14241 SW 120 ST Suite #107
Miami, FL 33186
Paralysis Recovery

Stroke: Understanding the Importance of Awareness

Stroke: Understanding the Importance of Awareness

Every year, millions of people worldwide are affected by a medical condition that can dramatically alter their lives in a matter of minutes: a stroke. A stroke is not just a sudden medical emergency; it’s a critical event that can have lasting implications on an individual’s health, functionality, and overall quality of life. With the increasing prevalence of stroke, it becomes imperative for everyone, from medical professionals to the general public, to have a comprehensive understanding of what a stroke is, its causes, and its potential consequences.

At its core, a stroke is a disruption of blood flow to the brain. The brain, a vital organ, controls everything we do, think, and feel. It’s responsible for our memories, our movements, and even our very consciousness. When blood flow to a part of the brain is interrupted, it can result in the death of brain cells, leading to permanent damage. There are primarily two types of strokes: ischemic and hemorrhagic. While ischemic strokes occur due to blockages in the blood vessels supplying the brain, hemorrhagic strokes are caused by bleeding within the brain itself.

But why is it so crucial for us to understand strokes? First, strokes are a leading cause of disability and death globally. Recognizing the signs of a stroke and seeking immediate medical attention can mean the difference between recovery and long-term disability, or even life and death. Furthermore, understanding the risk factors associated with strokes can help in their prevention. Knowledge about conditions like Transient Ischemic Attack (TIA), often termed as ‘mini-strokes’, can also aid in early detection and intervention, potentially preventing a full-blown stroke.

From understanding the intricate workings of the brain and how strokes impact its various functions to exploring the aftermath of a stroke and the importance of timely intervention, we aim to provide a holistic view of this critical medical condition. The more we know about strokes, the better equipped we are to combat them, ensuring a healthier future for ourselves and our loved ones.

What is a Stroke?

A stroke is a serious medical condition that occurs when the blood supply to a part of the brain is interrupted or reduced. This deprives the brain tissue of essential oxygen and nutrients, leading to the death of brain cells within minutes. Strokes can be categorized into two primary types:

  1. Ischemic Stroke: This is the most common type of stroke, accounting for a large percentage of all strokes. It occurs when an artery supplying blood to the brain becomes blocked. The blockage can be due to fatty deposits that accumulate in the arteries or blood clots that travel through the bloodstream and lodge in the brain’s blood vessels.

  2. Hemorrhagic Stroke: This type of stroke happens when a blood vessel in the brain leaks or bursts. The leaked blood can spill into the surrounding brain tissue or around the brain. The primary causes of hemorrhagic strokes include uncontrolled high blood pressure, overtreatment with blood thinners, and the presence of weak spots in the blood vessel walls, known as aneurysms.

Recognizing the signs of a stroke and seeking immediate medical attention is crucial. Some common symptoms include sudden trouble speaking and understanding, paralysis or numbness on one side of the body, vision problems, severe headache, and difficulty walking. The promptness of treatment can significantly reduce brain damage and improve the chances of recovery.

It’s essential to understand that anyone can experience a stroke. However, certain risk factors increase the likelihood of having one. These include age, family history of strokes, certain medical conditions like high blood pressure and diabetes, and lifestyle choices such as smoking and heavy alcohol consumption.

A stroke is a medical emergency that requires immediate attention. Understanding its types, causes, and symptoms can be the key to timely intervention and better outcomes.

How Does a Stroke Occur?

A stroke is a serious medical condition that occurs when the blood supply to a part of the brain is interrupted or reduced. This deprivation of blood leads to a lack of oxygen and essential nutrients, causing brain cells to begin dying within minutes. There are two primary ways a stroke can occur:

  1. Ischemic Stroke: This is the most common type of stroke, accounting for about 85% of all strokes. It happens when there’s a blockage in the blood vessels that supply the brain. The blockage can be due to fatty deposits that build up in the arteries or by blood clots or other debris that travel through the bloodstream, often originating from the heart. These blockages prevent blood from reaching a portion of the brain. Some research even suggests that infections like COVID-19 may increase the risk of ischemic stroke, though more studies are needed to confirm this.

