'Time Is Brain' When You Have A Stroke
Stroke is one of the most common medical emergencies. The effects of a stroke last a lifetime, and treating the condition can be extremely expensive. But if doctors can diagnose and treat a stroke quickly, they can reduce the damage a patient suffers.
The neurology department at the University of New Mexico is working to develop a program that could cut emergency response time for stroke patients way down.
Marvin Taylor still remembers the day he had a stroke. It was 1987, just a few years after he retired from a long career in the Air Force. Taylor said when it happened, he didn’t even know he was having a stroke.
“When I had my stroke I had no idea what it was,” Taylor said.
Taylor’s stroke affected his speech and cost him the use of his left eye, and now he needs a wheelchair to get around. He runs a support group for stroke survivors and says most people have no idea what a stroke is until they have one.
“Very quickly a stroke turns your life upside down,” Taylor said.
Most folks don’t know what to do if they are having a stroke, Taylor said. A lot of people feel the symptoms, like numbness on one side of the body, then try to wait it out, or take a nap and hope it goes away.
Dr. Atif Zafar, a neurologist at UNM Hospital, said that can be a bad idea.
“You know the main thing in stroke care which is sometimes different than the regular care for all other diseases is that time is brain,” Zafar said.
“Time is brain” because the longer it takes to get treatment after a stroke happens, the more damage the brain suffers.
“So that’s the key in all acute stroke management, it all comes down to this—that we need to provide care to our patients in a very timely way,” Zafar said.
But even if you call 911 right away, Zafar said, you have to wait for the ambulance to come and take you to the hospital, and for neurologists at the hospital to give you a diagnosis and start treatment. By that time, the damage can already be severe.
So how do you cut down the time it takes doctors to respond to a stroke? Zafar and the UNM Neurology Department think they have an answer. It’s called a mobile stroke unit.
“It’s a slightly larger ambulance than normal,” Grotta said.
Dr. James Grotta is a stroke researcher from Houston. He directs the mobile stroke unit program there, and he brought one to Albuquerque for a demonstration last month.
“The mobile stroke unit has this CT scanner right on board and all the other capability, so we can treat the patient right on the scene and save a substantial amount of time," Grotta said. "If you could treat a patient faster, you presumably will have less brain damage from the stroke and they'll get better.”
There are two different kind of strokes, and each has to be treated a different way. This mobile stroke unit comes stocked with stroke medications, and a live camera feed to the hospital’s neurology department so experts can diagnose a stroke at the scene and start treatment before they start driving to the ER. It also has an EMS crew that’s specially trained to respond to stroke cases.
It’s the state of the art in stroke medicine, and it’s made a big impact in places that have them, like Houston and Cleveland. But Dr. Chris Calder, who runs UNM’s neurology department said there’s a catch.
“They are extremely expensive,” Calder said.
Calder’s not exaggerating—the price tag on one of these mobile stroke units is about $1 million. That’s more than six times the cost of a regular ambulance. With New Mexico’s economy in such bad condition, Calder said figuring out how to pay for one will not be easy.
“We have no idea at this point how this is going to be paid for," Calder said. "Given our economic climate, I think this is something that we will be reliant on donors to provide funding for."
But when you look at the big financial picture, Calder said, buying a mobile stroke unit would actually be a big money saver in the long run.
UNM Hospital treats around 500 to 600 strokes a year. Each one of those strokes could cost up to $64,000. Calder said a mobile stroke unit could make a big difference for the stroke victims it saves and pay for itself in a few months.
For now, Calder said, if you feel any symptoms of a stroke, or you notice them in someone you know, things like unusual numbness or slurred speech, call 911 right away. Because remember, time is brain.
Ed Williams contributed to this report. KUNM’s Public Health New Mexico project is funded by the W.K. Kellogg Foundation and the McCune Charitable Foundation.