Charles Sims – Stroke

Charles Sims did not want to go to the hospital. He’s lucky his wife, Rebecca, overruled him.

As he dozed in his recliner, Rebecca noticed his head was turned to one side and his eyes were glassy. She tried to wake him, but got no response. He could hear her asking him questions, and he tried to answer, but the words wouldn’t come out. Neither could he move his right arm or leg.

“I thought he was having a stroke,” Rebecca said. She was right. She called an ambulance, although her husband later would admit, “I didn’t want to go to the hospital. I thought I could shake it off.”

Had she not gotten him to Saint Mary’s Health Care so soon, Charles likely would have faced a lifetime of disability from a massive stroke, if he had survived. Getting to a hospital – particularly one experienced in treating stroke – soon after onset is essential to minimizing brain damage.

The ambulance crew rushed Sims to Saint Mary’s Health Care, recognized by the Joint Commission on hospital accreditation as a primary stroke center. The ambulance crew, as is customary in stroke cases, took him directly to the emergency department’s CT scanner. Although all the emergency physicians are trained in treating stroke, they summoned Dr. Muhammad Farooq, a neurologist, who was one floor away.

The CT scan verified Sims was suffering an ischemic stroke, the most common kind characterized by a clot blocking blood flow in the brain, as opposed to a hemorrhagic stroke, caused by bleeding on the brain. That made him a candidate for a drug called tPA (tissue plasminogen activator), which dissolves clots.

Standard practice has been to administer tPA within three hours of the first symptoms, since it was believed giving it much later could cause bleeding on the brain. Saint Mary’s, however, has been part of a study giving tPA up to four and a half hours after onset.

Sims was past the three hours, but within four and a half, so, with the patient’s consent, Farooq began giving him tPA intravenously. Within a couple of hours, Sims could move his right hand. By evening, he was sitting up and joking, and the following day, he walked to the bathroom. Weeks later, Sims returned to his job as a truck driver.

“It was kind of like it never happened,” he said, although he knows he must follow Farooq’s advice to lose weight, stop smoking and lower his blood pressure to avoid another stroke. “He (Farooq) actually seems like he cares,” Sims said. “It’s not like one of those things: take this pill and get on down the road.”

Farooq and Dr. Michael Olgren, medical director of the emergency and trauma department, serve on the hospital’s stroke committee, looking for ways to improve care and educating the public on preventing stroke, the third leading cause of death in the United States.

“The best way to treat a stroke,” Olgren said, “is not to have one.”