Stroke is a sudden loss of brain function due to a problem in the brain's blood circulation. This can cause permanent disability or even death. Know the signs and symptoms of stroke, and call 911 right away if you think someone might be having a stroke. Getting fast treatment is important to preventing death and disability.
Fast treatment can limit the damage from a stroke and provide a better chance of recovery. Door-to-needle time is the amount of time that passes between a patient arriving in the Emergency Department with a stroke and our care team delivering the clot-busing medication tPA. In 2018, our median door-to-needle time was 35 minutes, well below the statewide median of 41 minutes.
The State of Missouri has created a system to help first responders know quickly which hospitals are best equipped to treat stroke patients. In this Time Critical Diagnosis system, Lake Regional Health System is designated as a Level II Stroke Center, or a hospital that provides a high level of expert care to patients who have experienced stroke or a transient ischemic attack (TIA).
Nationally Recognized Stroke Care
Lake Regional Hospital also is a recipient of the American Heart Association/American Stroke Association's Get With The Guidelines®–Stroke Gold Plus Quality Achievement Award with Target: Stroke Honor RollSM Elite Plus. The award recognizes the hospital's commitment and success in ensuring that stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.
There are two types of stroke: ischemic stroke (insufficient blood flow) and hemorrhagic stroke (a ruptured blood vessel). Treatment depends on the type of stroke. The only FDA-approved treatment for ischemic stroke is tPA (tissue plasminogen activator). According to the American Stroke Association, patients can benefit from the clot-busting drug tPA up to 4.5 hours after stroke symptoms begin. The guidelines apply to most patients with ischemic stroke, accounting for 80 percent of strokes each year.
Recovery and Rehabilitation
Stroke is one of the leading causes of long-term disability, affecting nearly 800,000 Americans each year. Recovery time after a stroke varies; it can take weeks, months or even years. If you have had a stroke, rehabilitation therapy may help.
Rehabilitation begins in the hospital as soon as possible following a stroke and should continue as necessary after your release. Your recovery and rehabilitation program may include the following.
Because anyone at any age can have a stroke, it's important to know the signs to prevent disability or death. FAST is an easy way to remember the signs of stroke.
Face: Ask the person to smile. Is there a droop on one side or an uneven smile?
Arm: Ask the person to raise both arms with their eyes closed. Does one arm drift down because of weakness? Is there arm numbness?
Speech: Ask the person to repeat a simple sentence. Can he or she repeat it? Is speech slurred or difficult to understand?
Time: Call 911 and get to a stroke center immediately. The faster treatment is administered, the better the outcome.
Stroke symptoms also may include:
- Numbness or weakness of the face, arm or leg, especially on one side of the body
- Trouble seeing in one or both eyes
- Trouble walking, dizziness, loss of balance or coordination
- A severe headache without a known cause
Stroke survivor Jon Wiebe was excited to reunite with some of his caregivers from Lake Regional Emergency Department. He knew they had to see him to understand the impact of their fast care.
“I stood up and walked toward them, and all three of them just froze in their tracks and their chins dropped,” Wiebe, 64, said, referring to Shawn Andreasen, R.N.; Crystal Lloyd, R.N., Stroke Center coordinator; and Mariah Swinker, R.N., Trauma Center nurse coordinator. “They couldn’t believe what they were seeing.”
Something was not right
Just five days earlier, Wiebe, a retired businessman, was driving home from the construction site of his future home in Village of Four Seasons when he noticed that something did not feel right. His wife was out golfing, so he knocked on a neighbor’s door for help. By then, his vision was blurry, “like I was looking through frosted glass,” he says. The neighbor called 911.
When the paramedics arrived, Wiebe was no longer able to speak and had to use physical cues to communicate. His symptoms pointed to a stroke. He needed to get the hospital immediately.
A stroke can occur when a blood vessel that feeds oxygen and blood to the brain is blocked by a clot. This is called an ischemic stroke and was what Wiebe was experiencing.
Within 43 minutes of his arrival at Lake Regional, the stroke team administered tPA, a lifesaving treatment that immediately broke up the clot blocking blood flow in his brain. National guidelines recommend a door-to-needle time of 60 minutes or less.
While the clinical care at Lake Regional Hospital was swift and exemplary, Wiebe was also impressed with the human connection.
“My emergency room nurse, Shawn, was fantastic,” Wiebe said. “And Crystal was phenomenal.”
A second stroke
Wiebe had made it through one stroke with no disabilities — but the second day, while he was still in the ICU, his right side suddenly went limp. His doctor, Neurologist Philip Kurle, was in the room and immediately recognized that Wiebe was suffering a major stroke and would need surgery.
A small hole in Wiebe’s heart, called a patent foramen ovale, had allowed a larger blood clot to form and pass to his brain. Wiebe needed to be transferred to University of Missouri Hospital in Columbia for emergency brain surgery to remove the clot.
Wiebe’s wife, Jannice, was with him in the hospital. Lloyd was able to keep her calm.
“Crystal told my wife not to worry and shared her cell phone number in case she needed her or had any questions,” Wiebe said. “I really appreciate the attention they gave to our family while I was there and even after I got up to Columbia. You just don’t find that every day in a hospital.”
Time is brain
At Columbia, Wiebe woke up from surgery feeling almost like his normal self. To the surprise of his medical team, he did not suffer any cognitive or physical damage from either of his strokes. He was released just two days after arriving — with no need for rehabilitation.
“Time is brain,” Lloyd said. “The quicker you receive treatment following the onset of stroke symptoms, the better the outcome. Mr. Wiebe is a great example of this.”
Even so, Lloyd said, Wiebe’s recovery was exceptional, and it was incredible to see him back to normal just days after he first arrived at Lake Regional.
“I felt amazed and grateful to see Mr. Wiebe walking toward me,” Lloyd said. “If you did not know he had just had two strokes, you wouldn’t believe it. Cases like Mr. Wiebe are my why — why I love being a stroke coordinator and why I feel community education about how to survive a stroke is so important.”