Sizing Up Strokes - ACH Seminar Focuses on Stroke Prevention, Treatment, Recovery
By Shannon Harsh, The Review, Published September 30, 2015
Alliance Community Hospital’s latest Community Lecture Luncheon, held Friday, focused on stroke prevention, treatment and recovery.
Dr. Karen Gade-Pulido, medical director for the inpatient rehabilitation unit and director of quality and patient safety at the hospital, spoke on the prevalent condition that involves a sudden interruption of blood supply to the brain, typically caused by a blockage of an artery due to a blood clot.
She said there’s a high incidence of strokes in the U.S., and, on average, someone dies of stroke every four minutes. “It’s a significant problem,” she expressed. “So what can we do to address this? It’s the leading cause of permanent disability in the U.S. as well. So we need to be able to try to find a way to prevent, first and foremost, and treat strokes.”
Gade-Pulido had attendees stand and then read off a list of high-risk factors. She asked people to sit who had any of them, showing that most people are at risk.
“By the nature of the beast, if you’re around for more than 45 to 55 years, you have an increased risk of stroke,” she noted.
However, she said, modifications can help lower the risks. She said maintaining a healthy lifestyle can offer an 80 percent reduction in stroke risk. “Smoking cessation, blood pressure control, low-fat diet, weight loss, regular exercise are just as important, if not more so, than any pill I can ever give you. I can’t emphasize that enough,” she said. “This is what you can do. I can give you a boatload of medicines, but what I can do for you is not nearly as good as what you can do for yourself.”
The doctor said when a stroke does occur, the degree of disability depends on how much of the brain is involved. “The more brain we can save, the better the function is going to be,” she explained.
She said it is extremely important to act FAST — an acronym used to remind people to check for signs of stroke in the face, arms and speech — and that time is of the utmost importance. “Let’s get them to the emergency room. The best chance for survival and improved outcomes is rapid recognition of stroke,” she said. “Call 911, have the emergency technicians come out to your house to pick up the patient and bring them to the emergency room so that they can be taken care of.”
Gade-Pulido said a decade ago, how the medical community dealt with stroke was disjointed, so an effort was made to improve this, starting with educating the community and then focusing on how best to treat people in a community setting, which led to the design of stroke centers. She said ACH has been a basic care hospital for a long time, but will be moved up to an acute stroke-ready hospital status next month, meaning the hospital will be able to administer clot-busting TPA medication without having a neurologist or neurosurgeon on staff. This is due to a partnership with Akron General Hospital and the Cleveland Clinic, which are giving access to their physicians via telemedicine.
The medicine is used often in acute strokes to dissolve the clots and restore blood flow, which helps prevent further damage. The downside of this treatment is that not everyone qualifies because of the dangers of bleeding.
She said for those who do qualify, they prefer to get the medication to the patient within three hours, which offers the best benefit and the least amount of potential harm.
Using telemedicine, patients can be evaluated by the specialists at the Akron or Cleveland location who then advise treatment. The partnership also allows the hospital to have a chain of treatment. Should the condition need more than ACH can offer, the patient is sent to Akron, and if they can’t handle it, the case is sent to Cleveland based on the needs. “We have a very good coordinated fashion of care for a person who presents to our hospital with an acute stroke,” she said. “We can address it now — we don’t have to wait — and then we can have them go on to the appropriate venue as needed.”
Gade-Pulido shared some other treatment options and advancements in rehabilitation the medical community is considering, which includes things like ambulation through a body weight harness. She shared her excitement for the emerging options like brain stimulation, robotic assisted therapy, brain computer interface, biotherapeutics and virtual reality which is used to help retrain the brain following a stroke.
Dr. Karen Gade-Pulido speaks about strokes during the luncheon lecture held Friday at Alliance Community Hospital (Courtesy of The Alliance Review, September 30, 2015)