
(09:41):
seven one, eight four eighty four. If you want to
call in and be a part of the conversation, we'll
be right back. Welcome back to Send It on Health
(10:09):
with Baptist Health here on news radio eight forty whas.
I'm your host, doctor Jeff Tomlin, and we're talking tonight
with Tina Walsh about the importance of recognizing signs and
symptoms of stroke and how important it is to act quickly.
Our phone number is five oh two, five seven one
eight four eighty four, and our producer, mister Jimfinn is
on standby ready to take your calls.
Speaker 4 (10:32):
So, Tina, you gave us.
Speaker 3 (10:33):
A really nice introduction to the role that Baptist is
playing in terms of the organization around stroke management. But
let's let's talk about stroke. Let's start with some of
the basics though. What what is a stroke?
Speaker 2 (10:50):
Well, there are two types of stroke. One is a
stroke that is caused by a blockage, and that term
we use is called a schemic stroke because it's a.
Speaker 1 (11:00):
Reduced blood flow.
Speaker 2 (11:02):
There's also a stroke that's caused by a blood vessel bursting,
and that's a hemorrhagic stroke.
Speaker 1 (11:09):
So you often hear those discussed as are.
Speaker 2 (11:12):
Being called a brain bleed or a ruptured blood vessel.
Speaker 1 (11:16):
So they're both uh different.
Speaker 2 (11:19):
They're both types of strokes, and they both present very
similarly in symptoms, but the treatment for for them is
very different obviously.
Speaker 3 (11:28):
So and the problem is it a blood flow, a
blood flow interruption to the to the brain. What what's
the what's the result of the stroke? I know we'll
talk about symptoms, but m.
Speaker 1 (11:41):
Hm, that's correct.
Speaker 2 (11:43):
Yes, it's there's a result of if there's decreased blood
flow because something is blocking it, then the tissue that's
not getting blood flow then begins to die and you
have an aeschemic area in the brain that can have
that could be damaged. If in certain cases we can
(12:03):
restore that blood flow in those blockage type strokes, we
can sometimes restore that before the damage has been done
to those cells, and patients can recover.
Speaker 1 (12:12):
In some cases. With the hemorrhagic.
Speaker 2 (12:15):
Strokes, the bleeding also causes a disruption in the blood
fel obviously to an area, but that presents a little
bit more of an issue because then you have bleeding
into the brain that can cause more pressure and can
cause the brain to swell.
Speaker 1 (12:30):
So there are different treatments for that.
Speaker 3 (12:34):
And I think you started pretty much to answer this,
but why is it an emergency?
Speaker 2 (12:42):
Well, it's emergency, because yes it is. It give you
life threatening. Not only can it be debilitating because once
the damage has occurred, it can cause you to have
various pages of disability, whether it's related to being able
to move an arm or a leg, being able to speak.
(13:03):
It also can actually, as you have mentioned, it can
cause not only disability, but also death because if a
large area of the brain is affected, then that can
cause the swelling and have an overall effect on the
brain that may not be able to be recoverable.
Speaker 3 (13:21):
So, you know, we as an audience listening to this,
I know we kind of can wrap our head around
the heart. We understand the heart, We understand heart attack,
lack of blood flow and the muscle being damaged, but
the brain is so complicated, And could you give us
a very you know, low degree level of the anatomy
(13:44):
of the brain and then why that might affect how
one stroke might present differently than another.
Speaker 2 (13:52):
Absolutely, and yes, that is so important because there are
different areas of the brain, and because of the brain
is so complex. Specific areas are what allow us to speak,
what allow us to move, what allow us to even
for our heart to beat, and for us to be
able to breathe. So in those specific areas of the brain,
(14:16):
whether it's you know, the top of the brain, the
back of the brain, the middle of the brain, there's
also different sized blood vessels, So that is important as well,
because if there's a blockage in a smaller blood vessel,
it is not going to be as impactful as a
larger blood vessel. And some of those larger blood vessels
(14:36):
in certain areas are the ones that we can actually
go in and retrieve and pull out at our at
our higher level facilities, the ones that are not in
as big a vessels, and we can give the clockbusting
medication to that medicine can open that area back up
and allow the blood to flow again and then de
(15:00):
treats that uh damage to the to the to the
tissue that's being compromised.
Speaker 1 (15:07):
Do you want me to talk about signs and symptoms.
Speaker 3 (15:10):
Yeah, I would think, Yeah, I'd love to hear it. Absolutely,
we need to. We need to milk all that knowledge
you have.
Speaker 2 (15:18):
Up there, right, So we basically we we use the
term called B fast. And I know some of your
listeners might be familiar with the term fast F A
s T. That's been out for for several years, and
that's one of the things that's been used to teach
about those symptoms. There's a new one that's called B
(15:40):
fast because what they found is that the that F
A s T didn't include that back part of the
brain that I was talking about, and those symptoms can
be very tricky and they can mimic other symptoms.
Speaker 1 (15:53):
So for B fast, b.
Speaker 2 (15:55):
UH stands for balance, So it means if you have
a sudden change in balance or coordination. You suddenly can't
hold your coffee cup, you suddenly can't button a button,
if you feel that you're walking and you can't walk
straight and your balance is off. This would be things
that are sudden, not caused by something else. The E
(16:17):
is for I's if you have a change in your
vision that comes on very suddenly UH, and that has
to do with that whole back part of the brain
that I that I was mentioning called the posterior part
of the of the brain. And then F A S
T is. The F is for facial group and that's
probably one of the most common things people are familiar.
Speaker 4 (16:37):
With familiar with, Yeah, sure.
Speaker 2 (16:40):
And then if that the A is for armor leg weakness,
sudden armor leg weakness, S S is for speech if
there's sudden not ability not to speak or or not
understand words. And then the T in in fast is time.
Time is brain. You heard that saying many times, because
(17:02):
there's many brain cells that are lost very quickly, in
just a matter of minutes. And so the faster that
you recognize the symptoms and that you, you know, call
nine one one and get help immediately, the better offense
that we have to be able to intervene and hopefully
be able to reduce any type of disability or death.
Speaker 3 (17:25):
And what about are there are there other atypical presentations
you mentioned some with your your grandmother, like what about
headaches or dizzyness?
Speaker 4 (17:35):
Are those things that are also symptoms?
Speaker 1 (17:39):
And I didn't thank.
Speaker 2 (17:40):
You, Yes, I did not include dizzyness in that balance,
and that is very important. Dizzeyness is one of the
most trickiest ones that that we find because that has
to do with a certain part of the brain that
could be affected.
Speaker 1 (17:56):
But it also could be an.
Speaker 2 (17:58):
Ear infection, it could be something else that's causing that dizziness.
It may not be stroked, but we do tell people
if you have a sudden onset of dizzyness.
Speaker 1 (18:09):
That was that you're not it's not normal for you,
and suddenly.
Speaker 2 (18:12):
You have that, that would be a cause for concern
in my in as far as headache, yes, a sudden
headache that is more associated usually with.
Speaker 1 (18:21):
The bleeding type strokes.
Speaker 2 (18:23):
It can be associated with a blockage type, but more
so with the bleeding type stroke is where we have
people that complain of a sudden headache and this would
be a sudden headache that comes on very suddenly and
it's like the worst headache of your life or something
you've got experienced before.
Speaker 1 (18:41):
In my grandmother's case.
