When a stroke interrupts a road trip, Connecticut family finds home away from home at Christiana Hospital
George and Gertrude Dingwell of Harwinton, Conn., have been making road trips with motorhomes since 1977. This March, they snuck away to Florida in their Winnebago.
But passing through Delaware on their way home, Gertrude had a stroke. The couple ended up having an unplanned, monthlong stay at Christiana Hospital.
From the time of Gertrude’s arrival until her discharge May 24, Christiana Care provided electricity and water for the RV, which served as home for George and their poodle Tobias as Gertrude recovered. This year, Mother’s Day fell on Gertrude’s birthday, and four generations of their family gathered in her hospital room, bringing a banner and cards.
George is effusive about the respect and compassion the staff has shown, embodiments of The Christiana Care Way. A nurse, for example, took time to explain to him why they were going to give his wife a certain medication and how it might affect her. The same was true of every procedure the staff undertook.
One afternoon, Rick Gerard, a security constable, knocked on the door of the RV and asked George if he’d like to join him and his family for a home-cooked meal. George was happy to oblige. They spent four hours sharing good food and conversation.
“It just made an adverse situation of my wife’s health into a pleasant situation for me,” George said.
Diane C. Bohner, M.D., FACP, medical director of Patient and Family Centered Care and Resource Management at Christiana Care, called the staff’s flurry of assistance “extraordinary.”
"And," she added, "it is exactly what you would want to have done if it was your family member. The Christiana Care Way is not only taking care of the patient, but also taking care of the patient’s family. And they treated him, even though he was from Connecticut, as if he was one of their neighbors. They figured a creative way to assist him while he and his wife were going through this particular traumatic period of their life. They did what they thought they needed to do for him without having a second thought about it.”
Teresa Celano, assistant to Christiana Care’s chief operating officer Gary Ferguson, got involved when two members of the X-ray staff asked for the administration’s help. Celano provided meal vouchers and ensured the public safety and maintenance departments were aware of the RV so they could share their water supply.
“When something like this happens,” Celano said, “it is difficult enough, but when you are hundreds of miles from home with no family support, it can be overwhelming.”
On Gertrude’s birthday, Chanel Etty, the charge nurse, ordered a birthday cake. Gertrude wasn’t able to eat cake – she had been without solid food for 24 days – but Etty gave her icing “so she could have a little taste of sweetness.”
During Gertrude’s fourth week of recovery, she began eating soft foods. Soon thereafter, doctors removed her tracheostomy tube. Five weeks after the Dingwells made their unscheduled stop, Gertrude no longer needed a feeding tube.
Meanwhile, she reached milestones essential to returning to her usual way of life, such as walking up and down stairs.
Jill D. Aaron, a radiologic technologist, said that even on days when Gertrude’s condition was touch-and-go, her husband would be walking the hallways, smiling, asking staffers how they were doing.
Though the Dingwells aren’t sure when they’ll embark on their next road trip, they intend to stop at Christiana Care when they pass through Delaware.
“I came into town a stranger, passing through,” he said. “I have met so many people here, that when I leave, I feel like I’m going to leave a lot of friends behind.”
Elizabeth Van Leeuwen was enjoying dinner and a lively chat with her 29-year-old grandson — and suddenly couldn’t speak.
At the time, the 86-year-old great-grandmother from Hockessin, Del., was staying in a rehabilitative center, where she was recovering from a fall.
This latest challenge was an ischemic stroke, sometimes called a brain attack, that occurs when an artery to the brain is blocked.
“When I lost my speech, my grandson immediately knew something was wrong — and he got help right away,” she recalls.
Van Leeuwen was rushed to Christiana Hospital, where a stroke team was poised to evaluate her.
“That saying ‘time is brain’ is true,” says Mary Ciechanowski, MSN, RN, ACNS-BC, CCRN, stroke advanced practice nurse. “We work in conjunction with the Emergency Department to quickly identify stroke patients so we can determine the appropriate intervention.”
Because Van Leeuwen arrived at the ED soon after her stroke, she could be treated with tissue plasminogen activator, known as tPA, a protein that is highly effective in breaking down blood clots. Ideally, tPA should be administered no later than 4.5 hours after the onset of stroke symptoms.
Gregg Zoarski, M.D., a neurointerventional surgeon, used a Solitaire, a new tool in the arsenal of stroke-fighting devices, to remove the clot. The device was approved by the Food and Drug Administration in March 2012, less than five months before Van Leeuwen’s stroke on July 29.
“Basically, it’s a stent on a stick,” he says. “After it’s inserted into a blocked artery with a catheter, it compresses the clot and traps it. Then the clot and the stent are removed.”
In all, the surgery took 44 minutes. Van Leeuwen was headed for recovery less than four hours after she suffered her stroke.
“We are making tremendous advances in stroke treatment and positive cases like Mrs. Van Leeuwen’s are becoming more common,” Dr. Zoarski says.
The Christiana Care Center for Heart & Vascular Health provides round-the-clock minimally invasive services and treatments in a state-of-the-art neurointerventional surgery suite. The health system has one of the highest volumes of stroke patients in the region, providing treatment for more than 1,200 patients a year.
“Everything we do here is 24/7, including surgery, labs, imaging and technicians,” Ciechanowski says.
Dr. Zoarski says Van Leeuwven’s experience illustrates the importance of seeking help immediately if someone shows signs of a stroke. In addition to difficulty speaking, symptoms include confusion, sudden and severe headache, problems with balance or walking, and numbness or weakness in the face, arm or leg, especially on one side of the body.
Today, she is healthy and happy and living at home. She has recovered her speech and is walking with a cane as she builds strength and balance.
“At Christiana Care, I got highly skilled doctors and the latest and greatest in technology,” she says. “After my surgery, I got wonderful care from the nurses. Everyone I encountered was very professional — and extremely nice.”
John Hetherington, 53, of Lincoln University, Pa., is proof of the progress that has been made in stroke recovery. One Saturday in late March, he was showering, getting ready to go to his job as a marine technician, when he suddenly found himself leaning on one side of the shower.
“I thought, ‘I should sit before I fall,’’’ Hetherington says. He called to his wife, who saw that he couldn’t move his left side and told their daughter to summon an ambulance.
At Christiana Hospital, tests showed Hetherington had a right internal carotid artery occlusion, which blocked blood flow to the right side of his brain.
“It’s amazing I’m walking and talking,’’ he says. “I’m working. I went in on a Saturday, came home Thursday and was mowing grass on Friday.’’
Hetherington didn’t know he was at a risk for stroke – he hadn’t seen a doctor in years. But the brush with mortality has changed his life. He stopped smoking, monitors the fat and cholesterol in his diet, takes his medicine and no longer avoids his doctor.
“I’m pretty grateful to be here,’’ he says, crediting Christiana Care with saving his life. “Sometimes I get a little choked up talking about it.’’