  2. Hemorrhagic Stroke: This type of stroke occurs when a blood vessel in the brain leaks or ruptures. The leaked blood can then spill into the surrounding brain tissue or around the brain. There are various factors that can lead to a hemorrhagic stroke, including uncontrolled high blood pressure, overtreatment with blood thinners, aneurysms (bulges in blood vessel walls), trauma, protein deposits in blood vessel walls leading to vessel weakness, and even a progression from an ischemic stroke to hemorrhage.

In addition to these primary types, there’s also a condition known as a Transient Ischemic Attack (TIA) or “ministroke.” A TIA is characterized by a temporary disruption of blood flow to a part of the brain. The symptoms are similar to those of a stroke but last for a shorter duration, sometimes as little as five minutes. However, a TIA is a warning sign and increases the risk of a full-blown stroke in the future.

Risk Factors: While anyone can have a stroke, certain factors increase the risk. These include age (people 55 or older are at higher risk), race or ethnicity (African Americans and Hispanics are more susceptible), gender (men are at a higher risk), and family history of strokes or heart attacks. Lifestyle factors such as being overweight, physically inactive, heavy alcohol consumption, recreational drug use, smoking, high blood pressure, high cholesterol, uncontrolled diabetes, obstructive sleep apnea, and certain heart diseases also elevate the risk.

Recognizing the signs and symptoms of a stroke early is crucial for timely treatment. Symptoms include sudden trouble speaking, paralysis or numbness on one side of the body, vision problems, severe headache, and difficulty walking. Early recognition and treatment can significantly reduce brain damage and improve outcomes for stroke patients.

Classifying Strokes:

Strokes are serious medical conditions that occur when the blood supply to a part of the brain is interrupted or reduced. This can lead to brain tissue damage as it is deprived of oxygen and nutrients. There are two primary types of strokes: ischemic and hemorrhagic.

  1. Ischemic Strokes:

    • Thrombotic vs. Embolic: Ischemic strokes are the most common type and account for a majority of all strokes. They occur when the brain’s blood vessels become narrowed or blocked. This blockage can be caused by fatty deposits that build up in blood vessels or by blood clots or other debris that travel through the bloodstream and lodge in the brain’s blood vessels. There are two subtypes of ischemic strokes:

      • Thrombotic Stroke: This type of stroke is caused by a clot (thrombus) that forms in one of the arteries supplying blood to the brain.

      • Embolic Stroke: This occurs when a blood clot or other debris forms away from the brain, commonly in the heart, and is swept through the bloodstream to lodge in narrower brain arteries.

    • Some research suggests that conditions like COVID-19 infection may increase the risk of ischemic stroke, but more studies are needed to confirm this.

  2. Hemorrhagic Strokes:

    • Intracerebral vs. Subarachnoid: Hemorrhagic strokes occur when a blood vessel in the brain leaks or ruptures. The leaked blood puts pressure on brain cells and damages them. There are two main types of hemorrhagic strokes:

      • Intracerebral Hemorrhage: This is the most common type of hemorrhagic stroke. It occurs when a blood vessel in the brain bursts, spilling blood into the surrounding brain tissue. The bleeding causes brain cells to die and the affected part of the brain stops working correctly.

      • Subarachnoid Hemorrhage: This type of stroke involves bleeding in the area between the brain and the thin tissues that cover it. It’s often signaled by a sudden, severe headache.

  3. Stroke Severity Scales:

    • NIH Stroke Scale: This is a systematic assessment tool that provides a quantitative measure of stroke-related neurologic deficit. It’s a 15-item neurologic examination stroke scale used to evaluate the effect of acute cerebral infarction on the levels of consciousness, language, neglect, visual-field loss, extraocular movement, motor strength, ataxia, dysarthria, and sensory loss.

The type of stroke determines the course of action in medical interventions. Immediate response and accurate diagnosis can significantly reduce brain damage and improve the chances of recovery.

The Aftermath of a Stroke: Immediate Responses

The aftermath of a stroke is critical, and understanding the immediate responses is vital for both the patient and their caregivers.

Brain’s Response to a Stroke

When a stroke occurs, the affected part of the brain starts to lose its function because it is deprived of oxygen and essential nutrients. This can lead to the death of brain cells within minutes. The brain’s immediate response is to try and restore the blood flow, but the damage can be extensive, especially if treatment is not sought promptly.