Speaker 2 (18:44):
As I mentioned, she was a little bit atypical. She
the only symptoms she had was she couldn't talk. She
suddenly could not talk. She was completely she was yes,
she was walking around doing everything and normal.
Speaker 1 (19:00):
And when I.
Speaker 2 (19:00):
Went to speak to her and she went to say
to respond to me. She could not talk, and so
that was very sudden, and luckily we were able to
get her to the hospital quickly. Not in her case,
she did not have to receive a clockbusting medicine because
her body did open that back up again.
Speaker 1 (19:22):
And I want to make sure and mention that to.
Speaker 2 (19:23):
People, because you know, there are cases where our bodies
might open that back up or the symptoms may go away.
And in her case, the symptoms went away, but we
still took her to the hospital and still how the
ambulance take her and do the full work up so
we could get her on the specific medications and treatment
so that we could prevent another one.
Speaker 1 (19:44):
And that's also very important.
Speaker 3 (19:48):
And Tina, I know, like as we're having this conversation
and you talk talk about your grandmother, I think our
natural instinct is to immediately go to, oh, this is
a problem of only elderly people. Can you tell us
a little bit about the range of patients that you see,
is it what kinds of ages is it? Is there
(20:09):
a difference in race, male or female? What do you
see in terms of who this effects?
Speaker 2 (20:17):
Well, they're definitely obviously you think that as you age,
you have more risk factors that come into play for
many diseases, and that does include stroke. However, there are
many times where we have younger people who even have
no known risk factors.
Speaker 1 (20:34):
That may present to us with those symptoms.
Speaker 2 (20:36):
Sometimes those patients may have an unknown blood issue where
their blood is clotting inappropriately, or they may have some
other lying disease that is they're that's they're unaware of.
So even in younger patients, we you know, in the literature,
there's you know, patients as young as fifteen years old
(20:58):
that has been given clockbusting medicine that have been had
I have a possible stroke. Now, of course that doesn't
it size of the hopit happened often, but it definitely
can be of any age. But your risk does increase
as you get older, as does all your risks for
any other things. The main thing I want to make
(21:20):
sure that the audience that here's what I talk about symptoms.
I mentioned that my grandma's symptoms went away on their own,
but we still had her go to the hospital in
the ambulance, and that part is really important. And and
there's also another type of conditions called a t I
A which you may already have been planned to ask about,
(21:43):
and that's called a transient schemic attack. Years ago, people
would call those little strokes. That was kind of what
it was called. But then as we learned more research,
we found those are not actually little strokes because there
was no actual damage done to the brain, but there
was a block in and that our body took care
of it and opened it back up again. The symptoms
(22:04):
went away. Many years ago, those patients were discharged from
the hospital because they their symptoms.
Speaker 1 (22:10):
Their symptoms were gone.
Speaker 2 (22:12):
We now know that even if someone has a TIA,
that that is still a reason to get a work
up to find out what caused it, because there are
a chance that the patient could have another stroke in
several months after that, and there's a higher incidence of
that happening. So you want to make sure that if
(22:35):
you had symptoms and they went away, you still need
to get that checked out because if it is something
that's going on, you'd want to be on the proper
medications to help prevent a stroke down the road. The
other thing I also want people to make sure and
know is that if you're having symptoms, oftentimes what people
(22:56):
do is they say, oh, I don't feel real well
and I'm having this symptom.
Speaker 1 (22:59):
I'm going to go lay down a little while and
see if I feel better when I.
Speaker 2 (23:02):
Get And then of course they either don't wake up
or they wake up and it's much worse. And then
at that time they're outside of the treatment window for
us to be able to do as much for them
to help with that disability. So that's why it's so important.
Speaker 1 (23:18):
To recognize the symptoms.
Speaker 2 (23:20):
You don't know the be fast that that was mentioning,
and recognize those symptoms and then be able to get
to the hospital quickly. And it's also important to not
drive yourself to the hospital if you want to call
nine one one and have an ambulance bring you, because
the ambulance cannot only start some treatment, they can also
pre notify the hospital.
Speaker 1 (23:42):
At the hospital know that that you're on the.
Speaker 2 (23:44):
Way and coming in, they can get ready for you.
Speaker 3 (23:49):
Well, you've happed a lot of important information in those
last few statements, So I think we're gonna we're going
to revisit that when we come back, so we can
pull out all those pearls that you just gave us.
But what a wealth of information we're going to take
a quick break and we'll be right back. You're listening
to Senate on Health with Baptist Health here on news
radio eight forty whas.
Speaker 4 (24:09):
I'm your host, doctor Jeff Tublin.
Speaker 3 (24:11):
We're talking with Tina Walsh about signs and symptoms and
the importance of quick treatment of stroke.
Speaker 4 (24:15):
Will be right back.
Speaker 3 (24:30):
You are back listening to Senate on Health with Baptist
Health here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin. We're talking with Tina Walsh tonight about
the importance of recognizing the signs and symptoms of stroke
early and early treatment. Our phone number five oh two,
five seven one, eight four eighty four if you'd like
(24:51):
to call in. And right before the break, we were
learning about b fast, which is balance, eyes, facial droop,
are or leg weakness, speech changes or and how important
timing is. So remember the befast. It's some really important
information that we're learning tonight. So Tina, right before the break,
(25:12):
you were telling us a little bit about tias and
I didn't want to shortchange how important that is because
I feel like we're all a little bit familiar with
the term mini stroke or one that kind of resolved
and tell us a little bit again about how we
should think about tias and how important they are to.
Speaker 4 (25:30):
Get followed up on.
Speaker 2 (25:33):
Yes, as I mentioned, even years ago, we did not
actually keep patients in the hospital for treatment if they
had a TIA, if there was no damage that we
could see on imaging, and if there's symptoms, second, who's resolved.
But what we now know is that they are at
a much higher risk of having a even bigger stroke.
(25:56):
I have an actual stroke several months downad because the
cause has got still been eliminated, we don't we there
may be a cause that we can help to treat
and prevent an actual stroke from happening. When the tia,
it's called transient a schemic attack because it's transient, meaning
that it goes away. You know it is a schemic
(26:19):
because it's a blockage. So for some reason there is
an area where there's blood flow that becomes blocked in
the brain and that area causes symptoms. So patients will
have symptoms, but then the area becomes opened back up
again because your body has its own mechanism of trying
to open that back up and that restores.
Speaker 1 (26:42):
The blood flow.
Speaker 2 (26:43):
Symptoms go away, but yet the cause has not been identified,
and so there are medications and prevention therapies that we
can recommend to help prevent an actual stroke from happening.
Once we have the patient, do the work up and
(27:04):
so we can talk. I know you mentioned wanting to
talk a little bit about once they get to the hospital,
but yes, as far as TIA, it's so important don't
ignore the symptoms. If they go away, you still want
to go to the hospital. Now, obviously they don't go away.
If they go away, it's not as urgent to have
to go immediately, but you definitely want to be seen
(27:28):
by your healthcare provider and have that evaluated.
Speaker 3 (27:32):
And you sort of answered this partially already. We had
a question that was submitted about whether having one stroke
actually increases your risk of having a second stroke. And
I understand from the TIA perspective that that's a sign
of a possible stroke. But for somebody who does have
a full on stroke, are they at higher risk later
(27:54):
to have another one?
Speaker 1 (27:56):
It depends on the cause.
