When Stephen Cote woke up for work two years ago, it felt like an ordinary morning, until it wasn’t. 

“All of a sudden, things didn’t work right,” Cote said. “My arm, my speech, everything was off.” 

Cote was having a stroke. 

His wife, who has experience in emergency medical services, recognized the warning signs and called 911 immediately. 

“I don’t remember everything clearly,” Cote said. “But she knew right away something was wrong.” 

Jessica Telesco, stroke coordinator and nurse practitioner at Intermountain Health, said that quick response likely saved his life and helped limit the stroke’s long-term effects. 

During Stroke Awareness Month in May, Intermountain Health stroke experts say every minute without treatment can increase the risk of permanent brain injury. 

“Time is brain,” Telesco said. “The faster we identify a stroke and get a patient to the hospital, the more brain function we can preserve and the better the chance of recovery.” 

An ambulance took Cote to Intermountain Health Lutheran Hospital in Wheat Ridge, Colorado, where he was treated before beginning intensive rehabilitation. 

After returning home, he continued therapy to rebuild strength, mobility, and independence. 

“It was definitely one of the hardest things I’ve ever been through,” he said. 

Cote, who previously served in the military, said recovery required persistence, patience and consistency. 

He said every stroke is different, but progress comes through steady effort, support and continued care. 

“Your stroke might not be the same as someone else’s,” Cote said. “But overcoming the deficits is about the work you put into it.” 

Telesco said recognizing the warning signs of a stroke is just as important as recovery. Sudden face drooping, arm weakness, speech difficulty, vision problems and loss of balance can all be signs.  

The acronym BE FAST — Balance, Eyes, Face, Arm, Speech, and Time, is commonly used to help people identify symptoms and respond quickly. 

“If you notice any of those signs, don’t wait to see if they go away,” Telesco said. “Calling 911 right away can save a life.” 

Today, Cote spends time supporting other stroke survivors, using his own experience to encourage people as they navigate recovery. 

“I know some people slip through the cracks,” he said. “They weren’t always getting the care they needed.”

As a volunteer, Cote checks in with patients after they have gone home from the hospital to ask about their recovery and whether they have returned to their daily activities. 

He also helps connect them with therapy services and community resources when needed. 

The work is personal for Cote. He understands the long road to recovery and the challenges that can come with it. 

One of his proudest milestones has been returning to the mountains. An avid skier before his stroke, Cote recently made it back onto the slopes. 

“That was huge,” he said. “Getting back out there meant everything.” 

Stroke remains one of the leading causes of death and disability in the United States, but many cases can be prevented by managing blood pressure, maintaining a healthy lifestyle, and getting regular medical care. 

When a stroke does happen, early recognition and fast treatment can make a meaningful difference in recovery. 

For Cote and his family, that quick decision made all the difference. 

“If we had waited,” he said, “I don’t know where I’d be today.” 

May is Stroke Awareness Month.  

One in 20 adult deaths are due to strokes, strokes are the fifth leading cause of death in the United States. Stroke is a term that physicians use when a part of the brain is damaged because of a problem with blood flow.  

Strokes can happen when: 

• An artery going to the brain gets clogged or closes off, and part of the brain goes without blood for too long. This accounts for approximately 85% of strokes.
• An artery breaks open and starts bleeding into or around the brain.  

The effects of a stroke depend on several factors including which part of the brain is affected and how quickly the stroke is treated.  

For Bryan Maples, 40, from Riverton, Utah, he just didn't feel right last December. 

"I didn't feel sick, I wasn't in pain," said Maples, explaining he mostly experienced weakness in his left side. He decided to be checked out at Intermountain Health Riverton Hospital. 

"They let me know that I had had a stroke," said Maples. " I was lucky enough to get there as quickly as I did, as opposed to people that had all the symptoms and may have longer lasting effects." 

“Quick medical treatment during a stroke is one of the most important factors in determining a good outcome,” said Jennelle Newman, NP, an advanced practice provider at Intermountain Health Neurology. “If a stroke does occur, there are treatments available to prevent long term brain injury but are very time sensitive.”  

Newman says a simple way to remember the signs of stroke is to BE FAST:  

• Balance: Sudden difficulty with balance or coordination
• Eyes: Sudden blurred or double vision, or loss of vision in one or both eyes without pain
• Face: Drooping or numbness on one side of the face
• Arm Weakness: Sudden weakness or numbness in one arm
• Speech: Sudden difficulty, slurring, or inability to speak
• Time: know when the last time you or your loved one had normal symptoms. Call 911. 

The right treatment depends on what kind of stroke you are having. You need to get to the hospital very quickly to figure this out.  

People should still call 911 and go to the nearest emergency department for rapid evaluation. Quick treatment during a stroke is one of the most important factors in determining a good outcome. 

