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The Be Well Podcast - Patti Brettell, MD and Jay Biessel, DO

Oct 10, 2022, 12:30 PM
Patti Brettell, MD, neurologist and Medical Director for the stroke program at Skagit Regional Health and Jay Biessel, DO, Emergency Department provider and stroke champion at Skagit Regional Health, discuss strokes, the signs and symptoms, what you should do if one happens and more.

Listen in to the full podcast or read from the partial transcript below as Patti Brettell, MD, neurologist and Medical Director for the stroke program at Skagit Regional Health and Jay Biessel, DO, Emergency Department provider and stroke champion at Skagit Regional Health, discuss strokes, the signs and symptoms, what you should do if one happens and more.

Patti, Brettell, MD     Jay Biessel, DO

Patti Brettell, MD: Hi, Prakash, and thanks for having us here today. Both Jay and I have a lot of heart for stroke and have spent a lot of time helping the community know more about it. Strokes are very common. There are over 800,000 strokes in the United States. In addition to that, there's another 250,000 things called TIAs or transient ischemic attacks. Sometimes people call them mini-strokes.

Most strokes are ischemic strokes, meaning there's been something interfering with blood flow to the brain. Usually, that's a clot that's formed in the brain. Eighty-seven percent of all strokes are ischemic. Another 10% of strokes are hemorrhagic, meaning there's been a vessel that's ruptured. And of the strokes that occur, almost a third of them are recurrent strokes. So yes, it's an extremely common problem. 

The Be Well Podcast Stroke Awareness


Prakash Chandran (Host): So understanding how common they are, Dr. Biessel, could you tell us a little bit about the signs and symptoms of a stroke?

Jay Biessel, DO: Thank you for having us. So as far as the signs and symptoms of a stroke, the brain is very complex, so it can present in many different ways. But we essentially advise the public. We have a little acronym called FAST, which stands for face, so does the person have any facial droop? Arm, does the person have weakness in one or both arms? S is for speech. Is the person having any trouble speaking or does a speech sound strange? And then T is for time, which just means time is of the essence. So if you recognize these symptoms, you have to call 911 and get yourself to the emergency department. Some facilities, we've also added BE FAST with a B-E preceding that fast. And the B is for balance. And then, the E is for are there any vision changes?

Prakash Chandran (Host): And Dr. Biessel, just expanding on those symptoms a little bit, what should you do if someone you know is experiencing some of the symptoms that you just mentioned?

Jay Biessel, DO: So most importantly, if someone that you know or yourself are experiencing any of these symptoms, I think the most important thing is to get on your phone and call 911 and get an ambulance to the house to get you to someone like myself in the emergency department to further assess and see what's going on.

Prakash Chandran (Host): Yeah. I'm so glad that you mentioned calling 911 is important, because I feel like if someone were to notice one of these symptoms, they would think, "Well, let me get you in my car and drive to the hospital as fast as possible," just to save time. Dr. Biessel, can you speak broadly to why calling 911 is so important rather than getting someone in a car and driving to the emergency room?

Jay Biessel, DO: Absolutely. So the symptoms are obviously concerning. And I think that the best thing to do is to have a 911 and EMS dispatch come to the house. There's a lot of things that they actually do pre-arrival to the emergency department that really helps my assessment and management that you could not do yourself in a private vehicle heading to the emergency department, such as checking a sugar, seeing what your blood pressure is, assessing and documenting your symptoms that time of onset. Those are all very helpful.

Prakash Chandran (Host): Yeah, that makes a lot of sense. There's almost some pre-triage that's done that just cannot be done if you someone in the car and drive to the emergency room yourself. So very important to call 911. Dr. Brettell, we just talked about what happens if you're noticing symptoms of a stroke, but is there a way to just prevent strokes from happening in the first place? I guess, broadly speaking, are strokes preventable?

Click here to learn more about the Skagit Regional Health telestroke program. 

