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Video: Man walks away from stroke thanks to fast coordinated care

Posted on May. 15, 2013 ( comments)

During a stroke, the longer that blood flow is interrupted, the more brain cells die.

Ken Smith’s stroke happened without warning.

It was 4:30 a.m. on Halloween morning and the 49-year-old was readying for work at the Milton restaurant he manages. One moment he was stepping into the shower. The next he was lying on the floor of his bathroom and unable to speak.

“I forced myself to stand up – I don’t know how long I was down there,” Smith recalls. “I remember putting my left hand on the door knob and trying to push the door open. My wife started calling for me and I collapsed into her arms.”

He remembers what happened next only in snippets: Watching his wife struggle to dial 9-1-1 on the new cell phones they’d just bought, hearing her accidentally call his daughter; shivering as he rolled down the hall of the Emergency Department at MultiCare Good Samaritan Hospital in Puyallup.

“My mind thought I was headed to my death,” he says.

But the South Hill man says his life was saved by the urgent response to his stroke, followed by surgery at MultiCare Tacoma General Hospital.

“It was unbelievable,” he says. “Everything went so fast.”

Rapid response

Ken Smith

Smith's first stop was the Emergency Department at MultiCare Good Samaritan Hospital, where Dr. Blake Gendron and staff members set a hospital record for "door-to-drug" time -- 70 minutes to run tests, make a diagnosis, and administer tPA, a clot-busting medicine.

Then Smith was rushed to MultiCare Tacoma General Hospital for surgery. Dr. Alison Nohara, the endovascular interventional neuroradiologist who performed the procedure on Smith, says that speed is by design. 

“You want to treat stroke patients as soon as possible,” she says.

A stroke happens when a blood clot blocks an artery or a blood vessel breaks stopping blood flow to the brain. The longer that blood flow is interrupted, the more brain cells die and the more damage can occur.

Nohara and Dr. Brian Kott, the South Sound's first endovascular interventional neuroradiologist and the medical director of MultiCare’s stroke program, have focused on creating a seamless, coordinated response to stroke patients – aimed at saving lives and minimizing injury.

The Emergency Department physicians contact the endovascular interventional neuroradiologist as soon as they recognize a patient is having stroke symptoms. Nohara says she’s often notified even before the patient has a CT scan, which the hospital aims to complete within 30 minutes of a stroke patient’s arrival.

“We want to interpret those scans so that we can make decisions as soon as we possibly can,” Nohara says.

Nohara and the neurointerventional team were waiting for Smith at Tacoma General when he arrived from Good Samaritan. The doctor could see from the CT scan that medication wouldn’t be enough to clear the clot – in fact, Smith’s stroke was so severe that some physicians may have chosen not to proceed with the clot removal procedure.

“We’re an aggressive stroke center,” Nohara says. “But we’re appropriately aggressive because we want patients to have the best possible chance of returning to normal life.”

Smith’s procedure stretched past two hours. Afterward Nohara told the family that though she’d done everything she could, they wouldn't know whether it worked until Smith woke up.

An amazing recovery

When Nohara walked into Smith’s hospital room the following morning, she was astonished. Smith was sitting up in his bed, talking and eating breakfast.

“I think I’m supposed to thank you for saving my life,” he said.

Nohara teared up. She called her husband later that morning.

“I know why I came to work yesterday,” she told him.

Smith left the hospital two days later. His right arm and hand were completely numb after the stroke, but he’s worked hard to regain some of that mobility through physical therapy, exercises and even computer games at home. He forces himself to button his shirt with his right hand – even if it takes 15 minutes.

He’s had no other lasting effects from his stroke.

"I just saw Mr. Smith in clinic yesterday, and it reminds me why I love my job,” Dr. Nohara said recently. “Also makes you appreciate every day, you never know what will happen.” 

The experience left Smith appreciative of everyone who helped him, including the team of doctors, nurses and therapists.

Smith says it also made him grateful for his life and loved ones. As Christmas approached last year, Smith says his friends and family asked him the usual questions about what he wanted in the way of gifts.

“I told them I don’t need anything,” he says. “I already have everything I need.”

A comprehensive approach to stroke care includes 24/7 neurointerventional radiology capabilities with physicians, nurses and technologists acting as a team.

MultiCare Tacoma General Hospital has been recognized as a Primary Stroke Center by The Joint Commission and also is categorized as a Level 1 (Comprehensive) Stroke Center by Washington State Department of Health. Tacoma General has been awarded American Heart Association/American Stroke Association's Get With The Guidelines®–Stroke Gold Plus Performance Achievement Award.

MultiCare Good Samaritan Hospital is categorized as a Level 3 Stroke Center by Washington State Department of Health and is a participating hospital with American Heart Association/American Stroke Association's Get With The Guidelines®–Stroke (GWTG–Stroke) program.

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