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Stroke care: Patient stories

Treating the stroke was just the first step

As captain of a St. Paul Fire Department Suppression and Emergency Medical Services crew, Jay Monogue was often called to be first responder to individuals demonstrating symptoms of stroke. Roles were reversed when Jay, now retired, suffered a stroke.

Jay was at home when he felt a "zing" in his left arm. The lights seemed to dim, speaking felt difficult and he kept dropping his glasses. Jay’s wife, Steph, observed Jay’s behavior and suspected he was having a stroke. She called 911 immediately.

A St. Paul Fire Department EMS crew arrived quickly. When they asked Jay which hospital he wanted to go to, he said United Hospital. Jay is familiar with the stroke program there and has confidence in the staff.

An alert had been sent to the stroke team at United in advance of their arrival, so staff was ready. After an assessment by an Emergency Department physician in consultation with a stroke neurologist, Jay went to the imaging suite and underwent a CT scan. That was followed by an advanced imaging procedure called computed tomography angiography (CTA) that pinpointed exactly where the blockage was in Jay’s brain.

About a half hour after arrival, Jay was started on medication, a clot-busting drug called tPA,to dissolve the blockage. Then, a neuro-interventional radiologist (a doctor specializing in treatment via the blood vessels in the brain) performed a procedure to remove the remaining clot and restore circulation to the affected part of Jay's brain. After spending two days in the hospital and undergoing evaluation by a number of specialists, Jay was cleared to return home.

Treating the stroke

Treating the stroke was just the first step; next, the stroke team wanted to ascertain what caused the clot to try and prevent it from happening again. Tests eliminated the possibility of a hole between chambers in his heart, but further tests revealed that Jay has atrial fibrillation, or an irregular heart rhythm. Atrial fibrillation can sometimes be a cause of blood clots, and therefore strokes, so Jay sees his primary physician and a cardiologist to manage this condition.

Today Jay feels fine and has few residual effects of the stroke. His positive outcome was due in large part to how fast he got to the hospital, and how quickly he was diagnosed and treated. Time is critical in treating stroke. Every minute during a stroke without treatment another 2 million brain cells die—every minute saved, saves brain.

Jay is thankful for the care he received at United and calls it a tremendous experience. “I know from my time as a first responder how important it is to begin treatment immediately for a stroke. I’m glad United has the trained staff and on-site technology that allowed me to be diagnosed and treated in time to minimize the effects of the stroke.” United Hospital hospitalist David Kroschel, MD, told Jay, “You are the poster child of early recognition and entry into the intervention system.”

Source: United Hospital patient Jay Monogue
Reviewed by: United Hospital hospitalist, David Kroschel, MD
First Published: 06/09/2014
Last Reviewed: 06/09/2014

Giving to others and receiving in return: Ken's story

When Ken Boelter, a firefighter in Coon Rapids, suffered a stroke that completely paralyzed his left side, many didn't think he would ever see the inside of a fire truck again.

But Boelter is a person who has made tremendous strides in the face of adversity and today serves his community in a variety of ways.

"“Ken has beaten the odds, that's for sure," said Erin Vesey, PT, Boelter's physical therapist. "He is one of those patients that every staff member and patient in our department knows. Ken fought hard to get where he is today, always pushing himself above and beyond."

As a fire captain, Boelter saved lives. He also changed many lives for the better through his dedication and commitment to his career.

He is motivated to return to public service and continue to serve the people of his city, but until that time comes, he has devoted himself to changing the lives of those around him, especially his fellow patients.

"Other people who have had a stroke often ask Ken why a young guy that looks so athletic is in our rehab department," said Vesey. "He tells them he has had a stroke and encourages them to keep working hard as well. They admire him and look up to him and become more motivated by him."

2011 Inspiration Award winner

Each year, Courage Kenny Rehabilitation Institute recognizes people who are an inspiration to their fellow patients, families, caregivers and to all who hear their stories.

Meet all the 2011 Inspiration Award winners here.

Boelter has also reached out to the community by speaking at Courage Kenny and to groups of firefighters. He wants to spread the word on stroke awareness and encourage people to seek immediate attention for stroke-like symptoms.

Vesey recounts an incident that she feels sums up Boelter's impact on the lives of others. There was a knock on his door. It was a man he recognized from a car accident he had been at as a firefighter.

The man had been pinned in a car and leg amputation was being considered to get him out. Boelter would not let this happen; he made the rescuers keep trying to free the man; and shortly thereafter, they did successfully free him.

