Rapid response: Time is critical for stroke sufferers like Jan Elliott

This labeled  illustration features two comparative views illustrating the different appearance between hemorrhagic vs. ischemic stroke. (Nucleus Medical Art, Inc.)

This labeled illustration features two comparative views illustrating the different appearance between hemorrhagic vs. ischemic stroke. (Nucleus Medical Art, Inc.)

Jan Elliott was on the tennis court when she had a stroke.

That was eight years ago, when she was 65. She still remembers how her head ached. Simply put, it was “excruciating,” easily the most intense pain she’d ever experienced — and that includes the pain of giving birth to two children.

Jan asked her fellow players to find her husband, Jay, who was somewhere else on the tennis court. When Jay saw his wife, he knew something was seriously amiss. She was cold and clammy to the touch. She needed to go the hospital, and he felt he could make it there faster than an ambulance.

“I didn’t even wait,” Jay recalled.

That kind of speed may have helped save Jan’s life. By the time the Bonita Springs residents arrived at North Collier Hospital, Jan was unable to get out of the couple’s car. She’d suffered a hemorrhage in her brain, the same sort of crisis experienced by Poison front man Bret Michaels in April.

Michaels and Jan Elliott recovered from their strokes. But veteran actress Rue McClanahan was not so fortunate; she suffered a brain hemorrhage earlier this month and died at 76.

Recently, Michaels and McClanahan have brought stroke into the headlines. But stroke is always an issue in the United States: It’s the country’s third leading cause of death and the leading cause of disability, said Robin McCarl-Galbavy, a registered nurse and the director of the surgical microsystem at Naples Community Hospital.

In treating a stroke, time is of the essence, she explained.

“Just as in having a heart attack, time is brain in having a brain attack,” she said.

To help recognize signs of a stroke, the hospital suggests using an acronym — FAST.

F stands for face; if someone has difficulty smiling or their mouth droops, it’s a possibly sign. A means arms, as someone suffering a stroke often experiences problems raising their arms or keeping them raised. Also, numbness in the arms is an indicator. S refers to speech. Ask the person to repeat a few basic words, McCarl-Galbavy said. If they cannot, or if the words are garbled, it’s another stroke sign.

Once again, the acronym’s last letter represents time. When a patient arrives at the hospital with symptoms of what might be a stroke, the hospital tries to observe a one-hour timeline with regards to treatment, McCarl-Galbavy said.

An ischemic stroke, where blood is cut off the brain because of a clot, can seem to be happening very slowly. A person’s hand may feel tingly, and there may be few or no other symptoms. But if the person dismisses the signs, the stroke will worsen, leaving the sufferer unconscious.

A hemorrhage, by contrast, can be a dramatic event. Regardless of which occurs, for every minute a stroke goes untreated, as many as 1.9 million neurons are lost, McCarl-Galbavy said.

“Those are the signals that tell your body to walk and talk and move muscles,” she said.

In an ischemic stroke, it’s sometimes possible to remove the clot with a wire coil or administer clot-busting drugs. Hemorrhages may be operated on. In Jan Elliott’s case, surgery was the course of action. After arriving at North Collier Hospital, the attending doctor immediately transferred her to Naples Community Hospital.

The prognosis wasn’t good: Jay was told that in a stroke such as Jan’s, only 50 percent of patients even survived to make it the hospital. After than, only 20 percent were expected to survive the brain surgery.

Jan’s doctor gently encouraged Jay to reach out their family.

“That just broke me right up,” Jay said. “He said go call your children if you can get them here.”

Jan’s surgery took four hours, and was followed up by 20 days in intensive care and another surgery to relieve fluid on her brain. Jay was diligent about recording everything that happened for family and friends, writing emails and giving updates. He still has all those messages, bound together in a white folder.

Jan no recollection of any of it. In some ways, she began to recover quickly — the stroke occurred Dec. 23, and by July, she was back on the tennis court — but she lagged behind in others. Mentally, the setback was great: In rehab, the therapist would ask her to identify a wristwatch, and she would say it was a book.

“I didn’t realize how badly she was,” Jay said.

She attended outpatient rehabilitation for one year, the full amount of time allowed by Medicare. But his wife hadn’t healed, Jay said. Her short-term memory was destroyed. Around the house, they played memory games to help it improve. Notes became an invaluable way of preserving small, daily details, such as who had called and when.

“He was the best doctor I could have had,” Jan said of her husband.

Over time, her ability to remember returned. Her sense of smell, however, never did.

“Which is good and bad,” Jan joked.

Still, it’s minor sacrifice.

“I got lucky,” she said.

“You didn’t have much time,” her husband agreed.

© 2010 marconews.com. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

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