Mark Matasic - My Father Didn’t Survive His Stroke. I Want to Make Sure Others Do.
Mark Matasic is a resident of Campbell, Ohio. He has become an advocate for improving stroke systems of care since his father’s passing in 2016.
In March 2015, I was at home sitting at the kitchen table and talking with my father. Nothing was out of the ordinary. Then things changed. He started showing signs of a stroke.
At the time I didn’t know exactly what was going on, but I knew something was wrong. I called for an ambulance. The paramedics came to the house and said it appears as though my dad is having a stroke. His speech was slurred. He had some drooping on the side of his face. His balance was off, and he couldn’t walk on his own.
They said he needs to go to the hospital. We live in Campbell, Ohio, a small town located right next to the east side of Youngstown. At that time, there were two main hospitals in Youngstown. The paramedics asked me which one we prefer, and I said the one which is about a 10-15 drive from our house. I chose it because it advertises itself as a stroke center.
At this hospital, my dad’s condition took a turn for the worse. Upon arriving at the hospital, my dad was taken to the ER. My dad sat in the ER for several hours with the same symptoms he had in front of EMS. The only doctor to personally eventuate him was an ER doctor. No neurologist, no neurosurgeon, no interventional radiologist saw my father. The ER doctor originally told my father and family that he had a clot in the back of his brain and that surgery was needed to remove the clot. If surgery wasn't performed to remove the clot, he could die. Then, my dad was reassured by the same ER doctor that he would be fine, and as a precaution, they were going to keep him overnight in the medical ICU and that he would be seen the next morning by a neurologist. I asked and was allowed to spend the night with my dad in the ICU room. The only doctors who saw my father in the medical ICU were two residents.
In the early morning hours, my dad crashed. He started shaking and stared off in the distance with his eyes fixed. There were still no neurological specialists around.
It wasn’t until several more hours that doctors attempted to remove the clot to allow blood to flow to the portions of the brain that were being affected by the stroke. This procedure to remove the blood clot is called a thrombectomy.
My dad never regained movement in any part of his body nor was he ever able to speak or eat again. After a few days in the neurology ICU, my family decided to have him sent to another hospital. Doctors there diagnosed my dad with a condition called Locked-In Syndrome. This is a condition where all voluntary muscles in the body are paralyzed except for the eyes. The person is still conscious and aware of their circumstances, however.
My dad spent a month in the neuro ICU, a month in a long-term acute care facility and then a few months at a rehab hospital in Chicago. In August of 2015, I brought my dad back home to care for him. My dad passed away on March 1, 2016. Had my father received the thrombectomy when he first got to the hospital in Youngstown, he would be alive and well today. Or, if the hospital had given us the option to have him transferred before he crashed where they could have and would have performed the thrombectomy, my dad would be here today enjoying his family especially his four grandchildren. Or, if the first hospital had performed a thrombectomy immediately after he crashed in the early morning hours, my dad would be here today enjoying his life and family.
Since my father’s passing, I have learned more about how stroke patients access care, and how often the systems of care fail them. I now know that my father was experiencing an acute occlusion of the basilar artery. The basilar artery is the primary source of blood to the posterior portion of the brain. The only way to treat patients with stroke is to restore blood flow to the portion of the brain by removing the clot that is preventing blood flow.
The kind of stroke my father was experiencing is often referred to by medical professionals as an emergent large vessel occlusion or ELVO. These strokes can be devastating without immediate treatment. The well-known maxim in stroke neurology is “time is brain.” This is because for every moment that the brain is deprived of blood, neurons and tissue are dying.
While nothing can lessen the pain of my father’s passing, I was heartened at the end of 2018 when Governor John Kasich signed a bill that will prevent other families from experiencing the pain my family has felt since the loss of my father.
Thanks to the bill, new written protocols will be developed to help EMS personnel assess patients, then triage and transport them to a facility equipped to provide the appropriate care. The protocols should include education for these personnel about identifying patients experiencing ELVO, for whom neuroendovascular stroke surgery (i.e., a thrombectomy) can be lifesaving if received in a timely manner. Finally, the bill clarifies the designations for hospitals depending on their capability for treating stroke patients.
In Ohio, where nearly 6,000 people died from stroke in 2016, this bill will help more patients avoid death and long-term disability after stroke.
Unfortunately, many states don’t have protocols that their emergency personnel can follow to make decisions about triage and transport of stroke patients. The choices these personnel make can be life-or-death decisions for patients, because millions of brain cells die each minute blood flow is denied to the brain.
My dad is proof that all states need to take action like the government in Ohio has to make sure patients get to the right place at the right time. I am grateful to our legislators for taking the steps to ensure more Ohioans can survive stroke, and I hope other states will follow suit so other families can avoid the devastation that mine has experienced. All patients deserve the chance to survive and thrive after stroke.