Let’s Talk About Stroke Month

Earley, Sidney (2)

Speaker 1:

Thanks for joining us for this episode of Centra Scripts, where we talk health and wellness and practical tips for your everyday life. And now here’s your host Kate Kolb.

Kate Kolb:

Well, thanks for joining us for this episode of Centra Scripts. I’m really excited today because we get to sit down with Sidney Earley, who is one of our nurse practitioners at the Centra Medical Group, neurology services office. And the reason that we’re sitting down with her is several fold, but specifically we wanted to honor the fact that it is Stroke Month and we have a few things that we want to talk about that and focus in on. But Sidney, I want you to go ahead and just introduce yourself and tell us a little bit about you and what you do here at Centra.

Sidney Earley:

Hi. So, my name is Sidney Earley. I’m so glad to be here talking with all of you guys. I am with the neurology department. I have been here… I moved here seven months ago. I grew up in Upstate New York. I actually was an ER for three years as a nursing assistant, went and got my RN schooling done where I worked in a neuro and trauma intensive care unit. I then worked on a resource team for a couple of years while I was getting my master’s degree. And then I taught for two years as an adjunct professor at the undergraduate level. I chose nursing… I guess everybody has their story as to why they get into their field, but it was always something that I thought was going to be the right career path for me. My grandma, she was a nurse. Growing up she would always bring me nursing supplies at home and I would give my stuffed animals injections and take their blood pressure ans stuff.

Kate Kolb:

I love that.

Sidney Earley:

That I was the coolest thing. And then I became a volunteer while I was in high school at one of our local hospitals and realized that, “This is just exactly what I want to do. I want to care for patients.” And then unfortunately one of my grandparents had gotten really ill and I just realized how awesome nurses are and how good they take care of their patients and how much impact they make on patients in the hospital. So, I’m like, “Wow, I want to be one of those kinds of people.” So, I went back, I got my bachelor’s and like I said, I worked in the neuro ICU where I found that you can learn stuff about the brain your entire life and never know everything about it. So, I just liked that there was this infinite knowledge about it that you can just keep studying and keep studying and really, like I said, never know everything about it.

Sidney Earley:

So, I really like neurology as well because your brain is what makes you, you as a person. So, if you can break your arm and break your arm and still be you, but if you have a stroke, there’s a potential that you could lose a part of your memory, a part of your ability to speak, your ability to interact with your family. Some of your personality traits. So, one of the most moments in my life that made me say neuro is for me, is one of the patients I had been taking care of for months in the intensive care unit, I didn’t think he was going to make it. And him and his wife, about four months after he was discharged, he walked back in and gave me a hug and he had remembered. He said, “I remember you talking to me, I know everything that happened.” And he was doing great.

Kate Kolb:

Oh, wow.

Sidney Earley:

So, that’s why I think neurology is just a great field to get into.

Kate Kolb:

Yeah, that’s awesome. I love what you said about our brains making us who we are because I think there’s so much that we do throughout the day that we don’t realize it’s actually being charged through the neurons in our brains and the synopsis connecting. So, for the lay person who may be listening to this that maybe does not completely understand what neurology is, can you describe that and define that for us?

Sidney Earley:

Yeah. So, neurology is the study of your brain. Your brain is what makes me talk right now, what makes me do my hand gestures that I’m doing. Your brain is your processing center. When something happens to you, your brain decides how you’re going to respond to it. Things that you do without even thinking like breathing, your brain and spinal cord are working at that point.

Kate Kolb:

Which is amazing to consider all the things that have to connect in order for us to do one very… Really, I guess it’s not simple, that act of breathing that we take for granted.

Sidney Earley:

Right. Exactly. Yeah. It’s what, like I said said, it controls everything. Your heart wouldn’t pump if your brain wasn’t having regulatory input. I guess it’s everything. I don’t know how else to describe it. It controls everything. Your ability to walk around and hold your grandkids and everything.

Kate Kolb:

People a lot of times will think, “Okay, I definitely need a primary care doctor.” Maybe they think of cardiologists as being a specialty that maybe a lot more people might need. But why is the field of neurology something that is just as important if not more important for people to know about and engage with?

Sidney Earley:

So, yeah. Neurology like I had said, it controls everything and people could be at risk for certain neurologic diseases and not really realize it.

Kate Kolb:

Okay. So, talking about neurology and the field and the importance there, there is this thing called Stroke Month that I mentioned at the beginning and I did not know until I came to work for Centra almost five years ago that there was even a thing called Stroke Month. So, what is the importance of that recognition month and why should we be aware of it?

