Nancy Edwards, MD, - Medical Director for the Tobey Hospital Stroke Program.

It’s ten o’clock at night and you’ve had a busy day.  You’re brushing your teeth to go to bed and you notice that you’re drooling a little out of the right side of your mouth.  You wipe it away and find that it feels a little numb… just like at the dentist.  But you haven’t been to the dentist.  You reach for the glass of rinse water and it slips from your hand.  You check yourself.  Your hand is numb and apparently weaker than it should be.  You don’t know what to think.  This has never happened before.  What should you do?

Call 911!

This could be a stroke and time is critical.  There are new therapies available to reverse the symptoms of stroke. Clinical trials have established that thrombolytic therapy such as tPA, a ‘clot-busting’ drug, is an effective treatment for acute “ischemic” stroke. The tPA therapy must be given within three-hours of the start of symptoms.

Every step in the process takes time; it takes about an hour for the hospital to gather all of the necessary lab tests and x-rays needed to determine if the therapy may be given.  That means that you must get to the hospital within two hours of the start of your symptoms.

That’s right!  Clot-busting medications aren’t just for heart attacks any more.  They can also be used to dissolve clots in blood vessels in the brain. There are other treatments for strokes that are not available at local hospitals but which can be arranged for at specialty hospitals.  They include administering clot-busting medications directly into arteries in the brain, removing blood clots with a coil and operating when there is a bleeding stroke.

Things to consider… You may think that you’re just tired and that you will feel better in the morning but waiting can mean many treatment options are no longer available to you.  You may think that you can drive yourself to the hospital but your newly discovered numbness and weakness mean that driving yourself is not a safe option.  You may think that a family member should drive you to the hospital but your symptoms could worsen and the driver would not be able to help you. Ambulances have medical personnel available to treat you en route to the hospital --- they can start IVs, check an EKG and begin the screening process for the clot-buster medication that you may be eligible to receive.  Ambulances can notify the hospital that you are on the way and give the hospital extra time to prepare for your arrival.

Symptoms

Symptoms of stroke can vary depending on the type of stroke and what area of the brain is involved.  Some strokes occur because an artery going to the brain is blocked.  Some strokes occur when a blood vessel ruptures and allows blood to escape into the brain or surrounding fluid.  Common symptoms of stroke include numbness and weakness of the face and limbs, loss of balance and coordination, and loss of speech.  Bleeding strokes can cause severe headache and vomiting.

Prevention

Prevention of stroke is very similar to prevention of heart attack.  To prevent strokes, don’t smoke, keep high blood pressure and diabetes under good control, take an aspirin a day to keep platelets from clumping together and keep cholesterol levels down.  If you have a heart rhythm problem called atrial fibrillation, contact your doctor about which prevention medications are right for you.  Never stop any of your medications or treatments without discussing with your doctor.

Primary Stroke Services

Charlton Memorial Hospital, St. Luke’s Hospital and Tobey Hospital have been designated by the Massachusetts Department of Public Health (DPH) as providers of Primary Stroke Services. The State’s designation assures that the Southcoast Hospitals Group emergency diagnostic and therapeutic services are provided by a multidisciplinary team and available 24 hours a day, seven days a week to patients presenting with symptoms of acute stroke. The greatest limitation to current stroke therapy is the time delay before patients seek treatment.  If you have symptoms of stroke, seek care immediately and call 911.

For more information about stroke care and prevention visit www.southcoast.org/stroke/ or contact the American Stroke Association at www.strokeassociation.org or 1-888-4-STROKE (888-478-7653).

Southcoast Health System

Southcoast Health System, a not-for-profit charitable organization, is a community based health delivery system with multiple access points, offering an integrated continuum of advanced health services throughout Southeastern Massachusetts and East Bay, Rhode Island. It includes Southcoast Hospitals Group, formed in 1996 from the merger of Charlton Memorial Hospital in Fall River, St. Luke's Hospital in New Bedford and Tobey Hospital in Wareham.

Southcoast has more than 40 ancillary facilities, including the Southcoast Health Van, home health care, hospice and infusion services, numerous outpatient medical services, an assisted living facility and a wellness center. For more information visit www.southcoast.org.

Southcoast is one of three community hospitals approved by the Massachusetts Department of Public Health to perform open heart surgery and primary angioplasty beginning in Spring 2002.

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