Sunday, January 13, 2013

Part Two - Mr. Johnson’s Amazing Stroke Recovery



By Chuck Jones

I’m sure you’ve been anxiously awaiting today’s blog so, today, I am presenting you with part 2 of the two part series based on an article written by Jan Jahnel RN, CNRN who is the Chief Stroke Nurse Coordinator for INI Comprehensive Stroke Center at OSF Saint Francis Medical Center in Peoria, IL.  

You can review Part One, if necessary, by clicking on its link at the right side of your screen under “Blog Archive”.  Jan wrote this in response to OSF Saint Francis Medical Center being certified as a Comprehensive Stroke Center by the Joint Commission, an independent, not-for-profit organization; The Joint Commission accredits and certifies more than 19,000 health care organizations and programs in the United States. Joint Commission accreditation and certification is recognized nationwide as a symbol of quality that reflects an organization’s commitment to meeting certain performance standards.

I have taken Jan's article and, with her permission, I have reorganized it to make it this two part series.  By doing this, I hope to impress upon you the necessity of learning the symptoms of a stroke and the urgency to act immediately after detection.  

Part Two - Mr. Johnson’s Amazing Stroke Recovery

Mr. Johnson’s Event

If you remember from last week, on a certain Wednesday morning, while working on his farm equipment, Mr. Johnson suddenly lost the use of his left arm and leg and sank down to the ground and his son acted quickly and got him to the hospital.  The medical staff at the hospital determined he had an ischemic stroke.  Four days later, he was discharged to his home with complete recovery from his stroke.

Last week I left you hanging with the question, “How did Mr. Johnson recover from his stroke so well and so quickly?”  The answer is that three very important things happened to make this possible:

1) His son, knowingly or unknowingly, applied the F.A.S.T. test I showed you in last week’s blog.  I’ll go over that again at the end of this article because it is important.  At this time I don’t know if his son even knew about F.A.S.T. but he acted as if he did.

2) His son acted quickly to get him to the hospital. As you may know, it is imperative that you get a person to the hospital and diagnosed within three hours of the onset of symptoms.  

3) The medical staff at the hospital was able to diagnose, in time, the type of stroke he had – ischemic – and administer the “clot buster” medication known as t-PA (Tissue Plasminogen Activator). 

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Now the continuation of Jan’s article:  

Because of these three things, Mr. Johnson was able to benefit from advanced treatments that followed, available at a comprehensive stroke center.  

A brain angiography was performed and the specially trained neuro-interventional surgeon discovered his carotid artery was severely blocked and a clot in the blood vessel was blocking flow to the brain tissue. A catheter was channeled inside the blocked blood vessel and the surgeon was able to open the narrowing in the carotid artery, placing a stent to keep it open.  The clot in his brain was successfully removed with special clot removal devices.  Right after the procedure, Mr. Johnson was able to move his left arm and leg well.   He was admitted to the neuroscience ICU and monitored by specially trained neuroscience nurses and staff.   

Since 1995 The Illinois Neurological Institute’s (INI) Stroke team at OSF Saint Francis Medical Center in Peoria, Illinois has saved many brains and lives like Mr. Johnson.  Equipped with the highest degree of service, dedication, compassionate care along with the most advanced diagnostic and therapeutic technology, OSF Saint Francis Medical Center is the 2ndin the nation to be certified by the Joint Commission as a Comprehensive Stroke Center.  This certification designates OSF Saint Francis Medical Center as the destination medical facility for receiving the highest level of comprehensive care for all types of acute stroke.

Stroke is the number 4 cause of death and is the leading cause of adult disability in the United States.  However, with appropriate comprehensive treatment, a stroke may be reversed, saving a person from death or devastating permanent disability.  Every 40 seconds someone in the U.S. suffers a stroke.
               