This is the man who came to Boelter's doorstep with his leg healed and fully functional. He said that he had read about Boelter's stroke in the newspaper and wanted to give Boelter something in return for having saved his life and leg. There he stood with his work crew – ready to provide free concrete service to Boelter in a true gesture of thanks.

Read the video transcript on

Source: Courage Kenny Rehabilitation Institute
Reviewed by: Courage Kenny Rehabilitation Institute
First Published: 09/16/2011
Last Reviewed: 09/16/2011

An artful recovery from stroke


Painting has always been Frank Hoffman's means of intellectual and artistic expression. After suffering a stroke, he now includes his artwork as a means of therapy.

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Stroke: What is it?

A stroke results when blood and oxygen flow to the brain is stopped or interrupted. This happens because of a ruptured or blocked blood vessel.

More on stroke.

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Signs and symptoms of stroke

Warning signs of stroke may last a short time and disappear. They are often present when you wake up. These are signs of a serious medical condition.

More on stroke warning signs.

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Stroke treatment

Stroke treatment begins in the hospital. Most patients who have had a stroke will need to stay in the hospital for a period of time.

More on stroke treatment.

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CT scan

A computed tomography (CT) scan is an imaging method that uses x-rays to create cross-sectional pictures of the body.

More on CT scans.

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Physician therapist/stroke recovery team

Physical therapists treat problems with balance, coordination, strength, walking and transfers (getting yourself in and out of a chair, bed or car). They help patients learn to use mobility aids such as canes, walkers or wheelchairs.

More on physical therapists and the stroke recovery team.

Hoffman had his stroke on November 14, 2009. He, his wife, Lolly, and daughter were attending a party in St. Paul. He was sitting next to his wife when he realized that something wasn't right.

Lolly Hoffman soon realized something was wrong, too, but many saw his attempt to leave the party as the staggering of someone who has had too much to drink.

"My wife said, 'He's not drunk, something is wrong,' " said Hoffman.

The party happened to be across the street from a fire department, so their daughter ran to the fire department for help.

Frank was quickly taken by ambulance to United Hospital. The St. Paul emergency medical staff recognized the signs and symptoms of stroke and activated United's stroke team.

"Successful stroke treatment can be extremely time sensitive," said Paul Schanfield, MD, stroke director at United Hospital and a neurologist with Neurological Associates of St. Paul. "You cannot restore the tissue once cell death has occurs, but rapid reestablishment of blood flow leads to recovery of injured and threatened brain cells. The clock is ticking, and the sooner the treatment is started, the better."

United is recognized by the Joint Commission as a Primary Stroke Center. One of the elements of a Primary Stroke Center is a stroke team that can quickly evaluate patients and begin treatment.

A CT scan revealed that Hoffman had a blocked blood vessel in the left side of his brain. He was given an IV of clot dissolving medication that quickly reopened the blood vessel.

"Frank was lucky. Timing is critical in treating stroke. His diagnosis was quickly made and treatment started," said Schanfield.

Hoffman agrees with his doctor.

"My short-term memory isn't what it used to be," said Hoffman. "But I feel good. I'm continuing to improve."

And he's drawing and painting again, activities his physical therapists encourage to help him recover.

Source: United Hospital, Healthy Communities Magazine, spring 2010
Reviewed by: Paul Schanfield, MD, stroke medical director, United Hospital
First Published: 11/02/2010
Last Reviewed: 11/02/2010

Is it a stroke? Richard's story

Richard Norvold is looking straight into the cameral through his wire-rimmed glasses. He looks distinguished, wearing a black suit, white shirt and tie.

Richard Norvold's first clue that something was wrong was a persistent swishing noise in his left ear. An active 73-year-old who works six days a week at his own business, Norvold was told it was probably nothing to worry about.

One September, Norvold and his wife, Ruth, spent a weekend in the Twin Cities visiting their daughter and her family. During the drive home on Sunday, he noticed his reaction time seemed slow.

The next day, he realized his left heel was dragging. "That's when we went to the emergency room," he says.

Doctors confirmed that he had a mini-stroke (transient ischemic attack), but could not pinpoint the cause. By Wednesday, Norvold was at Abbott Northwestern Hospital for further tests.

Finding and treating the cause
Most strokes result from blockages in the neck's carotid arteries or in smaller vessels within the brain. In less than 5 percent of cases the blockage occurs in one of the other arteries that supply blood to the brain.

