By Angela Hatton
http://stream.publicbroadcasting.net/production/mp3/wkms/local-wkms-948937.mp3
Paducah, KY – A stroke can devastate a person's life. Stroke is the fourth leading cause of death in the United States. In 2005, it was the fifth leading cause of death in Kentucky. The 51 percent in Kentucky who survive have the chance of lifelong paralysis. When a stroke hits, the key is response. As Angela Hatton reports, recognizing symptoms may save more than a person's life.
Jerry Beyer was having a relaxing Friday evening at his Paducah home. He and his fianc e Sharon Carpenter were sitting together in the den when she noticed something was wrong.
"She noticed that my head was drooped down on my chest. She went over and spoke to me and at that point noticed that my speech was slurred."
Then Carpenter walked Beyer to the bedroom. He was dragging his right leg. Carpenter knew Beyer had a history of high cholesterol, and heart disease. She asked him what he thought was happening.
"And I told her, or had presence of mind to tell I thought I was having a TIA, that is a Transient Ischemic Attack, meaning a mini-stroke per se."
An ambulance took Beyer to the Emergency Room at Western Baptist Hospital. The staff knew a stroke victim was incoming, and they were ready for him. Beyer went through a battery of tests, including an MRI and a CT scan before the medical team determined he was eligible for a drug called tPA, or tissue plasminogen activator. It's a clost-busting drug, which can reduce or eliminate the effects of a stroke. The catch is it must be administered within three hours after the first symptoms.
"By the time that you can get all the clinical tests ran, I think they were actually down to between twelve to fourteen minutes in that three hour time to be able to give the medication."
Beyer doesn't remember any of this. The story he tells comes via the family who were with him at the hospital. The first thing Beyer remembers is waking up the next evening, hungry. The only side effect from the stroke he says, was a slight loss in muscle tone on his right side. Now that's gone too.
"It's as if it never happened."
Dr. Niranjin Siva was the neurologist who responded to Beyer's medical emergency. Siva says the staff at Western Baptist doesn't get the chance to administer tPA very often. He says that's because most people don't get to the ER in time.
"People that have chest pain, they come into the ER because they have pain. It's a pretty clear sign that something emergent is happening, and people kind of know, OK, I've got chest pain, I need to go to the ER. Strokes are often painless."
Siva says unless signs are obvious, like paralysis in an entire arm, patients don't understand what's happening to them. There are a few easy tests to tell if someone is having a stroke. Their speech may be slurred, one side of their face may droop when they smile, or they may be unable to raise their arms in tandem. Siva says it's important to treat a stroke early because not only can they kill, but strokes are also one of the leading causes of disability.
"Strokes affect motor function, cognitive function. Y'know people have pretty significant disability. So there's a huge drain in society that's not even accounted for by the acute problem."
Siva says the use of tPA may reduce long-term health costs related to stroke, but he says it's hard to make a one-to-one comparison. For one thing, tPA doesn't work every time. And there are side effects. tPA is a clot-buster, which means it thins the blood.
"And it's almost like opening up the floodgates. In some people, that can cause bleeding. The restored blood-flow will basically cause bleeding in that part of the brain. And that's kind of biggest risk."
Siva adds that research shows tPA isn't more risky than other treatments. A study found life expectancy of patients that did, and those that did not get the drug, was the same.
The Kentucky Heart Disease and Stroke Prevention Program has successfully worked to bring down the rate of stroke death in the state. In 1999, 70 percent died from stroke. Now it's down to 51 percent. Program Manager Bonita Bobo says that's due to education, new drugs, and better treatment for repeat patients. Kentucky could still improve. The same data that show a reduction in deaths also show the number of people hospitalized for stroke has stayed pretty much the same. Dr. Siva says to stop people from having strokes Kentuckians need to go back to the basics. Eat healthy foods and exercise regularly.