Making Major Strides in Stroke Care

 
Behind the scenes, a group of highly skilled, dedicated professionals are quietly ensuring world-class stroke care is available right here in South King County.
 
Through The Stroke Center, a program of the Washington Neurosciences Institute at Valley Medical Center in Renton, these leading clinicians represent all areas where caregivers and services could be involved to help a stroke patient: Washington Neuroscience Institute (WNI), the Emergency Department, Radiology, Critical Care Unit, Pharmacy, Laboratory, Nursing, Food Services and Rehabilitation.
 
“We want to make sure we consistently provide the best patient care available for every stroke patient, from diagnosis to full recovery, whatever that may be for the individual,” said Jacqui Sinatra, MPA, administrative director of the WNI.
 
Recent advances in stroke care at VMC include:
  • staff neurologists, neurosurgeons, emergency medicine physicians and nurses specially trained to care for patients who have experienced a stroke;
  • a dedicated, 15-bed neurology unit equipped with telemetry and seizure monitoring equipment, staffed by nurses with neuroscience and stroke-specific education requirements;
  • nursing swallow screen to prevent problems associated with difficulty swallowing (aspiration pneumonia, malnutrition, dehydration) and to improve quality of life for patients by restoring participation in meals;
  • the Rehab Services Stroke Club, one of the first of its kind, offers monthly support and education for stroke patients and their families;
  • stroke education and a stroke hotline for the community’s first responders.
What happens if I have a stroke?
At the first signs of a stroke, immediately call 911. You will be taken to the Emergency Department, where you will receive imaging to diagnose the stroke and determine its location, extent of damage, and because each stroke is unique, which medications or vascular interventions will best stabilize the stroke.
 
“As a designated Stroke Center, Valley Medical can provide the most aggressive, leading-edge treatments that simply aren’t always available elsewhere,” explained Dr. Cynthia Murphy, a vascular neurologist at WNI who specializes in stroke care.
 
“We then closely monitor you throughout your hospital stay to prevent further injury, such as DVT (deep vein thrombosis) and swallowing problems. We also provide stroke rehabilitation to help you regain lost functionality to the greatest extent possible. Once you’re discharged, we follow up with additional rehab services and support. Our goal is to do all we can to help you prevent another stroke in the future.”
 
What can be done to prevent a stroke in the first place?
“Plenty,” said Dr. Murphy. “Lifestyle management plays a huge role in our risk for stroke. We can greatly lower our vascular risk by not smoking, eating right, maintaining a healthy weight, getting regular exercise, and closely managing conditions and diseases such as high blood pressure, high cholesterol and diabetes.”
 
Warning Signs of Stroke or “Brain Attack”
Symptoms come on suddenly, but may come and go, get worse with time, or simply disappear altogether. This is known as a Transient Ischemic Attack or TIA. A TIA occurs when a blood clot temporarily blocks an artery, limiting blood flow, and therefore oxygen, to a part of the brain. TIAs generally last just a minute, and do not cause permanent injury. It is important to diagnose and treat TIAs to help reduce the risk of a major stroke later on.
 
Symptoms of a TIA or stroke are the same. Symptoms will vary, however, depending on what part of the brain is affected, and how much brain tissue is involved:
  • Impaired speech – may be slurred, or the person may articulate well but their words do not make sense;
  • Impaired vision – may lose peripheral (side) vision, or experience double vision or even blindness; (Alone, blurred vision is generally not a symptom of stroke)
  • Body numbness or weakness – may be mild or paralyzing; generally seen in the muscles of the face, or an arm and/or leg, on the same side of the body;
  • Headache – if present, will come on suddenly and be extremely severe;
  • Dizziness – may feel woozy or drunk;
  • Diminished coordination – may have difficulty walking or using hands for tasks;
  • Difficulty swallowing – may also have trouble controlling movements of the lips or tongue.
Minutes Matter!
If you suspect a stroke, CALL 911 IMMEDIATELY. As with heart attack, survival and recovery depend on fast diagnosis and treatment.
 
“We see people who wait hours, or worse, who don’t come in until the next day,” said Dr. Maurice Montag, medical director of Emergency Services at Valley Medical Center. “When I ask them why they didn’t come in right away, they tell me they had the same symptoms weeks earlier and they went away, so they chose to just wait and see. Well, that first episode was a TIA—a huge warning sign that a full-blown stroke is likely imminent.
 
“If you think there is even a remote chance you may be having a stroke, call 911. We want you in the ED—now.”
 
Did You Know?
One-third of all strokes occur during sleep, so symptoms may first be noticed upon awakening.
 

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