If you think it's a stroke, get to the Emergency Room

Article Date: May 6, 2010

Gabriele Hartman, back at work as a medical reception specialist in Council Bluffs, had the full range of stroke care at Alegent Health, from Emergency Room to rehabilitation services.

If there’s a chance you’re having a stroke, Gabriele Hartman suggests you get to the hospital fast.

Gaby, of Council Bluffs, Iowa, tried to wait out what she thought was a migraine, but eventually ended up in the Emergency Department (ED) at Alegent Health Mercy Hospital.

“I had absolutely no idea that it was anything worse than a really bad headache,” she said. “I have headaches a lot, but that was the worst I've ever felt in my entire life.”

Gaby eventually got the full spectrum of stroke care at Alegent Health, from the ED to inpatient rehabilitation, said her husband, Kris.

Above and Beyond

"I’ve told everyone I work with that the care we received at Alegent was above and beyond our expectations, from the moment we got to the Emergency Room to the day we left,” said Kris. “I can't express how grateful we are to everyone involved in Gaby’s care.”

That level of care combined with the continuum that only Alegent Health can offer, are just a couple of the reasons that the Joint Commission certified all five Alegent Health metro area hospitals in stroke care.

“Consumers can be confident that a hospital with stroke certification can accurately diagnose this problem and give them the appropriate treatment to save them from long-term illness,” said Jeffry L. Strohmyer, M.D., a family practice physician and medical director of Alegent Health Midlands Hospital.

“That’s what makes stroke certification critical,” said Dr. Strohmyer. “This means our Emergency Departments are able to quickly handle strokes or ‘brain attacks’ with specific protocols, in the same way as we manage heart attacks.”

Gaby’s Story

Gaby’s story started on Saturday, Sept. 27, 2009 - right after her daughter’s college soccer game in Sioux Falls, South Dakota. Gaby, 49, had no family history of stroke.

“I walked back to the car while talking to one of my daughter’s teammates,” said Gaby. “All of a sudden, out of nowhere, the headache just hit me.”

Kris wanted to get medical help, but Gaby refused, chalking it up to exhaustion from their work on remodeling a house the day before. They made the three-hour drive home.

“He wanted to take me to the ER, but I said ‘no,’ ” she said. ”I was being stubborn because I didn't want the medical bill.”

The most common symptoms of stroke are weakness in one side of the body or numbness and tingling, or blindness in one eye, that comes on suddenly and for no apparent reason, according to Blanca L. Marky, M.D., neurologist with Alegent Health Clinic in Council Bluffs.

‘Time is brain’
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“Time is brain,” said Dr. Marky, “and the first few hours of a stroke are critical for getting a diagnosis, then starting therapy.”

“When the stroke alarm goes off, we all know we’re on a time constraint - if we are going to be successful everyone has to run,” said Dr. Marky. “The sooner you start the recovery process, the better it is going to be for the patient.”

In Gaby’s case, she got home from the game and went to bed, slept most of the weekend, then saw her doctor for a migraine shot Monday. She made it to work Tuesday, but only for an hour. Finally, she headed to the Emergency Department.

Diagnostics

“Gaby was disoriented, and told the doctor that she was having a hard time focusing on him,” said Kris. “That’s when he did a CT and found the bleed located in the lower left part of her brain.”

She was admitted to the Intensive Care Unit where the bleed in the parieto-occipital region of her brain caused her condition to deteriorate.

“She didn’t know me, who she was or where she was,” said Kris.

“Apparently, I was saying some pretty weird stuff,” Gaby said.

An Anniversary They Won’t Forget

By Friday, Gaby was unresponsive and another CT revealed further swelling and shifting of the brain.

"At that point, the doctor said, ‘We have to go in and relieve the pressure,’ ” said Kris. “It was our 28th wedding anniversary, and I just broke down at the point. I’d been up for three days straight.”

Narendra Nathoo, M.D., a neurosurgeon, immediately reassured Kris.

“He was very thorough in explaining everything he was going to do in great detail,” said Kris. “Everything was precision and it went like clockwork. Even in the waiting room, I got updates. That made it a lot easier.”

The day after surgery, Gaby could not see out of her right eye and had no right peripheral vision in either eye. “When I looked at a person, I only saw half of them,” she said. But she did recognize her husband again, and was surprised to learn how long she’d been in the hospital.

“Dr. Nathoo told us, ‘That's an anniversary you won't forget,’ ” said Kris.

Rehabilitation

After her hospital stay, Gaby was admitted to the Immanuel Rehabilitation Center. She had a week of speech, occupational and physical therapy to help restore her motor functions.

“They keep you busy, and I really like that because it made the day go faster,” said Gaby. “They have a schedule – you’re up at seven, dressed, have breakfast, physical therapy for an hour, then a break, then you have speech therapy.”

Kris said that once again the staff put his mind at ease.

“They explained everything they were doing in great detail, every step of the way, 24 hours a day,” said Kris. “There was never any question about treatment or medications being prescribed. If I had questions, they answered them all.”

Gaby returned to work right after Christmas. While much of her vision has returned, she had to turn in her reading glasses for a stronger prescription. She also is on medication to control her blood pressure.

Risk factors for stroke include high blood pressure, high cholesterol, a history of stroke or heart disease, and tobacco use. Now that their mother has suffered a stroke, the three Hartman children have been briefed on these warning signs by their parents.

Meanwhile, Gaby and Kris are looking forward to many more anniversaries.

Alegent Health’s Certified Stroke Centers

“A stroke can be more devastating than any illness that you can have,” said Dr. Strohmyer. “It’s a time-sensitive process. We have to move fast in coordinating with the nurses, lab, radiology, physicians and techs – we all have to be on the same page. ”The Joint Commission awarded Primary Stroke Center accreditation to:

Additionally, the metropolitan area Alegent Health Emergency Departments are all accredited Chest Pain Centers.


Reader Comments
Posted: May 12 2010 10:58 AM CST by Carrie

I am so glad to hear that you are back to work and feeling better!! I have a family history of strokes. My mother and grandmother (mom's mom). I worry about when & if it is going to hit me.




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