Surviving A Stroke With Quick Care

As I compose this column, I realize it was in the evening exactly two weeks ago that wife Susan and I were watching TV here at home. Like many of you who have DVRs, I’m sure, we record our favorite programs and then “fast forward” through the commercials. I consider this an even greater luxury than electric blankets and ice-makers. We have both developed a certain level of pride in being able to flick rapidly through the commercials, and stop exactly where we left off in the program. I’d bet more than just a few of you can relate: “Aha! Harnessed technology again!”

I had the remote control in my hand and was flying through a strip of commercials, but seemed not to be able to switch my finger to the “PLAY” button. I could see I was going too far and ran into the program again, then sat helplessly as it ran all the way to the next commercials. Susan turned to me with a sharp “What areyou doing?” But then she saw the perplexity in my face. “Are you all right?”

“No,” said I, as I handed her the remote with my other hand, slowly realizing, I may be having a … STROKE!

Susan called 911 immediately, and we soon heard the ambulance coming up the hill. At this point, I realized I had no feeling in my right leg; I couldn’t move it. During the transit in the ambulance, my memory kept going back to my maternal grandmother, who suffered strokes, leaving her dependent on a walker and dragging her limp foot behind her — a real downer prospect.

In the ER at Pali Momi, the duty doctor apprised us of a clot-busting drug that, if used within three to four hours of the stroke, has been very successful in reversing its adverse effects: tPA, or tissue plasminogen activator. After a CT scan confirmed my stroke was not hemorrhagic (bleeding in the brain, which tPA could have made worse) but ischemic (blood clot in the brain), tPA was administered intravenously, well within the time limit. But although tPA gained FDA approval nearly two decades ago and is considered by stroke specialists to be “the gold standard” in stroke treatment, studies show only about 4 percent of stroke patients receive the drug. Lack of knowledge is the only obvious culprit.

Later in the ICU, I kept trying to wiggle my toes and move my foot, but to no avail. Finally, as morning was dawning, I began to meet a little success, and by noon the next day I had full recovery of my right leg function (“no residual deficits”) — to indescribable relief, I might add. It simply took that long for the tPA to work.

Over the next couple of days, after another CT scan with a marker dye, I had a transesophageal echo-cardiogram, where the scanner is lowered down the throat to rest alongside the heart for the clearest possible recording of the heart’s function.

It was determined atrial fibrillation/flutter or “A-Fib” was the cause of my stroke. This is when the atrium of the heart works inefficiently to pump the blood out, allowing it to “stagnate” in the atrium and eventually causing a clot, which gets pumped to the brain, cutting off blood flow to a part of the brain — the part, in my case, that controls the movement of my right leg. My treatment also included a carefully monitored electrical shock to my heart to interrupt the fibrillation and to re-establish a normal rhythm.

The bottom line here, Dear Reader: Do not blow off the symptoms of a stroke or even what may be a stroke: e.g., lack of muscle coordination, difficulty speaking, numbness in any part of the body, blurred vision or just a weird feeling. Call the nearest hospital to home and work to inquire if they have a “stroke center” with consistent access to tPA, then insist the ambulance take you there.

And remember, time is of the essence. Minutes saved equate to brain cells saved.