Stroke treatments are focused on restoring blood flow to the brain to prevent brain tissue from dying due to lack of blood flow. 

Treatments include a blood clot dissolving medication called tPA and a procedure that uses a catheter to pull blood clots out of large arteries in the brain. Both treatments can significantly reduce disability but are very time sensitive.  

Intermounain Health experts say many strokes can be prevented, though not all. You can greatly lower your chance of having a stroke by taking your medicines exactly as directed.   

Medicines that are especially important in preventing strokes include: 

• Blood pressure medicines
• Medicines called statins, which lower cholesterol
• Medicines to prevent blood clots, such aspirin or blood thinners
• Medicines that help to keep your blood sugar as close to normal as possible (if you have diabetes) 

Risks for strokes can be partially genetics (or related to family history), but many risk factors are controllable through awareness and lifestyle changes. The number one stroke risk factor is high blood pressure. 80% of strokes in America are preventable. It’s important for everyone to know their risk factors.  

Making lifestyle changes can also decrease your risk of stroke: 

• Stop smoking, if you smoke
• Get regular exercise (if your doctor says it's safe) for at least 30 minutes a day on most days of the week
• Lose weight, if you are overweight
• Eat a diet rich in fruits, vegetables, and low-fat dairy products, and low in meats, sweets, and refined grains (such as white bread or white rice)
• Eat less salt (sodium)
• Limit the amount of alcohol you drink
• If you are female, do not drink more than 1 drink a day
• If you are male, do not drink more than 2 drinks a day 

“It’s vital to remain optimistic and recognize that the goal is to recover from a stroke. If you believe you or a loved one might be having a stroke, BE FAST and call 911,” said Newman. 

Scheduling an appointment now with a primary care provider for a regular check-up will help to discuss a plan to minimize potential risks.  

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A stroke can affect anyone at any age; however, they are less common in younger individuals. 

That is why when Krista Jenkins woke up one morning last January, her condition surprised her and her family.

“My dog was whining, and I called to her to be quiet, but it didn’t come out quite right,” said Jenkins, a 33-year-old mother of two from Fairview, Utah. “It was just like a jumble of slurred words.”

Her boyfriend, Tyrell Hammon, was concerned. 

Although Jenkins told him she was alright, he had recently had stroke awareness training through work at Christensen Ready Mix. 

“He was like, no, I think we need to go to the doctor,” she said.

Although Jenkins didn’t have many of the other common symptoms of stroke such as balance problems, eye or vision concerns, face dropping, or arm weakness, the speech issues in a woman so young caused concern for caregivers at Intermountain Sanpete Valley Hospital.

“Krista mentioned that her tongue felt swollen, so I checked but didn’t see that,” said Brett Johnson, DO, a family medicine physician and stroke and trauma medical director at Intermountain Sanpete Valley Hospital. “I asked her if her tongue felt numb and I asked her boyfriend if she was having a hard time speaking.  He replied, ‘Yes,’ and went on to say that she couldn’t get her words out that morning.”

Dr. Johnson, who was manning the ER, said they started looking at the possibility of stroke, but a CT scan of Jenkins’ brain came back negative.

After consulting with Intermountain Health’s Telestroke neurologists, Dr. Johnson told Jenkins he wanted to do an MRI which revealed the stroke.

“They got me right back and did two MRIs and six CT scans and found that I had had two mini strokes,” said Jenkins. 

She was immediately transported to Intermountain Utah Valley Hospital in Provo.

Jenkins described having two clots, one in the right cerebral hemisphere and one in the left middle frontal gyrus. 

“With the size of the clots, it’s a wonder I didn’t have more symptoms.”

Now in recovery, Jenkins is encouraging others to be aware of symptoms and to act fast if there are concerns. “Time is so important,” she said.

Quick medical treatment during a stroke is one of the most important factors in determining a good outcome. If a stroke does occur, there are treatments available to prevent long-term brain injury. These treatments are focused on restoring blood flow to the brain to prevent brain tissue from dying due to lack of blood flow.

The Intermountain Health neurosciences team is focused on saving brain and improving outcomes for stroke patients because every second a person has a stroke, 32,000 neurons die.

Treatments include a blood clot dissolving medication called tenectaplase (tPA) and a procedure that uses a catheter to pull blood clots out of large arteries in the brain. Both treatments can significantly reduce potential disability but are very time sensitive.

Strokes, which occur when a part of the brain is damaged due to a problem with blood flow, are the fifth leading cause of death in the United States. One in 20 adult deaths are due to strokes.

Intermountain Health experts say that, when it comes to strokes, individuals should “B.E. F.A.S.T” and call 911 when you see these signs:

• Balance: Sudden loss of balance or coordination
• Eyes: Sudden change in vision
• Face: Sudden weakness of the face
• Arm: Sudden weakness of an arm or leg
• Speech: Sudden difficulty speaking
• Time: Time the symptoms started.

