Main Presentation
"A Stroke of Luck"
Bob Newbold
In opening her introduction of speaker Bob Newbold, Capri Frank noted just how imbued with the "spirit of giving" the holiday season is. This was a perfect seque into Mr. Newbold's topic, which would include more than a little note of gratitude.
Bob Newbold's subject was that of "stroke", the commonly used term for a blockage of blood supply to any portion of the brain. Indeed on March 20, 2017 Bob had a stroke himself, survived and recovered, and his story is at once inspirational and cautionary.
An old Newington baseball friend of Capri's, Bob has been an active presence in his community for many years. Many of us will recognize his community involvement as similar to our own. Bob is a 40 year member of Newington Rotary, having served three times as its president. He is a Paul Harris Fellow and past president of the Newington Chamber of Commerce. His roots go back so far that Brian O'Donnell's mother was Bob's English teacher! More recently, Bob was awarded the National Stroke Association's RAISE ("Raising Awareness in Stroke Excellence")award for his work in educating the public about the recognition signs and urgency of response time in dealing with victims of stroke.
Bob's presentation included much that reflected the gratitude he feels for those who helped him, and also his powerful desire to give back. "On strokes, I'm an expert" he quipped, while also stating "I am blessed to be here" and "It's relevant that it's Thanksgiving, as I have so much to be thankful for."
"I preach stroke awareness" said Bob, "and the most important aspect of this is understanding stroke and recognizing its symptoms." Clarifying the underlying disorders leading to strokes, Bob explained the difference between the major types. "Ischemic stroke" is caused by a blood clot that either forms in, or travels to, the smaller blood vessels of the brain, lodges, cuts off blood flow and causes a portion of the brain to lose its oxygen and nutritional supply. This category of stroke includes the TIA (temporary ischemic attack) which causes a temporary interruption of blood flow to a portion of the brain, but resolves spontaneously with no permanent damage. This type is no less serious, however, as it often signals the high likelihood of a full blown ischemic stroke in the near future. TIA may be better characterized as "warning strokes" in that they signal an urgent need to see a physician.
The other major category of stroke is the "hemorrhagic stroke" in which a blood vessel in the brain bursts and bleeds, causing direct pressure on brain tissue and damage to that tissue. Hemorrhagic stroke can occur because of the progressive weakening of a blood vessel wall, leading to an "aneurysm" or rupture. They can also occur due to a preexisting, abnormal cluster of blood vessels known as an "arteriovenous malformation" which may also burst and bleed, causing similar consequences.
Spotting the signs of stroke is made easier through use of the acronym "F.A.S.T." which stands for "Face, Arm, Speech and Time."
"Face" means look for an uneven or abnormally crooked smile. Ask the person to smile and look to see if they can, and if the smile is even. "Arm" means check or see if one arm is weak or immobile. Ask the person to raise both arms and look for downward "drift" or weakness. "Speech" means listen for slurred or absent speech. Ask the person a simple question requiring a response. Is their speech normal or abnormal? "Time" means in the presence of any of these signs call 911 right away. Don't hesitate or assume taking them to the hospital in your car is faster. The rapid pre-hospital care provided by emergency medical system (EMS) personnel on scene and in transit, may make the difference in the eventual outcome for the person. Time lost in moving and transporting a stroke victim in a private automobile is precious time to the victim with potentially devastating consequences.
In Bob's case, EMS was called immediately and from the moment he was found down until he was in the hospital under care was less than 30 minutes. As in Bob's case, known inbound-to-the-hospital potential stroke victims are given the highest priority because time is so critical. Bob characterized his hospital admission experience in this case as having an "Easy Pass." Bob was delivered directly past the emergency department right into a dedicated stroke patient care "ready room", where he was immediately evaluated and treated. Bob can't say enough good things about Hartford Hospital's Comprehensive Stroke Center (https://hartfordhealthcare.org/services/stroke-center) and the care he received there. Bob was given a drug most commonly known by its acronym T.P.A. (more correctly "tPA", for tissue plasminogen activator) TPA is a body protein involved in the breakdown of blood clots in the normal clotting, and clot resolution processes of the body. It activates the enzyme plasminogen which, once activated, breaks down blood clots. Synthetic TPA is used in ischemic strokes, but not in hemmorhagic strokes, which are caused by bleeding not clots. It's logical that TPA would only aggravate a hemmorhagic stroke.
"Stent retriever"
Photo credit: British Medical Journal, January 1, 2017
Once stabilized and the brain's blood clot localized with advanced imaging techniques such as MRI, Hartford Hospital doctors fed a long catheter up through Bob's femoral (major groin) artery all the way into his brain adjacent to the clot. Then a specialized clot removal device known as a "stent retriever" was used to capture and withdraw the clot from Bob's body.
The clot retriever is opened inside a blood vessel to surround and/or embed itself within a clot
that is blocking blood flow. Once entrapped in the stent, the entire apparatus with the clot
is removed from the body through a small puncture wound in the femoral artery at the groin.
Photo credit: Covidien
A clot removed with a stent retriever device.
Photo credit: British Medical Journal, January 1, 2017
Bob completed his presentation by explaining how he is now compelled to share his story, both to express his gratefulness and to help others. He has no residual disabilities and did not need to undergo rehabilitation or physical therapy. His doctor calls him his "miracle man." One added point is that in administering treatment doctors need to know how long ago the stroke event occurred, as this affects the type of treatment given. The doctors ask "Who can verify the last time they saw the patient well and acting normally?" Bob's wife was called, he quipped, and when asked when the last time anyone saw Bob acting normally was?, "It was 5-years ago" she answered! The truth was, it had been just 15 minutes before that he was found by his wife.
Bob's summary message was encourage all to learn to recognize the signs of stroke, and when a stroke is suspected call 911 immediately so that pre-hospital care can begin in the ambulance while enroute to the hospital.
Since his recovery Bob has been in touch with his ambulance crew to thank them and has reached out to the hospital to offer his help in educating others. Bob now gives talks on stroke recognition and response throughout the community. In fact a video of Bob can be seen on the Hartford Healthcare Comprehensive Stroke Center website (https://hartfordhealthcare.org/services/stroke-center).
In the future Bob plans to start a 501(c)3 organization dedicated to stroke education and in support of the work of the National Stroke Association. Capri has promised to help him with this project. Contemplating his community activities on behalf of stroke victims, Bob's final message was: "I've already gotten paid more than I ever could repay."
Bob Newbold can be reached at: 860.874.1479, at: strokeawarenessguy@gmail.com, and at: www.facebook.com/strokeawarenessguy
Image from: http://www.mahindraraj.com/resources/daily-gratitude-and-why-stack-gratitude/
