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FAST response: Swift recognition, treatment saves stroke patient


It had been a typical day for Joan Izyk, 72, of Oswego. She had enjoyed a breakfast out and was relaxing in her living room with a coloring project. When her husband arrived home, she stood up to greet him in the kitchen. She never made it. She could hear her husband calling her, but she couldn‘t respond.

Joan Izyk, stroke survivor

Joan Izyk, stroke survivor

Izyk had suffered a stroke.

“I just went down, and I could not get up,“ she recalls of that morning at her home. “I couldn‘t talk, so I couldn‘t yell to him. He thought it was a stroke right away.”

Impaired speech is one of the signs of stroke outlined in the acronym FAST, which is designed to help people act quickly to assist someone who may be having a stroke. FAST stands for Facial drooping, Arm weakness, Speech difficulties and Time.

“Joan‘s husband recognized that she was having a stroke, which helped her get the treatment she needed quickly and ultimately led to her positive outcome,” says Josh Onyan, outreach coordinator for Upstate‘s Comprehensive Stroke Center.

Rescuers from the Oswego Volunteer Fire Department arrived at the Izyk home and quickly moved her into the ambulance. They noted the right facial droop, right upper extremity weakness and slurred speech, consistent with the signs of a stroke. They rushed her to Upstate. The stroke team had received notice of the 911 call and prepared for Izyk‘s arrival while the ambulance was en route.

Doctors and nurses from Upstate‘s emergency department and stroke team began treating Izyk immediately. She received the clot-busting medication known as tissue plasminogen activator, or tPA, just 24 minutes after arriving at the hospital. Then she was injected with a dye so that a computerized tomography angiogram could produce detailed images of her brain.

Interventional neurosurgeon Grahame Gould, MD, located a blockage in one of her vessels and quickly performed a delicate clot-retrieving procedure.

“The combination of tPA upon arrival, plus endovascular rescue techniques such as this have been shown to greatly reduce disabilities from stroke,” Onyan notes.

Three days later, Izyk was resting at home, with mild facial weakness, grateful for the fast response of her husband, the fire department volunteers and the caregivers at Upstate.

Extending expertise: Stroke experts in Syracuse consult with rural colleagues via telemedicine

stroke chartTelemedicine connects stroke specialists from Upstate University Hospital with physicians in rural hospitals throughout Central New York, so that patients can receive prompt assessment and treatment of stroke symptoms.

Five hospitals participate, including Carthage Area Hospital, Claxton-Hepburn Medical Center in Ogdensburg, Cortland Regional Medical Center, River Hospital in Alexandria Bay and Samaritan Medical Center in Watertown. The Fort Drum Regional Health Planning Organization helped deploy the equipment necessary to make these connections possible.

The telemedicine network provides Upstate neurologists with access to computerized tomography scans and the ability to talk with doctors and patients in hospitals many miles from Syracuse.

“Our telemedicine network allows the North Country access to expert stroke care, regardless of geography,” says nurse Jennifer Schleier, program manager of Upstate‘s Comprehensive Stroke Center. “We have come to think of this program as stroke care without borders. It is our mission to close the gap between expert medical care and location of the patient.”

magazine-fall16cvrThis article appears in the fall 2016 issue of Upstate Health magazine.