The blockage that caused Norvold's mini-stroke was found in an unusual location - an artery behind his left ear. Fortunately, the blockage could be treated. A neuroradiologist performed an angioplasty and inserted a stent to keep Norvold's artery open.

Richard Shronts, MD, neurologist with Abbott Northwestern's Stroke Program, says that understanding why a stroke occurred is critical to determining the best treatment and preventing subsequent strokes. Quick intervention also results in better outcomes.

Don't wait
"If you think you may be having a stroke, don't wait to see if it gets better. Get to an emergency room," says Shronts.

Clot-busting medications work best if given within the first 90 minutes after the stroke begins.

Looking back and moving forward
Norvold now believes that his blocked artery had been affecting him for some time. Writing had become more difficult and "it seemed like I was having more trouble with memory and dealing with stress," he says.

After his angioplasty, the first thing Norvold noticed was that the swishing sound was gone. He was back to work in less than a week and found that his other problems also quickly improved.

"We're just thankful that the doctors at Abbott Northwestern found the problem and were able to treat it right away," says Ruth Norvold.

Source: Abbott Northwestern Hospital, Healthy Communities Magazine, spring 2006
Reviewed by: Donna Lindsay, RN, clinical practice coordinator, Abbott Northwestern Hospital's Stroke Program; Paul Schanfield, MD, stroke medical director, United Hospital
First Published: 05/17/2006
Last Reviewed: 11/02/2010

Wrestling with stroke: A teen's story

Jacob McClellan wears his high school letter jacket.

When Jacob McLellan's parents let him go to the Minnesota state high school wrestling tournament, little did they know that this decision may have saved Jacob's life.

While at the tournament, 16-year-old Jacob had a stroke.

Jacob and his friends were at the Xcel Energy Center in downtown St. Paul, when Jacob developed a sudden, painful headache and an inability to sit straight or talk. A friend used Jacob's cell phone to speed dial Jacob's dad, Scott, who works a few blocks away. Scott ran to the Xcel Center and met the paramedics.

Teenage stroke
Jacob was rushed to nearby United Hospital, where a magnetic resonance image (MRI) showed that half of his brain was not receiving blood due to a large blood clot. Jacob was in the middle of an acute stroke.

Although stroke is the third leading cause of death in the United States, it happens rarely among younger people. Only about 10 percent of stroke patients are under the age of 55. Less than 1,000 people under the age of 30 have a stroke each year.

Stroke occurs when the blood supply to the brain is interrupted, robbing brain tissue of oxygen and nutrients. Brain cells deprived of oxygen start dying within minutes. Thus, medical treatment must happen in less than three hours from when stroke symptoms begin.

Treating Jacob
The stroke team at United Hospital immediately brought Jacob to the neurointerventional biplane suite. The suite has sophisticated X-ray equipment designed to diagnose and treat stroke and other neurological disorders. The equipment allows the stroke team to see the brain, arteries and spine with a single injection of contrast media (dye).

"Most hospitals don't have this equipment or the trained personnel," says Mark Myers, MD, neuroimaging and neurointerventional medical director of United's Nasseff Neuroscience Center.

The team soon pinpointed the blood clot that caused Jacob's stroke. Then Radiologist Michael Madison, MD, directly injected clot-busting medication to the clot via a catheter.

Within minutes, Jacob's headache began to vanish.

Returning to normal
"Once the artery was opened, Jacob quickly started returning to normal," says Myers. "It helped that Jacob was treated within two-and-a-half hours of the onset of symptoms."

Doctors could not pinpoint what caused Jacob's stroke, but he is surely one of the lucky ones. He has made a full recovery with no lasting effects of the stroke. He was able to return to school the following Tuesday.

"I'm just glad I was this close to the hospital," says Jacob. "I'm feeling good just like before the stroke. It doesn't feel like anything happened."

Source: American Stroke Association; Michael Madison, MD, neurointerventional radiologist; Mark Myers, MD, neuroimaging and neurointerventional medical director of Nasseff Neuroscience Center; National Stroke Association
Reviewed by: Donna Lindsay, RN, clinical practice coordinator, Abbott Northwestern Hospital's Stroke Program; Paul Schanfield, MD, stroke medical director, United Hospital
First Published: 05/17/2006
Last Reviewed: 11/02/2010

Bailey Carlson attends physical therapy five days a week at Abbott Northwestern Hospital. Her hands and wrists often get tired during exercises but she's come a long way after having a stroke when she was 16 years old.

Read the video transcript on