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Stroke Center

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.

Minutes Matter

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.

Treatment Options

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
  • Confusion
  • Trouble seeing in one or both eyes
  • Trouble walking, dizziness, loss of balance or coordination
  • A severe headache without a known cause

Patient Stories

When Stroke Strikes, Time is Brain: Jon Wiebe

Jon Wiebe with members of his Lake Regional care team Jon Wiebe with members of his Lake Regional care team

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.”

Wake-Up Call: Stroke Survivor Paul Wilke

A near miss changed Paul Wilke's life - for the better. 

Paul Wilke woke up at 4 a.m. Friday, May 27, 2016, unable to move his right arm and leg.

“I couldn’t get rolled over,” he says. “I thought my leg and arm were asleep.”

It lasted a couple of minutes. Then Paul got up, walked a bit and sat back on the bed. As he sat there, the numbness and weakness returned. His wife, Jill, woke up and asked if he was OK.

Paul knew he was not.

“I told her I thought I was having a stroke,” he says.

Alarm Bells

Paul knew what was happening because he had seen it hundreds of times. He is a retired paramedic, with 25 years of medical experience. And, Jill is a registered nurse.

They moved to the lake in 2014 from Wisconsin. Jill’s grandparents founded Wonderland Camp, and once Paul and Jill’s kids were grown, they decided to move back to her family’s land on the lake.

“He fishes all the time, and we like going out on the boat — just living that lake life,” says Jill, who serves as Lake Regional’s director of Palliative Care, Home Health and Hospice.

As soon as Jill heard Paul speak that morning, she knew his life was in danger. Not only was he having numbness and weakness on his right side, but he also was slurring his words. Jill tried to call 911, but the call dropped. Less than five minutes after the second attack began, it ended, and Paul could move and talk again.

Acting Fast

Wasting no time, Jill drove Paul to Lake Regional Emergency Department. There, staff initiated Code Stroke, alerting all providers and departments involved in stroke care. Lake Regional Neurologist Philip Kurle, M.D., diagnosed Paul with crescendo transient ischemic attacks, or TIAs. Sometimes called ministrokes, transient ischemic attacks have similar symptoms as stroke but are brief, without lasting effects. The “crescendo” indicates Paul’s attacks were coming at a fast rate.

“If not treated, there’s a very high risk of these attacks progressing to a full stroke,” Dr. Kurle says.

Dr. Kurle’s treatment for Paul focused on improving blood flow through restricted arteries in Paul’s brain.  Specifically, Paul received antiplatelet drugs, which prevent the formation of blood clots; aspirin; blood thinner; and fluids.

Next, Dr. Kurle ordered testing, including an MRI and cerebral angiogram. The results showed Paul had escaped a full-blown stroke. Dr. Kurle kept him in the hospital a little more than 24 hours for observation, and Paul had no more attacks.

“Having worked at a much bigger health facility in Wisconsin, we both were very impressed with the care Paul received here,” Jill says. “Dr. Kurle and the stroke team did everything right and saved him from progressing to a full stroke.”

Turning Things Around

Leaving the hospital, Paul had mixed emotions. Although thankful to be walking out with no disabilities, he knew he was at increased risk for a future stroke. He also had been diagnosed with diabetes during his stay, and he was angry at himself for years of poor health choices. He wasted no time making changes.

“I quit smoking May 27,” he says, “and I started watching my diet, exercising and found a primary care doctor, Dr. Barnum, who I see regularly.”

Even with these changes, Paul struggled to manage his blood sugar levels, especially in the mornings. So, he enlisted the help of a Lake Regional dietitian and diabetes educator, Wendy Castle, MPH, R.D., L.D., CDE. She explained how Paul should mix his proteins and carbs, even when snacking. Paul followed her advice and saw his levels improve.

For exercise, Paul started walking and after a couple of months, began running.

“I don’t particularly like running, but it’s the best way for me to lose weight and stay active,” Paul says.

Because of his commitment to healthier living, Paul has lost 60 pounds and achieved a healthy blood pressure.

“He’s probably in the best shape of his life,” Jill says, adding he’s shown amazing willpower. Paul says he hears that often.

