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Mar 09 2017

Learning How To Combat Stroke

By Gregg Bragg, The Island Connection Staff Writer

Photos by Kelly Bragg

Dr. Christine Holmstedt, Patrick Bosse, Dr. Leo Morantes

Dr. Christine Holmstedt, Patrick Bosse, Dr. Leo Morantes

The Kiawah-Seabrook Exchange Club was at it again on Feb. 1, this time over dinner at the Turtle Point golf course. Fresh from accolades for contributing nearly $120,000 to 35 local charities, laurels were not the philanthropic group’s objective. The health of their neighbors was the focus of last month’s meeting, and featured speakers from both the Medical University of South Carolina and Roper St. Francis on the topic of combating stroke.

“South Carolina has the 4th highest stroke death rate in the country, is a leading cause of long term disability, and response time is critical.”

“South Carolina has the 4th highest stroke death rate in the country, is a leading cause of long term disability, and response time is critical.”

I am sponsoring a presentation about the groundbreaking MUSC/[RSF] TeleStroke network, which we hope will make a great impact on the ability to prevent or reduce brain damage and other disability for stroke victims. South Carolina has the [4th] highest stroke death rate in the country, is a leading cause of long term disability, and [response] time is critical. As many as 2 million brain cells can die each minute. The average age of stroke patient is 45 years old, and most of us are much older! The presentation will outline new and enhanced procedures and capabilities for speedy diagnosis and treatment,” said Exchange Club member Carol King in an email to The Island Connection. The alarming statistics have drawn the attention of Dr. Christine Holmstedt-MUSC, and Dr. Leo Morantes-RSF.

First and foremost, CALL 911 IMMEDIATELY if you notice ANY of the following symptoms;

1. Drooping facial features (lopsided smile, one cheek sagging)

2. Slurred speech (thick tongued enunciation of simple phrases like “chicken soup”)

3. One arm hanging down (can’t lift both arms evenly)

These symptoms often get dismissed because they don’t seem significant, can pass/seem intermittent, or simply because too many feel “it can’t be happening to me.”

Holmstedt augmented King’s statistics by saying stroke was also the 5th leading cause of death in the U.S. and the 3rd leading cause of death in South Carolina.

She also characterized Charleston as the very “buckle” of an already dense “stroke belt,” of incidences. The gravity hit home with attendees, but she deftly pivoted to a description of the Lowcountry Stroke Collaborative.

We don’t need to be competing for patients. We need to be taking care of people,” said Holmstedt of the new partnership between MUSC and RSF.

Both hospitals have an Emergency Room (ER) in downtown Charleston, which are very close together. However, arriving at one facility while the expertise was on duty at the other, historically meant transferring the patient and losing time.

TeleStroke solves this problem by staffing one or the other facility 24/7 and manning the “REACH” system when a case comes in.

The system consists of a secure website used to access and control the “REACH” cart: a mobile unit composed of a computer, LCD screen, fully adjustable camera, and speaker. The million dollar [usually more] systems present diagnostic information and allow two way communication in real time. Physicians are able to care for a patient in their own facility, direct treatment occurring across the street or at any of 25 locations as far away as the western end of the state. The goal of “door to needle [treatment] in 60 minutes” is usually closer to 30 with the new system, especially when combined with state of the art procedures.

It’s like a stint on a stick to remove the clot,” said Dr. Leo Morantes describing an improved thrombectomy technique used in more serious situations. Physicians can not only remove the clot now, but simultaneously insulate blood vessels from the technique, and reinforce stroke damaged areas. There are many different types of strokes, said Morantes, but they generally fall in one of two categories.

Hemorrhagic [bleeding] strokes result from ruptured vessels, and are often associated with high blood pressure. They often result in severe headaches leading to the symptoms noted above, but only constitute about 20 percent of cases. The bulk of strokes are designated Ischemic, and result from clots. They are generally treated first with blood thinning agents like Alteplase, but thrombectomy is employed when indicated. Perhaps the most pertinent question following the presentations concerned the use of aspirin to mitigate a suspected stroke.

Aspirin has long been rumored as a layman’s first response to stroke. Both Holmstedt and Morantes wanted to like the idea, but stopped well short of endorsing the solution. The problem rests in diagnosing the type of stroke.

For example, aspirin would exacerbate a hemorrhagic [bleeding] stroke, they nodded in agreement. Best to call 911, they said, highlighting that even patients who required a thrombectomy within six hours after symptom onset showed improved functional outcomes at 90 days. Also, for every four patients who were treated, one additional patient was functionally independent at their 90 day follow-up.

For more information or to find out how you can help, contact Lauren Johnson, Director of Major Gifts, Roper St. Francis Foundation, 125 Doughty Street, Suite 790, Charleston, South Carolina 29403, 843.720.1205.

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