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Councillor returns home after stroke

McNaughton sets his sights on full recovery
Chris Bolster

A City of Powell River councillor is working hard to recover after suffering a stroke last summer. He is hopeful that the modern medicine which helped him will also help save others. His stroke occurred on August 26 while the councillor was fishing near Lang Creek.

“It’s so nice to be up and around,” said Chris McNaughton. “I credit a lot of little miracles.”

The stroke did not affect his ability to speak, though his left arm and leg were affected. He returned home after spending five weeks in Vancouver General Hospital and three months in Holy Family Hospital learning how to walk again. Before he left the Lower Mainland he challenged himself to going up and down stairs.

“I made it up the stairs no problem,” he said, “but you would have to put me in bubble wrap if you wanted me to walk down.”

Stroke, according to information from the Heart and Stroke Foundation of BC and Yukon, is the third leading cause of death in BC and a leading cause of acquired long-term disability in adults.

McNaughton was back at work last week for his first council meeting since the incident. He attended by telephone.

“Miracle number one was that I had my lifejacket on,” said McNaughton, who likes to fish from his kayak. “I happened to be on shore, but I hadn’t bothered to take it off.” He had promised his wife Arlette Raaen that he would wear his lifejacket whenever near the water fishing.

As the stroke hit, McNaughton dove headfirst into the water. A person who regularly fishes in the area and knows McNaughton saw him go into the water and ran over to assist him.

After he had recovered somewhat, Raaen told him how shocked the man was to see McNaughton dive in the water at that moment. “He said ‘I knew that Chris is a real avid fisherman, but when he went teeth-first for the fish I thought that was a little overboard,’” recounted McNaughton.

While in the water, he did not realize what was happening to him but remembers thinking about the effect drinking so much saltwater was going to have on his digestion. “Little did I know,” he added.

BC Ambulance Service and Malaspina Volunteer Fire Department came to McNaughton’s aid and he was taken to Powell River General Hospital (PRGH).

Miracle number two was the fact that the right doctors for someone with his condition were on duty at that time and that the hospital was in the process of bringing a telestroke program online.

“It’s very hard to get someone down to the city within the four hours,” said Lu Wuthrich, PRGH acute services manager, who over the past two years has taken the lead in establishing a telestroke program at the hospital. “If it’s longer than four hours it’s not very effective.”

Patients who suffer ischemic strokes, where a clot in a blood vessel restricts or blocks the flow of blood and oxygen in the brain, have approximately four hours to take a clot-dissolving medication tPA (tissue plasminogen activator).

The telestroke program gives patients who arrive with the symptoms of stroke a chance to meet a neurologist face to face and save precious time. Though emergency room physicians are experienced in diagnosing and treating patients suffering strokes, sometimes in complex cases where tPA might be useful, doctors can turn to a neurologist for extra assistance. Video conferencing and information-sharing technology allows a neurologist to examine and advise the emergency room physician about the best treatment plan for a particular stroke.

Eighty per cent of strokes are ischemic and 20 per cent are hemorrhagic, where a blood vessel ruptures and blood leaks into the brain, according to information from the heart and stroke foundation.

When McNaughton arrived at hospital both Dr. Blake Hoffert, one of PRGH’s internal medicine specialists, and Dr. Philip Teal, a leading neurologist at Vancouver General Hospital, were on duty and able to diagnose him. After a CT scan of McNaughton’s brain was taken, Hoffert and Teal were able to determine that he was a candidate for tPA.

Doctors estimate that between five to 10 per cent of patients who have ischemic strokes respond quickly to tPA which helps restore blood flow to the brain. “It will really make a difference for those people who can have it,” said Wuthrich. “They literally get up off the table. It’s amazing.”

Telestroke is part of the BC Stroke Strategy, a partnership between the ministry of health and the heart and stroke foundation. In 2009 the ministry of health ran its first pilot programs on Vancouver Island between hospitals in Cowichan, Nanaimo and Victoria. Over nine months of the Vancouver Island pilot 27 stroke patients used the system and 10 received the clot-busting drug. Then in 2010 the program was started between hospitals in Chilliwack, South Surrey and Vancouver.

To meet the criteria for using the drug, the stroke must be a witnessed event, so patients who wake up in the morning with the effects of having a stroke while asleep do not qualify, said Wuthrich.

“Every year, over 7,500 British Columbians have their first stroke, and more than 55,000 British Columbians are living with the after-effects of a stroke,” said Mark Collison, a director at BC Stroke Strategy in a media release. “The good news is that we can change those outcomes. Telestroke is an example of how the strategy helps patients receive the right treatment, at the right time and in the right place.”

Wuthrich said the program in Powell River has been up and running officially for the past month but has taken almost two years to pull together. “We needed the ability to do cat scans 24 hours a day, a neurologist to be on call, the equipment in place and everybody trained up,” she said.

She estimates that PRGH emergency room doctors see two to four patients per month with stroke symptoms. Despite that, the telestroke technique will be only be used a few times per year. “It’s good to have it though,” she said, adding that the telehealth video conferencing equipment has become increasingly popular for patients needing to see specialists in the province’s larger hospitals since it was brought online in 2012.

McNaughton sees himself one day being able to get back into his kayak for fishing.

Since returning back to Powell River, he has become more aware of accessibility issues for people who use wheelchairs and walkers. “It’s all these little things that you start paying attention to,” he said, adding that there are a number of stores which have wide isles, smooth level floors and accessible bathrooms.

McNaughton was aware of accessibility prior to the stroke. When he was having his current home designed he made sure that door frames were wider and the main floor of the home had level ground entry, “so we could accommodate guests and visitors with mobility issues.”

He and Raaen both commented that Powell River has been a lot easier for him than Vancouver. “It’s so important,” he added. “We’re a model community.”

A ramp and button-operated front door helps persons with mobility issues access city hall, but a major barrier for McNaughton is the stairs which lead up to council chambers.

Despite talk about renovating the MacGregor building by adding an elevator or a chairlift up the stairs, McNaughton said he will have to continue to attend meetings through teleconference.  “I’m certainly much more aware now of where a parking stall is,” he said. “I’m an advocate for change so perhaps this is something that will help me to focus more on what changes are necessary.”