fbpx

Posts

Managing A Collapse In Your Massage Therapy Clinic

Like it or not, it is going to happen one day.

You do your intake with a patient, leave the room and on your return there they are, lying on the floor not breathing.

Your adrenaline rushes because you never thought you’d actually have to deal with this…ever.

But the odds are against you.

According to the heart rhythm society, in the U.S. more than 350,000 deaths occur each year because of sudden cardiac arrest, which is more than breast cancer, lung cancer or AIDS.

Sudden cardiac arrest takes an average of one life every two minutes.

Unfortunately 95% of people who suffer a cardiac arrest lose their life because of delayed treatment.

However the bright side is that you can help. The odds of being able to revive someone greatly increases when you witness the collapse.

Fortunately when we have our patients in the clinic, chances are we are going to witness the collapse in case they experience a cardiac arrest.

Initial CPR

If you ever witness a collapse, or walk back into your massage treatment room and see someone unconscious, the first thing you have to do is assess if the person is breathing.

We do this by using a technique called: “look, listen and feel”.

Firstly, squeeze the persons traps and see if they respond in anyway. Then put your ear overtop the persons mouth, place a hand on their chest and look at the chest for 15 seconds.

See if you can feel a breath on your ear and watch to see if your hand on the chest rises at all to indicate breathing.

If there is no air exchange occurring, tilt the persons head back, check to see if they start breathing. If they don’t start breathing on their own keep the head tilted back and attempt to give the person two breaths.

Watch to see if the chest rises, indicating air going into the lungs.

If the chest rises, it shows that the person has an open airway, so you can begin chest compressions (if the air didn’t go in, it means something is blocking the airway so they could have choked on something).

If they had choked on something, you would start compressions as well, however the intent of the compressions now is to clear whatever the person had choked on.

To start your compressions, landmark at the persons armpit on the side of the body opposite to you. Then bring the palm of your hand up to the sternum and deliver 30 chest compressions.

Continue to deliver 30 compressions and two breaths until more help arrives.

Once you realized the person was not breathing and CPR was necessary it is important to get someone to call 911 for you, and if available get an A.E.D. (automated external defibrillator).

If you’re on your own, grab a phone, bring it back to the person and call 911. Put it on speaker phone and the 911 dispatchers will coach you on what to do.

Using An AED

People often think that an AED works like the paddles the doctors on TV shows like ER use to jumpstart a persons heart.

It doesn’t work like that.

If the heart is completely stopped and flat lined, the AED isn’t going to do anything.

There has to be a “shockable” rhythm, a tachycardia (fast rhythym) or bradycardia (slow rhythym) for the AED to do anything.

There are a few things to take into consideration when using an AED.

If you are in a wet environment (you sports therapists) you have to do a splash test.

If the ground is wet and you slap it, if it makes a splash you have to move the person before you can allow the AED to deliver a shock. If the ground is just wet and there is no splash, it’s fine to deliver the shock.

If the person has a really hairy chest, then you have to shave the chest before putting the pads on. The pads have to be in direct contact with the skin to work properly (fortunately AED kits come with a razor in them).

Also if there is any metal (ie: underwire bra, jewelery etc.) in the path of the pads, it should be removed or it will leave burn marks. Same for any kind of nicotine or medical patches, they should come off.

Then just turn the machine on and follow the directions, don’t try and jump ahead, just do what it tells you.

Make sure when the machine says “everyone stand clear”, no one is touching the patient. If someone was still doing compressions, the machine would read that as the rhythm of the heart instead of it’s actual rhythm.

Also, the second time it advises to make sure “everyone stand clear”, is when it’s about to deliver a shock. Make sure no one is touching the patient or they will get shocked as well.

If the AED detects a “shockable” rhythm it will deliver a shock and you will see the body rise up a bit.

If there is not a “shockable”rhythm it will say: “no shock advised, continue doing two minutes of CPR”.

If you have a second person with you, have them take over doing CPR, so you get a break. Then alternate with the other person every two minutes so that one person doesn’t get tired out.

It should look something like this:


This can be a pretty scary situation to have to deal with. I honestly hope you never have to. However if this ever happens and the outcome isn’t what you had hoped for, please reach out and talk to someone about it. As healthcare professionals we are constantly telling patients to do proper home care, or are referring people to get more help should they need it. This is one of those cases where we really have to take care of ourselves after an incident like this. Chances are if this happens in your clinic, you already have a therapeutic relationship (and possibly a long standing one) with your patient. Going through a shocking scenario (no pun intended) such as this can bring up some very strong and sometimes scary emotions from the person who has to perform CPR. So please reach out and get some counselling or talk to some sort of mental health professional should you ever go through this. Remember how important your own self care is.

