A new survey that finds most Canadians don’t know the signs of a stroke doesn’t come as a surprise to Dr. David Butler-Jones: The former head of the Public Health Agency of Canada didn’t even realize when one was happening to him.
In May, 2012, Butler-Jones suddenly developed weakness on his left side but assumed he was beginning a migraine. When his wife suggested he might need an ambulance, he talked her out of it, saying he didn’t want to bother the doctors in the emergency department.
Former PHAC chief public health officer Dr. David Butler-Jones
"Having worked emerg and knowing what the lineups are like, I wanted to be absolutely sure that I had a real problem before I went. Quite honestly, that was not very smart,” he says.
By the following morning, Butler-Jones was much weaker and knew he needed help. By then it was too late for him, however, to receive a key treatment for stroke called tPA (tissue plasminogen activator). In order to be effective, the clot-busting drug needs to be administered within four-and-a-half hours of the first stroke signs.
Butler-Jones’ stroke caused significant brain changes and he had to relearn basic skills, such as how to walk backwards and turn around. He also experienced problems with his memory and had to re-learn words and names, including those of his grandchildren.
Although he has made good progress in recovering, Butler-Jones had to step down from his position as Canada's chief public health officer because he no longer had the stamina for the job.
Knowing what he now knows, he realizes he should have sought help.
"In retrospect, I should have realized that something was happening with my brain and sought attention. And that’s too common a story ,” he said. "In the case of my situation, I wasn’t paying attention to the fact that I couldn’t do things and wasn’t doing things with my left side.”
Such an experience is not uncommon. Most Canadians still don’t recognize the signs of a stroke, nor what to do when it’s happening.
The Heart and Stroke Foundation released survey results Thursday that revealed that only 47 per cent of Canadians recognize sudden slurred speech as a sign of a stroke, while only 21 per cent know that a drooping face is another signal.
Only one-in-three know that it is important to call an ambulance at the first sign of a stroke, in order to get the immediate medical attention that’s required. And only one-quarter realize that paramedics can start assessing and treating a suspected stroke as soon as they arrive.
Stroke is common in Canada, occurring once every nine minutes, but the survey found that only one-third of Canadians even understand what a stroke is.
A stroke is a sudden loss of brain function caused by the interruption of blood flow to the brain, either from a blood clot, or sometimes by the sudden rupture of a blood vessel in the brain, which is called a hemorrhagic stroke. Depending on where in the brain a stroke occurs, a stroke can be fatal or cause a person to lose the ability to move, see, speak, or think clearly.
Neurosurgeon Dr. Michael Tymianski says quick action is crucial in stroke care.
“Every minute that a stroke is untreated you lose 2 million brain cells and the chance of having a good outcome and going home to be with your family decreases dramatically with time,” he says.
“So stroke is an even greater emergency from a time-pressure perspective than a heart attack.”
Risk factors and warning signs
According to the poll the Heart and Stroke Foundation commissioned for Stroke Report 2015, only one-fifth of Canadians know that high blood pressure is a main risk factor for stroke; in fact, it is the No. 1 risk factor.
Most Canadians also do not know that smoking, poor diet, physical inactivity and obesity are risk factors for stroke.
Although 77 per cent of respondents said they would call 9-1-1 if someone they knew was having a stroke, many don’t. According to the Canadian Institute for Health Information, only 59 per cent of people having a stroke arrive at a hospital by ambulance.
Ambulances not only get stroke patients to hospital more efficiently, they can get them to one that provides specialized stroke care, including the ability to administer tPA. Paramedics can also let an emergency department know they are on their way with a suspected stroke patient, ensuring that treatment can start as soon as the patient arrives.
The Heart and Stroke Foundation recently launched a campaign to make Canadians aware of the signs of stroke, using the acronym FAST
- FACE -- is it drooping?
- ARMS -- can you raise both?
- SPEECH -- is it slurred or jumbled?
- TIME -- to call 9-1-1 right away.