Importance of the “Golden Hour” in Stroke Treatment

The term “Golden Hour” refers to the critical one-hour window after a person starts showing symptoms of a stroke. During this time, receiving the right treatment can significantly reduce brain damage and other complications. It’s imperative to recognize the symptoms of a stroke and seek emergency medical care immediately. Some of the common symptoms include sudden trouble speaking, paralysis or numbness of the face, arm, or leg, problems with vision, and severe headaches.

If someone is suspected of having a stroke, it’s crucial to note the time the symptoms began. Some treatments are most effective when given soon after a stroke starts. Therefore, every minute counts. Once the patient reaches the hospital, the emergency team will conduct various tests to determine the type of stroke and the best course of treatment.

The immediate aftermath of a stroke is a critical period that can determine the extent of recovery and the quality of life for the patient. Recognizing the symptoms early and seeking prompt medical attention can make a significant difference in the outcome. It’s essential to be informed and prepared to act swiftly should you or someone you know show signs of a stroke.

The Impact of Stroke on the Body:

A stroke, often referred to as a “brain attack,” is a medical emergency that occurs when the blood supply to a part of the brain is interrupted or reduced. This deprivation of oxygen and essential nutrients causes brain cells to begin dying within minutes. The aftermath of a stroke can lead to a myriad of physical, cognitive, and emotional consequences, depending on the affected region of the brain and the duration of the blood supply disruption.

  1. Physical Consequences:

    • Paralysis or Muscle Weakness: A stroke can result in paralysis on one side of the body or muscle weakness in specific areas. This can affect the face, arm, or leg, often on just one side. For instance, one side of the mouth may droop when attempting to smile, or an arm might drift downward when raised.

    • Speech and Swallowing Difficulties: The muscles in the mouth and throat might be impacted, making it challenging to speak clearly, swallow, or eat. This can lead to conditions like dysarthria (slurred speech) or dysphagia (difficulty swallowing).

    • Visual Impairments: Stroke survivors might experience blurred or blackened vision in one or both eyes, double vision, or even complete loss of vision.

    • Mobility Issues: Difficulties in walking, loss of balance, dizziness, or a lack of coordination can arise post-stroke.

  2. Cognitive and Sensory Impacts:

    • Memory and Thinking: Memory loss is a common aftermath of a stroke. Some individuals might also face challenges in reasoning, making judgments, understanding concepts, or processing information.

    • Sensory Disturbances: Pain, numbness, or other unusual sensations might be felt in the parts of the body affected by the stroke. An uncomfortable tingling sensation, for instance, might be experienced in a limb that has lost its sense of touch.

  3. Emotional and Behavioral Changes:

    • Emotional Responses: Post-stroke, individuals might find it harder to control their emotions. Feelings of helplessness, frustration, depression, or anxiety are not uncommon. These emotional changes can be a direct result of brain damage or a reaction to the challenges faced after a stroke.

    • Behavioral Changes: Some stroke survivors might become more withdrawn or face difficulties in self-care, grooming, and daily activities.

The impact of a stroke on the body is profound and multifaceted. The affected brain region and the severity of the stroke play a crucial role in determining the extent of these consequences. Early intervention, prompt medical treatment, and comprehensive rehabilitation can significantly improve outcomes and enhance the quality of life for stroke survivors.

Stroke Symptoms and Diagnosis

Recognizing the symptoms of a stroke and seeking immediate medical attention is crucial for reducing brain damage and other potential complications.

Symptoms of a Stroke

  1. Speech and Understanding Difficulties: One of the primary symptoms of a stroke is sudden trouble speaking and understanding what others are saying. Individuals may experience confusion, slur their words, or have difficulty comprehending speech.

  2. Paralysis or Numbness: A stroke can lead to sudden numbness, weakness, or paralysis in the face, arm, or leg, typically affecting just one side of the body. For instance, one side of the mouth may droop when trying to smile, or one arm may begin to fall when raised.

  3. Vision Problems: Individuals suffering from a stroke may suddenly experience blurred or blackened vision in one or both eyes. In some cases, double vision may also occur.

  4. Severe Headache: A sudden and intense headache, possibly accompanied by vomiting, dizziness, or altered consciousness, can be indicative of a stroke.

  5. Walking Difficulties: A person having a stroke may stumble, lose balance, or experience sudden dizziness and a loss of coordination.

The acronym “FAST” is often used to help remember and recognize the signs of a stroke:

  • Face: Does one side of the face droop when the person tries to smile?

