Little Company of Mary steps up as a primary stroke center
Evergreen Park hospital puts its skills to use
Physical therapist Kathleen Trapani helps Joseph Smiley, 69, while his daughters, Jackie, right, and Lashawn, stand by his room at Little Company of Mary Hospital in Evergreen Park. (Abel Uribe, Chicago Tribune)
Neighbors called 911, and an ambulance sped Smiley, 69, to Little Company of Mary Hospital and Health Care Centers in Evergreen Park. Within several hours, he had been examined by nurses and doctors, had undergone tests that helped identify his stroke and received a clot-busting drug. By the next morning, Smiley was "ready to dance," though he still needed physical therapy and rest.
A stroke, or "brain attack," occurs when blood flow to an area of the brain is interrupted by a blood clot or ruptured blood vessel.
With stroke being the third-leading cause of death in the country after heart disease and cancer, the hospital decided to beef up its stroke program several years ago with an emergency care protocol requiring quick neurologic assessments, bloodwork, brain CT scan and other tests for diagnosis.
A team of specialists, including neurologists, neurosurgeons, physiatrists (rehabilitation medicine physicians), cardiologists, nurses, and physical, occupational and speech therapists, evaluate and treat patients.
The non-profit Joint Commission recently accredited and certified the hospital as a Primary Stroke Center because of the program changes. The commission launched the certification program in 2003. There are 54 in Illinois, including more than 30 in the Chicago area.
A recent study in the Journal of the American Medical Association found that patients with ischemic strokes who were treated at primary stroke centers had a slightly lower death rate than individuals treated at regular hospitals.
In 2009, Gov. Pat Quinn signed legislation creating a network of the special stroke centers and allowing ambulances with stroke patients to bypass regular health care centers for hospitals with the specialized programs.
Smiley's stroke was ischemic, the most common type, in which a blood vessel to the brain becomes blocked. A small percentage of strokes are hemorrhagic, caused by rupture of a blood vessel in the brain.
Hospital staff suspected stroke in his case because he had trouble speaking. Other stroke symptoms can include facial asymmetry, extreme weakness, numbness, unsteady gait, visual impairment or severe headache.
Risk factors for stroke include heredity, being male, being over 55, high blood pressure, a prior mini-stroke, cigarette smoking, diabetes, high blood cholesterol, heart disease, poor diet and obesity.
Stroke specialists stress the importance of diagnosing and treating patients within three to four hours.
"They get in quicker, and the so-called door-to-needle time or door-to-CT scan time has gotten significantly shorter based on the efforts of our team to improve the handling of these patients," said Dr. Michael Schwartz, medical director of the center and a neurologist.
"It expedites the care of the patient, and as they say, time is brain and the quicker you're able to evaluate and treat the patient, the better the care," said Schwartz.
Ann Miller, who coordinates the stroke program, said the hospital was holding seminars to educate the community about strokes.
Terry Guymon, executive director of neurosciences at Advocate Christ Medical Center in Oak Lawn, which has a comprehensive primary stroke center, said Little Company's program would be good for the hospital and community.
"It could make recovery from the stroke much easier and limit the damage the stroke can do," said Guymon.
Though Smiley's relatives were worried sick when he passed out and couldn't speak, by week's end they marveled at how well he was walking, talking and functioning.
"It's a miracle, really," said Geneva Smiley, his wife, who was visiting with daughters Lashawn and Jackie.
Her husband will need to continue regular physical therapy he started in the hospital to improve his gait, and build strength and balance. He must also stick to a low-fat, low-sugar and low-cholesterol diet and take a daily aspirin and several medications.
While Smiley applauded the hospital for his quality care, he said he was itching to get back home and be in control of his life again: "When I get home, there's some people I can boss."