There used to be no medical treatment for an ischemic stroke.  Treatment consisted only of preventing any further complications caused from the stroke. There was no way of restoring blood flow to the brain through the blocked blood vessel.  Without this blood flow and oxygen, permanent physical and/or mental disability is unavoidable since 1.9 million brain cells die every minute during a stroke.  Then the FDA approved the use of tissue plasminogen activator (tPA) for the treatment of acute ischemic stroke.  This medication is a clot buster that can minimize or dissolve many types of blockages in the blood vessel. This medication can restore blood flow to the blocked area of the brain.   When tPA is given to eligible patients there is a 1 in 3 chance the symptoms will improve or go away. This drug works best when given as quickly as possible after the start of symptoms.

Advances have been made in stroke treatment. People who recognize stroke symptoms and seek medical attention immediately may be eligible for more advanced stroke treatments.  The Illinois Neurological Institute at OSF Saint Francis Medical center has been providing these comprehensive treatments for several years.  Neurological interventional surgeons are able to thread a catheter inside a blood vessel to the blockage in the brain injecting a medication that allows them to visualize the clot.  Often this surgeon can dissolve the clot in the blood vessel by giving the clot busting medication directly at the clot or removing it with special devices.  If the physician identifies a segment of blood vessel narrowed by plaque or calcium, they can open the segment by placing a stent in the blood vessel in the brain.    Other treatments are performed by Vascular Neurosurgeons.  These include removing a section of skull called a craniectomy.  They can apply a clip to an aneurysm to prevent it from rupturing and can perform a carotid endarterectomy to remove plaque build-up in the large arteries in the neck.

In September 2012, the Joint Commission began recognizing hospitals that could provide the highest level of all-inclusive care.  This new designation was Comprehensive Stroke Certification.    OSF Saint Francis Medical Center is proud to have met the strict standards required to achieve this prestigious certification.  What does this mean for those experiencing a stroke?  The Illinois Neurological Institute Comprehensive Stroke Center at OSF Saint Francis Medical center offers the most advanced stroke care available anywhere.

Our passionate team of professionals can manage and treat the most complex acute strokes. We have experience in providing cutting edge treatments, interventions and surgical procedures 24/7, with minimal complications and favorable patient outcomes. We offer comprehensive stroke care beginning with the recognition of stroke symptoms through the rehabilitation process and beyond.  

Recognizing and responding quickly to the signs of stroke is the key to survival.  If you or your loved one experience any sign of stroke, such as weakness on one side of the body, droopy face, or difficulty with speaking or understanding language immediately call 911.   Ask to be taken to the emergency room at OSF Saint Francis Medical Center.  As a comprehensive stroke center, the type of treatment you receive and how fast you get it make all the difference.  You or your loved one deserve to receive the most advanced care available anytime, day or night and you get it at the Illinois Neurological Institute’s Comprehensive Stroke Center at OSF Saint Francis Medical Center.  

Submitted by Jan Jahnel RN, CNRN, Chief Stroke Nurse Coordinator, INI Comprehensive Stroke Center, OSF Saint Francis Medical Center.

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What I want you to take away from this today is to be able to apply the acronym of F.A.S.T. to help you with detection of a stroke and to get help immediately.  

F.A.S.T. is simply this:

Face – Does one side of the face droop? Ask them to smile.
Arms – Is one arm weak or numb? Ask them to raise both arms. Does one arm drift downward?
Speech – Is speech slurred? Ask them to repeat a simple sentence. Is the sentence repeated correctly?
Time – If they show any of these symptoms, call 911 or get to the hospital immediately. tPa must be administered within three hours of symptom onset and that three hours includes the time the hospital needs for its diagnosis to determine if the stroke is the type that will benefit from tPA treatment.

Please pass this simple test and the sense of urgency on to others!

Tissue Plasminogen Activator (tPA) is a drug researched, and marketed exclusively, by Genentech, Inc.  Genentech, by the way, is also our major sponsor for our MegaBrain and ELSIE exhibits.  

Thank you OSF Saint Francis Medical Center and Genentech for helping us promote stroke education to thousands of  people.

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