Speaker 2 (27:59):
Obviously, Sometimes if there's a if there is an underlying
cause that is found, maybe something where someone's blood is
plotting abnormally and that needs to be treated. There are
also I know everyone may be familiar with a true fibrillation,
which is a a a heart.
Speaker 1 (28:18):
Issue.
Speaker 2 (28:18):
Well, the heart beats faster than it should and that
can cause clocks to form in the heart.
Speaker 1 (28:24):
So you hear about aphib and a fib being making you.
Speaker 2 (28:28):
More at risk for a stroke because a clock can
move out of the heart. Obviously, if that is found
to be the cause, there are treatments that can be
done in medications to control the aphib to prevent that
from happening.
Speaker 1 (28:42):
So it depends on the cause.
Speaker 2 (28:45):
And but in many cases, if you're if the treat
if there's not treatment that's initiated and prevention put into
place with medications and therapies that you know, if you
have had a stroke, you aren't higher with for having
another one.
Speaker 3 (29:02):
And you've mentioned obviously how important you know, time is
brain I think that we've we've talked about that and
how important the urgency of treatment is in that respect.
But it also matters. You've mentioned the term clotbuster a
couple of times. Tell us tell us what you mean
by that and that that also is a time sensitive issue, right, Yes.
Speaker 2 (29:27):
Yes, it is, that there's a there's medication that we
can actually give that can they can bust the clot
apart and open the blood vessel back up again. That
can only be given in certain cases for certain areas
of the brain. But timing of that is very important
because if there's too much time it has happened from
(29:50):
the time your symptoms started to the time you get
to the hospital, then it eliminates that time window. So
you want to get you want to go to the
hospital as soon as possible, And the timing that we've
used at the hospital is four and a half hours
from the onset of the symptoms. But what happens when
(30:13):
you don't really know your onset of symptoms first of all,
and you know because you may not, And what happens
also when there may be a bigger vessel that we
could also help and in those cases that can be
twenty four hours out and we could still there's research
that shows that we can still be helpful to a
(30:34):
patient with one of those large we call those large
vessel occlusions or elbows. But those are the ones that
we can actually go in and pull a clot out,
and that can be done up.
Speaker 1 (30:46):
To twenty four hours.
Speaker 2 (30:47):
So we try not to We don't want patients to
worry quite as much about the timeline as much as
just remembering that if you have symptoms as soon as
you notice them, if they're sudden onset of those beefast
symptoms and you you know something is not right, then
you want to seek you know, help immediately and get
(31:08):
to the hospital. There are times where there are symptoms
that mimic strokes as well. We call them mimics, and
those are things like seizures, migraine, headaches, low blood sugar
for patients that are diabetic, those are the top three
mimics that we see, and especially the migraines and seize
(31:28):
are They can be very scary because they those patients
could actually have, you know, complete paralysis of one side
where they can't move an arm or a leg, or
not be able to speak. But it's not being caused
by a stroke. It's actually a migraine which is causing
a different mechanism happening in the brain. But those are
(31:49):
things that a person at.
Speaker 1 (31:51):
Home would not be able to figure that out.
Speaker 2 (31:56):
Absolutely, so we would rather you get to the hospital
quickly and then we would be able to diagnose if
it's if it's a migraine and be able to treat that,
or if it's a seizure, or if it's a low
blood sugar. So it's more important to get there quickly
so that we can have the opportunity to do all
(32:17):
of the things that we might be possible. But yes,
that time window, that's why it is so important to
get there quickly so that we can determine if you're
in the time window for us to do those treatments.
Speaker 3 (32:30):
You know, it's fascinating because you know you're giving us
such an insight into what's going on. I mean, starting
just with the concept of the time window, we have
to figure out if it is a stroke to begin with,
if it's a stroke, whether it's the hemorrhagic or the eschemic,
there's a lot that has to be done in a
very short amount of time with very high risk stake.
So we appreciate learning from you that there are people
(32:52):
out there coordinating all this to be done quickly.
Speaker 4 (32:55):
We're going to take a final break.
Speaker 3 (32:57):
Here and we're going to come back and talk about
risks that we can try and avoid so that this
doesn't happen to us. You are listening to send it
on Health with Baptist Health here on news radio eight
forty whas. I'm your host, doctor Jeff Tumblin. We're talking
with Tina Walts. We're learning a lot about how important
it is to recognize the signs and symptoms of a
(33:17):
stroke early.
Speaker 4 (33:18):
We'll be right back.
Speaker 3 (33:32):
Welcome back to Send It on Health with Baptist Health
here on news radio eight forty wahas. I'm your host,
doctor Jeff Tumblin. If you're just joining us, We've been
having an amazing conversation with Tina Waltz tonight about the
early signs and symptoms and importance of early treatment of stroke.
Remember to download the iHeartRadio app and re listen to
(33:52):
this or any of our previous segments and have access
to all the features that the app has to offer.
So you know, we had another question that came in
that I think you could probably help clarify. The question
was that they had a family member who had a
stroke and was put on a blood thinner, and if
bleeding is part of the problem with a stroke, why
(34:14):
why would that be something that would be part of
the treatment.
Speaker 2 (34:19):
Well, that is an excellent question, and the reason for
a blood thinner and stroke is that difference in the
types of stroke if and the cause of the stroke.
Speaker 1 (34:30):
So if a patient has had a stroke and it
was caused by.
Speaker 2 (34:33):
A blockage, and if that was found to be the reason,
and especially if the patient is having.
Speaker 1 (34:43):
A heart rhythm.
Speaker 2 (34:45):
Issue like a FIB, that is the most common reason
we will put someone on a blood thinner because we
don't want the blood to clot in the heart when
it's not beating properly, when it's beating too fast. We
want that blood doctor clot to be able to move
up to the brain and cause a stroke. Now, we
(35:06):
would not put patients that are a bleeding type stroke.
Those patients would not be put on a blood finner
as a treatment. So that's a very good question. But
having said that, as you might expect, patients that are
on a blood cinner for a blockage type stroke are
at higher risk for having a bleeding type stroke, especially
(35:30):
if they have other factors that might not be controlled,
such as have blood pressure.
Speaker 3 (35:36):
Yeah, so hearing that is a great segue into the
other part of the conversation, which is it would be
better never to have a stroke in the first place. Right,
So there are risk factors that we know about they're
not going to be terribly surprising, I think, but talk
to us a little bit about risk factors for stroke
that are out of our control and risk factors for
(36:00):
stroke that we might be able to modify.
Speaker 2 (36:03):
Sure, So, risk factors that are out of our control
are things like age, as I did mention that the
older that we get, the higher the risk. The history
in our family is another one there. There is a
family history that you with heredity, so that you have
family members that have had a stroke, you may be
(36:23):
at higher risk for a stroke. Those are things that
you cannot control. The things that you can control are
things like high blood pressure. And high blood pressure is
the number one highest contributor to stroke that can be
actually be controlled. And that's so important that if you
(36:43):
have been identified as having high blood pressure is actually
be taking your medicine properly and staying on track with that.
Other things besides high blood pressure are smoking.
Speaker 4 (36:54):
Big problem here in Kentucky.
Speaker 1 (36:57):
Yes, yes, absolutely.
Speaker 2 (36:59):
Sleep at net is another big one that people don't
realize that that puts you more at risk. Obesity another
issue for you here in this area of the United States,
and diabetes which also it is a you know, an
effect with the obesity and the sleep at me and
those kind of all go together. And here in Kentucky
(37:20):
I didn't mention earlier, but we are in what's called
the stroke belt. Some people may be familiar with that term,
but it's because of where we live that we there is,
like you said, a higher risk of stroke and a
higher mortality rate. It's a section in the mid section
of the United States and then called the stroke.
