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Stories of Hope

Tamra Schwyn

Tamra Schwyn

On a warm afternoon in August Tamra Schwyn, a devoted mother, grandmother and compassionate nursing assistant, was in her usual routine of stopping by a local convenience store after work. It was there that she fell to the floor and had jerking body movements. It appeared that she was having a seizure. Thankfully, the clerk on duty immediately called 911 and EMS personnel quickly transported Tamra to nearby Marion General Hospital. Tamra's body movements and loss of responsiveness were signs of a serious brain condition. In addition, her decreased level of consciousness caused her to have difficulty breathing and she was placed on a breathing machine. The Marion General Hospital ER staff worked swiftly including sending Tamra for a CT scan which showed that she had bleeding in her brain – in her case, a type of stroke called a subarachnoid hemorrhage (SAH). Spontaneous SAH usually occurs due to the leaking or rupture of a weakness in the wall of a brain artery called an aneurysm. Emergency brain surgery or neurointerventional treatment is crucial to the survival of SAH patients.

Fortunately for Tamra, she lives in the StrokeCareNow Network coverage area which gave her access to the most advanced care available for SAH patients. The StrokeCareNow Network is a collaboration of Fort Wayne Neurological Center (FWNC), Parkview Health System and Lutheran Health Network. Working together, these 3 healthcare providers offer the most comprehensive stroke care available to those living in the tri-state area.

Tamra was flown by helicopter to Lutheran Hospital in Fort Wayne, Indiana and, upon arrival, was examined by FWNC Neurointerventionalist, Dr. Rakesh Khatri. Dr. Khatri is a neurologist with specialized training in catheter based stroke treatment. By threading catheters from an artery in a patient's leg up into the brain, Dr. Khatri can administer treatment directly to the affected area of the brain without the need to open the skull to access the brain. For Tamra Dr. Khatri placed "coils" into the bulging aneurysm in her brain to stabilize the area and stop the bleeding. Tamra's family states, "The surgery seemed like hours." After the neurointervention procedure, Tamra remained critically ill. Tamra's survival was uncertain.

During her hospitalization, Tamra underwent a neurosurgical procedure to relieve the build-up of pressure in her brain, as well as catheter-based brain procedures to treat the critical narrowing of blood vessels in the brain – both of these conditions are common in severe SAH patients. She had many touch and go moments. Amazingly, just three and one half weeks after her admission Tamra was discharged from Lutheran Hospital and admitted to an inpatient rehabilitation facility in Marion, Indiana.

Back in Marion, Tamra began the long process of intensive physical, occupational and speech therapies to gain back her strength, both mental and physical. Recently Tamra was seen in follow up by Dr. Khatri. She has been released from inpatient rehabilitation and has made great strides in her recovery. To those aware of Tamra's journey starting on that fateful day in August to the moment she was able to take her first independent steps, she is nothing short of a miracle.

Jolene

Jolene

Jolene was a typical 22 year old college student, enjoying a lazy Sunday afternoon with her Mom and sister in November of 2008, when she suddenly developed difficulty speaking and weakness in her left arm and leg. Fortunately, despite her young age, her mother immediately realized the urgency, "My daughter may be having a stroke!"

They immediately called 911, and Jolene was taken to her nearby community hospital, Parkview Noble Hospital in Kendallville, Indiana. There the Emergency Department Physician recognized Jolene's symptoms as those of a potential stroke and activated the acute stroke protocol. As a part of this protocol, even though he was actually 30 miles away, the FWNC Neurologist in Fort Wayne, was able to examine Jolene through a "robot camera" within minutes of the "stroke activate." After performing the telemedicine exam, the Neurologist advised the Parkview Noble Emergency Department Physician to start a clot busting medication called tPA which was given through the intravenous catheter in the vein in Jolene's arm. She was then emergently transferred to Parkview Hospital in Fort Wayne for more advanced diagnostic testing and treatment.

Because of the severity of her stroke and the large clot, the IV medication was not powerful enough to open the artery in Jolene's brain –threatening to permanently rob her of any movement in the left side of her body. After arriving at Parkview Hospital, a specialized brain scan showed the exact location of the clot which was still blocking the artery and also revealed that most of her brain tissue could still be saved.

Jolene was immediately taken from the ER to the Neuroangiography Suite where the FWNC NeuroInterventionalist was able to rapidly thread a catheter from an artery in Jolene's leg into her brain. Using a "cork screw" device and a flexible suction catheter as well as a concentrated clot busting medication right at site of the clot, the artery was opened before permanent brain damage had occurred.