 

 

Choking Emergencies And Infant Massage

 

More and more I’m seeing Massage Therapists offering infant massage as well as massage classes for parents to teach them how to connect with baby and give that extra bit of care to their new infant.

But what happens when there is a medical emergency with an infant in your clinic?

Do you know what to do when one of those infants starts choking?

To start, play the first video below and I’ll get into some instructions on how to handle this kind of emergency in your clinic.

It’s a valuable skill to have and is important in and out of your clinic. But keep in mind, the videos are not a substitute for taking a proper course.

So remember, if the baby is coughing that means they have an open airway it is just somewhat restricted.

We don’t do anything except encourage them to cough up whatever it is they are choking on.

You need to intervene if:

  • The baby is making high pitched noises.
  • Is too weak to cough.
  • Is wheezing.
  • Becomes rigid due to a completely restricted airway.

Have someone call 911, get an AED (if available) and start your back blows and compressions.

Make sure the baby is always supported on your thigh, so there is a solid surface to deliver your back blows and compressions against. With the baby sandwiched between your forearms deliver five back blows between the shoulder blades.

Then flip baby over and rest on your other thigh, deliver five chest compressions with two fingers land marking between the nipples. You want to deliver about a 1.5 inch compression.

Continue to do this until the object is cleared and baby starts to cry, or becomes unconscious.

If the back blows and compressions didn’t clear the airway, now you’re doing CPR.

However once the baby went unconscious there is a chance the airway opened up because of the musculature in the neck relaxing, so we “look listen and feel” for 15 seconds to see if baby has started to breathe at all.

If they’re still not breathing, we slightly tilt the head back to try and open the airway and attempt to give two breaths. If there is still a blockage and we see that no air went in with the breaths, (if air does go in and baby is still unconscious and not breathing, we still continue) we landmark between the nipples and deliver 30 chest compressions using two fingers.

We continue with 30 compressions and two breaths until the baby starts breathing on its own, or more help arrives to take over CPR.

When First Responders arrive, they will take over CPR but have some equipment and different techniques they will use to help the baby.

Hopefully if you are doing infant massage, or just know someone who has a baby, these videos will help you feel a little more confident should you ever have to deal with a choking emergency. Please remember that these videos and this blog should not be used as a replacement for taking an actual CPR course. If this is something you do a lot in your practice, please take the time to go and get the necessary training to be confident in dealing with infant emergencies, it could literally mean someones life one day. If you know someone or have a colleague that could benefit from the information here please share it with them.

Osteoporosis And My Mistake

I came around the corner just as he was sitting this elderly gentleman down.

He looked at me and said: “deal with this I’m going back to the bench”.

Fairly confused, I looked at this elderly gentleman and asked what happened?

He was on the ice taking pictures of the hockey team, as he walked off he slipped and fell on the ice.

Bearing weight on the right side was painful, but there wasn’t a lot of pain while sitting down. I grabbed his leg and passively moved it, no pain.

He called his wife (who was more than a little upset as the game had just started and now she was missing it) because I said he needed to go to the hospital.

We draped his arms over our shoulders and walked him out to their mini-van. She took him to the hospital and I didn’t see them for another year.

The Mistake

For years I have taught first aid courses to other Massage Therapists.

I have viewed the power point slide, I have repeated the information in the slide, I have highlighted the importance of the slide.

The slide I’m talking about says you should all 911 if:

  • The injury involves the head, neck, or back.
  • The injury makes walking difficult.
  • The injury involves the thigh bone or pelvis.
  • There is an altered level of consciousness.

However, things didn’t add up.

When it comes to treating injuries and dealing with first aid, one of the things we always harp on is “Mechanism Of Injury” (MOI).

We always use this as a method to quickly determine if there is a spinal, head or neck injury, to see if spinal precautions need to be taken. For those of you who have taken advanced or even basic first aid (and let’s be honest, just as the anatomy pro’s that you are) you understand the importance of stabilizing the neck to reduces possible spinal injuries.

But in this case the mechanism of injury made me second guess myself.

We always worry about further injury when a persons injury is a result of:

  • A fall from any height.
  • Found unconscious for an unknown reason.
  • A diving injury.
  • A blow to the head, neck or trunk.
  • A car accident.
  • Lightning strike or electrocution.
  • A persons helmet is damaged.