An estimated 610,000 people in the United States suffer a new stroke each year, according to the Centers for Disease Control. 

While some factors that increase the risk of stroke — such as age, gender and ethnicity, can’t be controlled — managing unhealthy habits, including smoking, excessive drinking, poor eating habits, and inactivity, can reduce your risk of stroke.

Jenkins expresses gratitude that her boyfriend knew the symptoms, and for the care she received at both hospitals.

“Dr. Johnson was really thorough,” said Jenkins. “I’m so glad he caught this. He was just so willing to look into it and go as far as he needed to get it figured out. The doctors at Utah Valley also said he was really thorough.”

If you see someone exhibiting signs of stroke, remember to B.E. F.A.S.T. and call 9-1-1.

Sixty-six-year-old Gary Spahn was at work when he experienced a stroke. He was talking with a group of colleagues when he suddenly found that he couldn’t speak. He felt fine and wanted to participate in the conversation but physically couldn’t. He explains that although he knew the words he wanted to say, they simply wouldn’t come out. A coworker noticed something wasn’t right and asked him if he was okay. He tried to say, “I’m fine, I just can’t talk,” but the only words that came out were, “I’m fine.” Fortunately for Gary, another coworker sensed something was off and quickly dialed 9-1-1.

“I don’t know what I would have done had I not been around other people,” said Gary. “I could think clearly and my mind was working fine, I just couldn’t talk. I was very lucky my coworker recognized this as a sign of a stroke.”

An ambulance arrived within minutes and Gary was taken to a nearby hospital. There, the doctors in the Emergency Department were quickly treating him for a stroke. They gave him an IV thrombolytic to break up the clot and discovered he had a large vessel occlusion, which means a big artery in the brain was blocked. Therefore, he was transported by helicopter to Lutheran Medical Center. When he arrived at Lutheran, Gary went for an emergent procedure called neuroendovascular thrombectomy. As Gary recalls, they inserted a “vacuum” tube (known as mechanical aspiration), into an artery that went through his heart and to his brain in order to remove the clot. 

A stroke occurs when blood flow to a part of the brain is blocked, called an ischemic stroke, or when a blood vessel in the brain bursts, which is a hemorrhagic stroke. In either case, the brain cells are starved of oxygen-rich blood and a stroke occurs because those brain cells die. Stroke can lead to brain damage, disability, and death. 

“I was conscious when they transported me to the hospital and I was told I was being taken to Lutheran because their stroke specialists provide superior care,” said Gary. “They were right. The doctors were great. I’m really glad they were there and knew what to do.”

The doctors told Gary there was no way of knowing how long the clot was in his brain and that he was lucky he was with other people who recognized the signs of a stroke and called for help so quickly. 

When it comes to a stroke, every second counts. Each minute a large vessel occlusion stroke remains untreated, nearly two million brain cells die, and rapid access to medical treatment can often make the difference between a full recovery and a permanent disability. Some treatments only work if given within the first three hours after symptoms start, and a delay in care can increase the risk of permanent brain damage or death.

Stroke is the fifth leading cause of death in the U.S. and a leading cause of severe long-term disability. Each year, about 800,000 people in the U.S. have a stroke, and about one out of four of those strokes are recurrent. According to the American Heart Association, someone in the U.S. has a stroke every 40 seconds. 

Knowing the signs is key, and the acronym B.E.F.A.S.T. is a useful tool to remember what to look for and what to do if you suspect you or someone you know is having a stroke. B.E.F.A.S.T. stands for sudden trouble with your balance, eyes (change in vision or trouble seeing), face drooping, arm weakness, speech difficulty and time to call 9-1-1.

Gary spent four days in the hospital, including two days in the ICU for observation. 

“I’ve been out of the hospital for two weeks and am getting stronger and feeling good,” said Gary. “I’m a little more tired than normal, but the doctors put me on new medications, including a blood thinner, and it’s helping me to feel better.”

Having one stroke increases a person’s risk of having another. Although there are several factors that are beyond your control that can increase your risk, like age, sex and ethnicity, there are many factors you can control that will help reduce your risk. Unhealthy habits, such as smoking, drinking too much alcohol, having a poor diet and not getting enough exercise all increase your chances of having a stroke. High blood pressure, high cholesterol, diabetes and obesity can also increase your risk. However, treating these conditions can greatly reduce your risk. It is important to eat plenty of fruits and vegetables, limit foods high in fat, cholesterol and salt content, get enough exercise, limit alcohol consumption and if you smoke, quit. 

May is National Stroke Awareness Month and a reminder that, while a stroke can happen to anyone at any age, 80 percent of all strokes are preventable through healthy lifestyle choices.