May is National Stroke Month. Stroke treatment is based on time, the more quickly a patient is screened in the Emergency Department, the better the chances are of reversing symptoms and decreasing possible long term deficits. Time matters.
On October 1, 2016, Debbie Butler, a nurse at Barnesville Hospital almost had her life altered dramatically.
“Right from the beginning I was so fortunate,” said Debbie. “There were ten of us and we were camping out in the middle of nowhere. While I was roasting hot dogs over a fire, my daughter noticed I was not responding to questions, and she wanted to know if I was OK.”
Like many stroke patients Debbie thought she was fine. Even though she is a nurse she was unaware of her own early signs of a stroke. However, her family felt her voice was slow, possibly a little slurred and her face was perhaps slightly drawn. Luckily, her family insisted she go to the Barnesville Hospital Emergency Department.
At first Debbie refused and when they said they would call an ambulance she wished them good luck as she knew an ambulance would never find them in their remote camping location. After the family insisted, she reluctantly agreed to let them drive her to the Barnesville Hospital Emergency Department.
As soon as Debbie arrived in the Emergency Department she was assessed by Dr. Michael Baum, Emergency Department Physician and a ‘stroke alert’ was activated at both The Ohio State University Wexner Medical Center and Barnesville Hospital, which mobilized a team of stroke experts who through the use of real-time testing and a patient interview were able to help the medical team at Barnesville Hospital determine the best treatment option for Debbie.
“The Telestroke Collaborative provides our patients with immediate access to board-certified vascular neurologists at Ohio State who can assist us in providing a real-time assessment using video equipment and proven stroke protocols,” said Dr. Michael Baum. “The Ohio State University Wexner Medical Center Telestroke Collaborative brings advanced stroke care to our community.”
In this case, it was stroke expert Dr. Deepak Gulati at Ohio State’s Wexner Medical Center who assessed Debbie and helped to determine the best course of treatment for her.
“After examining Debbie within minutes of arriving to the Emergency Department through telestroke, I was glad and impressed that she along with her family quickly understood the importance of clot-busting medicine and got transferred to Ohio State’s Wexner Medical Center,” Dr. Gulati said.
“I remember talking to the Ohio State Physician via the video,” said Debbie. “He determined I was having a stroke and directed the immediate use of the clot-busting medicine, I was then promptly transferred to Ohio State via Life Flight. When my daughter and son-in-law arrived in Columbus a couple of hours later they said I had already shown signs of improvement.”
As Debbie’s case illustrates, Barnesville Hospital is part of a 26 hospital network that is partnering with The Ohio State University Wexner Medical Center, a certified Comprehensive Stroke Center. Barnesville Hospital patients have access to one of the most advanced stroke research study centers where neurologists are also dual-trained in Neuro Critical Care. This high level of expertise assists with rapid diagnosis and state of the art treatment for stroke and other neurological emergencies. Barnesville Hospital was one of the first hospitals in the state to be a part of Ohio State’s Telestroke Collaborative and in 2016 Barnesville Hospital utilized the Telestroke program 14 times.
In addition to the medical connection, the Telestroke program also establishes a human connection. During her stay at Ohio State’s Wexner Medical Center, Debbie said the physician she had talked to via the Tele-Stroke technology came into her room and asked if she remembered him. She told Dr. Gulati she did remember talking to him over the television while she was in the Barnesville Hospital Emergency Department.
“I was very pleased with the significant recovery shown by Debbie in the hospital,” Dr. Gulati said. “Debbie is an excellent example where collaborative care between the hospitals, use of technology, administration of clot-busting medicine and excellent stroke care at Ohio State made it possible for her to go home after only two days of hospital care, without the need of any inpatient rehabilitation facility. I would like to thank her family as well, who were vigilant enough to bring her to ED in timely manner.”
Because Debbie’s stroke was caught very quickly, she was only at OSU for 48 hours and then was discharged home. She has no deficits and was able to return to work in 12 days.
“I was fortunate in so many ways. First, I wasn’t home alone when this happened,” said Debbie. “If I had been home I would have just gone to bed as I was incredibly tired and did not think anything was wrong. Next, I am grateful I was taken to Barnesville Hospital and I was seen and assessed immediately. Through the utilization of tele-medicine I was correctly diagnosed, the TPA was administered and I was able to recover quickly and with no deficits.”
Because she doesn’t have any of the risk factors, Debbie said a stroke was the last thing that she ever thought would happen to her. Fortunately, Debbie made a full recovery and is now back to enjoying life to its fullest, traveling, gardening and working part-time at Barnesville Hospital.
Stroke accounts for 1 of every 20 deaths in the US and stroke is a leading cause of serious long term disability.
Stroke Warning Signs:
• Sudden weakness or numbness of the face, arm, or leg on one side of the body
• Sudden dimness or loss of vision, particularly in one eye
• Loss of speech, or trouble talking or understanding speech
• Sudden severe headaches with no apparent cause
• Unexplained dizziness, unsteadiness or sudden falls, especially along with any of the previous symptoms.
The most important piece of information is for patients to get to the hospital early when stroke symptoms first appear. Even if you are unsure don’t wait. Time is of the essence. To be effective, Alteplase, a clot busting drug needs to be administered within 4 hours of symptoms.
The Ohio State University Wexner Medical Center has been working with Barnesville since 2011 to advance stroke care in the community. More than 40 nurses at Barnesville have been trained in rapid stroke care and use of telemedicine.
Photo: Members of the Barnesville Hospital Team who assisted when Debbie came to the ED. (l-r) Miles Jefferis, RN, Care Manager, Staci Butler Graham (Debbie’s daughter), Debbie Butler, Dr. Michael Baum, Emergency Department Physician, Tiffany English, RN.