One in six Australians will suffer from stroke at some point in their lifetime according to the Stroke Foundation. Getting urgent medical help is critical to survival and recovery. Patients from migrant communities can face challenges in finding the right assistance. September 12 to 18 is National Stroke Week and we're urged to think FAST and act fast as soon as we notice signs of stroke.
34-year-old mother of five Cheryl Chhin didn't know much about stroke until she had one almost a year ago.
"I remember falling to the ground. Everything was like a blur."
"I told my husband I was getting headaches. Just sitting down and taking panadol and then I needed fresh air and so I went outside and I started getting dizzy. I remember falling to the ground. Everything was like a blur."
Cheryl didn't think her symptoms were serious enough to call an ambulance. Luckily, her husband insisted and dialled triple zero (000) immediately. Cheryl couldn't speak and lost movement on the right side of her body.
She almost didn't make it to her own wedding in May this year.
Cheryl didn't think her symptoms were serious enough to call an ambulance. Luckily, her husband insisted and dialled triple zero (000) immediately.
"I wanted to walk down the aisle. I thought even if I was in a wheelchair or if someone had to help me I was going to do it. Cos they wanted me to cancel my wedding and yeah I was just determined to just be able to do it."
She's since recovered most of her mobility and can even drive.
"It was motivation I think. I set myself goals and I wrote all my goals down and it was just everyday life doing things that I used to do before."
Stroke is one of Australia's biggest killers and our leading cause of disability.
Stroke is one of Australia's biggest killers and our leading cause of disability. Neurologist Dr Bruce Campbell is chair of the Stroke Foundation's Clinical Council.
"Most strokes are caused by a blocked blood vessel so not enough blood getting to parts of the brain. A few are caused by a burst blood vessel that's bleeding into the brain so when a blood vessel blocks or there's bleeding that obviously injures that part of the brain. Whatever that area is normally responsible for would stop working."
Most strokes are caused by a blocked blood vessel so not enough blood getting to parts of the brain.
Dr Campbell says different risk factors can lead to a stroke.
"When you've got a blocked blood vessel the reason that clot is formed is usually cholesterol plaque in the arteries and that relates to all the usual cardiovascular risk factors like hyper tension, high blood pressure, smoking, high cholesterol, diabetes, and then the lifestyle issues of obesity and poor diet. And there's also an irregular heart rhythm which is called atrial fibrillation its basically one of the chambers of the heart flapping in the breeze and that allows blood to stagnate, form a clot and then that clot can migrate up to the brain and cause a stroke."
A 2014 Stroke Foundation report found out of half a million stroke survivors in Australia, two-thirds of them have sustained a disability.
"Overall death after stroke would be 10 or 15 per cent. But unfortunately a lot of people are left with significant disability, so they might not be able to walk properly, talk properly, or they'll have memory and thinking problem. So they'll not be able to drive or manage their finances or do other cognitive task."
While stroke is more prevalent amongst older people, it doesn't discriminate on the basis of age.
"The average age is about 70. About a third of patients are in their working years under the age of 65. It can happen at any age. We have babies, children, teenagers who have stroke."
When it comes to identifying stroke, the key is to think of the word F-A-S-T and act fast - face, arm, speech, time to call 000.
"Face, arm, speech, time to call triple 0. So I think that's probably the key message for people out there to recognise stroke is the sudden onset of facial asymmetry, sudden onset of weakness down one side of the body in the arm or the leg, sudden onset of speech difficulty where its slurred or incomprehensible, or the patient cant understand what you're saying to them and time in that case to call triple 0."
"While waiting for an ambulance don't give the patient drugs or drinks."
"The main thing is really just to make that ambulance call and make people feel comfortable. We don't want people to give aspirin because unlike heart attacks, we don't know whether there is bleeding in the brain until we get them to the hospital and do a CT scan of the brain. If you give aspirin and someone has had a bleed and that may not be helpful and maybe harmful. We don't want to give people a drink or something to eat because they may not be able to swallow it properly."
Lisa Mangwiro works for the Stroke Foundation's StrokeConnect Follow Up program. She calls stroke survivors after they are discharged from the hospital to provide free support and advice to help them manage their recovery. Recovery can be extra challenging for those from migrant backgrounds as language and cultural issues can make access to health services more complex.
Recovery can be extra challenging for those from migrant backgrounds as language and cultural issues can make access to health services more complex.
"These include issues such as gender, generational and faith based issues as well. Challenges that we hear from survivors include feeling that they haven't received enough information verbally about their stroke care. There's certainly feelings of being lost and unsure about how to navigate the health system once home."
Another common concern is a lack of interpreters from certain communities.
"In those cases, families are sometimes used although this is certainly not the preferred method and this presents quite a few challenges for health care professionals who are providing the service."
Dung Pham is a dietician who runs courses to help people prevent the onset of heart disease, diabetes and stroke with the Life! program in Victoria. She says migrants tend to end up with the same risk factors as the rest of Australia after adopting a more westernised diet.
"Their diet changes so they're moving from a traditional diet to a more westernised diet, which is usually higher in processed food, higher in take away, higher in fats and that is why their risk of stroke definitely increase."
Following a Mediterranean diet can reduce one's risk of having a stroke, which involves more fish and less red meat.
"Things such as having extra virgin olive oil. There's lots of evidence now to suggest now that having three to four table spoons of extra virgin oil everyday can significantly reduce your risk of stroke and also other heart diseases. Having legumes and lentils on a regular basis. Having a handful of nuts everyday also having more fibre in your diet can also significantly reduce your risk of getting stroke."
A healthy lifestyle change also involves regular exercise of moderate intensity.
"The recommendation is about 150 minutes per week. That is roughly about 30 minutes, five days a week. So moderate intensity exercise is when you're doing some sort of exercise that increases your heart rate so you can talk but you can't sing."
For more information visit the Stroke Foundation. Resources are available in 8 languages.
If you need an interpreter call the Telephone Interpreting Service on 13 14 50, say the language you need and wait on the line for an interpreter. You can ask the interpreter to call StrokeLine 1800 STROKE (1800 787 653).