Board Success Stories
Three local residents who suffered but fully recovered from strokes head the Stroke Awareness Foundation. These officers discovered a lack of awareness among both the public and health care professionals about identification and treatment.
Charles E. Hoffman, a retired San Jose importer of machinery and parts, suffered his stroke in 1997 and was one of the first stroke patients at Good Samaritan Hospital to be treated with t-PA and experience no side effects.
During 2001, Patricia Dando, Vice Mayor of the City of San Jose, suffered a sudden weakness in one side, but did not realize that her symptom was a sign of stroke. Initially she was going to wait to see if she felt better before seeking help. Fortunately, she arrived at Good Samaritan Hospital within the three-hour window where she was diagnosed as having a partial blood blockage in the brain and was successfully treated.
Charles J. Toeniskoetter, a San Jose-based commercial building contractor and developer, experienced a particularly harrowing brain attack in 2000 when his entire right side was paralyzed after a day of downhill skiing in Bear Valley, high in the Sierra Nevada. A helicopter would have flown him to a hospital unequipped for treating stroke if a land-based paramedic had not clung to the door insisting that Mr. Toeniskoetter go instead to Sutter Roseville Medical Center. He arrived just within the three-hour deadline for using t-PA to dissolve the blood clot and has fully recovered.
Local Training Successes
Victims Treated with t-PA After Family Members Attended SAF Presentations
A San Jose woman was successfully treated with t-PA at Good Samaritan Hospital well within the three-hour window because her husband correctly identified her symptoms and immediately took her to the hospital. The husband had attended a presentation on stroke by Stroke Awareness Foundation Chairman Chuck Hoffman at The Villages in San Jose, where he was given a wallet card listing stroke symptoms and urging immediate action.
A Long Beach woman was successfully treated for stroke soon after she called her San Jose daughter and son-in-law for help. The son-in-law had attended a speech by Stroke Awareness Foundation Board Director Chuck Toeniskoetter at the annual American Heart Association luncheon in San Jose. Based on what he had learned, the son-in-law helped direct the stroke patient to a hospital in Los Alamitos that treated her successfully with t-PA.
Fitness teacher in top shape suffers a stroke at 56
Laurel Rudd is one of those people whom most of us would never expect to have a stroke.
She is a fitness instructor, in top shape at 56, and teaches very vigorous exercise classes several times a week. The day before Thanksgiving, while she was demonstrating in front of her class, her left leg started giving out.“I thought it was fatigue. And soon it got better.” But a short time afterward, her left leg became numb, as did her left arm, and she saw in the class mirror that she was leaning to the left.
“I still figured I was fatigued.” She went home, told her husband, and he announced, upon looking at her, that they had to go to an emergency room. “But I didn’t think it was a stroke,” said Rudd.
Despite symptoms that were classic at the outset, Rudd’s symptoms waxed and waned over the next hours and days. The hospital took her vitals, including a CT scan. Her blood pressure was 200/190, but Rudd rationalized saying,“I always have high blood pressure.” The doctors were worried about her blood pressure, but sent her home, recommending she have further evaluation after the holiday.“The next morning I woke up and started talking like I was drunk. I sat at my computer and couldn’t type with
my left hand. My husband took me back to the hospital.” But most of the hospitals were either full or lacked staff that holiday, so after several requests from hospital nurses where they tried to find help, the Rudds finally arrived at Good Samaritan Hospital.“The doctors thought I might have had multiple sclerosis. But they admitted me.” Another CT revealed a previously unidentified blood clot in a large portion of her brain. But Rudd was more than 30 hours past the window for administration of intravenous tPA. Good Sam physicians carefully threaded a very fine catheter from her leg into the brain and applied tPA directly to the clot. Then they installed a WingSpan® stent to hold the artery open.
Rudd is now back to teaching “Zumba” (hot exercise) classes daily, and is feeling better. She can drive and although her left shoulder feels fatigued at times, that’s not a big problem, she said. As to the stroke, Rudd said, “You never know when it might happen. I thought I was invincible.”
Nañez’s recovery came quickly — but less so for her facial expressions
‘I was talking to another woman and I heard my speech – I was starting to slur my words. So I took out my mirror and saw my face. Something looked wrong.’ Cynthia Nañez, 52, was at church when she first
experienced something was wrong.“During closing prayers I felt a shift on the left side of my face. I felt so strange … and then after church I was talking to another woman and I heard my speech — I was slurring my words. So I went in back, took out my mirror and saw my face. Something looked wrong.
“I thought maybe I was tired, since I only had coffee that morning, but I felt the Lord tugging at me to do something,” Nañez said. She asked a friend to take her to the emergency room at Valley Medical Center, where she waited in line. When she arrived at the check-in desk, she could feel the left side of her face go numb. She soon was admitted as a patient.“When they were undressing me, my left side collapsed.
