Page 7 - February 2020 Ulupono

At 7 a.m. on Saturday, November 9, 2019 preparing to go to Men’s Bible study, I felt a sudden shock through my body which caused me to bend over feeling woozy, weak and limp. There was no vertigo, no pain and no shortness of breath. Staggering to the living room, I asked my son-in-law who had just wakened, to take me to the ER.
I had been feeling well; I did my morning exercises as usual with no problems. I was monitoring my blood pressure because my antihypertensive meds were changed 12 days before. It was high, in the 160s which was unusual. In 30 mins it went up to the 170s. The feeling of “shock” occurred approximately 15 mins after this. Being
a Neurologist, I realized that this sudden shock was my central nervous system, not cardiac.
I called the ER as we made our way to Adventist Health Castle and notified the staff that I was coming in with a possible stroke. In the ER they quickly assessed me physically. Though my responses were weak, there were no problems with my speech or vision. The only severe deficit was my inability to raise my left arm. My left grip was weak too. Now my BP was 200/100.
Neurologists coined the phrase “Time is Brain” because the treatment with the drug tPA (clot busters) achieves the best result if given early, with the limitation
of having to be given within 3 hours
from onset of symptoms. Experience has shown, however, that the earlier tPA is given the better the recovery if the NIH criteria is met. Because of this, the ER staff needed to get their assessment done rapidly. The Castle ER associates (nurses, Kimberly Danks and Jessica Ellis, and Dr. Juliana Minak) knew exactly what needed to be done and performed the necessary procedures swiftly. The Neurological consultant, Dr. Vimala Vajjala, the pharmacist, the CT and MRI radiological techs all came in to do their part, following the required protocol. Swift teamwork is absolutely required to have a successful outcome and I want to recognize stroke specialist Dr. Jason Viereck for putting this protocol in place and coordinating with
the ER caregivers to be able to offer this treatment. It is a miracle – especially if you are the victim – but it takes a team of professionals on the front line to make it happen. We are fortunate to have such
personnel in a medical center in the midst of our community.
The story doesn’t end there. There is
much more to be done with more careful monitoring over the next 24 hours because of the danger of bleeding in the brain with this medication. The ICU staff (nurses Jessica Fa‘ainuinu, CJ Moody, Moyna Lipscomb and Dr. Dan Bendtsen) are very professional and compassionate and made me feel like I was the most important person they were caring for. In that 24 hours in the ICU, BP monitoring is crucial because if it drops too low, your brain would not receive the oxygen it requires to keep the brain tissue viable and you cannot let the pressure go too high because that could lead to bleeding after receiving the “clot busting” meds. There were optimistic signs of improvement, indicating the
tPA given in the ER was perhaps helping because I was able then to raise my left arm to the horizontal but could not lift it above that level till I was moved to the Telemetry unit the following day.
The telemetry nurses (Emma Burelson, Mei Ling, Lauren Miho, Veronika Von Schert, Stephanie Joyce Jones, Lauren Healy and Kristin Jacobson from Med-Surg) were outstanding. Being more alert and more stable, I caused some consternation, trying to get out of the chair or bed and causing the alarm to go off. The nursing staff is well organized, and with empathy and camaraderie they explained gently that they were there for me. With each change of shift, the relieving nurse was brought
to my bedside and introduced to me. Each nurse conveyed the attitude of being there
to make me comfortable and to relieve any pain I was experiencing.
It is difficult for physicians to be in this situation and not have control over it.
You do not realize how helpless patients are until the patient lying in bed is you. Closing my private practice in 2007, after 12 years at Castle, I have learned that
life and even the practice of medicine
is not about control. It is about respect
for others and love for your fellow men and women as Christ has preached. It
is so comforting to know you have a competent and gentle person taking care of you. When you are lying there, helpless, you appreciate the warm smile, and the caring attitude the associates convey. It
is a special person who can leave their own cares at home for the time they are in the hospital and focus on the patient’s comfort and needs. Not many people
can do this. I thank the Adventist Health Castle leadership for instituting this kind of patient care and fostering the type of attitude shown throughout the hospital. Even the dietitian who discussed my meals with me impressed me. He was already aware of my food allergies and lactose intolerance and had already substituted non-diary milk in my tray. I especially appreciated the comforting scripture cards emphasizing God’s love, attributing their accomplishments to Him.
I have been blessed to have been cared
for at Adventist Health Castle and know that I experienced a miraculous recovery with God using this Medical Center and the associates to do His will.
FEBRUARY 2020 - ULUPONO
| 7