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November 26, 2013 > Improving Stroke Outcomes Takes Teamwork, Community Awareness

Improving Stroke Outcomes Takes Teamwork, Community Awareness

Seminar Addresses Acute Management of Stroke, Chronic Pain After Stroke

Do you know what stroke is? Better yet, would you recognize signs of stroke if someone close to you were suffering one?
If you donÕt have all the answers about stroke, then itÕs a good idea to attend Washington HospitalÕs monthly Free Stroke Education Series, which helps people better understand stroke, including when to seek emergency medical attention.
Next Tuesday, Dec. 3, Dr. Ash Jain, M.D., medical director of Washington HospitalÕs Stroke Program, will talk about acute stroke management, and Doug Van Houten, R.N., Assistant Chief Nursing Officer and clinical coordinator of Washington HospitalÕs Stroke Program, will discuss the acute rehabilitation and chronic care phase of stroke recovery.
Acute management of stroke requires community awareness
ÒIn many cases, stroke is highly manageable if patients arrive in the ER as soon as possible following stroke,Ó Dr. Jain says. ÒCommunity members need to be aware that there is cutting edge stroke care available locally. Furthermore, by acting quickly and calling 9-1-1, they can make the difference between minimal damage and long-term disability or death.Ó
Fortunately for residents of Washington Township Health Care District, the Stroke Program at Washington Hospital is a Primary Stroke Center certified by The Joint Commission and the American Heart Association/American Stroke Association.
ÒThe moment 9-1-1 is called for a suspected stroke, it initiates a protocol intended to maximize outcomes for each patient who is brought to Washington Hospital for a stroke,Ó Dr. Jain says.
Once a patient arrives in the hospital, Dr. Jain and his team of health care professionalsÑfrom neurologists to nurses to interventionists who specialize in stroke careÑhave numerous tools at their disposal to achieve the best results possible.
ÒIf a patient comes in within four hours of suffering a stroke, at this point, we can get good results with administering tPAÑalso known as clot-busting medicationÑintravenously,Ó he explains. ÒAfter that, if the patient comes in between four and eight hours after the stroke, we would inject the drug directly into the brain and still get fairly good results.Ó
The goal, in all cases, is to preserve as much brain function as possible, according to Dr. Jain. Still, achieving this goal requires immediate actionÑbecause after eight hours most of the damage to the brain has been done, and the window for acute treatment has usually closed.
ÒBeyond eights hours there is still a subset of patients that can benefit from aggressive management, and we at Washington Hospital aggressively look for this subset, so as to give them a chance to recover from the damage caused by the stroke,Ó he says.
In addition to expert care by the team at Washington Hospital, effective management of stroke requires community awareness and knowledge of stroke that can be gained through educational seminars like the one Dr. Jain will be presenting.
ÒWith the latest research and best tools at our disposal, we save lives and help to reduce the chances of long-term disability from stroke,Ó Dr. Jain says. ÒAt the same time, we rely on members of the community to take the initiative and learn more about stroke so that they know when to seek emergency care for themselves or a family member.Ó
If you suspect someone is having a stroke, donÕt hesitate, Dr. Jain says. Call 9-1-1.
ÒEven small delays can have heavy costs, and research has shown that outcomes are better when people can properly identify signs of stroke and they know to seek help immediately.Ó
Stroke? What a pain
ÒWhen we hear about chronic care after stroke, how many of us think about pain as a major problem?Ó asks Doug Van Houten, R.N. ÒIt turns out that this is reality. Chronic, consistent pain is becoming more frequently identified in association with stroke.Ó
Following stroke, changes in the brain can lead to a perceived pain response from harmless stimuliÑlike touch or temperature changesÑthat wouldnÕt typically cause pain. Other types of pain associated with stroke include:
* Peripheral neuropathy, which usually occurs in legs and is frequently associated with diabetes
* Spasticity, or spastic paralysis, which occurs when the muscles become so tight that it causes pain
* Shoulder separation pain, which occurs when the shoulder falls out of joint, resulting in the muscles around it atrophying and causing pain
ÒWhen a stroke survivor has chronic pain, it can lead to more depression, and they may not want to be involved in rehabÑwhich makes it that much harder to get better,Ó Van Houten points out. ÒIn many cases, people are suffering in ways that they may not be able to describe, and traditional pain medicationsÑlike Tylenol, ibuprofen, and VicodinÑmay not be effective in relieving this type of neuropathic pain.Ó
He adds that a good neurologist has the expertise to prescribe appropriate prescription pain medicationsÑgabapentin (Neurontin), for instanceÑwhich is why itÕs important to discuss pain symptoms with a professional.
ÒPain management following stroke is complex, because not everybody is the same and not every pain problem is the same,Ó Van Houten says. ÒIf a patient is having an unusual type of pain, it may be hard for them to express. IÕm looking forward to talking to audience members to find outÑhas this been a problem, and if so, how did you deal with it?Ó
Attacking stroke with knowledge
To learn more about acute management of stroke, as well as how to address pain symptoms during stroke recovery, plan to attend the Free Stroke Education Series seminar next Tuesday, Dec. 3, from 6 to 8 p.m. in the Conrad E. Anderson, M.D. Auditorium, (Washington West building) located at 2500 Mowry Avenue in Fremont.
To register, visit www.whhs.com or call (800) 963-7070.

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