“When it comes to a stroke, BE FAST!” says Debbie Moser, RN, BSN, Coordinator of the Advanced Stroke Center of Northern Regional Hospital.
For Moser, “BE FAST” relates to the urgency of getting immediate medical attention at the first sign of a stroke … and also serves as an acronym for the major and most noticeable signs of a stroke: Balance (loss of balance), Eyes (vision loss), Face (an uneven smile), Arm (weakness in one arm), Speech (slurred speech), and Time (call 911 right away).
Northern’s nationally accredited Advanced Stroke Center serves as the first line of defense against strokes for the residents of Mount Airy and the greater Triad region. The Center is staffed, 24/7, by a team of clinical specialists who work rapidly and seamlessly to provide lifesaving therapy to patients who present with symptoms of a stroke – which occurs when blood to the brain is interrupted by a clot or a bleed in the brain.
Speed is paramount in responding to stroke, emphasizes Jason Edsall, MD, Chief Medical Officer of Northern Regional Hospital and Medical Director of the Stroke Center. “The sooner we provide appropriate treatment to a stroke patient, the less chance they will suffer significant or long-term neurological deficits,” he explains. “Our goal is to get patients to the functional status they had before the onset of symptoms.” To achieve that optimal outcome, it’s necessary to get patients to the hospital within an hour (or less) of when symptoms first appear.
Upon arrival to the Emergency Department, the Stroke Team’s physicians, nurses, and allied-health professionals meet the patient and whisk him or her to the Imaging Center for a CT head to determine the cause of the stroke and full nature of the emergency. Depending on the severity of symptoms and other clinical factors, patients may be given a highly effective clot-busting drug and admitted to the hospital or quickly transported to one of two comprehensive stroke centers in Winston-Salem for more extensive care.
Anyone, Anywhere, Any Time!
The Stroke Team at Northern is kept busy year-round – as strokes can happen to anyone, at any time, and in any place. Last year, the team treated 265 victims of stroke; this year, to date, they have treated more than 320 stroke patients.
“Like other hospitals, we are seeing an increase in the number of stroke patients – part of which is due to the aging of the population,” said Debbie Moser. “But we’re also seeing an uptick in the number of younger people.” While most strokes in younger people typically relate to lifestyle choices and undiagnosed or uncontrolled hypertension, she notes that the healthcare community has also begun to suspect and investigate a possible link between strokes and vaping.
Moser emphasizes that Northern Hospital Regional remains committed to aggressively pursuing community-outreach efforts to further educate people about the causes of stroke and the need for immediate medical attention at the first sign of a stroke. “Remember: BE FAST!,” she says. “Do not hesitate to get yourself, your relative, a friend, or even a stranger to the hospital once the symptoms of stroke appear.”
Stroke Survivors Share their Stories & Insights
Looking many years younger than her 81 years, Carol Hawks is a two-time stroke survivor who acknowledges and appreciates the rapid medical response she received at Northern Regional Hospital when she arrived there – both times – with symptoms of a stroke.
Carol calmly recounts the events leading up to her initial stroke, which occurred a little more than one year ago — on September 23, 2018. “It was a Sunday, a very beautiful day,” she recalls. “I had been to church and came home, then went outside with my five-year-old granddaughter to play hide-and-seek.”
After basking all afternoon in the warmth of the sun and her granddaughter’s giggles, Carol re-entered her house to find her husband Ray watching television. Deciding to get more comfortable before joining him, she went to change into her pajamas. “Suddenly, my right arm and hand got numb – and I told my husband something was wrong.”
Knowing that immediate attention was required, Ray drove his wife to Northern’s Emergency Department – where the Stroke Team specialists jumped into action. Following a quick physical exam, CT scan, and teleconference session with an off-site neurologist, Carol learned she had suffered a hemorrhagic stroke (or a “bleeder,” in the parlance of medical experts) – which occurs when an aneurysm in the brain bursts or a weakened blood vessel leaks blood. After being treated and stabilized, Carol was transferred to Novant Health, in Winston-Salem, for an overnight stay before returning home to begin rehabilitation therapy.
Her rehab progress was slow … but steady. “They had me riding bikes and climbing stairs – but I was 80 years old, so I’d say it was only a little bit helpful,” she laughs. For her, the most debilitating deficit was a partial loss of her sense of taste. While she can still distinguish between sweet, salty and sour, “the only thing I can really taste is a Kosher dill pickle,” she says.
Carol’s sense of humor and taste for adventure have always served her well – starting with her younger years when she met and married Ray, her husband of 64 years. During those early years, Carol worked in the Spencer’s Mill, operating a collarette machine that added binding to the pajamas, underwear, and bibs manufactured at the former textile plant. Carol also contributed her own home-cooked recipes – including a savory ‘Meatballs with Mushroom and Onion Gravy’ special — to the then-popular Spencer’s Cookbook (see page 75).
Together, Carol and Ray built a full and faith-based life, participating in church activities, working in a variety of jobs, and raising their children. Today, their reward is to settle back and simply enjoy the company of their five grandchildren, three step-grandchildren, three great-grandchildren. Although Carol jokes that she and Ray “never do anything together,” she knows that they both keep a close watch on each other.
