STROKE: What are the signs and what should caregivers know after?

During the National Stroke Roundtable Discussion on October 15, clinicians, patients advocates, and healthcare partners discussed how the Philippines can strengthen stroke care, from recognizing the first symptoms to emergency treatment and recovery at home.

For families and citizens, knowing stroke warning signs can help them respond quickly when a loved one suddenly becomes unwell.

Dr. Arnold Pineda, president of the Stroke Society of the Philippines, emphasized the importance of recognizing stroke symptoms through the acronym B.E. F.A.S.T.

The acronym B.E. F.A.S.T. stands for:

B – Balance. Watch for a sudden loss of balance, difficulty walking, or unexplained dizziness that affects a person’s coordination.

E – Eyes. Be alert to sudden changes in vision, including blurred or double vision or loss of sight. 

F – Face. Ask the person to smile. One side of the face may droop or appear uneven.

A – Arms. Ask the person to raise both arms, where one arm may be weak, numb, or drift downward.

S – Speech. Listen for slurred speech, difficulty speaking, or trouble understanding what others are saying.

T – Time. If any of these signs appear suddenly, immediately seek medical care.

“Stroke can happen to anyone, anywhere. And a person can see their life changing in an instant,” Sarno shared.

According to the Department of Health, a stroke can interrupt the blood supply to any part of the brain or result from bleeding in the brain. 

Therefore, the principle expressed by stroke specialists as “time is brain” means that delays can cost patients brain function and increase the risk of lasting disability.

Access to stroke care remains a challenge, particularly for patients in remote areas far from major medical centers. To address this, the Stroke Society of the Philippines (SSP) established its Acute Stroke-Ready Hospital (ASRH) certification program to promote timely, evidence-based treatment.

Dr. Christina Macrohon-Valdez reported that 113 hospitals nationwide are now participating in or certified under the program, with facilities expanding in Luzon and Mindanao.

Certified ASRHs must have a 24/7 Acute Stroke Team with response times under 15 minutes, round-the-clock CT scan availability, and supply of clot-busting medication. 

The SSP also developed the Stroke Ph App, available on the Apple App Store and Google Play, to help users locate nearby stroke-ready hospitals.

For Arlene Tayamora, the road to recovery for stroke survivors does not end upon hospital discharge. At home, patients and their families face a new set of challenges, from the financial and emotional struggle to long-term care.

According to the key opinion leader of the APAC Stroke Policy Alliance. & Stroke Society of the Philippines (SSP) former president Dr. Christina Macrohon-Valdez, the patient has to undergo rehabilitation in order to maximize recovery from their disability after hospitalization.

“Hindi lang po siya physical therapy. It’s a multidisciplinary care involving speech therapy, occupational as well as cognitive therapy. The patient has to be reintegrated back to the community and then prevent them from having another stroke,” she said. 

Macrohon-Valdez added that the patient is not immune to stroke after the hospitalization. 

The patient has a higher risk for having it again and that they must be well taken care of and monitored for them not to have another one.

Tayamora, who also represents Beyond Stroke PH under the Philippine Alliance of Patient Organizations, described the financial, emotional and practical demands that stroke places on families.

“Every day, you have to wake up early in the morning to prepare their food, prepare their medicines, prepare them going to the CR, papalitan mo ‘yong diaper, kasi parang may inaalagaan kang bata,” she shared.

When a parent needs constant care, adult children must work out who will look after them — sometimes at the expense of their own jobs and family responsibilities.

Roberta Sarno delivering her opening remarks. Photo courtesy of Ayumi Garcia, ABS-CBN News Digital Intern

According to a study by Macrohon-Valdez, stroke carries a significant economic and caregiving burden in the Philippines, with acute ischemic stroke projected to cost the country more than P416 billion over 15 years and caring for a stroke survivor who depends on assistance can cost families around P740,000 annually.

These figures include medications, transportation, rehabilitation, and salary for caregivers just for a stroke patient’s upkeep.

“If we recognize the signs of stroke on time and we are able to reach the hospital that is ready to provide care for stroke on time, then we will be able to prevent many of the disabilities that can follow a stroke episode,” Roberta Sarno of the APAC Stroke Policy Alliance said on the event’s opening remarks.

Sarno emphasized that timely recognition of stroke symptoms and access to properly equipped hospitals can help prevent long-term disabilities. Efforts to improve stroke care include expanding PhilHealth coverage, strengthening healthcare worker training, and exploring telemedicine amid a shortage of neurologists.

Dr. Giovanni Nazario of the Angels Initiative highlighted efforts to strengthen hospital readiness and train healthcare workers, including nurses, through the free Stroke Nurse Masterclass in partnership with the Stroke Society of the Philippines (SSP).

“Sa isa pang initiative ng AGELS is what we call the Stroke Nurse Masterclass. We work with the Stroke Society of the Philippines para i-train po ang mga nurses natin. So, not just the doctors but the nurses as well. And this is free,” Nazario shared.

The initiative also works to improve access to stroke care in rural areas. In La Union, the Stroke Links program brought together hospitals, local government units, and medical organizations to strengthen the stroke care network in Region 1.

Dr. Nazario concluded the roundtable discussion, emphasizing early stroke recognition, emergency response, and timely treatment to prevent long-term disability.

With acute ischemic stroke projected to cost the Philippines P416 billion over 15 years, he called for stronger collaboration among healthcare providers, government agencies, and other stakeholders to improve patient outcomes and help survivors to recover through rehabilitation.

“So let us continue working together so that a Filipino’s chance of recovery is not determined by geography, circumstance or access, but a healthcare system that is prepared, connected and ready to respond when every second matters.” Dr. Nazario added. – Ayumi Garcia & Nika Bondisto, ABS-CBN News Interns