New Page 1

WE HAVE THE CURE
BUT NOT THE WILL
Journal of Healing – June 6, 2007

By Mary Koch

In 1995, barely two years after my husband suffered a paralyzing stroke, researchers announced they had found a medication that could prevent paralysis in stroke patients.

The news was bittersweet. It came too late for my husband, but we rejoiced, thinking of the hundreds of thousands of people who would not have to endure paralysis. Sadly, our joy was premature.

Each year an estimated 700,000 Americans suffer strokes, which are fatal for about 150,000 patients. Survivors usually face disability. Stroke, more accurately called a “brain attack,” is the leading cause of adult disability.

So you’d think we’d jump right on the cure. But the drug that is so effective, tPA or tissue plasminogen activator, is being given to fewer than four percent of stroke patients.

* * *

OBSERVED a medical school neurology professor in a recent New York Times article: “I label this a national tragedy or a national embarrassment.”

The May 29 article explored why the anticipated “sea change” in stroke treatment never happened. One big problem is that the drug must be given within three hours of the stroke onset. Patients wait too long to get to the emergency room.

The other problem is, you guessed it, money. A confirmed stroke diagnosis requires expensive scanning equipment, not to mention highly paid specialists to read the scans. ER doctors are reluctant to give the drug because of a possible dangerous side effect: life-threatening bleeding in the brain that, in clinical trials, affected about 6 percent of patients.

“There is no particular penalty for not giving tPA,” noted the Times. “Doctors are unlikely to be sued if the patient dies or is left with brain damage that could have been avoided. But there is a penalty for giving tPA to someone who is not having a stroke. If that patient bleeds into the brain, the drug not only caused a tragic outcome but the doctor could also be sued.”

* * *

EFFORTS TO set up adequately equipped and staffed “stroke centers,” even in large cities, have fallen short.

“Stroke patients, unlike heart attack patients, are not moneymakers,” explained the newspaper. “Because of the way medical care is reimbursed, most hospitals either lose money or do little more than break even with stroke care but can often make several thousand dollars opening the arteries of a heart attack patient.”

According to the National Stroke Association, Washington State has only nine emergency stroke centers and only one – Sacred Heart in Spokane – in all of eastern Washington.

The stroke association likes to point out that 80 percent of strokes wouldn’t occur if we, as individuals, would take preventative actions. I don’t know how that number is derived. Seems to me it could leave a lot of stroke survivors not only disabled but also feeling guilty, as if they didn’t try hard enough to avoid the stroke. I know my husband tried diligently.

Stroke is a cruel teacher, but it offers an important lesson: Therapy and healing are based on what can come, not what might have been.

Return to Home Page