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Decision to BE FAST helps save stroke patient

Thursday, September 5, 2019
By William Alexander
Edmonds family and stroke team

Five minutes before a comedy show started at Raleigh Improv, Danae Edmonds, 27, (center, photo) knew something was wrong. She had easily opened her purse a moment before, but closing the zipper was now difficult. Danae’s mother, Raenel, noticed her daughter struggle, saw her face droop and heard her words slur together - two telltale signs of a stroke.

Raenel helped Danae get out of her seat and walked with her away from the crowd. “As soon as we got around the corner, I told her what I was noticing,” Raenel said. “[Danae] said she was okay at first. I said ‘no, you have to trust me. Do you trust me?’ She said yes, and then I called 9-1-1.”

An ambulance arrived and rushed Danae to Duke University Hospital. Just 14 minutes after she arrived at the Emergency Department, a neurology stroke team including residents Puya Abbassi, DO, Ovais Inamullah, MD and Wuwei “Wanye” Feng, MD had given her the clot-busting medication alteplase. Danae’s paralysis almost resolved immediately once the drug was into her body stem. Strength returned to the left side of her body, and she could walk and talk again.

Feng attributes Danae’s astounding recovery both to her mother’s quick decision to call 911 and to the record-breaking speed with which Danae received the life-saving drug.

“When it comes to stroke, time is brain and every minute matters. The faster we get treatment, the safer and more effective it will be,” Feng said. “Nearly two million neurons die every minute after a stroke. If Danae’s mother had hesitated for just a few minutes or the team was slow in assessing the patient and making decisions, she might not have had this kind of recovery.”

Feng also attributed Danae’s recovery to the flawless cooperation throughout the hospital system from paramedics, emergency department physicians and nurses, stroke neurologists, imaging technicians and pharmacists. Once in the door, providers in the Emergency Department had to register Danae within the hospital system, collect her history from the paramedics and her family, place IV lines and communicate with the stroke team. The stroke team then had to confirm her condition, assess the patient, interpret the CT reading, mix the proper medication dose and provide it to her. All of these steps together took less than 15 minutes to complete.

“Acute stroke care is all about teamwork,” Feng said.

Prompt treatment for strokes like Danae’s remains a national challenge. Providing stroke treatment in under an hour of arrival at the emergency room greatly reduces the likelihood of long-term disability and improves quality of life, with better results directly tied to faster treatment.

Unfortunately, only about one-third of stroke patients in the U.S. receive treatment within this window, according to the American Heart Association/American Stroke Association. Women, African-Americans, and older patients are even less likely to receive prompt treatment. Stroke remains the fifth-leading cause of death in the United States as well as a leading cause of long-term disability.

Danae’s condition has continued to improve since her stroke. She has been discharged from the hospital, and has returned to work as a content creator and graphic designer at AspiringCo, the business that she created. Danea hopes to get back to her normal schedule soon and plans to attend Forbes’ Under 30 Summit in Detroit this October. “Done is better than perfect,” Danae says as she returns to work.

Recognizing the signs of a stroke helped save Danae’s life. Use the acronym BE FAST to recognize a stroke and remember what to do. The letters in BE FAST stand for:

  • B - Balance: Is the person suddenly having trouble with balance or coordination?
  • E - Eyes: Is the person experiencing suddenly blurred or double vision or a sudden loss of vision in one or both eyes?
  • F - Face Drooping: Does one side of the face droop or is it numb? Ask the person to smile.
  • A- Arm Weakness: Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?
  • S - Speech Difficulty: Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence like, “The sky is blue.” Is the sentence repeated correctly?
  • T - Time to call 9-1-1

If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.