As a time-sensitive medical condition, stroke occurs when blood supply to part of the brain is disrupted and therefore, damaged – causing loss of its functions, resulting in the symptoms of stroke. For every minute a stroke is left untreated, an estimated 12 million brain cells die, which is why “Timing is Everything”. In fact, stroke is the leading cause of adult disability.

The Ministry of Health’s Stroke Services Improvem ent (SSI) entitled their annual stroke awareness campaign “Timing is Everything”, focusing on the importance of acting fast the moment the signs of stroke are spotted, as early stroke detection leads to better recovery and quality of life after.

Mini-strokes are a warning sign

Transient Ischaemic Attacks (TIA), more commonly known as a mini-strokes, have the same symptoms as an actual stroke but they typically get better within a few minutes. However, this does not mean that everything is fine as they are often followed by an actual (more severe) stroke. Therefore, mini-strokes and strokes in which the symptoms may seem to be improving are also emergencies and should not be dismissed. The same action of calling for an ambulance should be taken. More importantly, prompt medical attention allows early assessment and institution of treatment for better recovery and reduced risk of stroke recurrence.

Associate Professor Deidre De Silva, Chair, Stroke Service Improvement team, Ministry of Health and Head & Senior Consultant, Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), said: “Many stroke patients do not come to hospital because the symptoms are improving, have resolved or they hope they will improve with time so they wait and do not call an ambulance. When they do come to hospital later, we may not be able to offer early treatments which are proven to result in better outcomes or to start medications to reduce early stroke recurrence. Timing is everything. Even if symptoms seem mild or ‘disappear’, it is vital to call 995 immediately! In stroke, time is brain and minutes matter.”

The importance of managing risk factors

Stroke is a preventable disease. Up to 80% of strokes can be prevented by making lifestyle modifications and addressing risk factors early on. Controlling high blood pressure, high cholesterol levels and diabetes, having a healthy diet and regular exercise, and lifestyle modifications, such as not smoking, limiting alcohol consumption, and maintaining healthy body weight is proven to reduce the incidence of stroke.

With more people working from home during this pandemic and fewer opportunities for physical activities, more in Singapore are becoming more sedentary in our daily lives. One study reports that sedentary individuals are 25% to 30% more likely to have a stroke than their physically active peers.

According to the 2019 Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) , there has also been a substantial shift of stroke risk burden towards metabolic factors, where the top three factors that contributed to stroke include high systolic blood pressure (high blood pressure), high body-mass index (obesity), and high fasting plasma glucose (diabetes).

Stroke care goes virtual

Aside from SSI’s “Timing is Everything” campaign, other stroke advocacy groups are also stepping up in the month of October to shed light on this disease. Stroke Support Station (S3), the charitable organisation that supports rehabilitation for stroke survivors, will be focusing on caregiving and family care to support a stroke survivor’s recovery. As one of its 25^th anniversary events, the Singapore National Stroke Association (SNSA) will be launching their annual “Stepping Out For Stroke” campaign, which advocates for exercise and increased physical activity to reduce likelihood of stroke.

Due to the pandemic, support for stroke survivors has had to go virtual, including online talks, exercise sessions and peer-support group activities. The SNSA adapted its befriending service and retrained their volunteers, to provide befriending for over 50 stroke survivors through phone and video chats. S3 has also adapted their wellness programmes to go virtual on Zoom. The Re-Learn and Enjoy Active Living (R.E.A.L) Wellness programme is catered for stroke survivors and caregivers, to encourage fitness training, general strengthening and cognitive stimulation through interactive classes such as fitness and music therapy.

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