Stroke is the fourth leading cause of death in the United States and a leading cause of adult disability. Alegent Creighton Health offers six emergency departments in the metro—including five that, like the one at Mercy Hospital, are accredited Stroke Centers.
Corporal Rich Forristall knew something was wrong after he grabbed lunch and returned to work at the Pottawattamie County Courthouse where he escorts prisoners to courtrooms.
His right side was numb. Ordinarily a very neat man, the 52-year-old said he "made a mess" at his desk. He had trouble walking.
Nearby, Deputy Steve Barrier, who'd worked with him for more than 20 years, noticed Forristall wasn't acting like himself. "We knew something was wrong. His speech wasn't exactly slurred but he couldn't talk very well," Barrier remembered.
Up to that day, Forristall's only health concern was high blood pressure. As his condition further deteriorated, his fellow workers decided to rush him to the emergency department. "As deputies, we take people to the hospital every day," Barrier said. "We knew we had to take him to (Alegent Creighton Health) Mercy Hospital. It was where he needed to go."
In the car, Forristall's vision blurred. "We were at a stoplight and the cars in front of us were jumbled. They were merged together," he said.
A half hour had passed since his initial symptoms. "In the back of my mind, I was wondering if I was having a stroke," Forristall said. A stroke happens when a blood vessel that carries oxygen to the brain is blocked or bursts, and doesn't allow oxygen to reach the brain. At Mercy Hospital, Forristall couldn't remember people's names, including those of his wife's friend and a chief deputy he'd known over 30 years. He couldn't touch his nose with his right hand. He knew he wasn't thinking clearly.
Doctors immediately recognized he was having a stroke and began treatment through an IV. "Those who knew me couldn't believe it was happening," Forristall, who always watched his weight and stayed active riding his mountain bike and playing basketball with his kids, said. "I was too healthy."
Later, doctors told him he'd had a major stroke. The cause: a blood disorder, hyperhomocysteinemia, which he now manages with vitamin B6, vitamin B12 and folic acid. "I was in the right place at the right time," he said. "The people around me knew what was going on. What's the chance of recovering from something like this? Patients who have this typically die."
Gregory Thomas, M.D., a hospital and family medicine physician, agreed Forristall's co-workers made the right call. "We at Mercy were the first to be certified as a stroke center in Council Bluffs. It's part of our culture. The staff is specifically trained to spot strokes, even those that are very subtle. The staff is trained all the way through rehabilitation," he said.
Forristall spent two days in the intensive care unit and was off work three weeks. Unlike many stroke patients he didn't need rehab. Looking back, he had this advice: "Trust your instincts. You know your body. Don't think it'll go away. Don't be afraid to ask for help. This could have gone a lot differently."
Dr. Thomas said he sees a lot of denial about symptoms. "If there's any indication of numbness, weakness, speech disturbances or clumsiness, make sure you're seen in the ER. Don't sit and ignore it, saying, ‘I'm only 50 years old.' I see strokes in people who are even younger."
Most of the stroke patients he sees wait too long, Dr. Thomas said. "They might come in the next day and say, ‘Gee, I thought it would go away. I thought I slept on my arm wrong.' They respond to chest pain quickly but forget that a stroke is a heart attack of the brain." A recent study backed up Dr. Thomas, finding that more than 80 percent of people in the United States live within an hour's drive of a hospital but only four percent get recommended treatment in the key hours after a stroke.
Those like Forristall who go to the ER within three hours of the first symptoms receive the only FDA-approved treatment available. It's tissue plasminogen activator, or tPA; prompt treatment with the clot-busting drug limited stroke-related disability, according to a study released in Feb. 2014. Since many don't get to the hospital in time for tPA treatment, identifying a stroke immediately is critical. A recent study showed that every 15 minute delay in delivering tPA robs stroke survivors of a month of "healthy life."
Forristall, whose courthouse desk is covered with photos of his three children, looked forward to two of them graduating this spring. "I'm living on a second chance," he smiled. "I'm getting things done instead of putting them off. I — or anyone — could be gone tomorrow."