Warning Shots: Understanding Transient Ischemic Attacks with Justin Vechayiem - Episode 149

Are you ignoring the body’s early warning system?

In the world of stroke care, there is a dangerous misconception surrounding the term "mini-stroke." Many people believe that because the symptoms go away, everything is fine. But in reality, a Transient Ischemic Attack (TIA) is a critical "warning shot" that requires immediate action.

In this powerful episode of the Caregiver Relief Podcast, host Diane Carbo, RN sits down with Justin Vechayiem, a Stroke Certified RN and Nurse Navigator. Together, they break down the life-saving differences between a TIA and a stroke, how to navigate the broken healthcare system, and why acting fast is the only option.

🧠 What You’ll Learn in This Episode

This episode is packed with clinical insight and compassionate advice for caregivers. Here is a breakdown of the critical topics Diane and Justin cover:

1. What is a TIA vs. a Stroke?

Justin explains that while an ischemic stroke is caused by a clot that permanently blocks blood flow and causes damage visible on a scan, a TIA is temporary. The clot blocks the vessel temporarily and then dissolves or passes through, meaning symptoms might only last 15 minutes to an hour. However, Justin warns that this is a major red flag that a full-blown stroke could be imminent.

2. The Critical Role of a Stroke Navigator

Navigating the healthcare system is difficult. Justin describes his role as a Stroke Navigator, where he guides patients through the entire continuum of care—from hospital admission to 90 days post-discharge. He helps coordinate appointments, clarifies medication instructions, and provides resources to ensure patients don't fall through the cracks.

3. Risk Factors & Prevention 🥗

You have more control than you think. Justin and Diane discuss the "Big Three" risk factors:

• Hypertension (High Blood Pressure): The number one risk factor for stroke.
• Hyperlipidemia (High Cholesterol): Specifically high LDLs and triglycerides.
• Diabetes: High glucose levels can damage vasculature and increase clotting risk.

They also discuss the importance of the Mediterranean Diet and maintaining physical activity, even if it's just 10-20 minutes of walking or chair yoga.

4. The "Do Not Drive" Rule 🚑

One of the most important takeaways from this episode: Never drive yourself to the hospital if you suspect a stroke or TIA. Justin explains that calling 911 triggers a pre-notification system where the stroke team is waiting for you at the door, ready to scan you within 20 minutes. Driving yourself wastes precious time and can be dangerous if your symptoms worsen behind the wheel.

📝 Episode Outline

• Welcome & Introduction to TIA (Transient Ischemic Attacks).
• Meet Justin Vechayiem: From Cardiac ICU to Stroke Navigator.
• What does a Nurse Navigator actually do?
• Defining the Medical Terms: TIA vs. Ischemic Stroke vs. Hemorrhagic Stroke.
• Why "Mini-Stroke" is a misleading term.
• The Risk Factors: Hypertension, Cholesterol, and Diabetes.
• Lifestyle Modifications: Diet, Exercise, and Weight Loss.
• Medications: Statins (Lipitor), Blood Thinners (Eliquis vs. Coumadin), and compliance.
• The importance of follow-up appointments with a Neurologist.
• URGENT ADVICE: Why you must call 911 and never drive yourself.
• How to talk to your doctor: Preparing questions and using Nurse Practitioners.

American Stroke Association | A Division of the American Heart Association

The American Stroke Association is a relentless force for a healthier world with fewer strokes.

www.stroke.org

💊 Medication Management & Advocacy

Diane and Justin touch on the importance of medication reviews. As we age, we are often prescribed more pills without removing old ones. Diane recommends reviewing your medication list with your primary care physician at least once a year to look for interactions or unnecessary prescriptions.

They also discuss the advancements in blood thinners, noting how newer drugs like Eliquis have better safety profiles and require less testing than older drugs like Coumadin.

https://www.ninds.nih.gov/health-information/stroke

Community Resources for Survivors of Stroke - Stroke Support Association

Caring for stroke survivors’ needs is a big, often full-time job. Therefore, it is essential that caregivers also take the time to prioritize their personal needs and care for themselves. Taking much-needed breaks and reaching out for help and support is critical for caregivers’ well-being when looking after a stroke survivor. Community resources, such as... Read More

Stroke Support AssociationMike Sasso

🔗 Helpful Resources

Recovery and prevention are easier when you have the right support system and information.

• National Institute of Neurological Disorders and Stroke (NINDS): For comprehensive health information and official resources on stroke, visit the NINDS Stroke Information Page.

💡 Key Takeaway for Caregivers

If your loved one experiences facial drooping, slurred speech, or weakness—even if it goes away after 15 minutes—go to the ER immediately. Recognizing a TIA is your chance to prevent a life-changing stroke before it happens.

Don't forget to advocate for yourself! Bring a recorder to doctor appointments, write down your questions beforehand, and don't be afraid to utilize Nurse Practitioners for more in-depth conversations.

Listen to the full episode now to get all the details on protecting your brain health!