If You Think it’s a Stroke, Get to the ED

Gabriele Hartman
If there’s a chance you’re having a stroke, Gabriele Hartman says get to the hospital fast.

Gaby, an Alegent Health Clinic employee, tried to wait out what she thought was a migraine, but eventually ended up in the Alegent Health Mercy Hospital Emergency Department (ED).

“I had absolutely no idea that it was anything worse than a really bad headache,” she said. “I have headaches a lot, but that was the worst I've ever felt in my entire life.”

She eventually got the full spectrum of stroke care at Alegent Health, from the ED to a hospital stay to rehabilitation, said her husband, Kris.

Above and Beyond

"I’ve told everyone I work with that the care we received at Alegent was above and beyond our expectations, from the moment we got to the Emergency Room to the day we left,” said Kris.  “I can't express how grateful we are to everyone involved in Gaby’s care.”

It all started on Saturday, Sept. 27, 2009 - right after her daughter’s college soccer game in Sioux Falls, S.D.  Gaby, 49, had no family history of stroke.

“I walked back to the car while talking to one of my daughter’s teammates,” said Gaby. “All of a sudden, out of nowhere, the headache just hit me.”

Kris wanted to get medical help, but Gaby refused, chalking it up to exhaustion their work on remodeling a house the day before. They made the three-hour drive home.

“He wanted to take me to the ER, but I said no,” she said. "I was being stubborn because I didn't want the medical bill.”

The most common symptoms of stroke are weakness in one side of the body or numbness and tingling, or blindness in one eye, that comes on suddenly and for no apparent reason, according to Blanca L. Marky, M.D., neurologist with Alegent Health Clinic in Council Bluffs.

Care delayed

“Time is brain,” said Dr. Marky, “and the first few hours of a stroke are critical for getting a diagnosis, then starting therapy.”

“When the stroke alarm goes off, we all know we’re on a time constraint - if we are going to be successful everyone has to run,” said Dr. Marky. “The sooner you start the recovery process, the better it is going to be for the patient.”

In Gaby’s case, she went to bed, slept most of the weekend, then saw her doctor for a migraine shot Monday. She made it to work Tuesday, but only for an hour. Finally, she headed to the Emergency Department.

Diagnostics

“Gaby was disoriented, and told the ER doctor that she was having a hard time focusing on him,” said Kris. “That’s when he did a CT and found the bleed located in the lower left part of her brain.”

She was admitted to the Intensive Care Unit where the bleed in the parieto-occipital region of her brain caused her condition to deteriorate.

“She didn’t know me, who she was or where she was,” said Kris.

“Apparently, I was saying some pretty weird stuff,” Gaby said.

An Anniversary They Won’t Forget

By Friday, Gaby was unresponsive, and another CT revealed further swelling and shifting of the brain.

"At that point, Dr. Nathoo told me, ‘We have to go in and relieve the pressure,’ ” said Kris. “It was our 28th wedding anniversary, and I just broke down at the point. I’d been up for three days straight.”

Alegent Health Clinic

Narendra Nathoo, M.D., a neurosurgeon with Alegent Health Clinic, immediately reassured Kris.

“He was very thorough in explaining everything he was going to do in great detail,” said Kris. “Everything was precision and it went like clockwork. Even in the waiting room, I got updates.  That made it a lot easier.”

The day after surgery, Gaby could not see out of her right eye, and had no right peripheral vision in either eye. “When I looked at a person, I only saw half of them,” she said. But she did recognize her husband again, and was surprised to learn how long she’d been in the hospital.
   
“Dr. Nathoo told us, ‘That's an anniversary you won't forget,’” said Kris.

Rehabilitation

After her hospital stay, Gaby was admitted to the Immanuel Rehabilitation Center. She had a week of speech, occupational and physical therapy to help restore her motor functions.

“They keep you busy, and I really like that because it made the day go faster,” said Gaby. “They have a schedule – you’re up at seven, dressed, have breakfast, physical therapy for an hour, then a break, then you have speech therapy.”

