(L to R) Atif Zafar, Valerie McWhinnie and Captain Kulasingham.

(L to R) Atif Zafar, Valerie McWhinnie and Captain Kulasingham.

Stroke care at Unity Health Toronto spans all three of our facilities and includes hundreds of staff and physicians working in the emergency departments, intensive care units, stroke units and specialized follow-up clinics at St. Joseph’s and St. Michael’s, as well as rehabilitation units. at Providence Healthcare.

Providing excellence in stroke design is critical to community health: Stroke is the third leading cause of death in Canada and the leading cause of disability in adults. A stroke leads to a hospital or emergency room visit every five minutes in Canada, research shows.

For Stroke Awareness Month, we took to social media to ask people to submit questions related to stroke. Here are the answers, which Dr. Atif Zafar, a physician in charge of the stroke program at St. Michael’s, and Providence Healthcare physical therapist Valerie McWhinnie and occupational therapist Kapilan Kulasingham provided.

Q: I heard that strokes are on the rise in young people. Why is this happening?

Zafar: The number of strokes in younger people is increasing. We believe that this increase is due to the increased incidence of diabetes, high blood pressure, sleep problems, alcohol and drug use among younger individuals.

Q: How is rehabilitation different for young adults who have had a stroke compared to older adults?

McWhinnie and Kulasingham: Rehabilitation is generally the same for younger and older stroke victims. Stroke survivors here at Providence are treated by a specialized multidisciplinary team in our inpatient and outpatient departments. We listen to their concerns and formulate goals focused on maximizing their recovery.

Younger stroke victims often have many questions: Why did I have a stroke? Am I at risk of another stroke? Will I return to work? How can I take care of my children? How will I pay my bills? We support and help survivors find answers to their individual questions.

Younger stroke victims will likely have to live longer with disability. It is important that they learn ways to live a healthy life. At our stroke outpatient clinic, we offer a program for living with stroke that focuses on self-management skills. Continued physical activity is encouraged through our partnership with Variety Village (an accessible community fitness facility).

Q: Are the symptoms of stroke different between men and women?

Zafar: Sometimes there may be a slight difference. Recent studies have found no significant differences in stroke symptoms between genders, but previous studies have shown that women may experience more headaches and non-specific symptoms during a stroke.

Q: I have read that women who have a stroke feel worse than men. Why is that?

Zafar: Interestingly, women tend to survive better than men after stroke. However, when it comes to disability, women may experience more challenges. The exact reasons for this are not fully understood, but may be related to control of risk factors and access to post-stroke rehabilitation services.

Q: Why does pregnancy increase the risk of stroke?

Zafar: The hormonal changes during pregnancy contribute to an increased risk of stroke. The risk is especially high in the last trimester of pregnancy and the first weeks after birth. Pregnant people with high blood pressure and diabetes should be closely monitored by their doctors to reduce their risk.

Q: What is a small bump and what should you do if you think you have/have had one?

Zafar: A mini stroke, also known as a TIA (transient ischemic attack), is a temporary set of stroke-like symptoms. These symptoms may include temporary paralysis or difficulty speaking. Even though symptoms resolve within minutes to hours, a TIA should be taken seriously. Seek immediate emergency room evaluation if symptoms persist, or go to an emergency room or stroke clinic if symptoms have resolved. Treating the underlying cause is important to prevent a more serious stroke in the future.

Q: Does migraine with aura increase the risk of stroke?

Zafar: Migraine with aura is associated with a higher risk of ischemic stroke. It is important to have your migraine with aura properly managed and discussed with your doctor. Unlike regular migraines, migraines with aura should be taken seriously because of their association with stroke risk. Auras can include visual disturbances such as zig-zag lines or temporary loss of vision, followed by headaches and other symptoms.

Q: How do sleep habits affect stroke risk?

Zafar: Obstructive sleep apnea (OSA) is a risk factor for stroke. If you snore at night and feel tired during the day, it is important to discuss these symptoms with your doctor to explore the possibility of OSA treatment.

Q: Is it true that smelling burnt bread when there is none is a sign of stroke? Why is this associated with stroke symptoms?

Zafar: Contrary to popular belief, smelling burnt bread when there is none is not a proven sign of stroke. However, this misunderstanding may be due to the relationship between stroke and changes in perception. If you experience any unusual symptoms or suspect a stroke, it is important to see your doctor immediately.

Author: Marlene Leung

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