  • Arms: When raising both arms, does one arm drift downward or is unable to rise?

  • Speech: Is the person’s speech slurred or strange when asked to repeat a simple phrase?

  • Time: If any of these signs are observed, it’s crucial to call emergency services immediately.

Diagnosis of a Stroke

At the hospital, the emergency team will conduct a thorough review of the patient’s symptoms and perform a physical exam. Several diagnostic tests can help determine the type of stroke and the most appropriate treatment:

  1. Brain Imaging: CT scans or MRI scans provide detailed images of the brain and its arteries, helping doctors identify the affected areas and the nature of the stroke.

  2. Carotid Ultrasound: This soundwave test examines the carotid arteries, which supply blood to the front parts of the brain. It can detect any blockages or other abnormalities.

  3. Blood Tests: Blood tests can provide valuable information about the patient’s overall health and other factors that might contribute to the risk of a stroke.

Once the type of stroke (ischemic or hemorrhagic) is determined, doctors can devise a suitable treatment plan to address the specific condition.

Early diagnosis and treatment are crucial for reducing the risk of long-term complications and improving the chances of recovery.

Treatment and Management of Stroke

A stroke is a medical emergency that requires prompt attention and intervention. The treatment approach for a stroke depends on its type: ischemic or hemorrhagic. Here’s a look at the treatment and management of strokes:

Ischemic Stroke Treatment

Ischemic strokes occur when a blood clot obstructs blood flow to the brain. The primary goal is to restore blood flow as quickly as possible.

  1. Emergency IV Medication: The gold standard treatment for ischemic strokes is the intravenous injection of recombinant tissue plasminogen activator (TPA), also known as alteplase or tenecteplase. This drug dissolves the blood clot causing the stroke. It’s most effective when administered within 4.5 hours of the onset of stroke symptoms.

  2. Emergency Endovascular Procedures: These are treatments performed directly inside the blocked blood vessel.

    • Medications Delivered Directly to the Brain: A catheter is used to deliver TPA directly to the site of the stroke.

    • Clot Removal with a Stent Retriever: A device attached to a catheter is used to physically remove the clot from the blocked vessel. This is especially beneficial for large clots that TPA can’t dissolve.

Hemorrhagic Stroke Treatment

Hemorrhagic strokes result from bleeding within the brain. The focus of treatment is to control the bleeding and reduce the pressure caused by the excess fluid.

  1. Emergency Measures: These include counteracting the effects of blood-thinning medications, administering drugs to reduce brain pressure, and managing blood pressure.

  2. Surgery: In cases of significant bleeding, surgery might be required to remove the blood and alleviate pressure on the brain. Surgical procedures can also address the underlying causes of the hemorrhagic stroke.

    • Surgical Clipping: A clamp is placed at the base of the aneurysm to prevent it from bursting.

    • Coiling (Endovascular Embolization): Detachable coils are placed into the aneurysm to promote blood clotting and prevent rupture.

    • Surgical AVM Removal: Arteriovenous malformations (AVMs) can be surgically removed if they pose a risk of rupture.

    • Stereotactic Radiosurgery: This minimally invasive treatment uses focused radiation to repair blood vessel malformations.

Secondary Prevention

After the immediate treatment of a stroke, the focus shifts to preventing another one. This might involve procedures to open up narrowed arteries, such as:

  • Carotid Endarterectomy: This surgery removes plaque from the carotid arteries in the neck.

  • Angioplasty and Stents: A balloon is used to widen the narrowed artery, and a stent is placed to keep it open.

The primary goal is to minimize brain damage, followed by rehabilitation and preventive measures to reduce the risk of another stroke.

Secondary Complications of Stroke:

A stroke is a life-altering event that not only affects the physical functioning of an individual but also has profound effects on their emotional and psychological well-being. The aftermath of a stroke can lead to various secondary complications, which can further impact the quality of life of the affected individual. Here’s a comprehensive look at the secondary complications that can arise post-stroke:

  1. Paralysis or Loss of Muscle Movement: One of the most common complications post-stroke is paralysis or weakness on one side of the body. This can affect the face, arm, or leg, leading to difficulties in movement and daily activities.

