When a stroke happens, the clock starts ticking.
Treatments need to be given as soon as possible, in order to avoid lifelong disability or even death.
And lots of us are affected. Stroke is second biggest killer and the leading cause of adult disability in Australia.
A stroke happens when blood supply to the brain is blocked or interrupted. If the blood supply can be returned in the minutes and hours after the stroke, some brain cells may recover. If not, they will die.
“You'll lose about two million brain cells every minute that goes by,” says neurologist Bruce Campbell.
In the background of this race against time, Australian doctors are clashing over one particular clot-busting drug called TPA. It’s a medicine that dissolves clots so they don’t have to be surgically removed.
Neurologists say the TPA treatment gives patients a precious chance at reducing disability.
"If they don't have the drug, most of these patients have disabling strokes and they'll end up with a degree of disability. It's a discussion that you have with the patients when you can," says Campbell.
"Most of the time when you talk to patients about that, either before or afterwards, they fear death but they fear disability a lot more. Most of us would not want to end up in a nursing home and I think that's a common feeling throughout the world."
But emergency doctors say the treatment carries far too many risks as it can cause haemorrhages and even death.
"The big risk with TPA is that it causes bleeding around the brain and we know from the studies this is in about six per cent of patients," emergency physician Daniel Fatovich tells Insight.
"So bleeding around the brain makes the stroke worse, in fact it's a different kind of stroke. So it's rather strange that you're using the treatment for a stroke that can actually also cause a stroke. If it does cause bleeding around the brain, almost half the people will die as a result of that and usually that's within the first week after the stroke. So that's actually a very big deal."
When anxious loved ones are told about treatment options, they have no time to mull over their decision. Every minute counts.
This week Jenny Brockie hears from stroke patients who received different treatments and pieces together what’s had the best impact on their recovery – whether it was the TPA, or a surgical clot removal, or even a special rehab choir giving them back the power of speech.
If you think someone is having a stroke, please call 000 immediately. For more information, visit The Stroke Foundation.
Watch a preview
Phil McLoughlin can barely speak. But he can sing. He suffered a stroke three years ago which severely damaged his communication skills. Eventually Phil joined a “stroke choir” and he has since shocked his loved ones by singing karaoke at a family event.
Click to watch Phil and his stroke choir perform in the SBS studios:
