When Seconds Matter
James McCann of Franklin was taking a shower when the sensation of pins and needles tingled in his face, arm and leg. Nausea surged over him and weakness numbed his body.
“I told my wife to call an ambulance as I was having a stroke,” said Mr. McCann, 59. “When I got to the ER, the only movement I had on the right side was at the end of my thumb. I had double vision and my speech was slurred.”
Since Milford Regional Medical Center was designated a Primary Stroke Center by the Massachusetts Department of Public Health and the American Heart Association, the staff worked as a team to follow the established stroke protocol. Mr. McCann was an ideal candidate for the clot-busting drug tPA, which can help limit damage and disability from ischemic strokes – those caused by a blocked artery in the brain.
“It’s frightening to think your body is so debilitated and that you’re at the mercy of the medical crew and the fates,” said Mr. McCann. “I really felt I got my life back by going to Milford Regional versus somewhere else.”
According to the American Stroke Association, 700,000 Americans each year suffer a new or recurrent stroke and about 150,000 of them die. Dawn M. Pearson, MD, a neurologist at Milford Regional, said the hospital met specific guidelines to obtain the Primary Stroke Center certification. To maintain the designation, Milford Regional’s performance in stroke care must be monitored and undergo reassessment every two years.
“You have to demonstrate the ability to handle stroke quickly and appropriately in the field, in the Emergency Department and in the inpatient setting, and be able to mobilize the stroke protocol, which we have spelled out in packets on every floor,” said Dr. Pearson. “A lot of the drive behind Massachusetts designing this certification was the concern that tPA wasn’t being used as widely as it should be. This is a nationwide issue. We’ve had stroke discussions for the community, and have done training for EMTs, nurses, residents and doctors on stroke protocol and management. It’s a higher level of stroke awareness for everyone.”
Dr. Pearson said that patients with stroke symptoms can expect a CT scan, MRI, MR angiography, blood tests, cardiac monitoring and a cardiac ultrasound. She has high hopes that the Medical Center’s new 64- slice CT scanner will allow for CT angiography as part of the stroke workup.
According to Dr. Pearson, treatment depends on factors such as the type and severity of stroke and the patient’s medical history. For example, a patient with a clot in a major artery may be transferred to a tertiary care center for a different procedure. She said that while tPA therapy is not suitable for every patient, some people who could have benefited wait too long before coming to the hospital.
“The importance of tPA is that there is a three-hour time window from the onset of symptoms,” said Dr. Pearson. “One of the main reasons we find a patient is not a candidate is because they went to bed with their symptoms. Their arm might have been a little numb or they lost vision in one eye, and decided to sleep on it. Please call 911 right away. The EMTs will identify it in the field as a probable stroke and tPA is in people’s minds before you hit the door.”
Since his scare of January 10, 2006, Mr. McCann has progressed further than he believed possible. After rehab, he now exercises regularly at a YMCA. He lost weight, quit smoking and takes the anti-platelet medication Aggrenox to decrease his risk of future stroke. Although he still has after-effects including balance issues and a sensation of fullness in his right arm, Mr. McCann has returned to his full-time job as Director of Veteran’s Services in North Attleborough. He has also begun to slowly enjoy a favorite past-time -- playing the piano.
“I brag about Milford Regional all the time,” he said. “If anybody had told me when I had the stroke that night that I’d be where I am today, I’d have thought they were completely mad.”
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