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The F-A-S-T Question

Updated: Nov 2, 2023

In this article I'm answering questions about:

The F-A-S-T Question

The Patient Pathway

Q: There are many people who mentioned they didn’t have the classic “F-A-S-T” symptoms when they had a stroke, they are asking why?

A: Good question. First, let me explain what F-A-S-T symptoms for stroke are, for those unfamiliar with its meaning, it’s:

Face - One side of the face is drooping.

Arm - Weakness of one arm.

Speech - Difficulty with speech.

Time - It’s time to call for an ambulance!

The simple answer is - you’re not alone! Only one in three survivors have had F-A-S-T warning signs.

To my knowledge, I didn’t have F-A-S-T symptoms either, other than weakness on my left side. I was alone when it happened, so I don’t really know. However, there is information regarding your question.

For more information…

Only 1 in 3 adults may have had a warning of stroke, but most didn’t seek help! Click here for more on this.


Q: Hi Maureen, would you be free at some point to have a chat about the current patient pathway and how it might be changed in the future? Thanks!

A: Hi there, thank you for your question. Funny, before I read your question, I was just talking with my therapist about the very same thing!

The short answer is - the current methods have not changed in 30 years, and there’s no plan to change them at this time.

I’ll share his responses once you watch this video by Dr. Elyse Newland, OT, who explains the general process a stroke follows:

The current patient pathway is to get into neuro therapy as quickly as possible post-stroke. Your caregiver will be searching for one or more of the following stroke specialists:

  1. Occupational Neuro Therapist (OT)

OTs work on the upper body.

  1. Speech Therapist (OT)

They work with survivors with verbal, reading and writing issues

and cognition side effects. Speech is part of the OT category.

  1. Physical Therapist (PT)

PTs work on the lower body

The Occupational Therapist’s Role

Since the hand is generally the last limb to be rehabilitated due to its small muscular/nerve components, I’d highly recommend finding an experienced OT hand therapist ASAP. The OT will begin with your shoulder, then your tricep which is very weak, then your wrist, and finally your hand. There’s a reason for this sequence, so ensure the OT is aware of it. I’m sure they would be aware since they have extensive training in stroke recovery.

Highly experienced OTs (upper body rehab0 can be difficult to find and priceless when you find one. The OT will work on shoulder strength and shoulder issues, like subluxation which can cause:

  • Pain near the impacted joint.

  • Swelling.

  • Reduced mobility.

  • Feelings of instability around a joint.

  • Balance issues.

  • Numbness or tingling.

  • Stiffness.

  • Altered gait or range of motion.

The Physical Therapist’s Role

Experienced PTs (lower body) are much easier to find - there are plenty of them. The PT will work with you on regaining your ability to walk, your endurance, your balance, your hamstring and your drop foot. The ankle must be strengthened so it can flex upward and outward so you don’t trip and fall. The hamstring must be rehabilitated in order to assist your walking gait and bending your knee; and your PT

For the above improvements, the Bioness L300 Go ( has been my ticket to walking safely while recovering from drop foot. It’s an electronic cuff that, with a battery that, when stimulated, lifts your affected foot up and out. For the hand, Bioness produces the H200, an electronic device to activate your hand while performing exercises to “remind” your hand how to function again.

A positive attitude, consistency and persistence are required to fully recover.

So, back to my discussion about my discussion with my OT. I asked my OT this very same question, and others:

  1. Have stroke rehab procedures changed since you began your career? No. They haven’t changed in 30 years, and due to the lack of research funding, there are no plans for any future changes.

  2. Will stroke rehab procedures change in the future? Not to my knowledge.

  3. Why is it that stroke research funding, medical reimbursement, and the lack of affordable devices are minimal, if nonexistent? Due to the fact that diseases like cancer produce millions of dollars for hospitals, research labs and companies that produce the drugs and devices used in treatment, there’s no interest in or money for strokes; although strokes produce a heavy expense load on the patient, the hospitals, insurance companies and rehab facilities. Strokes are simply a drain on the system.

< Note: It seems to me, if the medical research entities would invest in stroke research, survivors wouldn’t be such a drain on the system. Their ROI (return-on-investment) would seem to me to be worth it. >

UNIVERSITY-SPONSORED RESEARCH STUDIES: This is another reason for my encouraging you to participate in university-sponsored stroke research studies, since to my knowledge, they’re one of the very few organizations that engage in such research; and they’re required to obtain grants and private donations to fund them.

Medical Reimbursement: My take on this: In my experience, America’s insurance carriers seem to be more interested in making money than providing care for their customers.

Affordable Devices: My take on this: There are more and more devices being developed by private companies, like the Bioness I use for my leg and hand, which is great. Yet, the cost for these is generally non-reimbursable by insurance companies; thus, you are responsible for 100% of the cost.

Since these private for-profit companies fund, create and develop these useful devices for us, it’s crucial they recoup their investment, as well as help fund future innovations. Thus, the majority of them are expensive.

As I learn of new innovations, research studies, etc., I will certainly let you know!

Until then, I wish you continued recovery and the greatest of health! Take care, and be well, fellow survivors!

*Remember to stay safe and all advice should be taken up with your doctor/therapist before trying (this post is not medical advice). Thank you everybody!




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