WHO IS THE TYPICAL STROKE VICTIM? YOU MAY HAVE THE IMAGE IN YOUR MIND OF AN OLDER MAN WHO SMOKES AND HAS HIGH BLOOD PRESSURE. SOME OF THAT IMAGE DOES INCLUDE KNOWN RISK FACTORS FOR STROKE, BUT THE TRUTH IS 60% OF THE PEOPLE IN THE US TO DIE FROM STROKE ARE WOMEN. THIS MONTH IS DEDICATED TO STROKE AWARENESS AND DOCTORS ARE WORKING TO GET THE WORD OUT ABOUT STROKE RISK FOR WOMEN. AT THE SAME TIME MAKING EVERYONE AWARE REGARDLESS OF THEIR AGE OR LIFESTYLE THAT NO ONE IS IMMUNE FROM THE RISK OF A STROKE. KNOWING WHAT SENTENCE TO LOOK FOR COULD SAVE YOUR LIFE. JOINING ME IS DR. WILLIAM NEIL. HE IS AVASCULAR NEUROLOGIST AND STROKE SPECIALIST FOR KAISER PERMANENTE. WELCOME TO THE SHOW. WITH HIM IS ANNELISE ONE OF HIS PATIENTS. -- WHAT EXACTLY IS A STROKE? A STROKE IS ANY DISRUPTION OF BLOOD FLOW TO THE BRAIN, THAT CAUSES PROBLEMS WITH ANYTHING THE BRAIN CONTROLS. THE BRAIN PRETTY MUCH CONTROLLED EVERYTHING. SO THIS DRAW -- A STROKE AND BE CAUSED BY A BLOOD CLOT OR IT CAN BECAUSE BY BLEEDING INTO THE BRAIN, AND THAT BLOOD CLOT ARE BLEEDING CAN CAUSE DYSFUNCTION AND IT CAN CAUSE DIFFICULTY THINKING, SPEAKING, SEEING, MOVING, AND WALKING AND PRETTY MUCH IT CAN CAUSE PROBLEMS IN ANYTHING WE DO. TWO STROKES ALWAYS RESULT IN BRAIN DAMAGE? NOT ALWAYS. OCCASIONALLY THERE WILL BE TEMPORARY DAMAGE OR PROBLEMS, AND PEOPLE CAN RECOVER WITHOUT A SCRATCH. THERE ARE EFFECTIVE TREATMENTS NOW THAT CAN BENEFIT A HANDFUL OF PATIENTS AND REALLY MAKE THE DAMAGE EITHER MINIMAL OR NONEXISTENT AFTER SOME TIME. THAT ALL DEPENDS ON THE TREATMENT OR WHERE THE BLOOD CLOT IS LOCATED? IT'S BOTH. SOMETIMES YOU CAN HAVE A LACK OF BLOOD FLOW FOR CERTAIN AMOUNT OF TIME, BUT THEN THE BLOOD FLOW CAN SPONTANEOUSLY IMPROVE TO WHERE YOU HAVE TRANSIENT PROBLEMS. YOU HAVE TRANSIENT EPISODE AVENUE NOT BEING ABLE TO TALK THAT CAN LAST 10 MINUTES OF TO AN HOUR. WE CALL THAT A TRANSIENT ISCHEMIC ATTACK AND THEY CAN GET BETTER ON ITS OWN. ON THE OTHER HAND, SOMETIMES IT CAN LAST LONGER AND IF PEOPLE MAKE IT TO THE HOSPITAL, WE CAN GIVE AN EFFECTIVE TREATMENTS THAT IN MOST PATIENTS WILL EITHER MINIMIZE THE DAMAGE OR EVERY ONCE IN A WHILE THE PATIENT ESCAPES WITHOUT DAMAGE. PART OF THE AWARENESS MONTH IS AN EMPHASIS ON THE FACT THAT WOMEN MAY NOT THINK OF THEMSELVES AS TYPICAL STROKE VICTIMS. THEY MAY EXPERIENCE DIFFERENT SYMPTOMS. POWER THOSE SYMPTOMS DIFFERENT? I WILL TALK ABOUT THE CLASSIC SYMPTOMS FOR US. I HAVE THIS IN PNEUMONIC THAT I LIKE. IT'S BE FAST . BALANCE, EYES, FACE, ARM OR SPEECH. ANY DIFFICULTY WITH THAT IT'S TIME TO CALL 911. THAT ACCOUNTS FOR THE MOST COMMON SYMPTOMS. THE DIFFERENCE IN WOMEN -- YOUNG HEALTHY PEOPLE IS THAT WE WON'T THINK ABOUT HAVING A STROKE. SOME OF THE DIFFERENCE IN DENSE CAN BE -- SYMPTOMS CAN BE A SUDDEN HEADACHE COMBINED WITH THE OTHER ONES MENTIONED. THEY CAN BE MORE SUBTLE. THE PROBLEM IS IF SOMEBODY IS YOUNG AND OTHERWISE HEALTHY, THEY WON'T PAY ATTENTION TO THEIR BODY. YOU THINK IT'S JUST GOING TO GO AWAY. ANNELISE I WANT TO SPEAK WITH YOU. YOU HAVE BEEN A PATIENT OF DR. NEIL . I SUFFERED A VENOUS SINUS STORM POSES WHICH WAS A BLOOD CAN'T -- CAUGHT IN MY BRAIN. YOU ARE A YOUNG WOMAN. HOW DID YOU EXPERIENCE THIS? YOU KNOW WHAT WAS HAPPENING? I HAD ORIGINALLY BEEN HAVING SOME SEVERE NECK AND HEADACHE SO I MENTIONED IT TO MY MOTHER WHO IS A NURSE AND I SAID THIS IS OUT OF THE NORM AND SOMETHING DOESN'T FEEL RIGHT. SHE SAID HOW ABOUT WE GO BUT -- TO THE DOCTOR GET A LOOK AT. THE DOCTOR GAVE ME AN EXAMINATION AND SAID YOU ARE AN ATHLETE SO YOU MIGHT HAVE HIT A NERVE IN YOUR NECK. HE PRESCRIBE A MEDICATION AND SAID -- PAIN MEDICATION. BUT I SAID THIS IS NOT JUST A NECK PAIN, SOMETHING IS HAPPENING THAT'S NOT RIGHT. SO YOU ARE THE ONE WHO PURSUED IT. YES IN WITH MY MOTHER WHO IS VERY ACTIVE IN THING YOU NEED TO LISTEN TO YOUR BODY. SHE SAID IF SOMETHING CANNOT WRITE YOU HAVE TO TELL SOMEONE. I WAS SENT HOME WITH THE PAIN MEDICATION. MY MOTHER WAS NOT SURE WHAT IS HAPPENING AND TOLD MY FATHER THAT I WAS GOING TO STAY WITH HIM TO MAKE SURE THAT EVERYTHING IS GOING TO BE OKAY. ON THE SECOND NIGHT I GOT UP IN THE MIDDLE OF THE NIGHT TO TAKE THE MEDICATION BECAUSE I THOUGHT MY HEAD WOULD BURST AND I ENDED UP COLLAPSING AND HIT MY FACE ON A WALL. I BROKE MY NOSE AND I MADE MY WAY TO THE BATHROOM WHERE THE DOG BARKED AND MY MOTHER ASKED ME IF I WAS OKAY. AT THAT POINT I MADE A REMARK LIKE I'M NOT. SHE WAS ABLE TO COME IN MAKING SURE THAT I HAD NOT BROKEN MY FACE HER TEETH OR ANYTHING. I WAS ABLE TO COMMUNICATE THAT I WAS OKAY. SHE HAD ME LAY DOWN AND CHECKED MY BLOOD PRESSURE. BUT THE NEXT MORNING I WAS TAKEN TO THE ER WHERE THEY DID AN MRI AND I WAS DIAGNOSED WITH A BLOOD CLOT IN MY BRAIN. AND THAT'S WHEN I MET DR. NEIL. THAT MUST'VE BEEN HARD TO UNDERSTAND CONSIDERING YOUR AGE, CONSIDERING YOUR LEVEL OF HEALTH. THIS WOULD'VE BEEN THE LAST THING YOU WOULD SUSPECT. WHEN THE DOCTOR CAME IN AND TOLD ME THAT THERE WAS A BLOOD CLOT IN MY BRAIN, I THINK I WAS IN SHOCK. I WAS TAKEN TO A HOSPITAL BED AND WAS ON BLOOD THINNERS AND HAD TO STAY FOR A COUPLE OF DAYS TO RECOVER. DR. NEIL HOW DO YOU TREAT A STROKES ? THERE ARE COUPLE OF DIFFERENT WAYS. BEFORE I EVEN THINK ABOUT TREATMENT I LIKE TO THINK ABOUT PREVENTION. WE WORK WITH KAISER AND ARE VERY BIG ON MAKING SURE THAT STUFF DOES NOT HAPPEN IN THE FIRST PLACE. THE BEST THING WE CAN DO IS PREVENT A STROKE -- BROKE FROM EVER HAPPENING. THE MAJORITY OF STROKES, ABOUT 80%, WE CAN ACTUALLY PREVENT. THIS IS BY CONTROLLING THINGS LIKE HIGH BLOOD PRESSURE, OBESITY, EATING LOTS OF FRUITS AND VEGETABLES, EXERCISING, IF YOU HAVE DIABETES CONTROLLING THAT, IF YOU HAVE HIGH CHOLESTEROL AGAIN IN LOTS OF FRUITS AND VEGETABLES, AND IF YOU NEED TO TAKE A CHOLESTEROL MEDICINE MAKE SURE ANY MEDICINE PRESCRIBED TO TAKE IT EVERY SINGLE DAY, AND THEN SO THAT'S THE MOST AND OBVIOUSLY IF YOU SMOKE CIGARETTES STOP. IF YOU DON'T, DON'T START. ONE QUESTION IS IS VERY LINK BETWEEN MIGRAINE HEADACHES AND STROKE? THIS NOT COMPLETELY WORKED OUT. WE ARE SEEING THAT THOSE WHO GET FREQUENT MIGRAINES, ESPECIALLY PEOPLE WHO GET MIGRAINES WHERE THEY WILL HAVE ON OCCASION THEY GET IT SO BAD THAT THEY GET VISION LOSS, THERE IS ABOUT DOUBLE THE RISK OF A STROKE COMPARED TO OTHERS BECAUSE PEOPLE SUFFER MIGRAINES ARE GENERALLY OTHERWISE YOUNG AND HEALTHY BUT THERE IS ABOUT A DOUBLING OF THE RISK OF STROKE. THERE ARE DIFFERENT THEORIES AS TO WHY, BUT IT HAS NOT BEEN COMPLETELY WORKED OUT. WOMEN ARE MOST -- MORE LIKELY TO SUFFER FROM MIGRAINES. EXACTLY. AND THAT'S WHY THIS IS SO IMPORTANT BECAUSE AS YOU MENTIONED WERE WE THINK OF AN OLD MAN WHO SMOKES A LOT AND WHO IS OVERWEIGHT AND HAS HIGH BLOOD PRESSURE. THAT'S WE HAVE SEEN ON OCCASION, FORTUNATELY IS IN THE MINORITY, YOUNG AND HEALTHY PEOPLE ESPECIALLY WOMEN, MIGRAINE IS CONTRIBUTED TO THIS, HORMONES, PREGNANCY, BIRTH CONTROL PILLS MAY ALSO CONTRIBUTE TO THIS AND OTHER WAYS IN YOUNG AND HEALTHY PEOPLE. WHEN A YOUNG AND HEALTHY PERSON COMES INTO THE EMERGENCY ROOM, AND EXHIBIT SYMPTOMS AS SHE DID, IS IT POSSIBLE THAT SOME OF THE STROKES MIGHT BE OVERLOOKED BECAUSE THE ER DOCTORS ARE LOOKING FOR THEM? ABSOLUTELY. THIS IS ESPECIALLY TRUE 10 YEARS AGO BUT I THINK PEOPLE ARE GETTING MORE INTO TO THIS, BUT A CAMBI. -- IT CAN BE. BECAUSE IT WOULD BE UNUSUAL TO HAVE A STROKE AND MAYBE THIS IS A MIGRAINE ARE PINCHED A NERVE. I THINK IT SUPPORT FOR PATIENTS TO ADVOCATES AND SAY THIS COULD JUST BE A HEADACHE BUT SOMETHING IS NOT RIGHT AND LET'S GET THIS LOOK AT AGAIN. WHAT WAS YOUR RECOVERY LIKE ANNELISE? THIS HAPPENED BACK IN JULY AND WHEN I WAS IN THE HOSPITAL GETTING THE BLOOD THINNERS I ACTUALLY DEVELOPED SEVERE DOUBLE VISION. SO I WAS ABLE TO GO HOME AFTER A COUPLE OF DAYS, BUT THE DOUBLE VISION LASTED FOR THAT ELEMENT -- FOR ABOUT A MONTH. I WAS NOT ABLE TO DRIVE. THIS WAS HARD BECAUSE I WAS SO INDEPENDENT AND NOW I HAD TO BE BACK AT MY PARENTS HOUSE. AS TIME WENT ON AND THE CLOT DISSIPATED IN THE PRESSURE MY BRAIN WENT AWAY, MY DOUBLE VISION ALSO WENT AWAY WHICH WAS GREAT. IT TOOK TIME. I JUST HAVE TO WAIT. WHAT DO THE DOCTORS TELL YOU ABOUT WHETHER OR NOT THERE MIGHT BE A RECURRENCE? I'M GOING THROUGH TESTING ON THAT TO HOPEFULLY, IF I HAVE A CLOTTING FACTOR IN MY BLOOD THEY CAN TELL, SO I CURRENTLY AM ON BLOOD THINNERS AND WILL BE ON THEM FOR THE FOR SIEBEL FEATURES OF THIS DOES NOT HAPPEN AGAIN BECAUSE I WOULD NOT LIKE TO GO THROUGH THIS AGAIN. SO IF I HAVE TO TAKE BLOOD THINNERS FOR THE REST OF MY LIFE I'M FINE WITH THAT. DR. NEIL DURING A REGULAR EXAMINATION YOU GO IN FOR YOUR SIX MONTH EXAM, IS THERE ANY WAY A DOCTOR CAN DETECT IF YOU ARE AT IMMINENT RISK FOR A STROKE? THEY ARE IS NOT NECESSARILY. WE CAN LOOK AT THE RISK FACTORS. AND THEY CAN TELL YOU WHETHER YOU ARE AT A HIGHER RISK. WE SAY AGAIN IF YOU ARE OVERWEIGHT LOSE WEIGHT, IF YOU SMOKE QUITS. IF YOU HAVE DIABETES TAKE YOUR MEDICINE. HIGH BLOOD PRESSURE PLEASE TAKE YOUR MEDICINES. WE ALSO CAN DO SCREENING NEUROLOGICALLY AND WE CAN PICK UP ON SUBTLE CLUES. FOR EXAMPLE, IF SOMEBODY'S ARM HAPPENS TO BE WEAKER ON THE RIGHT COMPARED TO THE LEFT, AND WE CAN REVIEW THOSE RISK FACTORS. THE BALANCE, ARM, PHASE AND SPEECH. I ASKED PATIENTS IF MAYBE THERE IS A CONCERN. HAVE YOU EVER HAD ANY EPISODES WHERE YOU WEREN'T THINKING CLEARLY ALL OF THE SUDDEN? SUDDENLY UNABLE TO SPEAK. IT SEEMS TO COME BACK OVER AND OVER AGAIN TO THOSE RISK FACTORS. WE WILL HAVE ON HER WEBSITE THOSE AS WELL. I WANT TO THANK YOU VERY MUCH. THANK YOU FOR COMING IN AND SHARING YOUR STORY ANNELISE AND DR. WILLIAM NEIL THANK YOU.
Annelise Wilding started experiencing headaches, that began with a pain in her neck, in July 2014.
She was 26, worked for the Navy as a construction manager and she thought she had pulled a muscle. She spent two weeks trying everything she could think of to get the headaches to go away. She got massages and eventually went to a chiropractor.
"Then my mom came over and said something is not right and took me to the doctor," Wilding said.
A doctor prescribed medicine for migraines and pain. But Wilding said her parents knew something wasn't right. They insisted she spend the night with them.
She woke up that night in pain, got up to take pain medicine and collapsed. She hit her head on the wall and broke her nose.
The next day she went to the hospital where she was given an MRI. Vascular surgeon Dr. William Neil reviewed her scan and diagnosed a stroke.
Neil is the regional stroke champion for Kaiser Permanente, which means he makes best practice recommendations for diagnosing and treating stroke in Southern California.
"The biggest problem with stroke right now is that people aren't aware of signs and symptoms," said Neil.
According to Neil, he’s raising awareness for stroke in women in particular because their symptoms may be different from those found in men.
He uses a mnemonic device "BE FAST" to help people remember the symptoms for stroke. The symptoms may occur when someone experiences an unexplained loss in function in the following: Balance, Eyes, Face, Arm or Speech. 'T' represents time, prompting people to call 911.
Women occasionally have additional symptoms like Wilding did, including sudden severe headache or neck ache that usually accompany the other symptoms, explained Neil.
Neil said, for the most part, the majority of stroke patients are over 50 but women present some special conditions.
"They can have a stroke related to different causes like pregnancy and birth control pills." he said.
Women who have migraines are also at greater risk for stroke Neil said.
"In general strokes will affect older women," he said. "But occasionally we see young and healthy men and women -- it’s a problem because women may not always think they’re at risk."
Wilding's stroke left her with double vision for a time but she says she's made a complete recovery. Depression was a big thing, she said.
"I was taken out of commission, I couldn’t hang out with friends," Wilding said. "Physically I wasn’t in tears but it was a loss in spirit."
According to the American Stroke Association, 80 percent of strokes are preventable.
Risk factors for stroke overlap with those for heart attack including high blood pressure — a sign that arteries are getting more rigid and narrowed -- obesity and smoking.
To prevent a stroke, Neil recommends daily exercise and lots of vegetables while minimizing salt, fried foods and meat.
Another specific risk is atrial fibrillation, a medical condition in which the heart can skip a beat, which sometimes leads to not enough blood going to the brain, according to Neil.
Today Wilding said she's back to her normal life. She returned to work in October but continues to take blood thinners to prevent another blood clot from forming.
She said she's speaking out to try to help people recognize their symptoms sooner than she did.
"Listen to your body," she said.
