June 25, 2008 > Quick Response Gives Stroke Patient a 'Second Chance'
Quick Response Gives Stroke Patient a 'Second Chance'
On February 15, 2008, Nayan Parikh visited Washington Hospital for a routine angiogram to look for blockages in his arteries. The procedure went well, and a nurse escorted him to the hospital's Outpatient Surgery Center to recover before returning home. After checking him in, the nurse returned to say goodbye, only to discover that the right side of Parikh's face was drooping, and he was unable to speak. He was having a stroke.
"The nurse noticed that my right side was numbing down," he recalls. "She asked me to lift up my right hand. I couldn't. She asked me to lift up my right foot, and I couldn't."
Acting quickly, the nurse summoned the team from the Stroke Program at Washington Hospital as well as Parikh's cardiologist Dr. Rohit Sehgal, who called neurologist Dr. Ravinder Kahlon.
"I knew something was drastically wrong," says Parikh. "I thought to myself, 'Is this the end of my life?' And then I asked for God's blessings. Within minutes, the stroke team was there to save my life and give me a second chance."
"We took the patient directly to have a CT scan of the brain," says Stroke Program Coordinator Doug Van Houten, R.N. "The scan reading showed that there was no hemorrhage - or bleeding in the brain - so we were sure it was an acute ischemic stroke caused by a blood clot. We took Mr. Parikh to ICU (Intensive Care Unit) immediately, and with the very good help of three ICU nurses, I got him ready for an intravenous drug called tissue plasminogen activator - tPA - that is used to dissolve blood clots."
Van Houten raced to the hospital Pharmacy to retrieve the medication and back to the ICU. In less than an hour from the time Parikh was last seen as "normal," the tPA IV drip was started. About 20 minutes after administration of the drug, he started to move his right arm and leg and could say a few words. Within 10 more minutes, he was back to normal.
"The entire staff was marvelous," says Parikh, a 54-year-old quality engineer in the semi-conductor industry. "Dr. Sehgal did not move from my side while they were treating me. My beautiful wife Ulka, who is a clinical scientist and knows a lot about strokes, was with me for the entire time I was in the hospital, day and night. I was able to leave the hospital after a couple of days, and I went back to work after only two weeks."
"This incident just goes to show that strokes can happen anywhere - even when you're already in the hospital," Van Houten notes. "We have spent a lot of time educating the nurses on the hospital staff about the signs of stroke and what to do. That training paid off with the quick response by Parikh's nurse. Not all cases have such great outcomes, but it is clear that the quicker you can start tPA treatment, the better the patient will do."
According to the American Heart Association (AHA), stroke is the third leading cause of death in the United States, and strokes cause more serious long-term disabilities than any other disease.
Strokes happen when the blood flow to the brain stops. There are two basic kinds of stroke:
* Ischemic strokes - which are far more common - are caused by a blood clot that blocks a blood vessel in the brain.
* Hemorrhagic strokes are caused by a blood vessel that breaks and bleeds into the brain.
"It's important to quickly determine which type of stroke a patient is having because using tPA in a patient suffering a hemorrhagic stroke would increase the bleeding and worsen the stroke," Van Houten explains. "For an ischemic stroke, though, administering tPA quickly - especially within the first three hours of the first stroke symptoms - can dramatically help limit stroke damage and disability."
Symptoms of a stroke can include:
* Sudden numbness or weakness of the face, arm or leg - especially on one side of the body.
* Sudden confusion or trouble speaking or understanding speech.
* Sudden trouble seeing in one or both eyes.
* Sudden dizziness, trouble walking, loss of balance or coordination.
* Sudden severe headache with no known cause.
Parikh's stroke experience has made him more aware of the importance of stroke prevention and recognizing the signs of stroke. It also has spurred him to volunteer to educate others about stroke prevention and treatment.
"My stroke changed the way I think about life," he says. "I am a Hindu, and for me, this was a 'rebirth' that affirmed my faith and made me want to give back to others. I use the word 'reciprocate.' I love that word. It says everything: If someone has given to you, you need to give back 100 percent, which is why I am now an advocate for paying attention to your health and your doctors' advice."
Parikh's own advice for others includes following a proper diet, getting plenty of exercise and taking medications to prevent cardiovascular emergencies such as strokes if your physician has prescribed them. "Don't take a chance with your health by trying home remedies - they don't prevent a stroke," he cautions. "If you think you are at risk for a stroke, consult a specialized doctor and follow his or her advice. And, if you or someone you love is experiencing the symptoms of a stroke, call 911!"
For more information about the Stroke Program at Washington Hospital, or to schedule a consultation, please call (510) 745-6480.
Stroke Education Series
Join Dr. Ravinder Kahlon and Doug Van Houten, R.N., at the next Stroke Education Series lecture on Tuesday, July 1. Dr. Kahlon will talk about stroke risk factors and Van Houten will cover stroke rehabilitation. The free seminar will take place from 6 to 8 p.m. at the Conrad E. Anderson, M.D., Auditorium located at 2500 Mowry Avenue (Washington West) in Fremont.