“A lot of people have asked, ‘How can you switch overnight?’” he says. “The answer is I thought I was going to die or be severely disabled. That gave me a different perspective. I realized that if I want to see my grandkids grow up, I had to change things. And I’m sticking to that.”

Stroke Center

As a state-designated Level II Stroke Center, Lake Regional Health System offers comprehensive stroke care and recovery, including treatment from a board-certified neurologist, specially trained Emergency Department physicians and staff, around-the-clock emergency imaging services, a skilled nursing facility located in the hospital, rehabilitation services and home health services.


"Don't Ever Give Up": Stroke Survivor Lois Shipp

Lois Shipp lifted her left foot, set it on a low wooden box and grinned.

“There!” she said to Lake Regional Physical Therapist Assistant Ann Perry. “It came straight down, didn’t swing to the side at all. Did you see that?”

Perry grinned back at her. “I did,” she said. “Good job.”   

Shipp, 83, has good reason to feel proud. She has come a long way since a stroke on Feb. 13, 2017, left her left side paralyzed. May is National Stroke Awareness Month, and Shipp shares her story to encourage others facing a stroke diagnosis.

“Don’t ever give up,” she said. “You can have a life after a stroke.”

From Depressed to Determined

Shipp wasn’t always so positive about recovery. After her stroke, she spent six days in Lake Regional’s Intensive Care Unit and then a day and a half on Lake Regional’s Medical/Surgical Unit. From there, she went to Lake Regional Skilled Nursing Facility for intense therapy. She couldn’t walk more than five feet with a walker, and even that required assistance from a therapist.

“She thought she was always going to be that way,” said her husband, Don Shipp, who is also a stroke survivor.

“I was depressed, and I didn’t want to get out of bed,” Lois Shipp said, adding she refused to do therapy the first two days. Then Jeanne Marie Loggins, an occupational therapist assistant, explained her options.

“That changed my life,” Lois said. “Jeanne Marie came into my room and said: ‘Lois, do you know that if you do not try to get some therapy, you will have to leave here in a couple of days and go live in a nursing home? If that’s what you want, that’s fine, but you know, we can help you.’ And there was something in her voice that sounded like she really cared. So I said, ‘Then let’s get at it.’”

And “get at it” Shipp did, impressing all of her caregivers.

“I worked hard and within two weeks, I could raise my arm above my head and was walking some with a walker,” Shipp said.

And within a month, she could walk 350 feet with a walker and go up and down stairs.

“She worked very hard,” Loggins said. “She wanted to be able to go home, and after 32 days in our Skilled Nursing Facility, she walked out of here with a walker.”

Grateful and Strong

In the weeks since, Shipp has continued her occupational and physical therapy on an outpatient basis, coming to Lake Regional Hospital three times a week. She has all of her movement back in her left arm and enough control in her left hand to lift a glass and take a drink without any spilling. Her left foot has been the slowest to regain movement and control, and she wears a special brace to help her not drag her toes. At home, she continues to use a walker to be safe, but with her therapists’ supervision, she walks with just a cane.

She continues to get stronger and is thankful for the therapists and other caregivers who have helped her recover.

“I could not have had a better team,” Shipp said. “They have been so good to me and have become like family to me.

“I hope if you ever have a stroke, you will think positive and work hard to get your life back,” she added. “You can do it, and it is worth all the hard work getting there. I worked as hard as I could, and by the grace of God, I’m where I am today.”

Stroke Care at Lake Regional

As a state-designated Level II Stroke Center, Lake Regional Health System offers comprehensive stroke care and recovery, including treatment from a board-certified neurologist, specially trained Emergency Department physicians and staff, around-the-clock emergency imaging services, a skilled nursing facility located in the hospital, rehabilitation services and home health services.


Suspect a Stroke? Act FAST

If you suspect a stroke, remember the word FAST.

F is for face — is it drooping?

A is for arms — can you lift them?

S is for speech — are you slurring your words?

T is for time — call 911 immediately because with stroke, time is brain.

Fast Treatment, Full Recovery: David Anderson

David Anderson credits his full recovery from a 2017 stroke to the fast care he received at Lake Regional Health System. David Anderson credits his full recovery from a 2017 stroke to the fast care he received at Lake Regional Health System.