Speaker 3 (37:39):
Belt, you know, and that is something you know why
the shows like this I feel like are are so
important because even just hearing you know, obstructures sleep at me,
I mean, I didn't realize that was such a respector
for stroke. And to remind people that hypertension is called
the silent killer for a reason. We want people to
(38:00):
find out if they have hypertension and to get that
treated and to try and modify any of these modifiable
risk factors. Tina, in your in your role as a coordinator,
what are the standards that you're holding baptists to. What
kind of metrics do you use? How do you evaluate
whether the hospital is doing what what you demand of them?
Speaker 2 (38:23):
Well, as I mentioned, we have those timeline goals that
we want to make sure that we're treating. Not only
do we want patients to get to the hospital quickly,
we want to be able to treat them quickly and
treat them and be able to identify if the patient
needs what treatment the patient needs. So when the patient arrives,
you are immediately looking at those symptoms, immediately getting imaging
(38:45):
to see if there's any kind of bleeding, because you
want to make sure that we rule out that there
is bleeding in the brain before we obviously give any
kind of clockbuster that would you know, be send things right.
We also check like glu close immediately, so we want
to identify those things very quickly. The other thing would
(39:06):
be when once we get to imaging and if we
identify where there is a large vessel, then we want
to make sure that we're getting that patient transferred out.
Since we do not perform those procedures where we pull
the clot out, but we have hospitals in our system
who do that, we want to make sure that we're
getting those patients out quickly because because of that time
(39:29):
is brain We on our side. Once the patient arrives,
we have timeline goals that we want to get to
and get that patient treated and out of transferred out
or get that treated as quickly as possible. One thing
I do want to mention that we didn't discuss was
EMS an important role of EMS, and I mentioned about
(39:50):
not driving to the hospital and making sure that do
you call nine one one. One of the things that
we're finding is that we're also the that's new and
stroke is helping to make sure that EMS is trained
on sounds and symptoms of stroke and making sure that
they know those large vessels are pleasing symptoms so that
(40:12):
because oftentimes it may be more beneficial for EMS to
take a patient directly to that a hospital do that
procedure as opposed.
Speaker 1 (40:21):
To stopping that hour.
Speaker 3 (40:23):
Well, Tina, yeah, I'm sorry, we are. We are running
out of time, but I'm glad you mentioned that EMS
thing because we do want and we appreciate all the
education you're doing not only for us tonight, but for
everybody in the community. So thank you so much for
being on the show, because that's going to do it
for tonight's segment of Centered on Health with Baptist Health. Tina,
(40:44):
thank you. I want to thank you for spreading your
knowledge and doing what you do. I want to thank
our producer mister Jim Fenn, and of course the listener
will see you next week.
Speaker 2 (40:53):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment.
Speaker 1 (41:04):
This show is not designed to replace the physician's medical
assessment and medical judgment. Always seek the advice of your
physician with any questions or concerns you may.
Speaker 2 (41:14):
Have related to your personal health or regarding specific medical conditions.
Speaker 1 (41:18):
To find a Baptist health provider, please visit Baptistealth dot
com
It's now time for Centered on Health with Baptists Help
on use Radio.
Speaker 2 (00:06):
Wait forty telny WITJS Now, here's doctor Jeff Tubble.
Speaker 3 (00:12):
Good evening, everyone, and welcome to tonight's episode of Centered
on Health with Baptist Health here on news Radio eight
forty whas. I'm your host, doctor Jeff Tublin. We are
joined from the studio by our producer, mister Jim Fenn.
He is waiting for your calls this evening to talk
to our guests tonight about warning signs of stroke and
(00:32):
the importance of quick action. Call us at five oh two, five, seven,
one eight four A four and be a part of
the conversation. In Kentucky's stroke is a very real cause
of problems, including both death and permanent disability. Unfortunately, Kentucky
is higher than the national average immortality, and in twenty
twenty one, Kentucky was fourteenth highest in the United States
(00:54):
and stroke accounted for twenty five hundred deaths, not to
mention the disability, making it the sixth leading cause of
death and five percent of Kentuckian's report having had a stroke.
So we're very lucky tonight to have Tina Walsh with
us tonight. Tina is the Stroke program coordinator about This
Health Floyd in New Albany, Indiana, where she has been
(01:14):
since October twenty twenty four. Previously, she was at the
University of Louisville Hospital since nineteen ninety one. She received
her Bachelor of Science in nursing from the University of
Louisville and master's in healthcare Administration also from the University
of Louisville.
Speaker 4 (01:28):
Since July of.
Speaker 3 (01:29):
Twenty sixteen, Tina has had just about any position with
stroke as one could possibly have, so we certainly have
an expert with us tonight. Tina, Welcome to Centered on Health.
Speaker 1 (01:41):
Hi, thank you, I'm glad to be here.
Speaker 3 (01:44):
Well, we're very excited to have you. Such an important
topic for us to talk about and educate, and I
just I actually want to start off by just mentioning
that Baptist Health Floyd is a primary stroke center.
Speaker 4 (02:00):
Tell us what that means.
Speaker 1 (02:04):
Yes, that is correct. So there are accreditation bodies that.
Speaker 2 (02:11):
Hospitals ask to come and check their hospital for appropriate
guidelines to make sure that we're actually following the best
guidelines that have been recommended by the American Heart Association
American Stroke Association for Practice in stroke care, and to
(02:31):
do that, you have to meet certain criteria for how
you care for your patients and you have to be
following the best practice guidelines. And so as a primary
stroke center, there's there's different levels. So there's a prime
there's primary stroke center which can do all of the
basic care for a stroke patient that comes to our facility.
We can give what's called the clock busting medicine, that
(02:54):
is an IV medication that can be given in some
cases when someone is having a certain type of stroke.
What we are not capable to do as a primary
is certain advanced level care that has to be.
Speaker 1 (03:09):
Sent to another facility.
Speaker 2 (03:11):
And we do have a comprehensive center in our Baptist
system that we send those patients to and that those
things consider procedures where there are things that can be
done to actually pull a clot out that might be
causing a blockage, and some of that advanced care for
also bleeding types of strokes that has to be done
(03:32):
on an advanced level hospital.
Speaker 3 (03:36):
And I know that you know this is such an
amazing service that we have in our community, and I
know that you don't want to brag on yourself, So
I'm going to brag on you for you that I
know that the American Heart Association just awarded a Target
Stroke Gold with Honor Elite Plus Award for twenty twenty
five for all the work that's being done at Bauptics
Health Floyd.
Speaker 4 (03:56):
So I feel like that's important for our listeners.
Speaker 3 (03:58):
To know and to congratulate you obviously on all the
work that you are all doing, which we are going
to hear so much about tonight.
Speaker 4 (04:06):
So tell us.
Speaker 3 (04:08):
A little bit about how you got involved in this area.
What were you doing before this became an interest of
yours and how did this become an interest of yours?
Speaker 1 (04:19):
Well?
Speaker 2 (04:20):
As you mentioned, I've been a nurse for many years,
and it doesn't seem that long sometimes that I've been
a nurse.
Speaker 3 (04:27):
For thirty nineteen ninety one was only ten years ago, right.
