June is Stroke Awareness Month. Approximately 40,000 to 50,000 strokes occur each year in Canada. About 15,000 people do not survive, making stroke the third leading cause of death. As well, stroke is the leading cause of disability, often robbing those who survive of the ability to walk, talk, think, or live independently. The lasting effects cost the Saskatchewan health care system $60 million a year, and for survivors and their caregivers, it exacts an untold emotional and physical toll.
In fact, every ten minutes a Canadian has a stroke. Here in Saskatchewan, an estimated 2000 people suffer a stroke each year. With our aging population, this pace is expected to increase dramatically – by as much as 32% in the next four years alone.
Just a few years ago, stroke was still considered unpreventable and untreatable. Here are just a few of the critical advances the Heart and Stroke Foundation has made, providing new hope for stroke patients.
Erasing the effects of stroke
A stroke can cut off blood flow to the brain, causing damage to the mind and body. That’s why the Heart and Stroke Foundation research has pioneered the development of tPA, a clot-busting drug that, when accessed quickly, can actually reverse these effects for strokes caused by blood clots, which account for 80 per cent of cases. So for many it’s as if the stroke never happened. The challenge is getting stroke patients to emergency care very fast - within a short time after the stroke’s onset, three hours at most.
The Heart and Stroke Foundation is working to have special stroke response teams in place throughout the province by 2010, so that everyone – from the operator who receives a 9-1-1 call right through to emergency room staff – are ready to fast-track a suspected stroke for a quick CAT scan or MRI and immediate clot-busting treatment.
According to Dr. Wadea Tarhuni, Heart and Stroke Foundation stroke spokesperson, in Moose Jaw (where the Five Hills Health Region has implemented a special stroke emergency protocol), this has meant that people have sat up to shake his hand following a stroke that might otherwise have severely disabled them.
“I am overwhelmed when we have this kind of success,” he says. “A decade ago there was so little we could do for a stroke patient: now we can help them recover more fully and require far less long-term care. Many can go home, as though the stroke never took place.”
Integrated Stroke Care
Stroke is Saskatchewan’s leading cause of adult disability and the third-leading cause of death. Yet what is currently done about stroke in our province too often lags far behind what is known about stroke, and varies greatly from hospital to hospital and health region to health region. The Heart and Stroke Foundation recognized early on that it will take a coordinated effort to reduce stroke’s devastating outcomes and is acting to make this a reality. Called the Integrated Stroke Strategy (ISS), it includes everyone from your family doctor right through to first responders, emergency room personnel, diagnostics and rehabilitation experts. Each has a role to play, and when working in combination, can radically improve stroke outcomes. In fact, research presented earlier this year at an International Stroke Conference revealed that nine out of 10 in-hospital stroke deaths could be prevented within the first week following stroke if integrated care was in place.
This is powerful justification for the ISS in Saskatchewan.
“We’re all familiar with treating heart attacks as emergencies, and most major hospitals have cardiac care units. We need the same system to care for stroke patients as well,” notes Dr. Tarhuni.
Provinces where the Integrated Stroke Care system has been adopted have measurable evidence of better outcomes for stroke patients. In Ontario, where the strategy has been in place since 2000, there has been a 21 per cent decrease in stroke patients requiring inpatient care and 25 per cent decrease in those requiring ongoing home care. In addition, increased public knowledge of the signs of a stroke has resulted in more stroke patients getting emergency care faster, resulting in quicker assessments and treatments and better outcomes.
Public Awareness – the vital link to survival
Early, accurate diagnosis of stroke is a critical component of optimal stroke care – but before any medical action can be taken, the signs of a stroke must be recognized and a 9-1-1 call made. The Foundation’s public campaign of the five warning signs of stroke will play an important role in helping Saskatchewan people learn the five signs – and know what to do.
Speeding stroke recovery
Research has proven that for the best chance at recovery, stroke patients should begin rehabilitation as soon as they are medically stable – not weeks or months later. By adding early intensive rehabilitation, length of hospital stay, referrals to long-term care and levels of disability are all reduced.
Southern Saskatchewan has been selected as a trial site for a new national study that focuses on how to bring the best new evidence on stroke rehabilitation to our clinics and hospitals. Regina’s Wascana Rehabilitation Centre is hosting the SCORE-IT trial, aimed at using new rehabilitation methods to benefit stroke patients, and also at helping find the best ways to integrate these techniques into stroke rehab programs across the province.
Overcoming our geographic challenges
Making the best possible recovery from stroke often boils down to where you live in our province. People in remote or small communities have extra challenges, because programs may not be close by. The Foundation has worked with Telehealth to bring our “Living With Stroke” series to outlying centres through their video conferencing technology.
Now is the time to act…
Now is the time to act. We have the knowledge to prevent some strokes, to halt others in their tracks, and to help people recover abilities faster and more completely than ever before. Please visit www.heartandstroke.sk.ca to learn more.