Stroke: Fast Care Gets Golfer Back on Course

With his wife and daughter out of town, Pete Woods snuck off for an early round of golf at St. Andrews Golf Club.

As he hunched over the ball on the third tee, his vision faltered. He reached to straighten his glasses, but they were in place. His vision cleared enough to hit the ball down the fairway but not enough to reach it.

Water seemed to slosh in his ear as he walked toward the ball. His right foot flopped, and he started walking in circles.

“You are not having a stroke,” he told himself.

Yet Pete, a perfusionist who runs the heart-lung bypass machine at Saint Luke’s Hospital of Kansas City, suspected he was.

His mind was clear. He sat down on the fairway, wondering how long before someone found him. What would his wife think when she learned what happened? Would the stroke make him useless as a father to his 10-year-old daughter? What if he died?

A lucky break

Only minutes later, groundskeeper Justin Beins found him and asked if he was OK.

Shaking his head no, Pete tried to say, “Take me to Saint Luke’s South Hospital.” What came out was gibberish. Justin radioed the clubhouse to call 9-1-1 and to send a golf cart for Pete. The ambulance drove up just as they reached the clubhouse.

The paramedics couldn’t understand Pete either but suspected stroke. The crew had special training from Saint Luke’s on treating stroke patients and knew the nearby Saint Luke’s South had the best treatment protocols in place. They notified the Emergency Department there to activate “Code Stroke.”

Per the protocol, a neurologist, emergency physician, critical care nurse, time management nurse, and lab technicians prepared for Pete’s arrival.

Fancy footwork

Pete’s wallet was still in his golf bag, so he was admitted as “John Doe.” Blood tests, an MRI, and CT scan confirmed a clot deep in Pete’s left cortex, blocking his left middle cerebral artery. It was in an area that would dramatically interfere with a person’s ability to speak, according to neurologist Karen Arkin, MD.

She had to make a quick decision. Should she order tPA? Tissue plasminogen activator is one of the only treatments for strokes caused by blood clots. However, its main side effect can be life-threatening.

“There was small risk of the treatment causing bleeding in the brain, but there was a 100 percent risk of neurological devastation without it,” Dr. Arkin said. She ordered the tPA.

The sooner the clot-busting drug tPA is administered, the less the chances for bleeding. The tPA was dripping into Pete’s vein only 52 minutes after he arrived. This fast action has helped Saint Luke’s achieve some of the nation’s lowest rates for tPA complications.

Alex Sommer, RN, the critical care nurse who had accompanied Pete through the Emergency Department, now prepared to transport him to Saint Luke’s Marion Bloch Neuroscience Institute at Saint Luke’s Hospital. Per the Code Stroke protocol, the same ambulance awaited them. Pete doesn’t remember much about the experience other than how comforting it was to have the same person caring for him.

Sommer and the paramedics anxiously eyed Pete, looking for signs of improvement. In the windowless cab, a paramedic asked whether anyone knew their location.

“We’re on Highway 69,” Pete said. It was the first sign of hope.

At the Saint Luke's Marion Bloch Neuroscience Institute, the paramedics waited for Sommer to return after getting Pete admitted.

They bombarded Sommer with questions: “How did he do?” “Is he going to make it?” “Will he be OK?”

When Sommer gave them the good news, they all jumped to high-five each other.

The sweet spot

Pete’s functioning continued to improve. The next day, he underwent a test to measure impairment on a stroke scale from zero (no impairment) to 32 (severe impairment). Pete aced the test.

“Getting a zero for stroke impairment was better than getting a hole in one,” Pete said.

The experience may not have changed him physically, but it altered his perspective.

“For 25 years, I knew Saint Luke’s was the best place to give care,” said Pete. “Now I know firsthand it’s the best place to get care.” He felt a deep gratitude for his good fortune and for all those who helped him.

On the anniversary of his stroke, he brought a cake he’d made to Saint Luke’s South. He iced it with a picture of a brain using blueberries to depict the blood clot.

“Saint Luke’s is the reason I’m still here now,” he told the Emergency Department staff.

While Pete felt like the luckiest man alive who’d gotten extraordinary care, he was wrong.

“What seemed so special,” explained Sommer, “is just standard protocol at Saint Luke’s.”