Speaker 2 (04:31):
I know, right? And so initially, you know, I worked
in critical care and then have the opportunity to become
interested in the neuroscience area, and so I did work
in that area for starting in two thousand and one.
(04:52):
Then my grandmother had a stroke and that is what
piqued my interest because I saw what happened heart and
her story. I tell when I do seminars. I talk
about how you know her sittings were a little bit
atypical and she was able to recover. However that did
(05:14):
I saw her through that pathway in the hospital, and
so that made me get interested in wanting to try
to learn the signs and symptoms and how to treat
people in the cute phase so that we can help
prevent that disability.
Speaker 3 (05:29):
Well, I am sure that your grandmother would never have
wanted to have a stroke, but having had one, it
was a chain of events that appears to have led
to you helping countless numbers of patients with strokes.
Speaker 4 (05:41):
So what a what a great story.
Speaker 3 (05:45):
I want to know a little bit about the role.
Speaker 4 (05:49):
Of a coordinator. What what does a coordinator do?
Speaker 2 (05:55):
So a stroke program coordinator is the person that's respect
possible for not only collecting the data and the performance
measures to make sure that we are following those special
requirements for primary Stroke Center and for the American Heart
(06:15):
Association get with the guidelines registry.
Speaker 1 (06:19):
We also are involved with.
Speaker 2 (06:23):
Teaching in the hospital, helping to teach providers, helping to
teach staff about current guidelines. Basically kind of making sure
to act as an expert in the hospital setting to
make sure that we are doing the best possible current
practice and best care, and with stroke that is constantly changing.
(06:46):
There's always there's new research coming out for better practice,
guidelines and things that we can do differently. You know,
years ago, many years ago, some certain types of symptoms
we're not really paid much attention to, and now that
we have certain research that's been done, we know that
(07:07):
when patients are having those symptoms, even if they go away,
so that's a very high chance that those symptoms may
come back and actually cause a stroke the next time.
Speaker 3 (07:17):
Yeah, and we're gonna we're gonna get into some of
that too, to educate our audience of how many coordinators
are there?
Speaker 4 (07:24):
Are you?
Speaker 3 (07:24):
Are you the one? Are there multiple stroke coordinators? What's
the sort of team.
Speaker 2 (07:31):
Yeah, at a facility the size of Baptist Health Floyd,
we have one coordinator. In most hospitals there there is one.
There's one coordinator there. There are at times in larger
facilities that maybe two. One may focus more on the
bleeding type strokes and procedures and one may focus.
Speaker 1 (07:54):
On more of the blockage type strokes.
Speaker 2 (07:57):
It definitely is a a role that uh involves.
Speaker 1 (08:04):
A lot of many hats, as I said, not.
Speaker 2 (08:07):
Only being acting as an educator, acting as a resource,
acting as a data expert, guideline expert, but also pulling
a lot of that data and then sharing it back
with the team in a meaningful way that can help
us be able to make improvements where we need to.
There has been you know, some uh information out about
(08:30):
this role because it is such a busy role and
and quite honestly doesn't get a lot of other help
as far as data and things like that. Right, So
oftentimes the burnout for this role is oftentimes around three
years for positions, and so there is sometimes a high
turnover rate at some facilities for this role. But that's
(08:54):
kind of there's there's more and more information being shared.
Speaker 1 (08:58):
And stroke is still also compared to heart.
Speaker 2 (09:03):
Treatment and trauma treatment, stroke acute treatment is still kind
of new. People have been treating trauma and heart as
emergencies for a long time now, but treating stroke is
an emergency is still relatively new.
Speaker 3 (09:19):
Well, that is fantastic introduction to what we're going to
delve into. We're going to take a very quick break tonight.
We're talking with Tina Walsh about the stroke signs and
symptoms and the importance of a rapid response to it.
I am doctor Jeff Tublin. You are listening to Centered
on Health with bout his Health here on news radio
eight forty whas. Our phone number five oh two, five
(09:41):
seven one, eight four eighty four. If you want to
call in and be a part of the conversation, we'll
be right back. Welcome back to Send It on Health
(10:09):
with Baptist Health here on news radio eight forty whas.
I'm your host, doctor Jeff Tomlin, and we're talking tonight
with Tina Walsh about the importance of recognizing signs and
symptoms of stroke and how important it is to act quickly.
Our phone number is five oh two, five seven one
eight four eighty four, and our producer, mister Jimfinn is
on standby ready to take your calls.
Speaker 4 (10:32):
So, Tina, you gave us.
Speaker 3 (10:33):
A really nice introduction to the role that Baptist is
playing in terms of the organization around stroke management. But
let's let's talk about stroke. Let's start with some of
the basics though. What what is a stroke?
Speaker 2 (10:50):
Well, there are two types of stroke. One is a
stroke that is caused by a blockage, and that term
we use is called a schemic stroke because it's a.
Speaker 1 (11:00):
Reduced blood flow.
Speaker 2 (11:02):
There's also a stroke that's caused by a blood vessel bursting,
and that's a hemorrhagic stroke.
Speaker 1 (11:09):
So you often hear those discussed as are.
Speaker 2 (11:12):
Being called a brain bleed or a ruptured blood vessel.
Speaker 1 (11:16):
So they're both uh different.
Speaker 2 (11:19):
They're both types of strokes, and they both present very
similarly in symptoms, but the treatment for for them is
very different obviously.
Speaker 3 (11:28):
So and the problem is it a blood flow, a
blood flow interruption to the to the brain. What what's
the what's the result of the stroke? I know we'll
talk about symptoms, but m.
Speaker 1 (11:41):
Hm, that's correct.
Speaker 2 (11:43):
Yes, it's there's a result of if there's decreased blood
flow because something is blocking it, then the tissue that's
not getting blood flow then begins to die and you
have an aeschemic area in the brain that can have
that could be damaged. If in certain cases we can
(12:03):
restore that blood flow in those blockage type strokes, we
can sometimes restore that before the damage has been done
to those cells, and patients can recover.
Speaker 1 (12:12):
In some cases. With the hemorrhagic.
Speaker 2 (12:15):
Strokes, the bleeding also causes a disruption in the blood
fel obviously to an area, but that presents a little
bit more of an issue because then you have bleeding
into the brain that can cause more pressure and can
cause the brain to swell.
Speaker 1 (12:30):
So there are different treatments for that.
Speaker 3 (12:34):
And I think you started pretty much to answer this,
but why is it an emergency?
Speaker 2 (12:42):
Well, it's emergency, because yes it is. It give you
life threatening. Not only can it be debilitating because once
the damage has occurred, it can cause you to have
various pages of disability, whether it's related to being able
to move an arm or a leg, being able to speak.
(13:03):
It also can actually, as you have mentioned, it can
cause not only disability, but also death because if a
large area of the brain is affected, then that can
cause the swelling and have an overall effect on the
brain that may not be able to be recoverable.
Speaker 3 (13:21):
So, you know, we as an audience listening to this,
I know we kind of can wrap our head around
the heart. We understand the heart, We understand heart attack,
lack of blood flow and the muscle being damaged, but
the brain is so complicated, And could you give us
a very you know, low degree level of the anatomy
(13:44):
of the brain and then why that might affect how
one stroke might present differently than another.
Speaker 2 (13:52):
Absolutely, and yes, that is so important because there are
different areas of the brain, and because of the brain
is so complex. Specific areas are what allow us to speak,
what allow us to move, what allow us to even
for our heart to beat, and for us to be
able to breathe. So in those specific areas of the brain,
(14:16):
whether it's you know, the top of the brain, the
back of the brain, the middle of the brain, there's
also different sized blood vessels, So that is important as well,
because if there's a blockage in a smaller blood vessel,
it is not going to be as impactful as a
larger blood vessel. And some of those larger blood vessels
(14:36):
in certain areas are the ones that we can actually
go in and retrieve and pull out at our at
our higher level facilities, the ones that are not in
as big a vessels, and we can give the clockbusting
medication to that medicine can open that area back up
and allow the blood to flow again and then de
(15:00):
treats that uh damage to the to the to the
tissue that's being compromised.
Speaker 1 (15:07):
Do you want me to talk about signs and symptoms.
Speaker 3 (15:10):
Yeah, I would think, Yeah, I'd love to hear it. Absolutely,
we need to. We need to milk all that knowledge
you have.
Speaker 2 (15:18):
Up there, right, So we basically we we use the
term called B fast. And I know some of your
listeners might be familiar with the term fast F A
s T. That's been out for for several years, and
that's one of the things that's been used to teach
about those symptoms. There's a new one that's called B
(15:40):
fast because what they found is that the that F
A s T didn't include that back part of the
brain that I was talking about, and those symptoms can
be very tricky and they can mimic other symptoms.
Speaker 1 (15:53):
So for B fast, b.
Speaker 2 (15:55):
UH stands for balance, So it means if you have
a sudden change in balance or coordination. You suddenly can't
hold your coffee cup, you suddenly can't button a button,
if you feel that you're walking and you can't walk
straight and your balance is off. This would be things
that are sudden, not caused by something else. The E
(16:17):
is for I's if you have a change in your
vision that comes on very suddenly UH, and that has
to do with that whole back part of the brain
that I that I was mentioning called the posterior part
of the of the brain. And then F A S
T is. The F is for facial group and that's
probably one of the most common things people are familiar.
Speaker 4 (16:37):
With familiar with, Yeah, sure.
Speaker 2 (16:40):
And then if that the A is for armor leg weakness,
sudden armor leg weakness, S S is for speech if
there's sudden not ability not to speak or or not
understand words. And then the T in in fast is time.
Time is brain. You heard that saying many times, because
(17:02):
there's many brain cells that are lost very quickly, in
just a matter of minutes. And so the faster that
you recognize the symptoms and that you, you know, call
nine one one and get help immediately, the better offense
that we have to be able to intervene and hopefully
be able to reduce any type of disability or death.
Speaker 3 (17:25):
And what about are there are there other atypical presentations
you mentioned some with your your grandmother, like what about
headaches or dizzyness?
Speaker 4 (17:35):
Are those things that are also symptoms?
Speaker 1 (17:39):
And I didn't thank.
Speaker 2 (17:40):
You, Yes, I did not include dizzyness in that balance,
and that is very important. Dizzeyness is one of the
most trickiest ones that that we find because that has
to do with a certain part of the brain that
could be affected.
Speaker 1 (17:56):
But it also could be an.
Speaker 2 (17:58):
Ear infection, it could be something else that's causing that dizziness.
It may not be stroked, but we do tell people
if you have a sudden onset of dizzyness.
Speaker 1 (18:09):
That was that you're not it's not normal for you,
and suddenly.
Speaker 2 (18:12):
You have that, that would be a cause for concern
in my in as far as headache, yes, a sudden
headache that is more associated usually with.
Speaker 1 (18:21):
The bleeding type strokes.
Speaker 2 (18:23):
It can be associated with a blockage type, but more
so with the bleeding type stroke is where we have
people that complain of a sudden headache and this would
be a sudden headache that comes on very suddenly and
it's like the worst headache of your life or something
you've got experienced before.
Speaker 1 (18:41):
In my grandmother's case.
Speaker 2 (18:44):
As I mentioned, she was a little bit atypical. She
the only symptoms she had was she couldn't talk. She
suddenly could not talk. She was completely she was yes,
she was walking around doing everything and normal.
Speaker 1 (19:00):
And when I.
Speaker 2 (19:00):
Went to speak to her and she went to say
to respond to me. She could not talk, and so
that was very sudden, and luckily we were able to
get her to the hospital quickly. Not in her case,
she did not have to receive a clockbusting medicine because
her body did open that back up again.
Speaker 1 (19:22):
And I want to make sure and mention that to.
Speaker 2 (19:23):
People, because you know, there are cases where our bodies
might open that back up or the symptoms may go away.
And in her case, the symptoms went away, but we
still took her to the hospital and still how the
ambulance take her and do the full work up so
we could get her on the specific medications and treatment
so that we could prevent another one.
Speaker 1 (19:44):
And that's also very important.
Speaker 3 (19:48):
And Tina, I know, like as we're having this conversation
and you talk talk about your grandmother, I think our
natural instinct is to immediately go to, oh, this is
a problem of only elderly people. Can you tell us
a little bit about the range of patients that you see,
is it what kinds of ages is it? Is there
(20:09):
a difference in race, male or female? What do you
see in terms of who this effects?
Speaker 2 (20:17):
Well, they're definitely obviously you think that as you age,
you have more risk factors that come into play for
many diseases, and that does include stroke. However, there are
many times where we have younger people who even have
no known risk factors.
Speaker 1 (20:34):
That may present to us with those symptoms.
Speaker 2 (20:36):
Sometimes those patients may have an unknown blood issue where
their blood is clotting inappropriately, or they may have some
other lying disease that is they're that's they're unaware of.
So even in younger patients, we you know, in the literature,
there's you know, patients as young as fifteen years old
(20:58):
that has been given clockbusting medicine that have been had
I have a possible stroke. Now, of course that doesn't
it size of the hopit happened often, but it definitely
can be of any age. But your risk does increase
as you get older, as does all your risks for
any other things. The main thing I want to make
(21:20):
sure that the audience that here's what I talk about symptoms.
I mentioned that my grandma's symptoms went away on their own,
but we still had her go to the hospital in
the ambulance, and that part is really important. And and
there's also another type of conditions called a t I
A which you may already have been planned to ask about,
(21:43):
and that's called a transient schemic attack. Years ago, people
would call those little strokes. That was kind of what
it was called. But then as we learned more research,
we found those are not actually little strokes because there
was no actual damage done to the brain, but there
was a block in and that our body took care
of it and opened it back up again. The symptoms
(22:04):
went away. Many years ago, those patients were discharged from
the hospital because they their symptoms.
Speaker 1 (22:10):
Their symptoms were gone.
Speaker 2 (22:12):
We now know that even if someone has a TIA,
that that is still a reason to get a work
up to find out what caused it, because there are
a chance that the patient could have another stroke in
several months after that, and there's a higher incidence of
that happening. So you want to make sure that if
(22:35):
you had symptoms and they went away, you still need
to get that checked out because if it is something
that's going on, you'd want to be on the proper
medications to help prevent a stroke down the road. The
other thing I also want people to make sure and
know is that if you're having symptoms, oftentimes what people
(22:56):
do is they say, oh, I don't feel real well
and I'm having this symptom.
Speaker 1 (22:59):
I'm going to go lay down a little while and
see if I feel better when I.
Speaker 2 (23:02):
Get And then of course they either don't wake up
or they wake up and it's much worse. And then
at that time they're outside of the treatment window for
us to be able to do as much for them
to help with that disability. So that's why it's so important.
Speaker 1 (23:18):
To recognize the symptoms.
Speaker 2 (23:20):
You don't know the be fast that that was mentioning,
and recognize those symptoms and then be able to get
to the hospital quickly. And it's also important to not
drive yourself to the hospital if you want to call
nine one one and have an ambulance bring you, because
the ambulance cannot only start some treatment, they can also
pre notify the hospital.
Speaker 1 (23:42):
At the hospital know that that you're on the.
Speaker 2 (23:44):
Way and coming in, they can get ready for you.
Speaker 3 (23:49):
Well, you've happed a lot of important information in those
last few statements, So I think we're gonna we're going
to revisit that when we come back, so we can
pull out all those pearls that you just gave us.
But what a wealth of information we're going to take
a quick break and we'll be right back. You're listening
to Senate on Health with Baptist Health here on news
radio eight forty whas.
Speaker 4 (24:09):
I'm your host, doctor Jeff Tublin.
Speaker 3 (24:11):
We're talking with Tina Walsh about signs and symptoms and
the importance of quick treatment of stroke.
Speaker 4 (24:15):
Will be right back.
Speaker 3 (24:30):
You are back listening to Senate on Health with Baptist
Health here on news radio eight forty whas. I'm your host,
doctor Jeff Tublin. We're talking with Tina Walsh tonight about
the importance of recognizing the signs and symptoms of stroke
early and early treatment. Our phone number five oh two,
five seven one, eight four eighty four if you'd like
(24:51):
to call in. And right before the break, we were
learning about b fast, which is balance, eyes, facial droop,
are or leg weakness, speech changes or and how important
timing is. So remember the befast. It's some really important
information that we're learning tonight. So Tina, right before the break,
(25:12):
you were telling us a little bit about tias and
I didn't want to shortchange how important that is because
I feel like we're all a little bit familiar with
the term mini stroke or one that kind of resolved
and tell us a little bit again about how we
should think about tias and how important they are to.
Speaker 4 (25:30):
Get followed up on.
Speaker 2 (25:33):
Yes, as I mentioned, even years ago, we did not
actually keep patients in the hospital for treatment if they
had a TIA, if there was no damage that we
could see on imaging, and if there's symptoms, second, who's resolved.
But what we now know is that they are at
a much higher risk of having a even bigger stroke.
(25:56):
I have an actual stroke several months downad because the
cause has got still been eliminated, we don't we there
may be a cause that we can help to treat
and prevent an actual stroke from happening. When the tia,
it's called transient a schemic attack because it's transient, meaning
that it goes away. You know it is a schemic
(26:19):
because it's a blockage. So for some reason there is
an area where there's blood flow that becomes blocked in
the brain and that area causes symptoms. So patients will
have symptoms, but then the area becomes opened back up
again because your body has its own mechanism of trying
to open that back up and that restores.
Speaker 1 (26:42):
The blood flow.
Speaker 2 (26:43):
Symptoms go away, but yet the cause has not been identified,
and so there are medications and prevention therapies that we
can recommend to help prevent an actual stroke from happening.
Once we have the patient, do the work up and
(27:04):
so we can talk. I know you mentioned wanting to
talk a little bit about once they get to the hospital,
but yes, as far as TIA, it's so important don't
ignore the symptoms. If they go away, you still want
to go to the hospital. Now, obviously they don't go away.
If they go away, it's not as urgent to have
to go immediately, but you definitely want to be seen
(27:28):
by your healthcare provider and have that evaluated.
Speaker 3 (27:32):
And you sort of answered this partially already. We had
a question that was submitted about whether having one stroke
actually increases your risk of having a second stroke. And
I understand from the TIA perspective that that's a sign
of a possible stroke. But for somebody who does have
a full on stroke, are they at higher risk later
(27:54):
to have another one?
Speaker 1 (27:56):
It depends on the cause.
Speaker 2 (27:59):
Obviously, Sometimes if there's a if there is an underlying
cause that is found, maybe something where someone's blood is
plotting abnormally and that needs to be treated. There are
also I know everyone may be familiar with a true fibrillation,
which is a a a heart.
Speaker 1 (28:18):
Issue.
Speaker 2 (28:18):
Well, the heart beats faster than it should and that
can cause clocks to form in the heart.
Speaker 1 (28:24):
So you hear about aphib and a fib being making you.
Speaker 2 (28:28):
More at risk for a stroke because a clock can
move out of the heart. Obviously, if that is found
to be the cause, there are treatments that can be
done in medications to control the aphib to prevent that
from happening.
Speaker 1 (28:42):
So it depends on the cause.
Speaker 2 (28:45):
And but in many cases, if you're if the treat
if there's not treatment that's initiated and prevention put into
place with medications and therapies that you know, if you
have had a stroke, you aren't higher with for having
another one.
Speaker 3 (29:02):
And you've mentioned obviously how important you know, time is
brain I think that we've we've talked about that and
how important the urgency of treatment is in that respect.
But it also matters. You've mentioned the term clotbuster a
couple of times. Tell us tell us what you mean
by that and that that also is a time sensitive issue, right, Yes.
Speaker 2 (29:27):
Yes, it is, that there's a there's medication that we
can actually give that can they can bust the clot
apart and open the blood vessel back up again. That
can only be given in certain cases for certain areas
of the brain. But timing of that is very important
because if there's too much time it has happened from
(29:50):
the time your symptoms started to the time you get
to the hospital, then it eliminates that time window. So
you want to get you want to go to the
hospital as soon as possible, And the timing that we've
used at the hospital is four and a half hours
from the onset of the symptoms. But what happens when
(30:13):
you don't really know your onset of symptoms first of all,
and you know because you may not, And what happens
also when there may be a bigger vessel that we
could also help and in those cases that can be
twenty four hours out and we could still there's research
that shows that we can still be helpful to a
(30:34):
patient with one of those large we call those large
vessel occlusions or elbows. But those are the ones that
we can actually go in and pull a clot out,
and that can be done up.
Speaker 1 (30:46):
To twenty four hours.
Speaker 2 (30:47):
So we try not to We don't want patients to
worry quite as much about the timeline as much as
just remembering that if you have symptoms as soon as
you notice them, if they're sudden onset of those beefast
symptoms and you you know something is not right, then
you want to seek you know, help immediately and get
(31:08):
to the hospital. There are times where there are symptoms
that mimic strokes as well. We call them mimics, and
those are things like seizures, migraine, headaches, low blood sugar
for patients that are diabetic, those are the top three
mimics that we see, and especially the migraines and seize
(31:28):
are They can be very scary because they those patients
could actually have, you know, complete paralysis of one side
where they can't move an arm or a leg, or
not be able to speak. But it's not being caused
by a stroke. It's actually a migraine which is causing
a different mechanism happening in the brain. But those are
(31:49):
things that a person at.
Speaker 1 (31:51):
Home would not be able to figure that out.
Speaker 2 (31:56):
Absolutely, so we would rather you get to the hospital
quickly and then we would be able to diagnose if
it's if it's a migraine and be able to treat that,
or if it's a seizure, or if it's a low
blood sugar. So it's more important to get there quickly
so that we can have the opportunity to do all
(32:17):
of the things that we might be possible. But yes,
that time window, that's why it is so important to
get there quickly so that we can determine if you're
in the time window for us to do those treatments.
