Rapid Stroke Care When Every Second Counts
It was a normal morning for Mike Rittel, 75, a Temecula retiree who worked 37 years in city government. His normal routine was to wake up and check the news on his laptop. “I couldn't get my computer to work,” Mike recalls. “I couldn’t understand what was wrong with it.”
When he went to talk to his wife, Stephanie, she could not understand what he was saying. “She told me I wasn’t making any sense,” Mike says. “In my head, I was making sense.” Stephanie was immediately worried and soon called 911.
Mike doesn’t remember much of the ambulance ride or what happened when he arrived at Southwest Healthcare Temecula Valley Hospital (TVH). “I was very confused,” Mike says. “I didn't feel any symptoms or any pain. I just didn't know what was going on.”
However, the highly skilled EMS team that cared for him in the ambulance knew exactly what was happening: Mike was having a stroke.
Ready and Waiting to Provide Lifesaving Treatment
As a Comprehensive Stroke Receiving Center for all of Riverside County and a designated Stroke Receiving Center for San Diego County, TVH was immediately notified by EMS that a patient had acute onset of aphasia (loss of speech).
“The very clear history by the emergency personnel allowed the team to quickly screen and clearly identify that indeed Mike was having an acute ischemic stroke,” says Robert J. Jackson, MD, Vascular Neurologist and Stroke Medical Director at the TVH Comprehensive Stroke Center.
Mike’s stroke scored a six on the NIH Stroke Scale (NIHSS), which assesses stroke severity. The score of six alerted the team at TVH that Mike’s stroke was a moderate one.
Jackson and his team quickly evaluated Mike and found he was a candidate for Tenecteplase (TNK) therapy. TNK is an intravenous drug that can break up blood clots that cause stroke when minutes matter. Door-to-needle time is the amount of time between when a patient arrives at the hospital to when TNK is administered.
“Given that we know a patient can lose up to 1.9 million neurons per minute during an acute stroke, the more rapid the evaluation and diagnosis, the faster that treatment can be initiated,” Dr. Jackson explains. “Mike was able to get the TNK injection within nine minutes, a record door-to-needle time at TVH,” Dr. Jackson says.
Right Back on His Feet
Mike spent about five days in recovery at TVH. “The morning of the stroke, people couldn’t understand me but the next morning people could,” he exclaims. “I was talking fine. It’s amazing.”
Mike was pleased with his first-ever inpatient hospital stay. “The care was very good and they answered all of my questions,” he recalls. “The nurses were all very caring and attentive.”
Thinking back to that fateful morning when he struggled to get his computer to work, Mike says: “I understand now that my brain wasn't working. I did not know the signs of stroke. I just always thought you would feel some kind of pain, but I didn’t feel any pain whatsoever.”
His stroke treatment was such a success that he has no lasting effects and did not even require rehabilitation.
“Mike had a complete return of his language and understanding capabilities,” says Dr. Jackson. “This highlights the collaboration of EMS, emergency department personnel, pharmacy, CT technicians and the neurology team at TVH to change the direction of a patient’s life.”
After he returned home, Mike did some research on that laptop and familiarized himself with stroke symptoms. He has a little advice: “I think especially once you get older you should read up on things that may happen to you, especially stroke,” he says. “Stroke can happen day or night. I didn’t know that much about it because I never read up on it.”
If you or a loved one are or may be experiencing symptoms of a stroke, such as sudden loss of balance, weakness, numbness, facial asymmetry or inability to speak, immediately call 911.