  2. Speech and Swallowing Difficulties: A stroke can impact the muscles of the mouth and throat, making it challenging for the individual to speak clearly or swallow. This can lead to conditions like aphasia, where the person has trouble understanding or producing speech.

  3. Memory and Cognitive Impairments: Strokes can lead to memory loss and difficulties in thinking, reasoning, and understanding concepts. This can affect the individual’s ability to perform daily tasks and make decisions.

  4. Emotional Challenges: Post-stroke, individuals may experience emotional problems such as depression, anxiety, and mood swings. The sudden change in physical abilities and the challenges of recovery can lead to feelings of frustration and helplessness.

  5. Pain and Unusual Sensations: Some stroke survivors experience pain, numbness, or tingling sensations in the affected parts of the body. This can be due to the damage to the brain areas responsible for sensory processing.

  6. Changes in Behavior and Self-care: The physical and emotional challenges post-stroke can lead to changes in behavior. Individuals may become more withdrawn and may require assistance with grooming, eating, and other daily activities.

  7. Post-stroke Depression: The emotional toll of a stroke can lead to depression, affecting the individual’s motivation to recover and engage in rehabilitation.

  8. Seizures: Some individuals may experience seizures post-stroke, which are sudden electrical disturbances in the brain. This can be due to the scar tissue formed in the brain after a stroke.

  9. Swallowing Difficulties (Dysphagia): Damage to the part of the brain responsible for swallowing can lead to dysphagia, where the individual has trouble swallowing food or liquids.

While a stroke is a significant medical event, the secondary complications that arise post-stroke can further challenge the individual’s recovery journey. It’s essential to be aware of these complications to provide timely intervention and support, ensuring a better quality of life for the stroke survivor.

Medications and Stroke:

Stroke, a medical emergency that occurs when blood flow to the brain is interrupted, can have devastating effects on an individual’s health and well-being. Timely and appropriate medical intervention is crucial in both the treatment and prevention of strokes. Here’s a look at the medications associated with stroke management:

1. Emergency Medications for Ischemic Stroke:

Ischemic strokes, which result from a blockage in the blood vessels supplying the brain, require immediate medical attention to restore blood flow. The following are the primary medications and treatments used:

  • Intravenous Tissue Plasminogen Activator (TPA): TPA, also known as alteplase (Activase) or tenecteplase (TNKase), is the gold standard treatment for ischemic stroke. Administered through an IV in the arm, this drug works by dissolving the blood clot responsible for the stroke. The effectiveness of TPA is time-sensitive, with the best outcomes observed when given within the first 4.5 hours of symptom onset.

  • Endovascular Procedures: In certain cases, doctors might opt for direct interventions inside the blocked blood vessel. This can involve delivering TPA directly to the site of the stroke or using a stent retriever to physically remove the clot. Advanced imaging technology has expanded the time window for these procedures, allowing for more patients to benefit from them.

2. Medications for Hemorrhagic Stroke:

Hemorrhagic strokes, caused by bleeding in the brain, necessitate treatments that control the bleeding and reduce the resultant pressure in the brain. Emergency measures might include counteracting the effects of blood-thinning medications, administering drugs to reduce intracranial pressure, and preventing seizures.

3. Preventive Medications:

To reduce the risk of subsequent strokes, doctors often prescribe medications that address the underlying causes and risk factors:

  • Anticoagulants and Antiplatelets: These drugs reduce the risk of blood clots, a primary cause of ischemic strokes. Commonly prescribed anticoagulants include warfarin and direct oral anticoagulants (DOACs) like dabigatran and rivaroxaban. Antiplatelet drugs, such as aspirin and clopidogrel, prevent platelets in the blood from clumping together.

  • Statins: These cholesterol-lowering drugs can help prevent strokes by reducing the buildup of fatty deposits in the arteries.

4. Potential Side Effects:

While these medications play a pivotal role in stroke management, they are not without side effects. For instance, anticoagulants and antiplatelets can increase the risk of bleeding. It’s essential for patients to be aware of potential side effects and to work closely with their healthcare providers to monitor and manage them.

Medication play a vital role in both the acute treatment and long-term management of strokes. Their timely and appropriate use can significantly improve outcomes, reduce complications, and enhance the quality of life for stroke survivors. As with all medical treatments, it’s crucial for patients to be informed and proactive in their care, ensuring they receive the best possible outcomes.

