Am I having a stroke?

By Philip Wagenaar, MD
This item appears on page 52 of the January 2018 issue.

Am I having a stroke?

“My right hand is numb,” my wife, Flory, mumbled while we were watching a show in the lounge of the ms Prinsendam.

As her face became paler, she started to slide down in her seat. I tried to talk to her, but she had no idea what I was saying.

A woman nearby called 911. The doctor arrived promptly.

Was she having a stroke or perhaps a mini-stroke? I worried.

TIAs, or mini-strokes

When the flow of blood to a part of the brain is completely interrupted, it leads, after a while, to the death of the cells the blood nurtures. This is called a stroke.

Temporary interruptions also occur. These are called mini-strokes or TIAs (transient ischemic attacks). TIAs usually last from a few minutes to less than an hour. Their symptoms, however, are similar to those of a stroke.

In the adjacent box on this page, I describe these symptoms and also suggest the course of action you should take if you suspect that you are, or another person is, experiencing a TIA.

You might consider attaching a copy of the box to your refrigerator or carrying it with your travel documents on your next trip. Read this article from time to time.

Purchase in advance

Meanwhile, if you are reading this article before you are so unfortunate as to be or to encounter a stroke victim, do the following.

A. Promptly buy a 50-count bottle of 325mg aspirin. ONLY buy aspirin, which makes the blood thinner. Don’t buy any other pain reliever. 

B. The aspirin you buy must have a non-enteric coating. This means that, immediately upon ingestion, the tablet will slide through the stomach and go forthwith to the small intestine, where it will promptly come in touch with the blood supply, where it is needed.

Check with the pharmacist to make sure you have the correct tablet.

C. Always have an aspirin tablet close by so you can quickly chew one whenever you think you might be having a heart attack, a stroke or a TIA. 

While the tablets will last for years, it is a good idea to check from time to time that the tablets have not become discolored.

Keep in mind

Be aware that once you have had a TIA, there is a good chance of having a subsequent stroke.

A mini-stroke can befall someone anywhere, including in a foreign country. Familiarizing yourself with the symptoms and being prepared to respond properly and promptly can make for a more beneficial outcome.    

A stroke or a transient ischemic attack (TIA, or mini-stroke) is a reduction of the blood supply to the brain for a short or a more extended period of time.

TIA symptoms, which usually occur suddenly, can include numbness or weakness in the face, arm or leg, especially on one side of the body; confusion or difficulty in talking or understanding speech; blurry vision in one or both eyes, and/or difficulty with walking, dizziness or loss of balance and coordination.

Because there is no way to tell whether symptoms are from a TIA or an acute stroke, you should assume that any stroke-like symptoms signal an emergency and you should not wait to see if they go away.

To quickly recall what might be involved in a stroke or mini-stroke, use the acronym “FAST, ”which stands for…

Facial drooping — A section of your face, usually on one side, is drooping or hard to move.

Arm weakness — You are unable to raise your arm.

Speech difficulties — You have difficulty understanding or producing speech.

Time — Time is of the essence when having a stroke, and emergency services should be called immediately.

 WHAT TO DO if you suspect a stroke

1. If you are having a TIA or suspect a TIA, immediately chew a 325mg, non-enteric-coated aspirin tablet and continue chewing it while calling 911. (“Non-enteric” means it will dissolve immediately in the stomach.)

2. As a TIA may last only a very short time, and its symptoms may have disappeared before the doctor sees you, it is important that all people who have seen you since the attack are questioned by the examining physician.

3. A prompt evaluation (within 60 minutes) is necessary to identify the cause of the TIA and to determine appropriate therapy.

— PHILIP WAGENAAR, M.D., Contributing Editor, ITN