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By Virginia Middleton and Michelle Osmond

When Bert Crews couldn’t pick up his water glass at the dinner table, his wife Patsy knew something was wrong.

When she looked at her husband, one side of his face was drooping. He insisted he was fine. Ms. Crews, however, knew differently.

After an assessment, it was determined that Mr. Crews had had a mini stroke — a warning that a bigger stroke could be coming. Two days later, he was in surgery.

The day after that, he was back home.

True signs

Stroke is the third-highest cause of death in Canada; Newfoundland and Labrador has a higher rate of stroke than any other province.

Choosing Wisely NL, an initiative at Memorial University’s Faculty of Medicine, is raising awareness about the true signs of stroke so patients, like Mr. Crews, can get the treatment they need as soon as possible.

Most strokes are caused by hypertension and heart disease, but about 20 per cent of strokes occur because of critical narrowing of a carotid artery, which supplies blood to the brain.

The arterial narrowing can be detected at diagnostic imaging departments of most hospitals and by a carotid artery ultrasound.

Act fast

One in five strokes in Newfoundland and Labrador occur secondary to warning symptoms.

That means patients may not respond to these symptoms or they are not getting the test they need at the right time.

Rapid detection of carotid disease in this situation is essential because stroke is preventable with urgent surgery.

Dr. Greg Browne, chief of vascular surgery with Eastern Health, describes some early, but important, signs a patient can be mindful of before the possible onset of a stroke in the following video.

Right test, right patient, right time

Dr. Patrick Parfrey, a physician leader with Choosing Wisely NL, says that in potentially high-risk situations like Mr. Crews’, it is important for the right patient to receive the appropriate test or intervention as quickly as possible.

“Carotid artery testing is an example of a procedure where getting the right test, to the right patient, at the right time, is very important to the health of patients,” he said.

“For example, when a patient experiences symptoms consistent with carotid artery disease and it is identified within the time window where surgery will be beneficial.”

In addition to Eastern Health, Choosing Wisely NL partnered with the Heart & Stroke Foundation on this latest initiative.

“Far too many Newfoundlanders and Labradorians do not know the signs of stroke.” — Mary Ann Butt

“It is of great importance that Newfoundlanders and Labradorians understand and act on stroke as a medical emergency,” said Mary Ann Butt, CEO, Heart & Stroke Foundation of Newfoundland and Labrador.

“Ongoing public awareness campaigns, such as our collaboration with Choosing Wisely NL and the Heart & Stroke F.A.S.T. campaign, are imperative to ensuring an informed public and critical to achieving the best possible outcomes. Far too many Newfoundlanders and Labradorians do not know the signs of stroke, and fail to call emergency medical services when they do recognize one.”

Prevention campaign

For more information about Choosing Wisely NL and the latest campaign about the prevention of recurrent stroke, visit here.

Choosing Wisely NL is a program to help clinicians and patients engage in conversations about unnecessary tests and treatments and make smart and effective choices to ensure high quality care. It is an educational initiative seeking to more efficiently match a patient’s medical needs with the most appropriate type of care that is safest for the patient. For each initiative and outreach program, Choosing Wisely NL has identified key areas of risk and will work towards improving, through the supply of educational resources, the appropriate use of testing and treatment in these areas. The program officially launched in October 2016.


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