But this guy didn’t fall from a height, so why would I worry about the injury being that extensive!?

All he did was slip on the ice, there was no fall from a height of any kind.

But like an idiot, I didn’t use the information I had taught so many times.

Walking was difficult and the injury was to the pelvis, it should have been a 911 call.

However since I didn’t think the mechanism was bad enough, I was comfortable to get him to the hospital without using an ambulance.

Photo by: CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=243621

Photo by: CC BY-SA 3.0, https://commons.wikimedia.org/w/index.php?curid=243621

Osteoporosis

For years I taught these courses and never understood why there would be a power point slide about Osteoporosis.

NOW I KNOW!

When I saw this fellow a year or so later, he looked completely different (he had developed some other health issues well beyond his fall that night).

I asked him how things turned out, he said he had broken his hip and had to have a full hip replacement (as a disclaimer, the injury caused the hip problem, not the fact that I didn’t call 911 that day, I just should have handled things a bit better).

Osteoporosis is the leading cause of bone and joint injuries in older adults, the bones don’t have enough calcium, which makes them frail.

According to osteoporosis.ca there are some frightening statistics:

  • 70-90% 0f 30,000 annual hip fractures are a result of osteoporosis.
  • 1 in 3 women and 1 in 5 men will suffer a fracture due to the disease.
  • Without BMD (bone mineral density testing) 80% of fracture patients are not getting proper osteoporosis therapy.
  • 80% of all fractures in people over the age of 5o are a result of osteoporosis.
  • Fractures from Osteoporosis are more common than heart attack, stroke and breast cancer combined.

Think about what this means for your practice.

How many people do you see on a regular basis that are over the age of 50?

This exact situation could happen at any point in your clinic with an older person coming in for treatment. That gentleman didn’t know he had Osteoporosis, but was diagnosed with it after he fell.

If at anytime one of your patients comes in and suffers a fall on-site that seems harmless enough but there is an injury to the pelvis or thigh and makes it difficult to walk, be sure to call 911 and get them to the hospital in an ambulance. If the person suffered a fall at home and is coming in for treatment, there are some things to look out for. Check for any deformities in the area they are complaining about, along with swelling and point tenderness that could indicate possible injury.(1)  

Studies are showing how exercise and strength training are effective ways to manage Osteoporosis once a patient receives the diagnosis, which also plays an important role in building confidence to prevent future falls. As Massage Therapists we want to make sure to use the appropriate pressure when giving treatment, to avoid any injury while the patient is on your table. One study researched a L5 unilateral pedicle fracture on a 66 year old man as a result of an aggressive back massage.(2)  

Do yourself, and your patients a favour by not making either of these mistakes when trying to help them out.


References

  1. Badiyani K, Bottomley J. OSTEOPOROSIS AND ITS MANAGEMENT IN THE ELDERLY. Gerinotes [serial on the Internet]. (2014, Mar), [cited October 24, 2016]; 21(2): 11-18. Available from: CINAHL Complete.
  2. Guo Z, Chen W, Su Y, Yuan J, Zhang Y. Isolated unilateral vertebral pedicle fracture caused by a back massage in an elderly patient: a case report and literature review. European Journal Of Orthopaedic Surgery & Traumatology [serial on the Internet]. (2013, Nov 2), [cited October 24, 2016]; 23(2): 149-153. Available from: CINAHL Complete.

 

Is The Use Of Oxygen A Placebo?

Forgetting to use it could be the difference between passing and failing a Sport First Responder test.

It has a wide range of uses in an emergency care setting, especially when dealing with your athletes in an acute injury or emergency.

Using supplemental oxygen therapy has been a major part of Sport First Responder courses over the years with various reasons for application including:

  • Shock prevention
  • Cardiac Arrest
  • Anaphylaxis
  • Carbon Monoxide poisoning
  • Asthma

However recently I have been hearing rumblings, the use of oxygen may be on it’s way out as an intervention and I recently worked with a sport med doctor who doesn’t use oxygen and downplayed its effectiveness.

But this practice is so hard grained into us, that with pretty much every patient we see in an emergency setting, they get oxygen.

But do we really need it in all cases?

Why The Use Of Oxygen

The biggest reason oxygen is used in these emergency scenarios is to prevent hypoxemia, which is a decreased level of oxygen in the blood, which then leads to hypoxia (oxygen supply which is insufficient to support life).

However there is also a risk of using too much oxygen which results in hyperoxia (too much oxygen in the system), if oxygen therapy is not used properly it can lead to complications, which also depends on the condition your patient is dealing with.