The Road to Recovery: iAM ABLE’s Comprehensive and Transformative Approach to Stroke Rehabilitation

Navigating the complex landscape of stroke recovery can be a daunting task. The physical, emotional, and cognitive challenges that come with it often make the journey seem insurmountable. However, with iAM ABLE’s specialized programs and compassionate approach, stroke survivors can find a path to meaningful recovery. Here’s an in-depth look at how iAM ABLE is revolutionizing stroke rehabilitation.

Harnessing the Power of Brain Plasticity with iAM ABLE

One of the most remarkable aspects of the human brain is its ability to adapt and reorganize itself, a phenomenon known as brain neuroplasticity. iAM ABLE’s intense therapeutic exercise programs are meticulously designed to leverage this natural resilience. Through a series of targeted exercises and therapies, they stimulate the brain’s ability to form new neural pathways, thereby aiding in the recovery of lost functions and skills. This approach sets the stage for meaningful improvements in quality of life.

Specialized Stroke Rehabilitation Programs: A Tailored Approach

Every stroke survivor’s journey is unique, which is why iAM ABLE offers specialized training and therapies that are tailored to individual needs. Their team of neuro-rehabilitation experts conducts a thorough assessment to identify specific challenges—be it hemiparesis, aphasia, or cognitive deficits. Based on this assessment, a customized rehabilitation plan is developed, incorporating a range of therapies such as physical, occupational, and speech therapy, all aimed at addressing the unique challenges you face.

Embracing Your New Reality: Emotional and Psychological Support

Life post-stroke is a new reality that comes with its own set of challenges and adjustments. iAM ABLE goes beyond physical rehabilitation by offering robust emotional and psychological support. Through mentoring programs and one-on-one counseling, they help you and your family come to terms with the emotional impact of stroke. They guide you through the process of acceptance and adaptation, empowering you to take control of your new reality and live life to its fullest.

The Power of Community: Staying Motivated with iAM ABLE

The road to recovery is long and often filled with setbacks. iAM ABLE understands the crucial role that motivation plays in this journey. They offer a vibrant and supportive community where stroke survivors can share their experiences, learn from each other, and celebrate their victories, however small they may be. This sense of community acts as a powerful motivator, helping you stay committed to your rehabilitation goals.

iAM ABLE is not just a rehabilitation center; it’s a sanctuary of hope and transformation. With their state-of-the-art facilities, team of experts, and a compassionate, family-oriented approach, they offer a comprehensive roadmap for stroke recovery. By choosing iAM ABLE, you’re not just opting for rehabilitation; you’re embracing a community committed to helping you find possibilities within impossibilities. Take that significant first step today, and discover how iAM ABLE can turn your road to recovery into a transformative journey of hope, resilience, and renewed life.

Understanding and Addressing Stroke

Stroke is a formidable medical condition that affects countless individuals worldwide. It stands as the fifth leading cause of death and a primary cause of disability in the United States. At its core, a stroke transpires when the brain’s blood supply is interrupted, either due to a clot or a ruptured blood vessel. This interruption deprives the brain of essential oxygen and nutrients, leading to the death of brain cells.

A striking revelation is a large part of strokes are preventable. The importance of awareness, early detection, and proactive measures. While many associate strokes with the heart, it’s crucial to understand that strokes occur in the brain. The effects of a stroke can be profound, impacting various body functions depending on the affected brain region.

It’s imperative to remember the significance of understanding stroke. Not only does this knowledge empower individuals to take charge of their health, but it also fosters a community of support for stroke survivors. By promoting stroke awareness and championing continuous education, we can collectively work towards a world with fewer stroke incidents and improved outcomes for those affected.

Find more information here at NIH: https://www.nhlbi.nih.gov/health/stroke

OUR VISION

iAM ABLE focuses on helping clients reclaim their lives by providing intense, exercise based health and fitness programs designed to increase function...

Medical Disclaimer

All material published by iAM ABLE, including its website, and third-party information, is for informational purposes only. iAM ABLE encourages clients and readers to confirm information. Clients and/or readers should review information with their health care provider. iAM ABLE will not be liable for any direct, indirect, or consequential damages from such information.
Copyright © iAM ABLE, iAM ABLE is a DBA of MIAMI SCI WELLNESS, INC. which is a 501(c)(3) non-profit organization.
map-marker linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram