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Treating stroke 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."