FOR IMMEDIATE RELEASE
November 20, 2018
Contact: Jon Ebelt, Public Information Officer, DPHHS, (406) 444-0936
Chuck Council, Communications Specialist, DPHHS, (406) 444-4391
After stroke: Missoula survivors share their stories
Early stroke intervention increasing
In 2015, Missoula’s Rob Owens knew something wasn’t quite right, but suspected his wife Jennifer was experiencing a stroke.
He knew he needed to take quick action. “Grab my hands and squeeze for all you’re worth,” he told Jennifer.
Two weeks prior, Rob’s co-worker Gordon Stabler had a stroke. Alarmed when he was told he wasn’t making sense, Gordon walked from work to the nearby emergency room at Providence St. Patrick Hospital. Moments after he arrived with a weak arm and confused speech, Gordon was in the hands of the hospital’s stroke team.
“I knew what to look for, because I’d seen how stroke affected Gordon,” Rob remembers.
Jennifer Owen and Gordon Stabler talk about their personal experiences with stroke in a new public health video designed to help Montanans recognize the signs of stroke. The video was developed by the Montana Cardiovascular Health Program of DPHHS in partnership with Providence St. Patrick Hospital.
Identifying a stroke and taking action quickly are key to stroke recovery. The crucial factor in effective treatment is time. The test for a possible stroke is based on F.A.S.T: Face drooping; Arm weakness; Speech problems; Time to call 9-1-1.
For most of the modern era of medicine, treatment for stroke was directed after the stroke was done doing its damage. If the patient survived, a rehabilitation team would step in to help the patient relearn movement and speech.
A game-changer occurred in 1996, however, when the Food and Drug Administration approved use of tissue plasminogen activator (tPA) to treat strokes caused by clots. Given early enough in the course of the stroke, the drug can restore normal blood flow. In the 22 years since this breakthrough, the medical approach to stroke has evolved dramatically. Early intervention is now the goal—not only to prevent death, but also to reduce disability.
“We are aggressive in treating stroke from the very early going,” says Dr. John Schaeffer, a neurologist with Providence Montana in Missoula. “When an artery is blocked, brain cells start to die. That’s what a stroke is: dead brain cells due to lack of blood supply. It’s imperative to get to the hospital immediately.”
The clot-dissolving drug can only be administered within the first three or four hours from the start of symptoms. Other options, such as removing the clot with advanced mechanical tools, also have a limited time window. Until treatment occurs, brain cells continue to die.
Those patients who receive acute stroke intervention such as tPA or mechanical clot retrieval may be 25 to 30 percent more likely to have an outcome with few or no impairments.
In Missoula County, the medical community has made a concerted effort to improve the number of patients receiving the best options in stroke treatment. Coordination between EMS, rural hospitals and a stroke hub like Providence St. Patrick Hospital have increased the use of the IV drug; some patients are receiving it prior to arrival. The number of St. Pat’s stroke patients who received tPA increased 280 percent from 2015 to 2017. As of September 30, 2018 a total of 37 patients have received the drug —a rate of about 22 percent. St. Pat’s averages about 250 to 260 stroke patients per year.
The hospital has also become a regional center of endovascular thrombectomy (EVT)—mechanical clot removal. In 2015, clot retrieval was performed twice; then three times in 2016. By the end of September in 2018, 19 clot retrievals were recorded.
Information about stroke signs and prevention is now available at many community outlets, area health care providers and @MTStroke.
Courtesy Photo: Neurologist John Schaeffer, DO, Providence Montana