Possible Stroke? Think FAST and Call 911
On April 26, 2010, Arthur Heide—a 62-year-old disabled Vietnam veteran—was repairing his laptop, something he had done many times. This time he had problems getting the last screw in the slot. Arthur started to feel angry because he couldn't get the part screwed together. He remembers feeling very tired but it was nearly 9:30 p.m. and he usually felt tired by this time of the evening. Still, something was not right.
"Stroke doc" Aaron Heide, MD, has worked diligently to develop a regional stroke network in King County and throughout Washington State.
Mr. Heide noticed that the left side of his face felt numb. Vision in his left eye went purple. He felt flashes of pain in his head and eye. That's when he knew he was having a stroke. He struggled out of his study and managed to say the words "911 stroke" to his wife Dianne. Dianne immediately called 911. Then she called her stepson, Aaron Heide, a neurologist at Auburn Regional Medical Center. He is known as "the stroke doc."
By time the aid crew arrived at the Heides' home, Arthur could not move. In his words, he "was locked in his body." He remembers being conscious and being able to understand what was going on around him, but could do nothing. In the emergency room at Auburn Regional Medical Center, a brain scan showed that Arthur had suffered a severe stroke.
Arthur was diagnosed and treated in the emergency department by his son via telemedicine. A monitor and camera were wheeled up to Arthur's bed so that Aaron could speak to and watch his father's responses and monitor his vital signs.
Aaron asked his dad to raise his left arm but he raised his right arm instead. His father was about to lose the use of his entire left side, possibly forever. It was a challenge, Aaron said, to keep control of his emotions. He could not vary from the known standard of care. During the process of assessing his father's condition, preparations were made and vital signs were monitored, but all the emotions and fear had to wait until his dad was admitted to the intensive care ward.
Arthur was treated with a drug called tissue plasminogen activator (tPA). tPA is a "clot-busting drug" that is effective in treating ischemic stroke, caused by blood clots that block blood flow to the brain. tPA can significantly reduce the effects of stroke and reduce permanent disability if it is given to a person within the first 3½ to 4½ hours after the stoke symptoms first appear.
By 11:00 p.m., Arthur was able to talk. Four days later, he went home. Over time, he has completely recovered from a stroke that could have locked him in his body until he died.
In the words of Aaron Heide, "You don’t die from a stroke. You go to a nursing home where you stay until something else kills you. It could be pneumonia, a heart attack, or some kind of infection."
Had Arthur ignored his symptoms and gone to bed, he would not have recovered from his stroke. His advice: "Everyone knows when something is not right, but they ignore or override it. Tell somebody. Call 911."
Call 911…that was exactly what I did on Easter day. I was in the kitchen cooking dinner, chatting with my dad. I noticed he was slurring his words. Then my dad said, "I think I’m slurring my words." I walked into the family room and said, "I think you are, too, and the left side of your face is sagging." So I gave him the FAST test.
I had done the FAST test with my dad twice before in the past six months. Both times he passed. This time he failed.
Luckily my dad's stroke was a TIA (transient ischemic attack). It's a type of stroke that is very short term and does no known damage. Still, he took an ambulance ride to the hospital and spent most of the next day being tested for future stroke possibilities. Any time you think someone is having a stroke, think FAST and call 911.
The Central Region EMS & Trauma Care Council is a nonprofit agency that provides planning and ongoing evaluation of emergency medical services in King County. For more information, visit their website or e-mail executive director Merrili Owens.