Speaker 3 (32:30):
You know, it's fascinating because you know you're giving us
such an insight into what's going on. I mean, starting
just with the concept of the time window, we have
to figure out if it is a stroke to begin with,
if it's a stroke, whether it's the hemorrhagic or the eschemic,
there's a lot that has to be done in a
very short amount of time with very high risk stake.
So we appreciate learning from you that there are people
(32:52):
out there coordinating all this to be done quickly.
Speaker 4 (32:55):
We're going to take a final break.
Speaker 3 (32:57):
Here and we're going to come back and talk about
risks that we can try and avoid so that this
doesn't happen to us. You are listening to send it
on Health with Baptist Health here on news radio eight
forty whas. I'm your host, doctor Jeff Tumblin. We're talking
with Tina Walts. We're learning a lot about how important
it is to recognize the signs and symptoms of a
(33:17):
stroke early.
Speaker 4 (33:18):
We'll be right back.
Speaker 3 (33:32):
Welcome back to Send It on Health with Baptist Health
here on news radio eight forty wahas. I'm your host,
doctor Jeff Tumblin. If you're just joining us, We've been
having an amazing conversation with Tina Waltz tonight about the
early signs and symptoms and importance of early treatment of stroke.
Remember to download the iHeartRadio app and re listen to
(33:52):
this or any of our previous segments and have access
to all the features that the app has to offer.
So you know, we had another question that came in
that I think you could probably help clarify. The question
was that they had a family member who had a
stroke and was put on a blood thinner, and if
bleeding is part of the problem with a stroke, why
(34:14):
why would that be something that would be part of
the treatment.
Speaker 2 (34:19):
Well, that is an excellent question, and the reason for
a blood thinner and stroke is that difference in the
types of stroke if and the cause of the stroke.
Speaker 1 (34:30):
So if a patient has had a stroke and it
was caused by.
Speaker 2 (34:33):
A blockage, and if that was found to be the reason,
and especially if the patient is having.
Speaker 1 (34:43):
A heart rhythm.
Speaker 2 (34:45):
Issue like a FIB, that is the most common reason
we will put someone on a blood thinner because we
don't want the blood to clot in the heart when
it's not beating properly, when it's beating too fast. We
want that blood doctor clot to be able to move
up to the brain and cause a stroke. Now, we
(35:06):
would not put patients that are a bleeding type stroke.
Those patients would not be put on a blood finner
as a treatment. So that's a very good question. But
having said that, as you might expect, patients that are
on a blood cinner for a blockage type stroke are
at higher risk for having a bleeding type stroke, especially
(35:30):
if they have other factors that might not be controlled,
such as have blood pressure.
Speaker 3 (35:36):
Yeah, so hearing that is a great segue into the
other part of the conversation, which is it would be
better never to have a stroke in the first place. Right,
So there are risk factors that we know about they're
not going to be terribly surprising, I think, but talk
to us a little bit about risk factors for stroke
that are out of our control and risk factors for
(36:00):
stroke that we might be able to modify.
Speaker 2 (36:03):
Sure, So, risk factors that are out of our control
are things like age, as I did mention that the
older that we get, the higher the risk. The history
in our family is another one there. There is a
family history that you with heredity, so that you have
family members that have had a stroke, you may be
(36:23):
at higher risk for a stroke. Those are things that
you cannot control. The things that you can control are
things like high blood pressure. And high blood pressure is
the number one highest contributor to stroke that can be
actually be controlled. And that's so important that if you
(36:43):
have been identified as having high blood pressure is actually
be taking your medicine properly and staying on track with that.
Other things besides high blood pressure are smoking.
Speaker 4 (36:54):
Big problem here in Kentucky.
Speaker 1 (36:57):
Yes, yes, absolutely.
Speaker 2 (36:59):
Sleep at net is another big one that people don't
realize that that puts you more at risk. Obesity another
issue for you here in this area of the United States,
and diabetes which also it is a you know, an
effect with the obesity and the sleep at me and
those kind of all go together. And here in Kentucky
(37:20):
I didn't mention earlier, but we are in what's called
the stroke belt. Some people may be familiar with that term,
but it's because of where we live that we there is,
like you said, a higher risk of stroke and a
higher mortality rate. It's a section in the mid section
of the United States and then called the stroke.
Speaker 3 (37:39):
Belt, you know, and that is something you know why
the shows like this I feel like are are so
important because even just hearing you know, obstructures sleep at me,
I mean, I didn't realize that was such a respector
for stroke. And to remind people that hypertension is called
the silent killer for a reason. We want people to
(38:00):
find out if they have hypertension and to get that
treated and to try and modify any of these modifiable
risk factors. Tina, in your in your role as a coordinator,
what are the standards that you're holding baptists to. What
kind of metrics do you use? How do you evaluate
whether the hospital is doing what what you demand of them?
Speaker 2 (38:23):
Well, as I mentioned, we have those timeline goals that
we want to make sure that we're treating. Not only
do we want patients to get to the hospital quickly,
we want to be able to treat them quickly and
treat them and be able to identify if the patient
needs what treatment the patient needs. So when the patient arrives,
you are immediately looking at those symptoms, immediately getting imaging
(38:45):
to see if there's any kind of bleeding, because you
want to make sure that we rule out that there
is bleeding in the brain before we obviously give any
kind of clockbuster that would you know, be send things right.
We also check like glu close immediately, so we want
to identify those things very quickly. The other thing would
(39:06):
be when once we get to imaging and if we
identify where there is a large vessel, then we want
to make sure that we're getting that patient transferred out.
Since we do not perform those procedures where we pull
the clot out, but we have hospitals in our system
who do that, we want to make sure that we're
getting those patients out quickly because because of that time
(39:29):
is brain We on our side. Once the patient arrives,
we have timeline goals that we want to get to
and get that patient treated and out of transferred out
or get that treated as quickly as possible. One thing
I do want to mention that we didn't discuss was
EMS an important role of EMS, and I mentioned about
(39:50):
not driving to the hospital and making sure that do
you call nine one one. One of the things that
we're finding is that we're also the that's new and
stroke is helping to make sure that EMS is trained
on sounds and symptoms of stroke and making sure that
they know those large vessels are pleasing symptoms so that
(40:12):
because oftentimes it may be more beneficial for EMS to
take a patient directly to that a hospital do that
procedure as opposed.
Speaker 1 (40:21):
To stopping that hour.
Speaker 3 (40:23):
Well, Tina, yeah, I'm sorry, we are. We are running
out of time, but I'm glad you mentioned that EMS
thing because we do want and we appreciate all the
education you're doing not only for us tonight, but for
everybody in the community. So thank you so much for
being on the show, because that's going to do it
for tonight's segment of Centered on Health with Baptist Health. Tina,
(40:44):
thank you. I want to thank you for spreading your
knowledge and doing what you do. I want to thank
our producer mister Jim Fenn, and of course the listener
will see you next week.
Speaker 2 (40:53):
This program is for informational purposes only and should not
be relied upon as medical advice. The content of this
program is not intended to be a substitute for professional
medical advice, diagnosis, or treatment.
Speaker 1 (41:04):
This show is not designed to replace the physician's medical
assessment and medical judgment. Always seek the advice of your
physician with any questions or concerns you may.
Speaker 2 (41:14):
Have related to your personal health or regarding specific medical conditions.
Speaker 1 (41:18):
To find a Baptist health provider, please visit Baptistealth dot
com
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