CHAPEL HILL, N.C. — Recently published guidelines show strokes may be more preventable than we realize.
The American Stroke Association, a division of the American Heart Association, released updated preventative measures for catching a stroke before it happens.
The stroke association recommends medical teams screen for these risk factors at a minimum:
- High blood pressure
- High cholesterol
- Obesity
More than half of strokes in the country are preventable, according to the association.
Recent medical advice suggests even a person with an otherwise perfect bill of health should be asked questions by their primary care provider.
These are not concerns Olivia Migli ever considered as a well-conditioned college soccer athlete.
“It's been a big learning curve in terms of just who I am,” Migli said.
The University of North Carolina graduate student is a stroke survivor.
Migli, 22, had a blood clot in a major artery on the right side of her brain, causing the stroke. The stroke occurred a day before the team’s first-round game against the University of South Carolina Upstate Spartans in the Women’s D-1 NCAA Soccer Tournament.
“It's definitely really difficult. I really, really enjoy the competitive side of things and it's fun to be good at stuff,” Migli said.
With the UNC program's campaign for a 23rd national championship beginning, spirits are high in Chapel Hill, including players not on the pitch, like Migli, who remains on the team even though she has been sidelined by her injuries.
“This is something I've always been good at, so it's kind of hard to give that up,” she said. “It's definitely a big part of my identity and who I've always been.”
Playing soccer is a family tradition — her parents played in college. The defender spent the first four years of her college career at Duke.
Migli said the goal of transferring from Duke University to play at rival UNC was to win a national title, but leg injuries and the stroke she suffered this summer forced her to take a step back.
“I definitely have struggled with a lot of fatigue, headaches and migraines,” Migli said.
The Centers for Disease Control and Prevention listed stroke as one of the leading causes of death in the U.S. in 2023.
It was during a July visit to her boyfriend in New York City that Migli started feeling funny. Fearing overcrowding in the city’s emergency departments, Migli traveled across state lines to Greenwich Hospital in Connecticut, where the medical team wasted no time.
“Due to the swiftness of the team in the E.R., I have not had any physical or neurological deficits, which has been incredible, and what has allowed me to live this normal life,” Migli said.
Dr. Kunal Desai is one of the Greenwich Hospital Stroke Center team members who cared for Migli. He uses the phrase "time equals brain" because brain cells are dying every minute the organ does not receive good blood flow and oxygen.
“This is why we respond and want to respond as fast as possible,” Desai said.
Desai said they use the F.A.S.T. method recommended by the American Stroke Association to identify the signs of a stroke.
- F = Face drooping
- A = Arm weakness
- S = Speech difficulty
- T = Time to call 911
“It's very unusual, I would say (it is) rare for somebody her age and in the kind of shape she is, to have a stroke,” Desai said.
She felt the side effects months after her stroke.
“Instead of like going to celebrate after a game like, or hang out with friends, I just kind of wanted to like, go home and get in bed,” Migli said. “It's just been kind of one thing after the other this past couple of years. So it was just hard.”
Desai has specialized in stroke-related care for much of his medical career. He said there is a door-to-needle time of 60 minutes generally referred to as the “golden hour.” Desai said they gave Migli a clot-busting medication called a thrombolytic. The drug improves blood circulation and the volume of oxygen flowing into her brain.
“A lot of these things are time-sensitive. That’s the reason for the push of the early recognition and the early diagnosis of strokes,” Desai said.
Stroke association recommendations for preventing a stroke include:
- A Mediterranean-style diet
- 150 minutes a week of moderate-intensity physical activity
- Quit smoking
- Better sleep
“I think it's important for people to know they're not alone when they go through things like this,” Migli said.
Migli said she is lucky to be surrounded by a thoughtful training staff at UNC who helps her manage her physical workload.
“It's weird to not be on the field and to be in a different role than I expected to when I decided to come here last December,” she said.
Migli said changes in roles aside, she’s embracing life. She said no matter what anyone says, you know your body better than anyone else does.
“Listen to yourself, listen to your body and make those decisions for yourself. But don't let people put a limit on you. And also don't let people push you past what you can do,” Migli said.
Migli, who calls South Carolina home, has played in 12 games this season.
She has maintained an attitude of gratitude throughout the ordeal.
“I still am a student, still on a team, and I still get to do a lot of the things that I enjoy,” she said. “Learning how to be a different kind of leader than I've ...been in the past.”