Boulevard, March 2009
Dr. Suzanne Steinbaum
It happens all the time. Friday at 4 p.m. a new patient comes in, wide-eyed, scared and waiting until the last minute to get help before the weekend. Usually these patients are the most sick and the ones who need the most attention. By the time you figure it all out it is 5:05 p.m. and no one is answering the phones. You suggest that the patient go to the emergency room, because you have a gut instinct that it is not good.
Two weeks ago, a familiar face walked in. I’d met him at CBS on The Early Show, where I’ve gone to speak about heart health and living healthy. He had heard my viewpoints and information, yet here he was on Friday at 4 p.m. I knew it wasn’t a good sign. And he smelled like cigarettes.
He looked frightened. As he described his symptoms of weakness and numbness in his face and left arm, I knew that he was in trouble. He said that three days before his visit, the symptoms began suddenly and never went away. His blood pressure was 170/110 and his heart rate was 102, instead of the expected 120/80 with a heart rate of 60. I knew he was having a stroke. He knew he was having a stroke and he was scared, so he had waited three days. We did some testing, but needed an MRI and MRA of the brain to confirm our suspicions. That wasn’t going to happen until Monday.
The best treatment for a stroke is clot-busting medication that should be given within three hours of symptoms like numbness, difficulty with speech, or lack of strength in one side of the body. People who get the medication have less recurrence of stroke. It was a medical emergency on Tuesday, when it happened.
I explained the gravity of his situation. He didn’t want the emergency room and refused any hospitalization. I gave him all the medications that have been proven to help with a stroke to ensure that he remained stable. I told him to be ready to quit smoking. He was so scared. I was, too.
On Monday he was in my office, rosy-cheeked. He had just come from his MRI that documented he had a stroke. His blood pressure was under control, his heart rate down. He was feeling a little better, with his arm less numb and tingly. He looked at me sincerely and thanked me. I felt the enormity of his thanks and responded, “Congratulations on quitting smoking.” I went off to see my next patient.
When I came back to my office, I found a love note, a Friday night memory. There on my desk, he left me his pack of cigarettes and his lighter. We will both survive.