That vigilant oversight was especially helpful during Carol’s second stroke episode – which happened almost one year to the day after her initial stroke. “It was September 15th of this year, and my husband had gone to bed and I was watching TV,” she recalls. “When I went to get up, my right leg just gave away – and I thought it had gone to sleep,” she said. Despite dragging her leg and foot behind her as she made her way to bed, Carol decided to just go to sleep. “I slept until about 3:30 or 4, and when I tried to get up, I couldn’t walk.” At that point, Carol nudged Ray – and they called their daughter, who shouted, “Get up, get up, get up – we only have so many minutes to get to the hospital!”
Carol’s doctors believe that her second stroke resulted from an errant piece of plaque that must have broken loose in her bloodstream. Carol’s high-blood pressure, which had been diagnosed previously with the advent of her earlier stroke, was also treated. “I’m beginning to get stronger,” she says appreciatively, adding that she feels better in the mornings than afternoons and evenings. “I do housework – the cooking, washing, and cleaning,” she adds, while noting that the family tradition of whipping-up a huge, family holiday meal has been passed on to her daughter.
Carol’s caution to others is to be aware that a stroke could strike anyone. “Most people think it will never happen to them, but it can,” she says. She also advises people to work closely with their doctor to monitor their blood pressure. Finally, for those who have had a stroke already and may be feeling anxious about having another, Carol suggests they share those feelings with their doctor so that, if needed, they may get medication to help quell their anxiety.
Thirty-eight years ago, love was in the air … Air Force, that is – when John and Barbara Steffy found themselves both stationed at Keesler Air Force Base in Biloxi, Mississippi. As their friendship turned to love, the young medic and nurse realized their lives would be forever changed … and forever linked together.
Over the next several decades, they lived in various states along the eastern seaboard – from New York to Florida – with Barbara re-entering civilian life to work as a nursing professional and John remaining in the military to serve as an air traffic controller. After John retired, the couple decided about six years ago to settle in Mount Airy, where Barbara’s mother resides and where the four-season climate permitted John to pursue his favorite outdoors activities, especially hiking.
This past summer, August 29th started out like every other day for the then-60-year-old John, whose typical health-related complaints echoed those of other seniors – namely, the expected aches and pains that come with aging and arthritis. Putting on his game face, John suited-up and headed to his favorite gym in Pilot Mountain to begin his regular work-out routine – starting with a 20-minute ‘ride’ on the stationary bike while listening to pulsating funk tunes. “I remember I was about five minutes into the bike, and I felt I couldn’t go anymore,” recalled John. “My right side went numb; I just couldn’t speak; and then my head phones fell off.” Fortunately, John’s distress was noticed by another gym patron, a local attorney, who raced to John’s side to stabilize him and call 911. “He stayed with me until the EMS guys arrived, about five minutes later,” says John, gratefully.
The EMS crew rushed him to Northern Regional Hospital, where the Stroke Team immediately activated their clinical protocols to quickly and accurately assess, diagnose, and treat John. After determining that John had sustained a stroke due to a blood clot in his cerebral artery, he was given the clot-busting drug TPA, and then stabilized and transferred to Novant Health in Winston-Salem.
“I remember feeling better during the ambulance ride,” says John, “and that the EMTs never left my side until after we got to the Emergency Room and they ran me straight to Interventional Radiology to have the clot removed.” John’s doctors successfully retrieved 90 to 95 percent of the clot; and concluded that his stroke had been caused by an undiagnosed heart condition called Atrial Fibrillation (or Afib), which is an irregular, and often rapid, heart rate that causes poor blood flow.
“John now has two issues: a prior stroke and a cardiac condition,” says Barbara, whose nursing knowledge and skills have been put to good use throughout her husband’s ongoing recovery. “I tell all our friends to get an EKG as part of their regular check-up!” she adds.
Following his discharge from the hospital, John attended rehabilitation sessions, including speech therapy. As he continues to improve, he estimates that about one-half of his overall physical strength has returned, along with a 50 percent restoration of the strength and functionality of his affected right arm. He has also dropped 50 pounds since his stroke, and continues to carefully manage his diet and food choices. “There’s no more junk food, and no more eating at night,” he says.
Now 61, John’s typical day involves getting up early to work-out a few hours at the Reeves Community Center; doing light chores in the afternoon; and, in the evening, relaxing at home or, on occasion, enjoying a night on the town at a sporting event, the community theater, or a restaurant. He admits he still feels a bit unsteady – which, he says, is his “new normal.”
To help prevent a stroke or better manage one’s recovery after a stroke, both John and Barbara suggest paying close attention to lifestyle and diet choices. They also recommend the use of an at-home, wireless EKG monitor to help people track their heart rate with their fingertips. John uses a portable ‘Kardia Mobile’ monitor – which has a large display screen to show users their BPM, heart rate and EKG wave pattern in real time.
They also encourage others to be willing to act quickly if and when they see someone struggling with the first signs of a stroke. John remains forever grateful to his own Good Samaritan – now a family friend – whose kindness, alertness and quick action helped save his life!
Emergency physician Dr. Jason Edsall simulates performing the NIH stroke scale assessment to determine if a patient has any deficits or effects from a possible stroke. Any patient presenting at Northern Regional Hospital with stroke like symptoms can expect this process when they come to the emergency room.