Sidney Earley:

So, Stroke Month is a month that’s all about increasing your awareness of the symptoms of stroke, when to seek help if you’re having them. And also your risk factors that you could be working in your life to improve. My main thought with Stroke Month is trying to get our population to be more activated in their own healthcare and take control of their life and know when they need to be seen. It always breaks my heart when I have peach people who come in and have strokes and they said, “I didn’t know. I don’t know why I had a stroke.” And I look back through their medical history and they’ve been having stroke, whether it be symptoms or risk factors for years and they’re still very surprised that, “This happened to me.” It can happen to you. So, this Stroke Month is trying to bring people to know their risks and know when they need to go to the hospital and seek treatment because time is brain. The earlier you can get to the hospital, the more likely we’ll be able to help you.

Kate Kolb:

Mm-hmm (affirmative). I like that phrase, time is brain. That makes a difference in everything. So, let’s talk then about some of these maybe warning signs and symptoms and things like that. Well first of all, before we maybe get into that, let me ask this question. Strokes are something that I think most people tend to think of as only affecting a certain population, maybe just the elderly or… And really probably that’s where most people’s brains go when they think of this. But is stroke something that affects everyone? How young can you be and still be looking out for these warning signs?

Sidney Earley:

To be honest, I’ve personally cared for patients that are in their twenties that have had strokes. They have various risk factors, but again if you know your risk factors, you can better predict if this is going to be something you need to worry about. So, it can really happen to anyone. Somebody has a stroke every 40 seconds. So, I don’t know how long we’ve been talking for, but-

Kate Kolb:

We’ve been eight and a half minutes-ish.

Sidney Earley:

So, eight people have had a stroke since we’ve been talking. And then somebody dies from a stroke almost every four minutes. So, two people have died since we started talking.

Kate Kolb:

That’s crazy. I had no idea that the numbers were that high. That’s amazing.

Sidney Earley:

Yeah. So, what I kind of want to drill home is 80% of strokes are preventable. So, American Heart did a study where they show that 80% of strokes are preventable. So, if people are able to understand their risk factors and take some initiative in their life to try and prevent these or at least work with their primary care doctor or nurse practitioner to take care of some of these concerns, these risk factors that they have, they can really lower their risk of having one of these events.

Kate Kolb:

That’s amazing. I had no idea that the numbers were that high and that they are really that preventable. So, let’s talk a little bit about that then. Those risk factors that you need to be on the lookout for. What does that look like? Does it change from person to person or are there blanketed signs across the board?

Sidney Earley:

Right. So, as far as risk factors for stroke go, the main… There’s four of them that are the big ones. So, hypertension. So, that’s high blood pressure. When they take your blood pressure at the office that you see, the top number they typically want less than 140, is what American Heart would recommend. And they recommend you at least get screened every a year. So, I don’t know if… It’s really important people have primary care providers or means to get this checked. There’s tons of resources where people can go and get their blood pressure check, there’s health fairs, I know that. I don’t know now with this COVID, but at CVS you can go and get your blood pressure checked and monitor this. So, what high blood pressure does is it can damage your blood vessels, make you higher risk for stroke and it can also predispose you to certain heart rhythms that could cause you to have a stroke as well. So that’s really important.

Sidney Earley:

The next risk factor is hyperlipidemia. So, high cholesterol. High bad cholesterol is more specific, so your LDL. So, what that does is it increases the plaque buildup in your vessels, which can make your vessels narrow and make it easier for you to have a stroke. So, with that we recommend you eat a healthy diet. So, high fruits, vegetables, whole grains, low fat. And if your doctor tells you to take a statin then you should take a statin. I was reading another study that said that they would recommend that at least 50% of our population is on a statin.

Kate Kolb:

Really?

Sidney Earley:

Yes. So, these drugs do help. I know that they get a bad rap that people… But they really do save lives and they help prevent this progression of narrow vessels.

Kate Kolb:

Yeah, I think there’s probably some of that populace that is like, “Oh, that’s just like an added measure, I don’t really actually need that.” But you’re saying it’s definitely a key factor.

Sidney Earley:

Yes, definitely. And diabetes. So, this is the only one that’s an independent risk factor for stroke. So, you can have diabetes by itself and your risk of stroke is actually double that of somebody that doesn’t have diabetes.

Kate Kolb:

Wow!

