In the Stroke of Time

Telemedicine technology links doctor, stroke team and patient in just a click

Dennis McClurg strums again after a stroke.

Dennis McClurg, a long-time Huber Heights resident, is an avid musician. If it has strings, he can play it. So imagine his distress when late one evening last November, he lost feeling and control in his right arm and hand. “I was watching TV and suddenly dropped the remote,” Dennis remembers. “I could see it, but I couldn’t pick it up. My wife, Mabel, and I knew something was really wrong.” Dennis McClurg, age 66, was having a stroke.

When he arrived at the emergency room, Good Samaritan’s stroke team was ready and waiting. By this time, the numbness had spread to the right side of his face and down his right leg.

Time is Brain

“The first thing we must do for all potential stroke patients is determine by CT scan what kind of stroke they are experiencing,” explains Erin Greene, RN, MS, CCRN, CNS-BC, neuroscience clinical nurse specialist. (See Types of Stroke). If it is the most common type – ischemic – which is caused by a clot in the brain, we may be able to give the patient the drug tissue plasminogen activator or tPA to dissolve the clot. tPA can be used within four and a half hours of the onset of stroke symptoms. The longer you wait, the less chance of recovery. That’s why we say ‘time is brain.’ ”

Dennis’ CT scan revealed that he was not having a hemorrhagic stroke and so was a candidate for tPA. But since it was late at night, as in most hospitals in the nation, no neurologist was on site to evaluate Dennis according to mandatory Stroke
Center standards set by the National Institutes of Health and to prescribe tPA.

Telemedicine to the Rescue

Dr. Bradley Jacobs (on screen) participates remotely in a patient exam with Erin Green, RN, CCRN.

Fortunately for Dennis, however, Bradley Jacobs, MD, medical director of Good Samaritan’s Stroke Program and chief of the Division of Neurology at the Wright State University Boonshoft School of Medicine, was at Dennis’ bedside almost instantly via Good Samaritan’s remote presence robot. “Telemedicine brings an expert to the stroke patient’s bedside immediately to ensure that the latest sciencebased treatments are used,” Dr. Jacobs explains.

Good Sam is the region’s only hospital to offer this technology. From his computer at home, Dr. Jacobs can connect to the robot to see, hear and virtually examine the patient via the robot’s two-way camera. He can listen to a patient’s heartbeat and respiration using the robot’s stethoscope and highly sensitive headset, “walk” around the bed for different views, ask the patient questions, talk to the medical team and even transmit orders and prescriptions via an onboard printer. When the exam is over, the robot attaches to its dock on the wall to recharge.

Recovering Thanks to tPA and Therapy

“I was aware of everything during my exam,” Dennis recalls. “It was amazing. Because of the robot, Dr. Jacobs saw me right away. We didn’t waste any time. I got the tPA and in about three hours, started to get feeling back in my hand.”Dennis spent about a week in the hospital – due to some other health issues doctors wanted to check. Once home, he proceeded with physical and occupational therapy. Today, Dennis is just shy of 100 percent recovered and is back with his country gospel, country, bluegrass and rockabilly groups. “When you’re playing,” says Dennis, “it’s not enough to just know the next note. You have to feel it in the strings. I am so fortunate. Thanks to Good Sam’s innovation, I am still making music.”

Are You Having a Stroke?

If you see one or more of these signs, call 911 immediately. If given within four and a half hours of the start of stroke symptoms, a clot-busting drug called tissue plasminogen activator (tPA) can reduce potential long-term disability caused by the most common type of stroke.

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden, severe headache with no known cause
• Source: American Stroke Association

Types of Stroke

The third leading cause of death in America, stroke can lead to serious, long-term disability.

• Ischemic stroke is caused by a clot blocking blood supply to the brain.
• Hemorrhagic stroke happens when a weakened vessel bursts and bleeds into the brain.
• Transient ischemic attack (TIA), also known as a “warning stroke,” is caused by a clot. The only difference between TIA and stroke is that TIA is temporary, with symptoms resolving within 24 hours.

Source: American Stroke Association

Learn more information on Good Samaritan’s innovative stroke services.