Kris said that once again the staff put his mind at ease.

“They explained everything they were doing in great detail, every step of the way, 24 hours a day,” said Kris. “There was never any question about treatment or medications being prescribed. If I had questions, they answered them all.”

Thanks to the collaborative team of care providers at Alegent Health and Alegent Health Clinic, Gaby returned to her job at Alegent Health Clinic right after Christmas, on Dec. 28. While much of her vision has returned, she had to turn in her reading glasses for a stronger prescription. She also is on medication to control her blood pressure.

Risk factors for stroke include high blood pressure, high cholesterol, a history of stroke or heart disease, and tobacco use. Now that their mother has suffered a stroke, the three Hartman children have been briefed on these warning signs by their parents.

Meanwhile, Gaby and Kris are looking forward to many more anniversaries.

My 2008 Heart Attack

On September 21, 2008, I suffered a massive heart attack. My wife Jan and I had just finished washing our boat when I stood up and felt pressure in my chest. Never having had a heart attack before and only being in my mid 40's, I assumed I just had indigestion. My left elbow was cramping up but I attributed that to the work we were doing. Jan asked if I thought I might need to go to the hospital. After a few minutes I reluctantly agreed. A couple of blocks from our home the pain subsided and I assumed I must have indigestion or an anxiety attack or something; surely it wasn’t a heart attack. We went back home and after about five minutes the pain was back, only stronger. So off we go to Midlands Hospital again.

This time the pain did not subside but continued to get worse. By the time we got to Midlands I was in severe pain. It felt like someone was squeezing my chest with a vice. When we pulled up to the emergency room my wife ran in to get some help. When she came out I tried to get out of the car. I can remember saying to her that I didn't feel right and I was dizzy. That is the last thing I remember.

This next part is what I was told happened next. My eyes rolled back in my head, I lay back in the seat and was basically gone. One nurse jumped into the car, climbed up on top of me and performed CPR. Then they pulled me out of the car placed me on a gurney and had to shock my heart to get it going again. Within minutes the staff had rushed me into the cath lab and Dr. Carstens and Dr. Ramachandran placed a stint in me. During this extremely hectic time, the hospital Chaplain never left Jan's side.

When I awoke I was in the ICU. The staff was not only professional, but was far more kind and comforting than I would have ever imagined. Even the cleaning lady was amazing. Remarkably, I was only there for two days, but really felt like I knew everyone I came in contact with. They were so nice! It did not end there. Cardiac Rehab was awesome. From beginning to end I was made to feel like I was the most important patient they had. When I completed rehab they even gave me a graduation t-shirt and a diploma. It was a truly amazing experience.

Terry

Bergan Mercy's Outstanding Customer Service

Bergan MercyI cannot begin to tell you how pleased we have been with the services provided to our son, daughter-in-law and new grandson during their recent stay at Bergan Mercy Medical Center.  The customer service offered within the Labor/Delivery and the NICU was beyond description.  I must specifically thank Traci (Delivery/Labor) and Rose, Deanna and Erin in the NICU.  They were all fabulous in their attentive care to Brayden and Erin (our daughter-in-law).  I even need to mention Kallie and Robin for their incredibly friendly and helpful food service.  Even beyond all this there was just an atmosphere of friendly customer service everywhere in the hospital.  Even the cafeteria was exceptional and reasonable.  The readily available snack foods in the break areas are also a very nice extra touch that was much appreciated.  Ben, Erin and Brayden will be forever grateful. 

-Steve

Thank You Dr. Dunning

Robins-Bolter FamilyMy Compliments to "Triple D" (Dr. Douglas Dunning) and his phenomenal nurse, Rhonda! Our entire family has been patients of Dr. Dunning for close to ten years. We've been so happy with their services that I have called to give Triple D and Rhonda a pat on the back several times a year.  I am so happy that this website is now available to give our doctors and health care workers a shout out loud for the whole public to hear!