It turns out that hypoxia (which is determined by using a pulse oximeter) is the only evidence based reason to give oxygen to a patient.

The other reasons are based on the assumption that it will help prevent hypoxia and relief of symptoms in an emergency setting.

Shock

I’m sure we all remember what shock is from our time in college, but there is more than one type of shock and we should all be familiar with the various types.

Medical shock is the type we are mainly worried about as opposed to emotional or psychological shock resulting from a traumatic experience or an emotional event.

When someone is suffering from or going into shock, the body is redirecting blood to service the internal organs and keep them alive, which is why you will often see the persons skin turn pale, cool and clammy.

The extremities are not getting the blood supply they’re used to.

But within the classification of “medical shock” there are further classifications of types of shock:

  • Anaphylactic
    • life threatening allergy to a substance
  • Caridiogenic
    • failure of the heart to pump sufficient blood to the body, usually occurs with cardiac arrest
  • Hypovolemic
    • lack of blood in the body
  • Neurogenic
    • failure of the nervous system to control the size of blood vessels causing dilation, common with head and spine injuries
  • Respiratory
    • the lungs fail to get sufficient oxygen into the bloodstream, common with breathing emergencies, respiratory arrest
  • Septic
    • intake of a poison causes blood vessels to dilate

Within the license of a Sport First Responder we would treat all of these types of shock the same way, by putting the patient on oxygen at a 10L flow along with keeping them warm.

In the case of someone having a heart attack (caridogenic shock) there are studies showing the use of oxygen in the first 12 hours may be unwarranted, however would still be appropriate for the sport first responder or until the patient reaches the hospital.

But in some cases with angina attack, oxygen can help with pain relief.

This is also because in the stressful environment of being a first responder, to determine exactly when it is appropriate to administer oxygen (signs of dyspnea or heart failure), so would more efficient to give it to everyone until arrival at hospital.

Common breathing emergencies like breathlessness or asthma should only be treated with oxygen if there is hypoxia present, this is one of those areas where we have always put oxygen on a patient .

In dealing with traumatic injuries that would typically cause hypovolemic shock a study showed that only half of adult trauma patients actually required the use of oxygen in pre-hospital care, yet it was still being administered to everyone.

When it comes to using oxygen therapy for shock it looks like a bit of a mixed bag as to when it’s appropriate to use it and when it is not.

However our Sport First Responder guidelines at this point still say that oxygen should be used to either help prevent or to deal with shock.

 

Photo by: Offutt Air Force Base

Photo by: Offutt Air Force Base

Strokes, COPD And Other Emergencies

I know these aren’t typically seen in the Sport First Responder setting but it’s still important information to know in case you ever have to deal with it.

Again, these are all instances where oxygen would always be put on a patient having an emergency.

New research is showing us that it may not be the best approach.

In patients having an acute COPD (Chronic Obstructive Pulmonary Disease) we have always been told that high flow oxygen is the method to treat the situation.

Studies have shown that using reduced flow oxygen actually decreased the risk of mortality by 58% (1) and leads to worse clinical outcomes. (2)

Using oxygen with someone who is suffering a stroke is also coming under skepticism even though it too has always been promoted as an acute therapy. I’ve used it on patients several times because of the recommendations.

But newer studies are saying that unless there is hypoxia present, the use of oxygen should be avoided (although it is also referring to the first 24 hours of hospitalization).

The same article points out that unless hypoxia is present with a pregnant woman or someone experiencing breathlessness, oxygen should be avoided.

However there is still hope for our friend Oxygen.

Someone with carbon monoxide poisoning should still be given Oxygen. It reduces the level of carbon monoxide in the blood in 40 min compared to 4-5 hours just breathing regular air. 

Even though studies have started to question the use of oxygen in emergency settings, it is still imperative to stick to your local guidelines when responding to an emergency with your athletes. Most of the studies outlined in this post were based on the reading of gas exchange in the bloodstream using a pulse oximeter. Your average Sport First Responder probably doesn’t have one of these in their kit, so it is ALWAYS better to err on the side of caution. Another caveat for the use of oxygen (that I have seen first hand at emergency scenes) is distracting your patient. Having a mask on that is delivering oxygen brings some comfort to a patient, especially with breathing emergencies. I’m not sure it could be considered a placebo effect, but it definitely helps to calm a patient down. The point of this post wasn’t to tell you not to use oxygen anymore, you most certainly should. It was more just to make you aware that there could be changes coming down the road and the next time you re-certify, things might be a little different. In the meantime continue using your O2 cylinders and keep those athletes safe.

