So You Think You Might Be Having a Stroke…….

It’s that call you never think about and never want to get!  The phone rings, and your daughter tells you that your husband has just had a stroke!! Jack left Panama the 12th of July for a job interview in Orlando.  When the phone rang, I thought it was his usual morning call until I saw my daughter’s cell phone number.  She was calling from an emergency room to tell me that Jack had just suffered a stroke.  As it turned out and luckily for all of us, Jack happened to have the stroke in just the right place.   My daughter immediately recognized it as a stroke; 911 responded within 5minutes; and he was at a stroke center within 10 minutes.  In a stroke situation, EMS does not bother with IV’s, EKG’s, etc.  They grab the victim and go!  The important thing is to get the stroke victim to a stroke team ASAP.  Stroke center facilities are staffed by telemetry doctors from all over the state for specific treatment advice.

strokeWhen a stroke victim comes into the facility, the first thing to be determined is whether the stroke has been caused from a clot or from a hemorrhage, because the type of treatment hinges on the cause of the stroke.  Had Jack’s been caused by a hemorrhage, they would then have sent him to another hospital.  But a CT scan showed a clot.  TPA (Tissue Plasminogen Activator) was administered, and those who have seen Jack since his return to Panama, know the maximum recovery was achieved!

Soon after Jack’s stroke, I went to the San Fernando Clinic here in Coronado to check on the availability of TPA locally.   Presently, they DO NOThave TPA onsite; however, it is available in the city.  How unfortunate and disappointing for all of us who are living here in the beach communities!  For our well-being, we need to have TPA available here in Coronado, not hours away!  This subject has been discussed in length at our CSA (Coronado Social Association) meetings.  As members of this community where we have many retired and elderly people, we need to have TPA available as well as a person, either at the clinic or on call, who is able to do CT scans at any hour of the day or night.  We all need to make our wishes known and work together to accomplish this.   As you are continuing to read this article, please post a comment asking San Fernando Clinic to carry the TPA and to have a person available to do CT scans when needed.

TPA– Tissue Plasminogen Activator is the only drug approved by the FDA for acute treatment of ischemic stroke.  The drug costs approximately $2216- $2750 per dose.  Compare this price with the cost of recovering a stroke patient, and you can see that it is worth every cent. BUT for a stroke victim, TPA must be administered within a 3-hour window of when the stroke first occurs.  And, it must be preceded by a CT scan to determine whether the stroke was caused by a clot or by a hemorrhage. Now, let’s look at the potential timeframe for us who live here in the Coronado area:  (1) You think you’re having a stroke, maybe, (2) so you go to clinic for an exam, stabilization, etc.  (3) If they agree, (4) they send for, and wait for, an ambulance, (5) and then it is at least 1 ½ hours to town.  Most people who are having a stroke do not have this amount of time.

We all need to take responsibility for our own well-being and that of our loved ones; and we need to be able to recognize the signs of a stroke.  If you are with someone whom you think might be having a stroke, there are three simple tests which you can apply:

1.       Have the person smile and be sure it is symmetrical.

2.       Have the person raise both hands above his/her head

3.       Have him/her repeat a simple sentence.

If the person is unable to perform these functions, it’s time to get professional help.  However, if it happens that someone close to you is showing signs of a stroke, but things are not really going according to plan as far as treatment is concerned, there is something you can do.  Believe it or not, now we come to the Irish Coffee.  Something I am sure you did not anticipate seeing in this article; however, it can save someone’s life!!   There is another new drug out, not being used as much as TPA but sometimes along with TPA, called caffeinol.   And, my guess is that you don’t have any of that on hand in your medicine cabinet!  So all you need to do is to mix up 2 cups strong black coffee, 1 tablespoon sugar, and 2 ounces Irish whiskey.  However, just be sure your patient can swallow.  As for me, I’d force it down Jack; we can always cure the pneumonia later.  Not having TPA at the clinic, I think I would give Jack the Irish coffee, have one myself, and call one of our Mario Andretti friends to get us to the city.

One more important thing to always remember, very new information:  If someone is having a stroke or heart attack, DO NOT lay the person down.  Sit him up, and if you can’t get him in a sitting position, lay him on his RIGHT side.  This helps with arterial circulation.  And, please don’t forget you can call 911 for accidents and medical emergencies.

Most importantly, please have your physicals regularly!  Jack would never go, and it would have taken a simple exam to discover his carotids were blocked.  Just stop putting it off and take a day to visit your physician.

In addition, get your papers in order.  Put them in an envelope and keep them handy.   Send copies to your attorney and/or family.  These should include your pertinent medical history, allergies, medicines you are taking, an advanced directive which should include your living will and DNR decisions, and a durable power of attorney for health care.  Also, keep copies of insurance policies, wills, retirement plans, deeds and mortgages, registrations and titles, and a family contact list.  Don’t put these things off!  Believe me, I know it is easier to have them and be ready for an emergency rather than to try to pull them all together once the damage is done.

And, very importantly, have good friends.  I would never have gotten through this without our friends.  If you are new and haven’t made a lot of friends yet, come to our CSA meetings and meet members of the community and form new friendships.  CSA meets the 1st Wednesday of each month, 10:00 am at Rincon del Chef.   CSA will also get together a list of all the info you should have and may need and send it out to our members.

And, DON’T FORGET!!!  Before going on to the next article, please post a comment asking San Fernando to carry TPA at the clinic and to have a person always available to do CT scans.  And, did I tell you???  TPA is also administered for a myocardial infarction…….pretty good stuff to have around, isn’t it?????