Team takes on strokes

When Sallie Boyd was taken to the hospital Aug. 4 after suffering an ischemic brain stem stroke, she couldn’t look at people.

Ask her how she felt, and you get a simple answer.

“I didn’t feel,” Boyd, 72, said. “Strange things were happening.”

But with help from a team at Medical Center Hospital, Boyd was preparing to go home Friday. The group coordinates from the time emergency workers pick up a patient to the time she leaves the hospital and beyond.

Connie Mudd, Boyd’s speech therapist, said she isn’t even going to recommend continued speech therapy once Boyd leaves.

“I don’t think she realizes how far she’s come,” Mudd said. “When you’re in the state she was in, cognitively you don’t usually recover from it.”

Part of the reason Boyd was able to recover was because she sought treatment early, Levi Stone, Medical Center’s divisional director of acute care and critical care, said. The process begins in the ambulance, when EMS workers relay symptoms of a stroke to doctors and nurses.

Stone said it’s crucial for long-term recovery to get patients TPA, a clot-busting drug, within the first three hours after a stroke. That’s when the symptoms take hold.

Doctors, using a CT Scan, must quickly determine whether a patient has suffered a stroke, how severe it is and what type it is, Dr. Thomas Allen, Medical Center’s emergency department director, said. An ischemic stroke is a blockage of blood flow to the brain. A hemorrhagic stroke, a brain bleed, is more likely to require surgery.

“The stroke patient is definitely one of the types of patients we have to have a rapid assessment of,” Allen said.

From the emergency room, patients are transferred to the acute and critical care area. There, Stone said patients undergo a dysphagiagram to determine if they have a swallowing disorder. They also receive a lipid profile, where blood tests help determine a plan of treatment.

While in acute and critical care, a course of therapy is also determined. Eva Mills, director of physical medicine and rehab, said it’s important for the patient to get into therapy as quickly as possible.

Determining what the patient can do is an important part of therapy, Mills said.

“It’s kind of like a baby,” she said. “You have to go through these phases of sitting and balancing, then standing and balancing, then walking.”

Speech therapist Dawn Hale said she not only uses verbal education but also writes down many of her lessons.

“They’re kind of overwhelmed when they get here,” she said. “So when they go home they might have something to look at.”

Working together is the key among departments, stroke unit charge nurse Louisa Urias said.

“It’s an interdisciplinary action,” she said. “We all communicate with each other.”

Medical Center treats between 250 and 300 stroke patients a year, Stone said. The hospital began focusing on stroke care last year. It is now a member of the Stroke Sense network of public hospitals and is trying to become the first designated stroke center in West Texas.

The need to be a stroke center is magnified by an increasing number of strokes in recent years, said neurology medical director Dr. Abdul Kadir, one of four neurologists who take turns on call to serve stoke patients.

“People are living longer lives,” he said, “long enough to have Alzheimer’s and strokes.”

But, while risk of stroke increases with age, Kadir stressed they happen to younger people, as well. He recently treated a 27-year-old woman who had a stroke as a result of diet pills.

It’s important to look at the risk of stroke as seriously as they would a heart attack, Mills said.

“A lot of people who suffered heart attacks, they go back to the life they had before,” she said. “With a stroke, 80 percent of where they were before is very optimistic.”

Yet Allen said many patients do not react quickly when having a stroke.

“People with chest pains, they get in here right away,” he said. “But people will sit there with their left arm not working for five or six hours and say, ‘Well maybe I should go in.’ ”

Urias said therapists can be tough, but it’s necessary.

“One way or another, we want to make sure the patient gets healthy,” she said. “The last thing we want is for the patient to end up in the nursing home.”

Boyd said she’s grateful for her therapists.

“They worked me diligent every day,” she said.

Toward the end of their stay, arrangements are made for patients to receive outpatient therapy or to get help at a facility like the West Texas Aphasia Center.

Boyd looks forward to her outpatient treatment. Although she was happy with the care she received, she also gives credit one other place.

“It strengthens your faith in Jesus,” she said. “I don’t have no fear of what comes upon me. What time do they serve (dinner)? Five o’clock?”

Stroke symptoms

>> Sudden numbness or weakness of the face, arm or leg, especially on one side of the body.

>> Sudden confusion, trouble speaking or understanding.

>> Sudden trouble seeing in one or both eyes.

>> Sudden trouble walking, dizziness, loss of balance or coordination.

>> Sudden severe headache with no known cause.

Source: American Stroke Association