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Last post : 12/02/2022

The Be Well Podcast - Patti Brettell, MD and Jay Biessel, DO

Oct 10, 2022, 12:30 PM
Patti Brettell, MD, neurologist and Medical Director for the stroke program at Skagit Regional Health and Jay Biessel, DO, Emergency Department provider and stroke champion at Skagit Regional Health, discuss strokes, the signs and symptoms, what you should do if one happens and more.

Listen in to the full podcast or read from the partial transcript below as Patti Brettell, MD, neurologist and Medical Director for the stroke program at Skagit Regional Health and Jay Biessel, DO, Emergency Department provider and stroke champion at Skagit Regional Health, discuss strokes, the signs and symptoms, what you should do if one happens and more.

Patti, Brettell, MD     Jay Biessel, DO

Patti Brettell, MD: Hi, Prakash, and thanks for having us here today. Both Jay and I have a lot of heart for stroke and have spent a lot of time helping the community know more about it. Strokes are very common. There are over 800,000 strokes in the United States. In addition to that, there's another 250,000 things called TIAs or transient ischemic attacks. Sometimes people call them mini-strokes.

Most strokes are ischemic strokes, meaning there's been something interfering with blood flow to the brain. Usually, that's a clot that's formed in the brain. Eighty-seven percent of all strokes are ischemic. Another 10% of strokes are hemorrhagic, meaning there's been a vessel that's ruptured. And of the strokes that occur, almost a third of them are recurrent strokes. So yes, it's an extremely common problem. 

The Be Well Podcast Stroke Awareness


Prakash Chandran (Host): So understanding how common they are, Dr. Biessel, could you tell us a little bit about the signs and symptoms of a stroke?

Jay Biessel, DO: Thank you for having us. So as far as the signs and symptoms of a stroke, the brain is very complex, so it can present in many different ways. But we essentially advise the public. We have a little acronym called FAST, which stands for face, so does the person have any facial droop? Arm, does the person have weakness in one or both arms? S is for speech. Is the person having any trouble speaking or does a speech sound strange? And then T is for time, which just means time is of the essence. So if you recognize these symptoms, you have to call 911 and get yourself to the emergency department. Some facilities, we've also added BE FAST with a B-E preceding that fast. And the B is for balance. And then, the E is for are there any vision changes?

Prakash Chandran (Host): And Dr. Biessel, just expanding on those symptoms a little bit, what should you do if someone you know is experiencing some of the symptoms that you just mentioned?

Jay Biessel, DO: So most importantly, if someone that you know or yourself are experiencing any of these symptoms, I think the most important thing is to get on your phone and call 911 and get an ambulance to the house to get you to someone like myself in the emergency department to further assess and see what's going on.

Prakash Chandran (Host): Yeah. I'm so glad that you mentioned calling 911 is important, because I feel like if someone were to notice one of these symptoms, they would think, "Well, let me get you in my car and drive to the hospital as fast as possible," just to save time. Dr. Biessel, can you speak broadly to why calling 911 is so important rather than getting someone in a car and driving to the emergency room?

Jay Biessel, DO: Absolutely. So the symptoms are obviously concerning. And I think that the best thing to do is to have a 911 and EMS dispatch come to the house. There's a lot of things that they actually do pre-arrival to the emergency department that really helps my assessment and management that you could not do yourself in a private vehicle heading to the emergency department, such as checking a sugar, seeing what your blood pressure is, assessing and documenting your symptoms that time of onset. Those are all very helpful.

Prakash Chandran (Host): Yeah, that makes a lot of sense. There's almost some pre-triage that's done that just cannot be done if you someone in the car and drive to the emergency room yourself. So very important to call 911. Dr. Brettell, we just talked about what happens if you're noticing symptoms of a stroke, but is there a way to just prevent strokes from happening in the first place? I guess, broadly speaking, are strokes preventable?

Click here to learn more about the Skagit Regional Health telestroke program.