Sidney Earley:

So, getting your blood sugar under control, getting that taken care of is major. That increases your risk of stroke, leg amputations, tons of different vascular events in your body. So, that’s one of the main ones and then smoking. Smoking is just bad for vessel stuff as well. People again, leg amputations and strokes. So, there’s a lot of resources around that will help people quit smoking. I know it’s not an easy thing by any means, but I was reading an article that said that it only takes one day of not smoking to help decrease your risk of a stroke.

Kate Kolb:

Wow!

Sidney Earley:

So-

Kate Kolb:

Now, will that also include… Because I know a lot of people now instead of smoking cigarettes, they’re transferring over to vaping and things like that. Is that the same type of a risk factor or do we know enough about that yet?

Sidney Earley:

I’m not really sure what vaping does, but I do know that chewing tobacco is not a good alternative. People sometimes think that chewing tobacco is better than smoking, but that still has the same effects on the vessels in the body and increases your blood pressure and all of that. So, I would imagine if they’re getting the same dose of the nicotine it would have the same effects, but I’m not really sure to be honest to speak on that.

Kate Kolb:

Seems like it’s the sleeper thing that not many people are sure about right now.

Sidney Earley:

Yeah.

Kate Kolb:

But you’re saying even just one day without that nicotine in your system drastically increases your chances of not having an episode.

Sidney Earley:

Yup. So, that same article I was reading said about six months fully decrease your risk completely of stroke, but all it takes is one day and then even 20 minutes after your cigarette, you quit smoking, you have a decrease in your blood pressure, your vessels relax. So…

Kate Kolb:

Wow!

Sidney Earley:

Yeah. Other things, they’re not considered risk factors, but inactivity, that can increase your risk of developing hypertension, diabetes and obesity. So, the American Heart recommends that you get active at least 150 minutes per week or 75 vigorous minutes, which is like sprinting, running on a treadmill or something like that. But what I think about this is I feel like people, if they can’t do 150 minutes, they say, “I’m not going to do it.”

Kate Kolb:

Right. Because we’re lazy. Let’s be honest.

Sidney Earley:

“I just can’t go to the gym today. It’s just not in the cards for me.” Well, then maybe take the stairs, maybe do something else, get yourself active. That will help decrease this risk as well. And then there’s also been studies that show stress actually increases your inflammation in the body that increases the deposition of plaque in your vessel walls. So, maybe find something that is your enjoyment and stick to it. Personally, I enjoy getting outside and doing some yoga. Some people might like to read some books, listen to music, but do something that you can decompress to help keep your stress under a reasonable level.

Kate Kolb:

Yeah, I think that that even just now in the current state of everything going on with COVID and everything like that, everybody’s stress levels are so much higher and there’s this unknown factor of we just don’t know what the world is going to look like even from week to week it seems like. So, I feel like that’s probably an even larger factor in everything.

Sidney Earley:

Exactly. Yeah, definitely do what you can to try and take care of yourself, keep your stress under control. Also, there’re some other risk factors that would be something you would discuss with your primary care, there has been some studies that migraine headaches actually increase your risk of stroke, particularly with an aura and in combination with oral contraceptive pills, birth control pills and smoking. So, that’s something to be on the lookout for. A lot of times our young population we see is smoking, birth control combo. Also, other inflammatory diseases and diseases like sickle cell anemia also increase your risk of stroke and sometimes sleep apnea as well. So, those are things that are great to be aware of and actually here at Centra Neurology we have started a risk assessment program.

Sidney Earley:

So, it is called Stroke Aware. And what this does, it’s a short quiz and it walks you through all of these questions that we’re talking about for risk factors and it populates a screen that tells you exactly where your highest risks are of stroke. If you flag high enough on there, we actually will bring you into our neurology office for a free consultation where I will walk through every risk factor with you and give you specific goals for your health journey.

Kate Kolb:

Yeah. And that is completely free to take that quiz. And then again if you flag high enough then that consult is completely free as well.

Sidney Earley:

Exactly.

Kate Kolb:

So, there’s no excuse not to go do that.

Sidney Earley:

Exactly. And then we will actually send your primary care provider a list of what we discussed and what we plan on doing and our goals that we’ve come up with. So, if you want to take this, it’s on centrahealth.com/neurology or if you are avid with your phone, you can text stroke, to (434) 264-7931.

Kate Kolb:

Awesome. And we’ll also make sure that it’s on the Central Scripts website too when we publish this podcast so that there will be no question on where people can find it for sure because that is a needed resource and one that I think people should definitely be getting out there and using. Okay. So, you’ve talked about some of these risk factors and some of it you wove some of these preventative measures in while you were talking, but is there a specific shortlist of things that you’re like, “Okay, these four things are the preventative measures that you need to keep in your life.”

Sidney Earley:

I would say be active, eat right and don’t smoke.

Kate Kolb:

There you go. It’s even three. It’s even shorter. It’s not even four things. I think several of the topics that we’ve talked about, we’ve done cardiology, we’ve done a couple of other things, I feel like sometimes people are like, “Well, everybody’s saying the same thing.” But it’s true and these are all integrative pieces of our bodies that work together and they are very closely related. Would you say that cardiology issues is something that is closely related to stroke as well?

Sidney Earley:

Right? If you have vascular disease in your heart or your leg vessels, then you probably have them in your neck and your brain.

Kate Kolb:

Yeah.

Sidney Earley:

So, it all weaves together. The same kind of risk factors that cause you to have heart attacks are very similar to the ones that cause you to have strokes.

Kate Kolb:

Right.

Sidney Earley:

So, you could be preventing more than just strokes by trying to know your risk factors.

Kate Kolb:

And I think that’s the beautiful thing about the body in general, is that all these things, if you are trying to approach it from a holistic health standpoint, all of these systems are going to be working together in the long run. So, if you’re preventing stroke and you’re preventing heart disease, ultimately you’re preventing a lot of really bad things from happening to your body. So, that’s great. So, let’s talk a little bit about if you have had stroke activity or if you’ve been diagnosed maybe like you said through the quiz or even through a doctor’s appointment where you come in at a very high risk level for things, what does treatment and recovery and things look like that after you’ve actually had an episode or something where you would need to be treated?

Sidney Earley:

Yeah. So, why don’t we talk about what an episode is?

Kate Kolb:

Yes, actually that’s great. Let’s do that.

Sidney Earley:

So, we use the BEFAST.

Kate Kolb:

Okay.

Sidney Earley:

So, that is an acronym. That is B-E-F-A-S-T. So, B stands for balance. If you have any difficulty walking, any incoordination. E is eyes. So, difficulty seeing, vision changes. F is face. Any facial asymmetry, tongue deviation, tongue is at midline. Arm, any weakness in your arms or legs slumping to one side. And I would even say numbness in any arms, legs, half of your face. And speech. Any slurring of those people’s speech, any garbled sounding speech. And then T stands for time. Like I said, time is brain. So, time to call 911. So, if you have any of those, seek emergency medical attention because you could be having a stroke or a warning sign for a stroke down the road.

Kate Kolb:

Right. And is that an acute onset of those symptoms? If you have just been trucking along in life and everything is fine and then suddenly one of those things pops up and it’s a very unnatural thing for you.

Sidney Earley:

Right, exactly. So, studies show that if you get to the hospital within three hours your likelihood of recovering from a stroke is much higher than if you were to wait. Like I said, time is brain. As soon as it starts happening, nobody’s going to shame you for coming to the ER, we want to see you, we want to treat you, we want to help you get better. So, there’s like you asked about treatment options. We live in a very advanced time. So, now is a better time to have a stroke than it was even in 2000. So, stroke deaths have dropped by 35% within the past 10 years. So, we have a lot more advanced treatments. I work in the interventional neurology department with myself and Dr. Nalluri. So, we have the capability to fix these problems.

Sidney Earley:

So, if you come in and you have a blood clot in your brain and you’re within a reasonable timeframe, we can go in and try and get the blood clot out for you and get blood flow back to that area of the brain. Or if you have a TIA, where you’re having a temporary disruption in blood flow to your brain, we can open up that vessel for you. We can get the blood flow back to your brain. And we also have medications. We have TPA, so it’s a clot blood busting drug that we can give people if they get into the hospital soon. So, we have lots of options to try and help people fix their outcomes and get better from these strokes. Just get to the hospital let us help you.

Kate Kolb:

Yeah. Time is brain. We’ll just keep repeating that-

Sidney Earley:

Time is brain.

Kate Kolb:

… over and over and over again. For sure. So, what does rehabilitation and recovery look like after being involved in an episode like that?

Sidney Earley:

So, it depends on the severity of the stroke. So, some strokes are mild, some people are able to return home and have therapy in their house. Sometimes people have to go to what’s called acute rehab. We like to send people to Virginia Baptist, they’re actually a stroke certified rehabilitation center and they do a really good job. We also have a new stroke support group for patients and their families. So that helps deal with the mental and emotional parts of having a stroke and the impact it has on the patient and their family. And then also following up with us in neurology is very important. So, we actually have been at recurrence of strokes. So nationally, one in four people will have another stroke after having one.

