CHRISTUS Santa Rosa Health System - LiveWell

DUTY Having a stroke was the furthest thing from Crystal's mind as she worked her shift at CHRISTUS Santa Rosa Hospital – Westover Hills last fall. As a registered nurse, Crystal is more accustomed to providing emergency care than receiving it. She was quickly thrust into the patient role, however, when a two-day headache escalated into other stroke-related symptoms. SPOTTING THE SIGNS Crystal remembers treating her headache with over-the-counter medication. On Sept. 28, 2016, her headache pain increased — something she attributed at the time to an intense day spent taking care of a patient and maybe hypoglycemia. After eating lunch with a friend, the situation only got worse. She saw a flashing white light and began seeing stars. She started to squint and rub her eyes. "I went to the bathroom to wash my face, stood upright, and had no vision in my left eye," she says. Immediately, Crystal felt sweaty and nauseated. "I sat down on a stretcher outside the office of an emergency room physician who was preparing to leave but stopped to check on me." The physician noticed that something wasn't quite right with the normally energetic nurse and insisted that she get treated immediately. That hunch would save Crystal's life. ALL HANDS ON DECK Her coworkers sprung into action, and Crystal became a patient. The emergency department staff rallied around her as they would any patient in their care. The team wheeled Crystal into triage, transferred her to a stretcher and completed a full workup on her. "She's in her 40s, so no one immediately thought stroke, but we recognized the symptoms," says Daniel Garcia, M.D., attending physician at CHRISTUS Santa Rosa Hospital – Westover Hills. Crystal had a computed tomography (CT) scan, and doctors recommended tissue plasminogen activator, also known as tPA, a clot-busting drug that helps restore blood flow to the brain during an ischemic stroke. About 87 percent of strokes are ischemic — a type of DUTY: Use of tPA for Strokes Tissue plasminogen activator, or tPA, is a clot-busting drug that needs to be administered within three to four-and-a-half hours after ischemic stroke symptoms begin. "The sooner stroke symptoms are recognized and the patient receives emergency medical attention, the better," says Daniel Garcia, M.D., attending physician at CHRISTUS Santa Rosa Hospital – Westover Hills. "Tissue plasminogen activator [tPA] given within the prescribed time frame significantly lowers the risk of death and disability due to an ischemic stroke." stroke caused by a blockage in an artery that disrupts blood flow to the brain. The tPA drug is the gold standard of care for an ischemic stroke and the only FDA-approved treatment for the condition, according to the American Stroke Association. Crystal has administered tPA hundreds of times to patients, but she was still concerned that her symptoms weren't caused by an ischemic stroke. She worried they were signs of a hemorrhagic stroke, a less common but potentially more dangerous type caused by bleeding in the brain. Members of her team took time to reassure her and talk through the treatment plan together, ready to act in the event that Crystal needed additional care. As soon as tPA was administered, Crystal felt an excruciating pain in her head. A second CT scan revealed she did, in fact, have bleeding in the brain. Luckily, her vision was already starting to return, and the team continued treating her brain hemorrhage to save her life. Ultimately, the careful treatment paid off. "If I hadn't received tPA, I'd be blind," Crystal says. "The Santa Rosa team was amazing. They take everything seriously and are some of the most talented nurses I've ever seen." APPRECIATING PREVENTION Rehabilitation is an essential part of the after-stroke recovery process, and CHRISTUS Santa Rosa Hospital — Westover Hills has an expanded stroke care program to provide the necessary help for aftercare. After three days of observation in the intensive care unit, Crystal moved on to rehabilitation, a post-stroke service available at CHRISTUS Santa Rosa Hospital – Medical Center and CHRISTUS Santa Rosa Hospital – New Braunfels. After 10 days, she was back at work helping patients. It hasn't been easy getting back to her routine, and some things will never be the same. She still experiences pain in her leg at times, a common irritation for stroke patients, and is more susceptible to seizures, but with a better awareness of her body, Crystal is taking care of herself as well as her patients. Stroke patients are more susceptible to additional strokes, but there are preventive measures to help avoid them. These include lifestyle changes such as quitting smoking, managing high blood pressure and blood sugar levels, eating a healthy diet, adopting a regular exercise regimen, and taking medications as prescribed. "If it can happen to me — I take very good care of myself — it can happen to anyone," Crystal says. "Listen to your body." ✚ Don't let stroke catch you off-guard. Find out if you're at risk by visiting christussantarosa.org/strokecare. Fall 2017 | christussantarosa.org HERE FOR YOU 5

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