Wednesday, January 13, 2016


Barb Polan
Barb's Recovery
January 7th / 2016

Well, I was wrong: Speaking about my book in front of a group of only 6 people was fun – I didn’t cry until I did the reading (pp. 45-46, if you care); then there was no sobbing, just tears running down my cheeks (my miniscule amounts of mascara and eyeliner didn’t even run) and a breaking voice. It was all OK, though, because the first part of the program was interactive: I started my story, and people interrupted politely and asked for further elaboration (for example, one asked the name of the intake ER doctor, which I don’t remember); that made it more relaxing for me than doing a presentation straight through, and my fear of public speaking didn’t show up at all. Then I read.

When I finished, everyone agreed that what I’d written was “exactly what every other stroke survivor feels.” If you’re curious about what prompted that response and don’t have a book to look it up in, please buy a copy here:
buy my book.

And it turned out that one thing in my book is drastically wrong: the Standard of Care at the local hospital, where I was admitted and diagnosed with stroke, has changed drastically. According to the organizer of the support group, who is an RN in charge of stroke care in that ER, there are now four criteria used to establish if a patient qualifies for tPA (a clot-busting drug touted as a miracle treatment to reduce/prevent brain injury in patients with ischemic stroke), which I was not given in the ER because it was “too dangerous.” The criteria are (1) no more than 3 hours have passed since the patient exhibited “normal” function, (2) a CT brain scan shows that the stroke is not hemmoragic (bleeding), (3) a clot has been found, and (4) the patient’s LDL (bad cholesterol) is not above a certain threshold.

If those criteria are met, the doctor is required to administer tPA, which can totally eliminate the clot and prevent most damage. According to the organizer, our local ER doctors have spent years being “afraid of” tPA, but now use it far more often because of her persistence in researching stroke treatment studies in peer-reviewed journals and communicating the results convincingly, which makes me really admire her – that she can get medical momentum to be redirected.  You’ve got to love her: in addition to helping change the Standard of Care for stroke, she gets paged whenever stroke is diagnosed in the ER, and she goes to see the patient and ensure that protocol is followed.

In my case, (1) my symptoms were coming and going from normal to not, then back, (2) my CT scan showed no bleed, (3) an ultrasound showed the clot in my carotid artery, and (4) my LDL has always been low. So, I would have gotten tPA, and there’s a good chance this whole struggle would not have happened. I told her that the change makes me very happy, that others are protected from this heartache.

In my book, I said that nothing has changed, that if I were to go to the ER today, my treatment would be the same. I was wrong.

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