Stroke protocol helps woman meet all her post-stroke goals

May 10, 2016 | by Edward-Elmhurst Health
Categories: Healthy Driven Heroes

On Feb. 1, 2016, Lombard resident Marlene Neurauter, 68, woke up and noticed her speech was slightly slurred and her balance was off.

"I've been diabetic since age 12 and thought I was reacting to a drop in blood sugar," she recalls.

When she got home from work that evening she still didn't feel well but her monitor told her that her glucose level wasn't the problem. She called her primary care doctor who said she might be having a stroke.

Her husband, Bill, took her to the Elmhurst Hospital Emergency Department where she had a CT scan, a carotid artery ultrasound and blood work. The conclusion:  Marlene had suffered an ischemic stroke, the type that occurs when a blood clot disrupts the flow of blood to the brain.

"The first choice of treatment would have been an infusion of tPA (tissue plasminogen activator), but this (clot-busting) medication has to be given within 4.5 hours of onset of symptoms," says Mark Fehr, M.D., a neurologist with the Elmhurst Neurosciences Institute. Neurauter arrived at the hospital about 12 hours after symptoms appeared.

Her symptoms lingered to some degree, and she was admitted to the hospital for further evaluation, and physical, speech and occupational therapy.

On Feb. 4, even more alarming symptoms began. Her smile was one-sided and she was seeing double. She soon started shaking and babbling. Her cardiac unit nurse, Laura Balzer, RN, called in the hospital's Rapid Response Team, critical care experts who advise hospital staff when a patient's condition is deteriorating. They soon called a Stroke Alert.

This code brought a Stroke Team to Neurauter’s bedside, including Dr. Fehr, Michele Gobber, RN (stroke coordinator), cardiac unit nurses and others. The process also put the pharmacist on standby, alerted imaging staff to reserve a CT scanner, and posted phlebotomy and patient transport staff outside Neurauter’s room.

Dr. Fehr and other team members stayed with Neurauter during her CT and on the trip to the ICU, where Dr. Fehr called for the tPA infusion. The pharmacist prepared the dose and delivered the medication to the ICU. The team beat the national ideal standard of tPA administration within one hour of a stroke.

Says Gobber, "During the hour-long infusion, the nurse asked Neurauter how she felt and she said, ‘OK,’ the first word she'd spoken since the stroke."

Soon after that, she was delivering one-liners that made everyone smile.

"Even when I'm uncomfortable I try to make people laugh,” she says.

But Neurauter has a serious message about her care at Elmhurst Hospital.

"The protocol, Stroke Alert, was fabulous,” she says. “Everyone gathered and did what they were supposed to do. Dr. Fehr is my hero. He has a wonderful bedside manner."

Her 10-day stay at Elmhurst Hospital was followed by a 10-day stint at Marianjoy Rehabilitation Hospital, where she worked on fine motor skills and balance.

Neurauter had three post-stroke goals: talking, driving and getting back to square dancing. She happily reports she's doing all three.

Says Dr. Fehr, "People may find it hard to want to go to the hospital if they aren't in pain, and just feel dizzy or find they're walking a little funny. But, it's important to learn to identify symptoms early so you have the best chance of getting the medicine that's most likely to help."

Learn more about neuro services at Edward-Elmhurst Health.

To learn if you’re at risk for stroke, take a free, five-minute StrokeAware assessment.

Join us on May 26 from 6:30-8:30 p.m. for “Headaches and Stroke: Update on Diagnosis and Treatment,” a free, healthy three-course meal and presentation at Seven Bridges Golf Club in Woodridge. Seats are limited so register online today or call us at 630-527-6363.

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