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Fast action puts patient on the road to recovery after massive stroke

On June 16, Ellen Drapkin experienced a massive stroke, stopping blood flow to her brain and leaving her unable to move or even swallow. It could have been a catastrophic event for Drapkin, rendering her paralyzed or even worse. Thanks to the quick thinking of her husband, Ed, well-trained paramedics and the fast action of the stroke team at Ozarks Medical Center, three days after her stroke, she walked out of the hospital on her own and now, two months later, is on her way to a full recovery.

"How can I possibly thank these people enough who cared for me," Drapkin said of the physicians, nurses and paramedics. "It's because of them that I'm here; it's because of what they did."

Drapkin's story begins on a normal Monday evening. She had been reading in bed before turning out the lights. A few minutes later, without realizing it, she began coughing. Her husband told her to try turning over to see if that would help and when she did, she fell out of bed and was unable to get up. Her husband reached to help her and when she reached back to grab onto him, only her right hand rose.

"He immediately called 911 and told the operator, 'I think my wife is having a stroke,'" Drapkin said.

Ed knew the four sudden signs of stroke – face drooping, arm weakness, speech difficulty and time to call 911, which can be remembered by the acronym FAST (face, arm, speech, time). It was his knowledge of stroke that set the medical response into action so quickly.

A stroke occurs when a vessel in the brain ruptures or is blocked by a blood clot. Currently, the gold standard for treatment is tissue plasminogen activator, also known as tPA, given through an IV. The drug works by dissolving the clot and restoring blood flow to the brain, improving the chances of recovering from a stroke if administered within three hours, according to the American Stroke Association.

Ed stayed on the phone with the operator while the ambulance was dispatched. The couple lives in a very rural area between Pomona and Willow Springs.

"We are at the corner of no landmark and no landmark," Ellen now laughs.

Thanks to Ed's quick thinking and immediate response, the ambulance arrived quickly and Ellen's treatment for her stroke was not negatively impacted by their rural location. Ellen praises the paramedics from Willow Springs Ambulance Service who arrived at her house that night.

"The paramedics were amazingly well trained and recognized exactly what was going on," she said. "They treated me with so much dignity and respect. They even brought my bedspread with us to cover me up and preserve my modesty, which meant so much to me."

Meanwhile, at Ozarks Medical Center, the Stroke Team was called into action. This multidisciplinary team is made up of nurses, physicians, neurologists, ambulance services, therapists and Emergency Department workers who respond quickly and efficiently to stroke, 24 hours a day, seven days a week. Upon arrival at the hospital, the first step is to confirm the stroke through a CT Scan and then, as quickly as possible, administer tPA if the patient is eligible based on factors such as the type of stroke and time since symptoms began. The national standard is to deliver the tPA within 60 minutes of arrival at the hospital. However, OMC has set a higher standard to deliver tPA within 45 minutes and the hospitals current average for 2014 is 39 minutes after treating 34 patients.

Ellen's tPA was delivered 14 minutes after arrival.

By the time her husband arrived at the hospital, she was already in the trauma room and prepped. The stroke had paralyzed Ellen's entire left side and left her unable to swallow, which is what had caused her initial coughing in bed. OMC Neurologist Dr. Clara Applegate administered the medicine and within minutes, Ellen was beginning to respond with movement.

"It was a massive, massive stroke," Ellen said. "When I began responding I remember the cheers of the people in the room. One paramedic in particular, Nathan Wickham, was so proud of the fact that I was responding I remember him saying 'she's coming back! She's coming back to us.'"

Although the details of the evening are hard for Ellen to remember, one thing does stand out.

"In the ambulance, in the Emergency Department and on into the hospital, everyone called me by my name," she said. "It meant so much to me. I was so far into this black hole that hearing my name helped me. It helped me come back."

Unfortunately, although Ellen was responding to the medication, it also had an unwanted side effect; she was allergic to the drug. Her throat began swelling. The team attempted to control the reaction with medication but an emergency intubation was necessary to help her breathe. Ellen was transferred to the OMC Intensive Care Unit.

"Luckily, I was sedated during the intubation and have no memory of it," she said. "ICU was as much a part of my recovery as the treatment in the Emergency Department. The home run that was hit in the ED continued on throughout my stay. They didn't drop the ball."

Ellen remembers the ICU nurses taking the time to brush and braid her hair before she had visitors.

"They were extremely concerned about my pain and comfort but they also cared about me as a person."

Ellen also began working with the OMC physical and occupational therapists to regain her movement and fine motor skills. Three days after her stroke, on her 70 th birthday, she was released from the hospital.

"When I first had the stroke, everyone was concerned about my long-term care, worried about placing me in a nursing home and who would be my caretaker," she said. "The therapist and the physician, all of these people were so dedicated to getting me well. They wanted me to get better, so I could walk out of the door of that hospital and not have to go to a nursing home. So I could be self-reliant. And, that's exactly what I did. I walked out, without a cane or walker even."

Today, two months later, Ellen has returned to almost all of her day-to-day activities and has even begun driving short distances. She still struggles with some tasks, such as typing, but with ongoing physical and occupational therapy through OMC Rehabilitation Services and OMC Riverways Home Care, she is making great progress and hopes to soon return to work in quality control at Robertshaw, formerly Invensys.

"It never felt that I was anything but special and important to everyone involved in my care," she said. "It's hard to say thank you enough. It's because of them that I have the quality of life that I do. It's because of them that I am here."

For more information on stroke, contact the OMC Neurosciences Center at 417-257-6777.

Today, Ellen Drapkin is on the road to recovery after her June 16 stroke. Thanks to the fast action by OMC and paramedics, she is back to almost all of her day-to-day activities, including driving.

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