“I felt like Popeye, talking only out of the right side of my mouth,” Nañez said. After several tests, the doctors determined that she was having a stroke due to a blockage of one of the blood vessels in her brain. Luckily, she was within the three-hour treatment window for tPA, a medication that can dissolve blood clots that are blocking arteries. The doctors administered tPA to Nañez.“Before tPA came along in 1995, we simply didn’t have anything we could do to open up the blocked artery,” notes Dr. Jeff Fraser, director of the Stroke Program at Santa Clara Valley Medical Center. “The sooner we give it, the more likely it is to help. One of the biggest problems now is educating people to come to the hospital immediately, as soon as they experience a symptom of stroke. Nañez has done exceptionally well because she came in right away. To improve the chances of prompt treatment even more, in most cases it would be best to call 9-1-1.” Transport by ambulance is faster, delays in the waiting room will be avoided, and paramedics can call ahead to alert the Emergency Department staff to prepare for a potential stroke victim. She stayed three days, and within that period regained the left side functioning of her body — but not her face.“I was told the stroke had completed the cycle — and that my face may not come back,” Nañez said. She went home dejected. But five days later the muscles on the left side of her face were fully restored. She credits that to her fellow-churchgoers at Jubilee Christ Center in San Jose, who were praying for her recovery — and to her own prayers. She is now fully recovered, takes baby aspirin, blood pressure and cholesterol reduction medicines each day and is doing fine. She had been working as a “Pampered Chef” consultant, which involved visiting people’s homes to demonstrate cookware and do demos. Nañez has had to cut back on that, but she is thankful and grateful today.
The issue is recognizing any symptom when it happens
People sense the onset of a stroke in different ways. For some, it is a sudden realization that something is wrong; for others, the physical impairments slowly appear. Responding promptly to symptoms makes a difference in the stroke treatment available to the patient. Take Scott Levene, a healthy 48-year-old who runs his own plumbing contracting business. He never even thought about a stroke — “a heart attack, maybe, but certainly not a stroke,” he said. His family has no history of the disease, and Levene doesn’t smoke or drink. But he had a stroke, right before Christmas last year.
“I went to work and was talking to the guys. I began to feel a little dizzy and things I looked at seemed fuzzy and cloudy. And then it became harder to talk.” During the next two hours, Levene went back into his office, told his secretary he wasn’t feeling well and might go home, but first had to work on payroll.
So he did, and finally left. “I had some trouble with walking and getting to the car, but I got home and then felt more dizzy. I called my wife on the way and she suggested I go to the emergency room to see what was wrong.” Luckily, his son was home and was able to take him to Good Samaritan Hospital, because Levene knew at this point that this probably was not a simple ER issue. When he checked in, his speech was slurred, but his body functions were still intact. The charge nurse issued a stroke alert, and the Stroke Team deployed, shuttling Levene through a series of tests — a CT scan, MRI, angiogram, blood tests, etc. “They never found any clots,” he said. Levene was beyond the three-hour IV tPA window, and although one test showed an occlusion of the left brain stem, a clot was not clearly defined.
The neurologist told him he may have a form of palsy, but he was admitted for observation. The cascade of stroke symptoms could not be stopped. It is not uncommon for stroke symptoms to continue to develop after the interruption of blood flow has been resolved. Later that day, his physical problems intensified. He could hardly walk; his son had to guide him to the bathroom. Levene was treated with anti-thrombotic medications to prevent further clotting, and began to receive physical therapy and occupational therapy in a three day hospitalization. On Christmas Eve, he was transferred for two weeks of rehabilitation to prepare for return to work. Levene is back at work full-time, doing well, and completely functional. “My only problem is that I get tired in the afternoons, particularly my leg.
“But I have been so lucky!” Can it happen again? “I’m sure,” Levene said, “but this time I will be more alert to what is happening to me and get treatment as fast as I can.”
University of Texas Houston Medical School
“San Jose is lucky to have the Stroke Awareness Foundation educating the public about stroke, and helping hospitals and emergency personnel to respond more rapidly. Such efforts have been very successful in Texas, where we used a similar approach of community education and training of hospital and emergency medical personnel to increase the number of stroke victims who could be administered t-PA.”
James C. Grotta, MD
Professor of Neurology
University of Texas
“The Stroke Awareness Foundation has made a spectacular effort to encourage certification of local stroke centers and paramedic diversion of acute stroke patients to appropriate care facilities. This effort will likely have a major impact on public health in our areas.”
Gregory W. Albers, MD
The Stanford Stroke Center
“The Stroke Awareness Foundation has been particularly helpful to our staff at Good Samaritan Hospital as we worked to become a Certified Stroke Center.”
William K. Piche
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