Every Minute Matters with Ischemic Stroke: Joe’s Story

Posted on Dec 4, 2012

Joe and June Rio

If Joe Rio had not taken a truck ride with his son Dino the morning of June 22, he probably would not be alive today.

“We were driving along and suddenly, my vision was blurry. Then I lost my speech. I couldn’t speak—even though I knew exactly what I wanted to say the words wouldn’t come out,” recounted Mr. Rio who was at work with Dino, delivering fire extinguishers.

“My son knew exactly what to do and drove as fast as he could to the Emergency Department at Sutter Delta Medical Center. Within minutes of arriving, the Emergency Department doctors and medical staff knew I was having a stroke.

“I was surrounded by a medical team who took care of me right away. They worked very quickly to save my life at Sutter Delta.”

When minutes matter

Fortunately, Mr. Rio and his son Dino were not far from the Sutter Delta ED the morning of his stroke. Mr. Rio, who is semiretired, was helping his son make a delivery for Contra Costa Fire Equipment, where Dino works installing and selling fire equipment.

“When we examined Mr. Rio in the ED, we knew his situation was very serious. Based on his symptoms, we suspected that he was having an ischemic stroke, which occurs when a blood clot causes a blockage in an artery that supplies blood to the brain,” noted emergency medicine physician Mary Fitzsimons, M.D.

When a clot blocks the flow of oxygen-rich blood, brain cells die within minutes. That’s why every second counts when a patient has a stroke because the longer the brain is left without oxygen, the greater the chance of brain damage and permanent disability.

“Our main concern was that the clot would lead to further weakening on the right side of his body or further speech and vision problems—or worse—if we didn’t act very quickly,” added Dr. Fitzsimons.

tPA (tissue plasminogen activator) is a medication used to treat ischemic stroke. Known as a “clot-busting medication,” tPA must be given to patients within a few hours after they experience their first symptoms of an ischemic stroke. Quick treatment not only reduces stroke complications but can greatly improve the chances of survival.

“We have a small ‘window of opportunity’ to give this medication, so time is of the essence. If too much time passes, the medication is not as effective and can even be dangerous: the risk of bleeding increases, and the patient can get worse,” explained Dr. Fitzsimons.

Even when given under the appropriate circumstances and time frame, tPA can still have serious risks, such as internal bleeding—not only in the brain, but in the intestines and other parts of the body as well.

“We needed to be timely, but we also had to be sure that giving Mr. Rio the medication would be appropriate for his situation, so a CT scan was necessary to confirm that he was having an ischemic stroke,” said Dr. Fitzsimons.

Clot-busting teamwork

To successfully treat Mr. Rio required not only the giving him the right medication at the right time, but a team effort.

From the time he arrived in the ED, Dr. Fitzsimons and our team of nurses and technologists rapidly examined him and quickly transported him to the CT scanner suite in our Radiology Department where medical imaging staff immediately performed a brain scan.

The scan results were rapidly reviewed by our radiologist who promptly discussed the results with Dr. Fitzsimons: Mr. Rio was having an ischemic stroke.

Dr. Fitzsimons determined that tPA was medically appropriate to give Mr. Rio, which the pharmacy quickly provided for injection into a vein in Mr. Rio’s arm. Once in his vein, the tPA flowed through Mr. Rio’s bloodstream to the clot to break it up, restoring blood to flow to his brain.

“After they gave me the shot of stroke medication to break up the clot, I began to feel better,” said Mr. Rio. “My speech returned little by little until I could talk normally. They were right on the ball—from the doctor treating me to the nurse writing down my symptoms. The minute I arrived at the ED, they took great care of me.”

Recovering in the ICU

Like most patients who receive tPA, Mr. Rio was admitted to the Intensive Care Unit (ICU) so that he could be closely monitored to make sure there was no evidence of bleeding, changes in blood pressure or worsening of stroke symptoms.

By the time he arrived at the ICU after leaving the ED, his speech had returned to normal and he had normal strength in his right arm.

“It was very rewarding for me to see Mr. Rio’s rapid response to the tPA, while he was still in the Emergency Department, and to learn that he did not suffer any complications from the tPA therapy,” added Dr. Fitzsimons. “It’s always a pleasure to be able to provide the type of care Mr. Rio received—with the team support I have at Sutter Delta—and to see such a wonderful outcome.”

Know the signs

The most important thing that Mr. Rio and his family did was to recognize the signs of a stroke and to come immediately to the Emergency Department.

“My son Dino is a volunteer fireman, so he could tell from my symptoms that something was wrong the morning I had my stroke,” recounted Mr. Rio. “When I tried to tell him something nothing would come out, and I could no longer see the street addresses for making our deliveries: My son looked at me and said, ‘I think you are having a stroke.’”

Approximately 795,000 people are affected by strokes each year, and strokes are the primary cause of disability in the U.S. Men are at a higher risk than women, and the likelihood of a stroke increases with age.

Call 911 immediately if you or a loved one suddenly experiences any of the following “FAST” ischemic stroke symptoms:

• F: FACE–Uneven smile, facial droop/numbness, vision disturbance and/or headaches
• A: ARM & LEG–Weakness, numbness, difficulty walking, dizziness
• S: SPEECH–Slurred, inappropriate words, mute
• T: TIME–Time is critical; CALL 911

If not caught early, a stroke in the brain can lead to paralysis, speech problems, pain, emotional difficulties, and problems with thinking, learning and remembering.

“Pay attention to your body and get to the hospital as fast as you can if you think you are having a stroke,” added Mr. Rio.

Always in the truck

“My son Dino wants me to drive with him in the truck now; he likes to take me with him so he can watch over me,” said Mr. Rio about life after his successful stroke treatment at Sutter Delta.

“I can do all that I did before I had the stroke, and I did not suffer any abnormalities to my body or limbs. I can enjoy my family—my wife, daughter and two sons—as well as fishing, wood working and just being able to work at my age.”

“I had great care at Sutter Delta. Everyone did such a great job. Thanks to all of you.”

Brought to you by Sutter Delta Medical Center

2 Comments

  1. I just wanted to acknowledge the ER staff for a job well done! It is good to know that Sutter Delta has such a caring staff. After reading this story about Mr. Rio, I can see why our ER is ranked in the top 5 percent!

    Our bouffants are off to you, from the OR!!
    Susan

    • Thank you Susan for the nice accolades, we will share with ER staff.

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