Just nine days later, Jolene was able to walk out of the hospital without assistance. Today, she notes that her left arm is slightly weaker and clumsier than it was prior to the stroke – but this is not noticeable to others. Jolene graduated from Indiana-Purdue University in Fort Wayne in May of 2010 with a Bachelor of Science Degree in Criminal Justice. She wants to be a Probation Officer and also plans to pursue a Master's Degree in her field.

Since the time of Jolene's stroke, Lutheran Health Network, Parkview Health System and Fort Wayne Neurological Center have formed the StrokeCareNow Network. Now many patients throughout Northern Indiana and Northwestern Ohio have access to the same telemedicine diagnosis, rapid transfer and catheter treatment that allowed Jolene to walk out of the hospital with bright hopes for her future and the ability to pursue her dreams.

Vicki Groves

Vicki Groves

Vicki Groves never slows down. For years, she's been taking care of others — raising a family, nursing thousands of patients back to health, even watching her own children explore the joys of parenthood. So the day she felt overwhelmed and knocked out by headaches and nausea, she knew something was really wrong.

Not long after heading to her bedroom to take a shower and lay down, Vicki's husband said he heard her call for him. By the time he found her in the bathroom, she was unresponsive. As she slowly regained consciousness, Vicki told her husband she hardly had the strength to lift her left arm and leg. Having suffered a stroke himself, he knew just what to do.

"He called 9-1-1 immediately!" Vicki explains. The ambulance arrived four minutes later and took Vicki to St. Joseph Hospital, centrally located in downtown Fort Wayne. When she arrived, the attending physicians immediately recognized Vicki's symptoms as those of a potential stroke and activated the StrokeCareNow Network. Six and a half miles away at Lutheran Hospital, FWNC Neurologist Dr. James Stevens was able to perform a telemedicine exam on Vicki using a robotic camera, and based on that consult, authorized the use of the clot-busting drug tPA, before having her transferred to Lutheran for more diagnostic testing and treatment. "That was the key to my recovery—fast-acting physicians."

Before Vicki's stroke, neither she nor her husband had heard of the StrokeCareNow Network or the clot-busting drug used with her treatment. "The ambulance driver explained that they were taking me to the closest hospital, St. Joe," Vicki remembers. "He told us they'd be able to work directly with my doctors at Lutheran, coordinating my care. It was very reassuring to know that I was receiving the best care so close to home."

"The StrokeCareNow network was the key to my recovery."
— Vicki Groves

As part of the StrokeCareNow Network, Lutheran's Stroke Center is able to extend its care to emergency departments throughout the region. Through telemedicine, physicians are able to provide remote neurological consults and assess the level of impairment a patient is experiencing, reducing the time from stroke to treatment and maximizing the chance for a full recovery.

According to FWNC Neurologist, Dr. Thomas Banas, "Having a cohesive team in place is paramount when minutes can make a major difference in a patient's outcome. We have been blessed with exceptional components required to treat strokes and are able to provide acute stroke care at a level comparable to the finest programs in the country."

Vicki encourages others to know the warning signs and act FAST. "It's important to respond fast when you recognize the symptoms of a stroke," she says. "Every second counts. Thanks to the StokeCareNow Network, I was able to get to the closest hospital, start a consultation with my doctor and get the critical clot-busting drug way faster than if I had tried to drive all the way to my doctor at Lutheran Medical Park."

"We're always looking for ways to reduce the time it takes radiologists to analyze and interpret CT scans so we can get stroke patients the treatment they need, faster," explains Dr. Banas. "After all, each minute a blood supply is cut off to the brain, a patient loses 1.8 million brain cells. Through continuous process improvements, our average is 12 minutes from the moment the CT is performed to the second the neurologist gets the report from the radiologist."

For Vicki, having access to the StrokeCareNow Network, a unique collaborative effort of the Fort Wayne Neurological Center, Lutheran Health Network and Parkview Health System, has helped her bounce back to a normal way of life. "I was in intensive care for a couple days and home within a week. I've had a 100 percent recovery and am so grateful for everyone. Thanks to everyone from the 911 dispatcher and paramedics to the physicians and staff at both St. Joe and Lutheran hospitals, I was able to take my grandkids camping this summer!"

Vicki's story is just beginning.