Kate Kolb:

Wow! Okay.

Sidney Earley:

So, we actually are starting on the other side of the COVID crisis. We are going to be doing a stroke followup clinic and it’s going to be multidisciplinary. So, we’re going to have a provider and physical therapy and people who are able to help our patients in their home, the paramedicine program.

Kate Kolb:

Awesome.

Sidney Earley:

So, this will really help bridge patients and prevent them from having recurrence of strokes, we’ll help them figure out why they had the first stroke and do everything we can to try and prevent another one from occurring. So, this is huge for our area for continued follow up care for our patients that they can get in and we can help them to try and decrease their risk of having another stroke.

Kate Kolb:

Right. And obviously depending on the severity of the stroke activity and what it has affected in the body, there will obviously be some people that might not fully recover to where they were before, but you have had really good success with people maintaining the life they’re used to previously and that sort of thing. So that’s huge. Talk a little bit about that in terms of recovery.

Sidney Earley:

Yeah. I am not sure actually the statistics on this, but people that are able to get in earlier and fix and don’t sustain these huge strokes in their brain from waiting so long or sometimes it’s out of the hands and sometimes we can do everything we can and still people have pretty severe effects from it, but people do recover. And people continue to recover up until six months after their stroke. So, the brain is a very interesting thing. We do see people get better from these. Just come and see us.

Kate Kolb:

Yeah. There is no substitute for being able to just come in and be seen and to start with even that quiz that we had talked about before is great. Well, is there anything else that you would want to make sure that people know in this conversation that we’re having that maybe we haven’t touched on yet? Whether it’s Stroke Month or just symptoms or recovery or any of that?

Sidney Earley:

I just want to hammer home that if you’re having any of these balance difficulties, difficulty seeing, any weakness, anything like that come into the hospital. Even if we just take a picture and we have peace of mind that it’s not a stroke, then it’s peace of mind it’s not a stroke and we can figure out what’s. going on.

Kate Kolb:

Yeah. I appreciate what you said a few minutes ago too, that nobody’s going to shame you for coming in. And I think that’s huge because I think a lot of times, and I can be like this too, there will be something maybe a little off in how I feel and I’m like, “Oh, they’re going to think I’m a crazy person if I come in and I say, this just doesn’t feel right.” But that’s not the case at all. Our providers are there to help and to heal.

Sidney Earley:

Absolutely. And like I said, your brain is what makes you you. Anything that’s going to potentially affect how you are as a person and your ability to live your life, I would say take it seriously and be seen and do those steps. Take that quiz, take some activation in your life and try your best to give yourself the best odds of not having a stroke. And come and see us, we’ll take care of you.

Kate Kolb:

Yeah. Well, that’s awesome. Sidney, thank you so much for being here with me today and for having this conversation. And yeah, like I said, we’re just really excited to get this information out about Stroke Month and make sure that people know that not only is it a thing, but it’s something that you can prevent and really get good information.

Sidney Earley:

Yeah. And it’s Nurse’s Week.

Kate Kolb:

It is, yes.

Sidney Earley:

We have excellent nursing staff in the hospital that take care of our patients very well. We have a neuro ICU, we have a neuro step down unit. We have great team of people in the hospital and here in the clinic that are very educated specific knowledge about neuro and strokes and rehabilitation and medications for patients that sustain these injuries to their brain. So, we have a great team and our nurses are ready to take care you.

Kate Kolb:

Yeah, that’s huge. And thank you so much for what you do too as a nurse practitioner and partnering with the doctors and everybody as well. And we want to emphasize that this team that has been built here at Centra, just like you just said, it’s full of amazing people, they’re passionate about what they do, they’re passionate about serving the community. And you can see it written all over your face too that you really, really love what you do. So, thank you so much for sharing that.

Sidney Earley:

Yeah, thank you for having me. And I hope to see you guys in my clinic.

Kate Kolb:

Yes. Yeah, we will make that definitely available online in multiple places for you. Please make sure that you go and take that quiz. We would love for people to be able to prevent that. So thanks again for tuning in today, we just love being able to share all this information with you and we look forward to having you check out the website and many of our other resources, don’t forget to check out centrascripts.com, for additional resources and additional podcast episodes to catch up on those. We look forward to talking to you next time.

Leave a Comment