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Halifax Health offers new advanced stroke treatment
News-Journal - 1/5/2019
Jan. 05--DAYTONA BEACH -- At 12:10 a.m. on Nov. 28, William Bennett, 75, rolled out of bed and fell to the floor.
"He took the sheet with him and didn't try to stop himself," said his wife, Mary Bennett, with tears in her eyes. "He didn't answer when I asked, 'Are you okay?'"
She couldn't pull him up off the floor. His left arm was limp and his face had begun to droop. Against her husband's wishes, she called 9-1-1.
By 12:25 a.m., paramedics had arrived at the couple's condo in Daytona Beach and a stroke alert had been issued to Halifax Health Medical Center.
At 12:45 a.m., Bennett was at the the hospital where a team of seven doctors were waiting for him.
"I had seven V.I.P doctors," Bennett said with a chuckle. "I kept saying, 'I haven't had any stroke.'"
A CT scan was done on his brain, which revealed Bennett had not one, not two, but three blood clots in his brain. Since he was sleeping when the stroke occurred, his doctors ran his scans through a new software Halifax Health started using in September called RAPID that identifies which parts of the brain have died and which parts can still be saved if the blood clots are removed.
The RAPID software allows doctors to determine if they will be able to do treatment after the six-hour window, the traditional amount of time medical professionals have to treat a stroke before the patient is considered lost. This is crucial for patients who have strokes in their sleep or when they are alone and the time of the stroke is unknown.
"Studies conducted this year have determined that time is not what's important, but if the brain tissue is alive or dead," said Dr. Alireza Bozorgmanesh, interventional radiologist at Halifax Health. "With this software, in just two minutes we know what sections of the brain are salvageable."
Bozorgmanesh said 40 percent of people who have strokes are uncertain of the time it occurred. When the scans on Bennett's brain came back, they showed a lot of green which Bozorgmanesh said means the brain tissue is still alive and can be saved by removing the clots.
At 2:10 a.m., Bennett was finally convinced that he was having a stroke. He agreed to treatment and doctors immediately gave him a shot of TPA, a medication that breaks down newly formed clots.
"When I told her to give me the shot I said a prayer and told God that I'm not ready to go yet," Bennett said. "I want to see my wife a few more times, I want to watch the sunrise, and I want to go hunting again."
The problem with TPA is it does not break down old blood clots that have made their way up to the brain, which means it can't be used to treat every stroke patient. For Bennett, the medication was not breaking down his clots.
"If patients go to a primary stroke center, (a TPA injection) this is the only type of treatment they will receive unless they are transferred to another hospital," Bozorgmanesh said. "This medicine can not be given after three hours, so if the patient doesn't know when they had the stroke they may not be offered the treatment."
Halifax Health has become certified as a "comprehensive" stroke center which allows them to offer treatments beyond the TPA medication. This treatment includes the RAPID testing as well as stroke procedures that remove the clots. They are the only hospital in Volusia and Flagler counties that is a comprehensive stroke center.
"This is the difference between being in a nursing home and bound to a wheel chair or just having a minor limp and still being a viable person in society," said Dee Gillet, stroke navigator at Halifax Health.
At 3 a.m. Bennett underwent surgery to remove the three clots. Doctors used a tool called React, a catheter that snakes up to the brain, restores blood flow by breaking through the middle of the clot and then sucks the clot out of the brain.
"This is a real game changer in my opinion," said Dr. Scott Klioze, interventional radiologist at Halifax Health. "It sucks the clot out of the body in just 90 seconds."
By 4 a.m. Bennett was in recovery, less than four hours after his wife woke up to him crashing to the floor.
"Once I saw him move is arm and his leg I was relieved," said Mary Bennett. "I didn't want to see him paralyzed. I truly believe we witnessed one of God's miracles."
According to Klioze, stroke is the fifth leading cause of death in the United States and the No. 1 cause of disability.
"Someone has a stroke every 40 seconds," Klioze said. "It costs 75-to-80 billion dollars each year for stroke treatment, and that includes all the care that comes after the stroke like therapy, nursing home care and medication."
Klioze said the implementation of more comprehensive stroke centers and the use of RAPID will help to decrease the amount of people who need prolonged care after having a stroke.
"If you are a 30 minutes difference from a comprehensive stroke center, go there instead of a primary stroke center," Klioze said. "It will save valuable time and you have a better chance at getting back to a normal life."
Symptoms of stroke include one side of the face drooping, slurred or strange speech, numbness or weakness in the face, arm or leg especially on one side of the body, confusion, trouble seeing, problems walking or standing, dizziness and a severe headache that comes on for no reason.
Klioze said strokes present themselves differently in each person depending on which side of the brain is affected. If the left brain is affected then the patient's speech will be slurred. For Bennett, the right side of his brain was affected so he was still able to communicate with his wife and doctors.
Bennett was released from the hospital the following Friday, just two day's after he'd been admitted for a stroke. Three weeks later, he's almost back to normal.
"I had a slight limp and I'm tired all the time," Bennett said. "Otherwise I'm fine. I want to know when I can drive again."
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