Fast care at St. Mary’s leads to miraculous recovery

It had been a routine night for St. Mary’s telephone operator Jeremiah Wiggs, but now something was wrong. He almost never had headaches, but he had developed a terrible one. Worse, he was starting to have trouble seeing clearly.

Maybe it was just being tired; after all, it was nearly 5 a.m. and he had been hard at work all night. Maybe the headache was from staring at the computer screen, or the constant ringing of the phone.

He took a break, heading to the restroom to rinse his eyes in cold water. It didn’t help. On the way back to the switchboard, Jeremiah stumbled; walking was becoming difficult.

Somehow, he made it to the switchboard office where he managed to call hospital security, despite sudden difficulty talking. Officers John Gray and Al Fieldman rushed to his aid. Finding him stricken, they summoned the night nursing supervisor, Cathy Griffeths, who immediately recognized that Jeremiah was showing signs of a stroke. She had him rushed to St. Mary’s Emergency Department.

Fast treatment

Jeremiah was in the right place at the right time. St. Mary’s is the only hospital in the Athens area certified by the Joint Commission as a Primary Stroke Center. The hospital also had just entered into a partnership with the Medical College of Georgia to further advance stroke care. In addition, St. Mary’s recently had created the region’s first neurohospitalist program, putting two neurologists on-site within the hospital to provide the most effective care possible for stroke patients and others with serious neurological conditions.

In the Emergency Department, Jeremiah’s emergency physicians consulted with St. Mary’s neurohospitalists and also used a state-of-the-art, web-based, video link to bring a stroke expert at MCG in on the case.

Together, they activated St. Mary’s streamlined emergency stroke protocols, rushing Jeremiah to diagnostics that would help determine what kind of stroke he was having and what kind of treatment he should receive.

“If it’s an ischemic stroke, one that is caused by a blocked blood vessel in the brain, then we may be able to treat it with the clot-busting drug tPA,” says neurohospitalist H. McCord Smith, M.D. “But if it’s a hemorrhagic stroke, one that is caused by a ruptured blood vessel, tPA must not be given. In the latter case, we consult a neurosurgeon possibly to perform emergency procedures to remove the blood or repair the blood vessel.”

The diagnostics showed Jeremiah was having an ischemic stroke. Because Jeremiah had called for help quickly and received such fast care, he was a candidate for tPA.

“To be effective, tPA must be administered within three hours of the onset of symptoms,” says neurohospitalist C. Van Morris, M.D. “That’s why it is essential for people to call 911 and get to the hospital as fast as possible when symptoms appear. Time is brain, and the longer patients or family members wait before calling for help, the more brain cells die.”

Before doctors could give Jeremiah tPA they had to get his blood pressure under control. Fighting against the clock, they worked and watched as the “golden hour” passed. His blood pressure was still too high. They gave him another course of medications, and then another. Finally, 90 minutes after arriving in the Emergency Department, Jeremiah’s blood pressure settled down. His doctors gave him tPA and then admitted him to St. Mary’s Neuroscience Critical Care Unit, where St. Mary’s experienced neuroscience team continued his care.

The good news was that Jeremiah had survived the stroke. But his doctors and nurses knew that tPA, a powerful new weapon in the battle against stroke, is not a “magic bullet”. They joined his family in praying for the best.

Prayers answered

Fast-forward four days to Jeremiah’s discharge day, and the Neuroscience Unit is humming with excitement. A group of St. Mary’s staff and doctors has gathered in front of the nurses’ station to wish him well. The worried looks of a few days ago are replaced by amazement as Jeremiah walks out of his room and into the midst of his friends.

Walks.

Walks!

No wheelchair. No walker. Just his own two feet.

He smiles as he thanks those who have cared for him. A keen observer might note a slight change in his voice from before the stroke; now it’s just a shade softer and slower. He readily mentions that he may be getting speech therapy from St. Mary’s Outpatient Rehab Center to work on this residual stroke damage.

But his recovery is nothing short of miraculous, and he knows it.

“If it wasn’t for the Lord, I wouldn’t be here now,” he says. “So I thank the Lord for allowing me to be here, and for all the staff at St. Mary’s.”

Jeremiah says he is ready to work with his physicians, including cardiologist Charles Neckman, M.D., to find out what caused the stroke and prevent another one – actions that may also help him prevent a heart attack. That is because ischemic strokes and heart attacks are caused by the same disease process: plaque in the wall of a blood vessel that may block the vessel or break off and flow downstream until it blocks a smaller vessel.

“I told my wife I wasn’t going to sit there and be an invalid,” Jeremiah says. “I will be going to speech therapy. I’m going to take my medicine. If they tell me to work out, I’ll work out. I’m blessed. I’m happy, and I’m ready to come back to work.”