Health First Neurohospitalist Dr. Amanda Cheshire: Stroke Symptoms Don’t Wait — And Neither Should You

know the BEFAST acronym for stroke symptoms

WATCH: Brian Ellison is grateful to be alive after suffering a stroke thanks to rapid medical care at Health First’s Viera Hospital. Despite the high volume of patients that day, the emergency department team at Viera Hospital moved quickly (Health First image)

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From birthday scare to survival: Brian Ellison credits fast action at Health First and now hopes others will learn from his close call.

BREVARD COUNTY • VIERA, FLORIDA ─ Space Coast interior designer Brian Ellison was in the drive-thru at his credit union, making a deposit, when his body gave him a warning he couldn’t ignore — on his birthday, no less.

“I felt like somebody just injected Novocain into my jaw and my skull,” he said. “I couldn’t feel my tongue and my teeth felt different.”

“I was reaching out to grab the bank tube and that was when my arm went numb, then my leg. I’ve had that before, but it didn’t go any further — this time, it kept going.”

He called his mom immediately. “She said, ‘Stay on the phone with me and go straight to the hospital.’” Ellison drove himself to Health First’s Viera Hospital.

“The symptoms were developing, and I knew something big was happening inside of me,” Ellison said.

At the front desk of the emergency department, the urgency of the situation became clear.

As Ellison stood anxiously at the security checkpoint, already feeling the signs of a medical emergency, he locked eyes with the triage nurse and silently mouthed, “I think I’m having a stroke.”

While Ellison drove himself to the emergency department, experts strongly advised against this.

“I told him, ‘Stop and call 911,” said Dr. Amanda Cheshire, a Health First neurohospitalist.

“When 911 is called, the stroke alert is activated before you arrive. That means we’re already preparing. But when you drive yourself, you go through triage and lose precious time. You might also have an accident on your way to the ER due to the physical impairment.”

Despite the high volume of patients that day, the emergency department team at Viera Hospital moved quickly.

Ellison was assessed right away in the hallway, where an emergency department physician performed an initial evaluation, ordered imaging and connected him with a specialist via telemedicine who stayed with him virtually throughout the process.

“They brought the monitor on a stand and the neurologist that was seeing me virtually was an extremely nice guy. He wouldn’t leave me and stayed on the screen, even during the awkward silence. He was just there, reviewing my scans.”

Within moments, the team began administering Tenecteplase, or TNK.

TNK is a clot-busting drug similar to tissue plasminogen activator or TPA, but faster to administer and with a comparable risk of bleeding.

“He met all the criteria, and there were no exclusions,” said Cheshire.

Cheshire noted that if left untreated, Ellison could have been left with a permanent disability. Ellison found comfort in how quickly and confidently the care team worked around him.

“I felt so blessed. Everyone was great,” he said.

Though Ellison’s symptoms were unmistakable, his age made the diagnosis more shocking. He was 47.

“I was still in disbelief. I thought I just needed to calm down, that it was my blood pressure or the stress I had been under.”

“We are seeing way too many strokes in younger adults,” said Cheshire. “It’s no longer uncommon to see patients in their 40s or even younger. High stress, unmanaged blood pressure, drugs and other lifestyle factors are major contributors.”

Younger stroke patients often dismiss early symptoms — especially if they’re subtle.

“Many people assume it’s something else,” Cheshire said. “They think it’s a neck or back problem. If they can still move their arm or leg, even if it’s not working quite right, they’ll often wait it out thinking it’ll improve on its own.”

Cheshire added that patients with minor deficits — those who can still compensate — are often the ones most likely to ignore the warning signs. “The ones who suddenly can’t move at all usually come in right away. But the people who can still function a little, they tend to brush it off — especially if they’re younger.”

Ellison has a strong family history of cardiovascular issues — his grandfather suffered multiple heart attacks, all believed to have been triggered by high blood pressure from stress. Combined with Ellison’s own high blood pressure and stress, the stroke became a dangerous culmination of risk factors.

Ellison was treated without delay and soon admitted to the ICU, where he spent three nights under close observation and care.

“On my last day, the physical therapist, the speech therapist — everyone came in to evaluate me,” Ellison said. “It felt good to go through all the assessments and know I was doing well.”

He passed every evaluation without the need for rehab and was cleared to return home.

“Everybody came in and finally said, ‘You’re good to go.’ That was the moment of relief.”

One factor working in Ellison’s favor? His age.

“Younger brains have more elasticity,” said Cheshire. “The tissue around the stroke can sometimes take over some of the functions of the damaged tissue. That kind of recovery is less common in older patients. Brian had an incredible outcome — but we can’t count on that. The faster you get treated, the better your odds.”

The clock starts counting down once symptoms begin, and the four-hour window is critical.

After returning home, Ellison quickly began reevaluating his lifestyle — especially the stress and habits he believed contributed to his stroke.

“I knew right away I needed to change,” said Ellison.

He started making intentional choices to reduce pressure and protect his health.

Ellison is now taking medications to help regulate his blood pressure, cholesterol and blood clotting risk — critical steps in preventing another stroke. He’s also staying proactive with ongoing care, regularly checking in with a neurologist and his new primary care physician.

Even during a medical emergency, Ellison noticed the little things that made a big difference.

“Viera Hospital passed with five stars in my mind. Even the food was good, and everything was above my expectations.”

What mattered most to Ellison, though, was how the team made him feel during a terrifying moment.

“The team around me — they made me feel like everything was going to be OK. And that’s an important feeling to have while you’re having a stroke,” said Ellison.

Cheshire emphasized the importance of knowing the BEFAST acronym for stroke symptoms:

B – Balance: Sudden loss of balance or coordination.
E – Eyes: Sudden trouble seeing in one or both eyes.
F – Face drooping: One side of the face drooping or numbness.
A – Arm weakness: Weakness or numbness in one arm.
S – Speech difficulty: Slurred speech or difficulty speaking.
T – Time to call 911: Time is critical when recognizing stroke symptoms.

“Slurred speech, sudden numbness, or trouble understanding — especially when paired with weakness, including a facial droop — should never be brushed off,” Cheshire said.

Ellison urges others to take every symptom seriously, regardless of age.

“Don’t be afraid to go into the hospital, even if it seems small. The outcome of what I had is a miracle — I walked in as I was having a stroke. Not many people are fortunate. Health First takes stuff like that seriously. I was very impressed.”

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