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FirstHealth of the Carolinas
The life-changing experience of stroke By Brenda Bouser
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Life-changing experience of stroke

A Joint Commission Stroke Center

There are only 18 Joint Commissioncertified Stroke Centers in North Carolina. One is at FirstHealth Moore Regional Hospital.

Moore Regional’s stroke care program earned the Joint Commission’s Gold Seal of Approval after an on-site review in February 2009. The designation, which is based on the American Stroke Association’s guidelines for stroke care, recognizes programs that have made exceptional efforts to ensure better outcomes for stroke patients.

According to neurologist and Stroke Center medical director Bruce Solomon, D.O., the Stroke Center designation acknowledges Moore Regional’s commitment to provide quality stroke care to the communities it serves.

“The Stroke Center designation has been the culmination of the hard work and commitment by our nursing staff, nursing administration and physicians who are involved with caring for people with stroke,” Dr. Solomon says. “This designation will assure our patients that the best possible care is being given to our patients. We are proud to be able to provide the service we would want for our own families.”

Moore Regional Hospital treated more than 470 stroke patients in 2008, providing care in the Emergency Department, the Medical/Neurology Intensive Care Unit, the Neurology Nursing unit and Rehabilitation Services with the support of almost every other department in the hospital.

The paramedics and EMTs of Moore County EMS and FirstHealth Regional EMS are also important members of the stroke care team.

“If you look at our continuum of care, you see that we provide everything that most stroke patients need,” says Joy Martin, R.N., the hospital’s stroke coordinator and chair of the Stroke Performance Improvement team. “Our patients can be confident in what we do here. We have protocols in place, they are followed, and we do them well.”

April 29, 2008, began as a typical Tuesday for Seven Lakes resident T. Ray Jackson. He was working as an EMT, as he is given to do, at the Seven Lakes EMS Squad when his leg began to ache. Because of a past history of blood clots, he approached the paramedics on duty and announced, “Ladies, we’re going to the hospital.”

Minutes later, he was in the Emergency Department at FirstHealth Moore Regional Hospital, where he was examined, found to be OK and released. Unfortunately, the story didn’t end there.

That evening, while watching the news, Jackson attempted to get out of his recliner and, as wife Joanne recalls, sort of slithered to the floor. She called 911, and he was once again on his way to the hospital.

Jackson, who recalls little about the next several days, had had a stroke. With the event, he joined more than 700,000 Americans who had a similar medical emergency last year.

All things considered, Jackson is relatively lucky. Except for a few speech and comprehension problems and the temporary loss of some peripheral vision, he has essentially recovered and now volunteers with the stroke program at Moore Regional. Many people aren’t nearly so fortunate. Although the number of stroke deaths fell by 14 percent between 1995 and 2005, stroke remains the third leading cause of death in the United States and THE leading cause of serious, long-term disability in adults.

Jackson had his own strength of will and the care he received at Moore Regional in his favor. “He got wonderful care,” says Joanne. “You couldn’t have asked for better care in either place (inpatient and outpatient).”

Jackson’s hospitalization, which included a brief stay in Inpatient Rehab, lasted only a few days. He followed that up with several weeks of outpatient speech and vision therapy, and now rides a stationary bike and walks with Joanne to improve his coordination.

A vocal advocate of improved services to stroke patients, Jackson also spends one day a week calling former stroke patients and/or their families about the care they received at Moore Regional.

“T. Ray approached us to help volunteer specifically with stroke patients,” says Joy Martin, R.N., the hospital’s stroke coordinator. “As a survivor, he strongly felt a desire to give back, so our need for discharge phone calls to be done for our stroke patients was a win-win for both of us. His insight into how we are doing with our stroke patients has been very helpful.”

When asked a few months ago to speak to some local nursing students, Jackson prepared several pages of text about his experience and what he has since learned. In that information, he explained the life-changing experience of stroke by comparing a stroke-affected brain to a filing system gone awry.

“I like to think of the brain as a large filing cabinet,” he said. “It stores a tremendous number of files of information about what has happened to the body over the years…When you are looking for a thought or an idea or a memory, you scan the filing cabinets and identify the correct drawer. Once you find the correct drawer, you can look through the files and select the one that is appropriate to the problem at hand. If that does not provide the necessary information, you put your brain back on scan and start again. The problem is when a stroke occurs, these file drawers are slammed shut and the needed information is not readily available.”

The warning signs of stroke:

  • Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause
  • If you’re with someone who may be having stroke symptoms, call 911 immediately.

Q. What is tPA, and how can it help someone who is having a stroke?

A. Tissue plasminogen activator (tPA) is known as a “clot-busting drug” because of its ability to dissolve blood clots. In 1996, the U.S. Food and Drug Administration approved its use for the treatment of ischemic strokes (those caused by clots) in the first three hours after the start of stroke symptoms. Because of the narrow time element involved, it is very important for people who think they are having a stroke to seek immediate help by calling 911.

If given properly, tPA can greatly reduce the effects of stroke and reduce permanent disability— but ONLY if given within the appropriate timeframe. Because a risk of bleeding is involved, tPA administration is considered a complex procedure and is done through an IV line in the arm by hospital personnel.