The stroke folks have a new acronym: Be Fast. To celebrate it one of the local hospitals had a run walk to raise money for stroke awareness. As the Lady de Gloves is a stoke survivor we were sure to go. She got a spiffy red shirt while MWG was stuck with a bland grey one.
Interestingly, there seems to be a minor dispute over the meaning of the last letter. At our walk, T stood for Terrible headache while the site above has a different T, time:
Balance – Is there a sudden loss of balance or coordination?
Eyes – Is there sudden blurred or double vision or sudden, persistent vision trouble?
Face – Ask the person to smile. Is one or both sides of the face drooping?
Arms – Ask the person to raise both arms. Does one side drift downward? Is there weakness or numbness on one side?
Speech – Does the person have slurred or garbled speech? Can he/she repeat simple phrases?
Time – Call 911 for immediate medical attention if you notice one or more of these signs. Also, take note of when symptoms began.
We like Terrible headache because Be Fast seems to make the time message clear. Either way, if you are concerned about the possibility of a stroke time is of the essence. The main reasons is tPA:
We treat ischemic stroke with a clot-busting drug called tissue plasminogen activator (tPA). The drug dissolves the clot [you might think of it as extra strength blood thinner], and blood flow to the affected part of the brain improves. If tPA is given within three hours of an ischemic stroke, the patient has a much better chance of a full recovery. Unfortunately, too many stroke victims don’t make it to the hospital in time for tPA treatment. [Emphasis added].
The Lady de Gloves was one of those folks from paralyzed on one side to a full recovery with tPA in about an hour. It can be a miracle drug but the time window is small so Be Fast.
We were surprised to see an Instapundit link to the continuing debate over tissue plasminogen activator (TPA) in the NYT. Big organizations have made their decision:
Stroke treatment guidelines issued by the American Heart Association and the American Stroke Association strongly endorse T.P.A. for patients after they’ve been properly evaluated. But treatment must start within three hours (in some cases, four-and-a-half hours) of the stroke’s onset, and the sooner, the better. [Emphasis added]
But individual doctors have dissented. We are about individual rights so we have some sympathy for those doctors. And TPA only works for certain types of strokes so the properly evaluated in the quote above is critical. The NYT quotes an example of the dissenters:
At Sierra Vista Regional Medical Center in San Luis Obispo, Calif., Dr. Scott Bisheff, an emergency medical physician, tells patients there is great uncertainty about whether T.P.A. helps or harms. If it caused bleeding in a patient’s brain, the consequences could be catastrophic.
We think the last sentence is stating the obvious but the first is just wrong. We have a sample of one, Lady deGloves. About 15 years ago she suffered a stroke. We got her to the hospital in a timely fashion where she was properly evaluated first by the emergency room physicians and then by a neurologist. The neurologist came to ask us if we should try TPA. They called it tPA then. Our non-physician analysis was that she was 100% incapacitated on her left side with severe speech problems. When then poked her with needles we jumped but she did not notice them. The doctor said there were risks but TPA might help. We thought what does she have to lose and approved the treatment. They administered the treatment and told us that she would be moved from the emergency room to intensive care. By the time we met her there our analysis was that she was 00.01% incapacitated. The next day the physical therapist came in and said there was no need for her services. The emergency room physicians came to see the miracle. She needed surgery later to eliminate the arterial blockage. Now, 15 years later and without any problems, it is beyond obvious that we made the right choice.
We know the dangers of small sample size. We know that there are risks associated with TPA. We know you need to get to the hospital FAST
Sidebar: FAST stands for Face drooping, Arm weakness, and Speech difficulties. The T is for time. If you are too late you can’t use TPA. End Sidebar.
when a stoke happens. Don’t wait or your options are limited. If they offer TPA after we would suggest that you take the risk.