It felt like an electric shock shooting up through his fingertips. David Anderson, 77 of Camdenton, looked with alarm at his trembling left hand. The sensation went up to his left shoulder and then, suddenly, stopped. His left arm went limp. He could barely curl his fingers.

It was 2 p.m. on June 28, 2017, and Anderson, a retired certified registered nurse anesthetist, knew there was no time to waste. He found his brother, who shares a home with him, and told him what was happening — and that he thought it was a stroke. His brother noticed his speech was slurred. Immediately, they headed to Lake Regional Emergency Department.

Time is Brain

Every 40 seconds, someone in the United States has a stroke. Strokes happen when a blood vessel carrying oxygen and vital nutrients to the brain is either blocked by a clot or ruptures. As a result, part of the brain is deprived of blood and oxygen, destroying nerve cells within minutes.

“Damage from strokes can lead to death or significant disability,” said Crystal Lloyd, Lake Regional stroke coordinator. “Paralysis on one side, speech problems and emotional difficulties are all common. But if patients seek care immediately, at the first signs of stroke, proper treatment can limit the damage and give them a better chance of recovery. Time is critical in treating stroke.”

In most cases, emergency departments can diagnose and treat stroke more quickly when the patient calls 911 and comes in by ambulance. That’s because emergency medical staff call ahead, preparing the emergency team to take the patient directly into testing. Anderson did not call ahead but still received exceptionally fast care at Lake Regional.

Crystal Lloyd, Lake Regional stroke coordinator, reports Lake Regional’s average door-to-needle time is just 37.3 minutes, far better than the national average of 60 minutes. Crystal Lloyd, Lake Regional stroke coordinator, reports Lake Regional’s average door-to-needle time is just 37.3 minutes, far better than the national average of 60 minutes.

Teamwork Saves the Day

Anderson arrived at the Emergency Department at 2:53 p.m. A volunteer helped him from his car into a wheelchair and alerted the care team that they had a potential stroke patient. Within minutes, Lake Regional Neurologist Philip Kurle, M.D., examined Anderson, took labs and sent Anderson to have a CT scan, which revealed a stroke resulting from a clot. Dr. Kurle ordered the clot-busting medication tPA, which Anderson received through an IV at 3:32 p.m.

This gave Anderson a door-to-needle time of 39 minutes. “Door-to-needle” is the amount of time that passes from a patient’s arrival at the hospital to delivery of tPA. The American Heart Association/American Stroke Association reports the national average is 60 minutes. Lake Regional’s average door-to-needle time — thanks in part to early communication with first responders — is 37.3 minutes.

Having worked in health care for 35 years, Anderson knew from the time his stroke started that his outcome would depend on how quickly he received proper treatment. And he was in awe at how coordinated the Lake Regional team was in responding to his emergency.

“It was amazing,” he said. “It was all done so fast and just like clockwork.”

During his hospital stay, Anderson was diagnosed with atrial fibrillation, a heart problem that greatly increases the risk of stroke. He now takes a blood thinner and other medication to reduce his risk for future problems.

Anderson had some weakness throughout his left side immediately after the stroke, but by the time he left the hospital three days later, he had already recovered nearly all of his strength and muscle control.

“I can do everything I did before the stroke,” he said. “I’m extremely grateful that my recovery was 100 percent, that I wasn’t paralyzed on my left side, that I don’t walk with a limp, that I can use my left arm just like my right arm. And that’s all because of the care I received. I can’t praise it enough.”

Level II Stroke Center

To help stroke patients receive the best care possible in the shortest amount of time, the State of Missouri has identified hospitals that are well-equipped to treat stroke. Lake Regional was among the first hospitals to earn a Level II Stroke Center designation in 2015, and now it has earned recertification through March 2022.

Because Lake Regional has earned this designation, EMS providers can bring stroke patients to Lake Regional. In addition, rather than having to transfer stroke patients on to another care center, Lake Regional can receive transfers from other hospitals.

Lake Regional Health System is the only hospital between Columbia and Springfield that is a state-designated center for trauma, stroke and heart attack.