There were two things that Dan Wilkins did not expect to happen on one Thursday afternoon that will forever live in his memory — his wife, Caroline, getting home early from work and him surviving a massive stroke.
Just a week before, Caroline had been scrolling through Facebook and came across a stroke awareness post shared by one of her friends. She read through the entire post and learned how to identify the early signs of a stroke. Caroline didn’t know then, but would later find out that this information helped save Dan’s life.
Caroline, described by her husband and co-workers as a hardworking and dedicated librarian, rarely got home early from work. On that day and shortly after her arrival, Dan started showing early signs and symptoms of a stroke. “His balance and eyesight were off, and I could see half of his face drooping,” she explained. “He couldn’t move his arms and his speech was not making sense. I knew that it was a stroke!” Caroline wasted no time and called for help right away.
Dan was transported to Kaiser Permanente Anaheim Medical Center, where Dr. Alireza Noorian was the on-call Neurologist for the telestroke program. This program allows emergency physicians in community hospitals to activate a neurologist at a remote location. The neurologist can assess the patient visually using video technology, all of which shaves precious minutes off the time it takes to determine if the patient is a candidate for tPA, a “clot busting” medication delivered intravenously, used to break-up the clot that is causing a blockage or disruption in the flow of blood to the brain and helps restore the blood flow to the area of the brain
Dr. Noorian was able to access Dan as soon as he arrived at the emergency room. “When we see acute stroke symptoms, the various department involved begin to work in parallel. While the ER team stabilizes the patient, the radiologist carries out a CT scan, the pharmacists begins to get the tPA medication ready, the neurologist explains the treatment options to the patient’s family,” explained Dr. Noorian.
Stroke is a major cause of death and a leading cause of serious long-term disability in the United States. Acute ischemic stroke, the most common type, is caused by a clot obstructing the flow of blood and oxygen to the brain, which can result in the death of brain cells. Every minute in which an ischemic stroke is not successfully treated, 1.9 million brain cells are lost. Every minute counts.
Based on the history, physical exam and CT scan not showing any evidence of bleeding, there was a high suspicion for acute ischemic stroke and with no time to waste, the tPA medication was administered. The tPA medication, to be effective, must be administered within 60 minutes of the onset of stroke symptoms, and it is more effective the sooner it is delivered.
Due to Dan’s symptoms being so severe, it was feared that there was a large blood clot logged in one of his brain blood vessels, and that the tPA medication alone might not be able to remove. A CT angiography, a medical test that combines a CT scan with an injection of a special dye to produce pictures of blood vessels and tissues in a part of your body. The dye is injected through an intravenous (IV) line started in your arm or hand. confirmed that a large blood clot was still present. Dan was immediately taken to surgery to have the blood clot removed, confirmed that a large blood clot was still present. Dan was immediately taken to surgery to have the blood clot removed.
Just a few days later, after having received successful stroke treatment, Dan was discharged to go home. “With the help of Caroline, I got up and got dressed and I was ready to go,” said Dan. During his follow up appointments, no one could believe Dan had a massive stroke. “Recovery would still take a lot of work,” he said. “Being able to walk around the block took a few months to build up to, but if I didn’t get the timely treatment I received, I probably wouldn’t even be able to walk.”
Just a short month after his stroke, Dan and Caroline were ready to go to a summer concert. “Dan wouldn’t have had the same results if we had gone to another hospital,” explained Caroline. “The quick thinking of everyone involved help waste no time. That is what saved his life.”
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