I want Dr. Dunning and Rhonda to know that my family appreciates them and all they do for us, and other families, too.  It is such a great feeling to be able to go to your doctor's office and feel comfortable knowing you're getting the best care each and every visit. Dr. Dunning always takes the time to answer any questions we may have. He always lets us know there is never any stupid question.

His nurse, Rhonda, is such a beautiful and compassionate person. Rhonda was our nurse prior to Dr. Dunning joining the office ten years ago. Rhonda has always promptly returned our phone calls, explained test results; and lets face it, Rhonda is Dr. Dunning's third and fourth arm and on some days…..his third leg to stand on.

I want Lakeside to give a big shout out loud to Dr. Douglas Dunning and his nurse Rhonda, because they are very professional, caring, and great people.

I want people to know that all too often all you hear about are the horror Patient Stories about doctors. Turn your Patient Stories into corrective critism when calling in. No one is infallible. The reason I am saying this, is because sometimes I hear people complain in the waiting room that it's taking too long. Take a deep breath, relax, know that you will get your turn too. Health care workers are a special kind people. I am sure if people take the time to talk to their doctor and/or nurse, they will find out their patient/doctor relationship would be stronger.

When my family has an appointment with Dr. Dunning, we write down any questions we have on a piece of paper, so that during our appointment, we get answers to the questions we have.  It's very important to me not to waste my time, or the doctor's time.  All of our questions are addressed to our satisfaction before we leave the office.  Dr. Dunning and Rhonda always take the time necessary to give our family peace of mind with all of our medical concerns. 

They're a great team. Polite, Professional and Personable. 

They have seen our family through laughter, tears, boo boo’s, stitches, runny noses, coughs – due to colds, shots, aches, pains, x-ray’s and more.

Do you know how big my sticker collection is ?????

Thank You from the Robbins-Bolter Family

Best Kept Secret in Council Bluffs

Best Kept Secret in Council Bluffs

My wife, Becca, and I moved to the Council Bluffs/Omaha area about a year ago.  Shortly after moving, we found out we were pregnant.  My wife found Dr. Sotolongo at Metro OB at Mercy Hospital in Council Bluffs and instantly knew he was our doctor.  Through the entire pregnancy, he was very warm, helpful and shared in our concerns - always easing the mind. When it came time to deliver (Due Jan 1, 2010), he decided to keep us after our appointment on the December 23rd because of the winter storm moving in.  Glad he did. Dr. Sotolongo said early on in the pregnancy that he would deliver our baby and there was no need to meet the other doctors in the hospital.  He was so true to his word.  He was not the on-call doctor the night of the 23rd, but he stayed by our sides waiting. 

Our Daughter, Meliah, was born at Mercy Hospital Christmas Eve at 3:49 a.m.  The entire staff, with special recognition to Laurie and Fran, was incredible and a joy to be around.  I could not have asked for a better crew that night.  Even with having a c-section delivery, everything went very smoothly.  Mom was doing great, baby was in wonderful hands (and Dad was tired).  Laurie was one of the main reasons why we chose Mercy Hospital in Council Bluffs.  Her knowledge, warm heart and great thoughtfulness really pushed us over the edge.  The undivided attention that we received from the staff was awesome.  Fran is another nurse that really stood out to us.  Her concern for our well-being and the health of our baby was her top priority.  She was very informative and helpful.  The entire staff, while we were there, even with the terrible weather blowing in, was a warm welcome. 

Dr. Sotolongo, Laurie and Fran will always have a place in our hearts (and baby book!).  We can hardly wait to get pregnant again because we know exactly where we will be coming and know that the staff at Mercy Labor and Delivery will be ready for us!   I just want everyone to know what an incredible experience we had, both with the hospital and with the staff.  We both feel that Mercy Labor and Delivery is one of the "best kept secrets" in Council Bluffs.

-Brian

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