 

References:

1. Ntoumenopoulos G. Using titrated oxygen instead of high flow oxygen during an acute exacerbation of chronic obstructive pulmonary disease (COPD) saves lives. Journal Of Physiotherapy [serial on the Internet]. (2011), [cited September 12, 2016]; 57(1): 55. Available from: MEDLINE with Full Text.

2.Cameron L, Pilcher J, Weatherall M, Beasley R, Perrin K. The risk of serious adverse outcomes associated with hypoxaemia and hyperoxaemia in acute exacerbations of COPD. Postgraduate Medical Journal [serial on the Internet]. (2012, Dec), [cited September 12, 2016]; 88(1046): 684-689. Available from: CINAHL Complete.

Massage A Variety Of Patients For A Better Practice

When I decided to become a Massage Therapist all I wanted to do was work with athletes.

While in college, I signed up for every sport outreach available and started volunteering with a local hockey team.

I remember my first hockey game, there was a certain pageantry about it. I was so excited to have the opportunity to be a team member behind the scenes.

Immediately I texted buddies because of the sheer excitement of being there. This was what I wanted, this is what I went to school to do.

Then I started signing up for more sport outreaches. Anything or anyone I could get my hands on with sport, I was in.

I graduated and started working at a rec centre, all with the hopes of working with athletes and sport minded people, helping them perform better. Then I sat quietly in my clinic room. I watched people work out in the gym. The odd time they would come up and ask me questions in the hopes of getting some free advice. None of them booked in.

Then I met an elderly gentleman one day.

He told me he used to get regular massage when he lived in Edmonton. We got to talking for a while and he booked in.

He booked in every two weeks for the next few years.

But I wanted to work with athletes?

A Lack Of Funding And Sport Massage

Pride and dreams are a funny thing.

I stood proud during that first hockey game, proud that I had taken the chance to ask and was taken on by a team as a student. Proud that I was working in my favorite sport. Proud that I was the only one in my class doing this kind of thing.

As I progressed with that team, each week I would work with the team Chiropractor, Athletic Therapist and Sport Med Doctors.

I never brought up the issue of money, I was a student gaining experience after all.

But the topic did come up one day. I learned that all of those healthcare professionals were there volunteering their time. The common theme among all of them “We do it for the kids on the team”.

WHaaaaa?? No one is getting paid?

Things started to get clearer. Working in sport was not going to be the sole way I could earn my living as a therapist (at least to start). Amateur athletes don’t have much money and the majority of the money they do have, comes from funding from other organizations.

This changed everything.

Athletes have become something in my career where I make decisions based on my heart rather than my pocketbook.

While I get a variety in the clinic that are athletes, most of them have other jobs where their benefits package is paying for their treatments. Working with teams in the area is something I still get to do and is still one of my favourite things to do but have to work with them based more on my passion for it instead of basing my income on it.

Quite often teams are underfunded or don’t have the extra funds to put towards a full time Massage Therapist.

In order to work with teams it has become either a strictly volunteer option or part paid, part volunteer, but nothing I could make a full time living on.

Sadly the pocket book has to win out.

Extended Benefits And Massage Therapy

I have often said a Massage Therapist around here could build a practice on hospital workers.

Their benefit plan is phenomenal. They get unlimited massage therapy as part of their benefits package. That’s right, UNLIMITED.

But that almost changed.

Recently their union was at the bargaining table and one of the topics for discussion was their benefits. Rumour has it, there were some in the union that were billing a ton of massage therapy hours to their benefit plans and the company wanted to scale it back.

Last I heard everything stayed status quo.

What if it had changed? What if they did scale it back?

It would have affected the businesses of probably every Massage Therapist in the province.

If all of a sudden this population of people who came in for regular treatment couldn’t afford the same frequency, there was the potential for a massive drop in business for every Massage Therapist.

Several other insurance companies put a cap on the amount of treatment one person is allowed to use throughout the year and they book in according to what the plan covers unless they suffer some sort of injury as the year progresses.

It never fails at the end of the year, people book in around November and say “I’ve got $500 I have to use up, book me in until it’s used up!”

While that’s great business wise for a month or so, it’s not sustainable because you usually don’t see these people until the same time next year.

Untitled design-1

Cash Based Massage Therapy

That elderly fella that booked in every two weeks was a gem.

Going through college I hadn’t focused much on different populations, just sports.

Other classmates were signing up for outreaches that focused in these areas, working in old folks homes, extended care medical facilities, other charity events and whatever their interests entailed.

I wanted none of it.

Since being in practice and meeting people like the elderly gentleman I mentioned, I realized how much fun it can be working with the elderly. In fact now, some of my favourite, most regular patients are elderly people. The beauty part is how much you can learn from them. I love how most of them don’t really care what people think of them, they’re comfortable in their own skin and pretty much say whatever they want.

I find if refreshing (and pretty damn funny).

While many of these patients have extended health that covers them, the majority don’t.

But they still love coming in for treatment.

Could you build an entire practice on them? Maybe, but it’s doubtful, or would take a lot more time.

This enters into the realm of cash based therapy.

There are a few different blogs out there that specifically target marketing ideas and methods of setting up a cash based practice.

To some, the title is probably a bit off putting, thinking you’re just getting patients in the door for cash. But this couldn’t be further from the truth.

The reality is, you probably have to give these people more value than those with benefits.

I know some people are losing their minds reading this and saying “you can’t treat one patient different than another, you have to give the same value to everyone”.

While this is true and I totally agree, the point is more to the fact that people who are paying cash out of their own pockets (who don’t have extended health benefits) aren’t as likely to come in for a weekly maintenance appointment to stay on top of things.

They are probably going to come in when something is wrong and need it fixed asap. The luxury of maintenance appointments to stay on top of things isn’t typically something affordable for them. When they come in, chances are it’s because they really need it as opposed to having the luxury of benefit coverage.

This is where many of your other skills (assessment, clearer communication, interviewing) come in to play that aren’t always used for those regular maintenance patients.

There are more insights to setting up a cash based practice that can be found in Paul Potters blog if you want to check it out.

Chances are we all have different interests when it comes to our practice and would like to focus on something specific. Over the years if you can build up a patient base that is predominantly part of your interest it will make going to work a lot more rewarding. However there is still the ugly side of life where we have to pay the bills. Focusing into one specific population may make that a bit tougher, I’m not saying it can’t be done, just that it will be tougher. Don’t be too quick to rule out different populations as a group that you’re not interested in working with. They could end up making your practice a more profitable one. The other thing is that you never know what you can, or what you need to learn from various populations booking in with you. Yeah I love working with athletes, but the amount I learn from my elderly patients far outweighs what my athletes have taught me. Not only about life but also about being a therapist. Usually when I work with my athletes they come in, look at me and say things like “I need my gluts, quads and low back worked on”. They are in tune with their bodies and know specifically what they need more often than the general population. It’s with my elderly people, weekend warriors and everyday office workers where I need to do orthopedic testing, muscle tests and sharpen my interview skills. Take the time in your practice to see several different populations of people. Remember variety is the spice of life. And it will probably help the business too.

A Massage Therapist Guide To Dealing With A Stroke

 

Every time I teach a First Aid course, I use the story about an old workmate who had a stroke.

I use it because it’s effective in painting the picture of how a person presents when this happens.

It was around 1am Monday morning, when I realized there was an issue.

That night, something seemed different but nobody else really noticed. Standing with his arms crossed almost supporting one arm with the other, our conversation seemed confused as he constantly gazed at the floor.

As we walked to the First Aid shack for a coffee, I asked how he was feeling:

“not good”

How was the weekend?

“I don’t remember, apparently I didn’t show up to work on Friday”

Did you leave the house to go to work that day?

“I remember dropping the kids off at school Friday morning, but that’s really the last thing I remember”

As we kept talking, his slurred speech became more noticeable. When he relaxed, those crossed arms became one crossed arm and one seemingly limp arm. Looking into the eyes and face of this normally strong, athletic man there was something missing. His left side was almost motionless, wilted.

Can you lift your arms above your head for me?

The right arm went up, left one didn’t move.

Can you kick your legs out for me?

The right one kicked out, left one stayed put.

We need to get you to the hospital.

Tips For Recognizing Someone Has Had A Stroke

How To Help A Patient With A Stroke

 

One of the reasons this is so important for us as healthcare professionals is because we see our patients so regularly. In my friends case in the story, he went the entire weekend and not one friend or family member picked up that anything was wrong. I saw him about five years later and he was a shell of the man he once was. If only someone would have recognized his situation sooner, the damage from the stroke could have been significantly less than what he went on to live with. Later that morning I went to the hospital to check on him. As I walked in the room he looked at me and shouted to the nurse:

“Hey nurse there’s the little jerk that sent me in here” (they had him on some pretty good stuff)

“You should thank that little jerk, he saved your life”